Social Anxiety and Heavy Situational Drinking: Coping and Conformity Motives as Multiple Mediators

Individuals with clinically elevated social anxiety are at greater risk for alcohol use disorder, and the relation between social anxiety and drinking problems is at least partially accounted for by drinking more in negative emotional (e.g., feeling sad or angry) and personal/intimate (e.g., before sexual intercourse) situations. Identification of cognitive/motivational factors related to drinking in these high-risk situations could inform the development of treatment and prevention interventions for these high-risk drinkers. The current study examined the mediating effect of drinking motives on the relationship between social anxiety and drinking these high-risk situations amongst undergraduates (N = 232). Clinically elevated social anxiety was associated with greater coping and conformity motives. Both coping and conformity motives mediated the relation between social anxiety and heavier alcohol consumption in negative emotional and personal/intimate contexts. Multiple mediation analyses indicated that these motives work additively to mediate the social anxiety-drinking situations relationship, such that that heavy situational drinking amongst undergraduates with clinically elevated social anxiety can be jointly attributed to desire to cope with negative affect and to avoid social scrutiny

Randomized Controlled Trial of BASICS for Heavy Drinking Mandated and Volunteer Undergraduates: 12-Month Outcomes

This is the first randomized trial testing whether heavy drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy drinking volunteers up to one year post-intervention using high-risk control groups to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; Mage = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or control (n = 110). Outcome measures collected at baseline, 4 weeks, 3, 6, and 12 months post-intervention included the Daily Drinking Questionnaire and Rutgers Alcohol Problem Inventory. At 4 weeks post-intervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer) BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). Decreases in alcohol problems were of large effect size (d = .87). At 12 months post-intervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared to controls. Significant intervention gains for peak drinks and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. BASICS was associated with less drinking and fewer alcohol problems, even among heavier drinking mandated students up to one year post-intervention. Provision of BASICS-style programs within disciplinary settings may help reduce heavy drinking and alcohol problems among at-risk students

Context-Specific Drinking and Social Anxiety: The Roles of Anticipatory Anxiety and Post-Event Processing

Individuals with clinically elevated social anxiety are especially vulnerable to alcohol-related problems, despite not drinking more than those with less anxiety. It is therefore important to identify contexts in which socially anxious persons drink more to inform intervention efforts. This study tested whether social anxiety was related to greater drinking before, during, or after a social event and whether such drinking was related to the psychosocial factors anticipatory anxiety or post-event processing (PEP; review of the social event). Among past-month drinkers, those with clinically elevated or higher social anxiety (HSA; n = 212) reported more anticipatory anxiety, more pre-event drinking to manage anxiety, and PEP than those with normative or lower social anxiety (LSA; n = 365). There was a significant indirect effect of social anxiety on pre-drinking via anticipatory anxiety. Social anxiety was related to more drinking during the event indirectly via the serial effects of anticipatory anxiety and pre-drinking. Unexpectedly, PEP did not mediate or moderate the relation between social anxiety and post-event drinking. In sum, anticipatory anxiety was related to more drinking before, during, and after a social event and HSA drinkers were especially vulnerable to drinking more to manage this anxiety, which increased drinking before and during the event. This effect was specific to anticipatory anxiety and not evident for another social anxiety-specific risk factor, PEP. Thus, anticipatory anxiety may be an important therapeutic target for drinkers generally and may be especially important among HSA drinkers

Alcohol-induced risky sexual behavior among socially anxious drinkers

Heavy college drinking is associated with risky sexual behavior. It is therefore important to identify groups that are especially vulnerable to alcohol-influenced sexual risk (e.g., unplanned/unexpected sex). Undergraduates with elevated social anxiety represent one such vulnerable group given that social anxiety is associated with fear of intimacy and heavier drinking in intimate situations and situations with expected negative affect. Drinking to cope with negative affect induced by fear of intimacy might render socially anxious undergraduates vulnerable to risky sexual behavior, yet no known studies have examined this relationship. The current study tested whether social anxiety was related to alcohol-related sexual behaviors among current (past-month) drinking undergraduates (88.1% female; 77.6% non-Hispanic Caucasian) with higher (i.e., clinically elevated) social anxiety (HSA; n = 40) or lower (more normative) social anxiety (LSA; n = 94). Coping motives were examined as a moderator of the social anxiety-risky sexual behavior relationship. Gender was a covariate. HSA students reported more frequent alcohol-influenced sexual risk including regretted sexual situations, unprotected sex, sex with unwanted partners, unwanted sex, pressured/forced to have sex, and pressured someone to have sex. Coping motives significantly interacted with social anxiety group in the prediction of risky sexual behaviors except regretted sexual situations, such that HSA students with greater coping motives experienced more frequent sexual risk when drinking. Findings indicate that HSA students may be particularly vulnerable to risky sexual behaviors and suggest that coping motivated drinking may be an important target for therapeutic interventions geared toward reducing risky sexual behaviors among this high-risk population

