Stress Reactivity, Social Anxiety, and Alcohol Consumption in People With Alcoholism: A Laboratory Study

Abstract

Objective: Social anxiety may maintain alcohol dependence through increased reactivity to stressful events, a propensity to drink to cope with stressful events, or both. The current study is a secondary analysis of an existing dataset that examined differences between individuals with alcohol dependence and concurrent high and low social anxiety in objective and subjective stress reactivity to a laboratory stressor (Trier Social Stress Test; TSST), as well as consumption of alcohol following the stressor.

Methods: Forty participants with alcohol dependence (20 women) were randomly assigned to the TSST condition as part of the parent study. Post-hoc analysis of social anxiety measures yielded high (n = 19) and low (n = 21) social anxiety groups. Participants completed the TSST, followed by a small dose of their favorite alcoholic beverage (target blood alcohol concentration 0.03g/dl) to prime subsequent laboratory drinking. Participants received a sham beer taste test of two glasses (710ml total) of beer. Differences between high and low social anxiety groups was assessed via subjective and objective (mean arterial pressure, serum cortisol) reactivity to the TSST and consumption of alcohol during the taste test (total mls consumed, mls/kg of body weight, and likelihood of consuming all the beer available).

Results: No differences emerged in either objective or subjective measures of stress reactivity between high and low socially anxious groups. There were also no differences between social anxiety groups in amount of alcohol consumed during the taste test.

Conclusions: No differences were observed between high and low socially anxious participants with concurrent alcohol dependence on stress reactivity or alcohol consumption following a stressor. Given that all participants in this study had alcohol dependence, negative results may suggest that heightened stress reactivity and drinking to cope are more relevant to the development of alcohol dependence and that other factors may maintain alcohol use once dependence has developed.

Keywords: alcohol dependence; social anxiety; stress reactivity.

Figure 1

Stress reactivity responses to the TSST by social anxiety group across time. Note. TSST = Trier Social Stress Test; SA = Social Anxiety; BL1, BL2 = baseline 1 and 2 prior to stressor; PT1 – PT4 = post-stressor measurements at 15 minute intervals. Bars indicate standard error.