Social Anxiety and Alcohol-Related Impairment: The Mediational Impact of Solitary Drinking

Social anxiety disorder more than quadruples the risk of developing an alcohol use disorder, yet it is inconsistently linked to drinking frequency. Inconsistent findings may be at least partially due to lack of attention to drinking context – it may be that socially anxious individuals are especially vulnerable to drinking more often in specific contexts that increase their risk for alcohol-related problems. For instance, socially anxious persons may drink more often while alone, before social situations for “liquid courage” and/or after social situations to manage negative thoughts about their performance. Among current (past-month) drinkers (N = 776), social anxiety was significantly, positively related to solitary drinking frequency and was negatively related to social drinking frequency. Social anxiety was indirectly (via solitary drinking frequency) related to greater past-month drinking frequency and more drinking-related problems. Social anxiety was also indirectly (via social drinking frequency) negatively related to past-month drinking frequency and drinking-related problems. Findings suggest that socially anxious persons may be vulnerable to more frequent drinking in particular contexts (in this case alone) and that this context-specific drinking may play an important role in drinking problems among these high-risk individuals

Distress Tolerance among Students Referred for Treatment Following Violation of Campus Cannabis Use Policy: Relations to Use, Problems, and Motivation

Students referred to treatment after violating campus drug policies represent a high-risk group. Identification of factors related to these students’ cannabis use could inform prevention and treatment efforts. Distress tolerance (DT) is negatively related to substance-related behaviors and may be related to high-risk cannabis use vulnerability factors that can impact treatment outcome. Thus, the current study tested whether DT was related to cannabis use frequency, cannabis-related problems, and motivation to change cannabis use among 88 students referred for treatment after violating campus cannabis policies. DT was robustly, negatively related to cannabis use and related problems. DT was also significantly, negatively correlated with coping, conformity, and expansion motives. DT was directly and indirectly related to cannabis problems via coping (not conformity or expansion) motives. Motives did not mediate the relation of DT to cannabis use frequency. DT may be an important target in treatment with students who violate campus cannabis policies

The neural substrate of positive bias in spontaneous emotional processing

Even in the presence of negative information, healthy human beings display an optimistic tendency when thinking of past success and future chances, giving a positive bias to everyday's cognition. The tendency to actively select positive thoughts suggests the existence of a mechanism to exclude negative content, raising the issue of its dependence on mechanisms like those of effortful control. Using perfusion imaging, we examined how brain activations differed according to whether participants were left to prefer positive thoughts spontaneously, or followed an explicit instruction to the same effect, finding a widespread dissociation of brain perfusion patterns. Under spontaneous processing of emotional material, recruitment of areas associated with effortful attention, such as the dorsolateral prefrontal cortex, was reduced relative to instructed avoidance of negative material (F(1,58) = 26.24, p = 0.047, corrected). Under spontaneous avoidance perfusion increments were observed in several areas that were deactivated by the task, including the perigenual medial prefrontal cortex. Furthermore, individual differences in executive capacity were not associated with positive bias. These findings suggest that spontaneous positive cognitive emotion regulation in health may result from processes that, while actively suppressing emotionally salient information, differ from those associated with effortful and directed control

A meta-analysis and critical review of prospective memory in autism spectrum disorder

Prospective memory (PM) is the ability to remember to carry out a planned intention at an appropriate moment in the future. Research on PM in ASD has produced mixed results. We aimed to establish the extent to which two types of PM (event-based/time-based) are impaired in ASD. In part 1, a meta-analysis of all existing studies indicates a large impairment of time-based, but only a small impairment of event-based, PM in ASD. In Part 2, a critical review concludes that time-based PM appears diminished in ASD, in line with the meta-analysis, but that caution should be taken when interpreting event-based PM findings, given potential methodological limitations of several studies. Clinical implications and directions for future research are discussed