Social Anxiety Disorder and Alcohol Use

By Book, Sarah W.; Randall, Carrie L. | Alcohol Research, January 1, 2002 | Go to article overview

Social Anxiety Disorder and Alcohol Use

Book, Sarah W., Randall, Carrie L., Alcohol Research

Social anxiety disorder-an excessive fear of social situations, such as eating or speaking in public-affects 2 to 13 percent of the U.S. population. About one-fifth of patients with social anxiety disorder also suffer from an alcohol use disorder (AUD) (i.e., alcohol abuse or dependence). One theory to explain the comorbidity between social anxiety disorder and A UDs is the tension reduction theory, which posits that people with social anxiety use alcohol to alleviate their fears. This expectation that alcohol reduces anxiety may motivate alcohol consumption even if pharmacological studies do not support that assumption. Social anxiety disorder is treatable with both pharmacotherapy and psychotherapy, and some of those treatments also would be expected to be effective for patients with comorbid AUDs. Evaluation of patients seeking alcoholism treatment for coexisting social anxiety disorder is important for improving treatment outcome. KEY WORDS: comorbidity; anxiety; social phobia; AODU (alcohol and other drug use); alcoholic beverage; tension reduction theory of AODU; diagnostic criteria; prevalence; positive AOD (alcohol and other drug) expectancies; drug therapy; psychotherapy; monoamine oxidase: benzodiazeines; serotonin uptake inhibitors; literature review

Many people experience social anxiety-that is, they feel uncomfortable or even anxious in social situations, such as talking with strangers (or even friends) or speaking in front of a group of people. In the general population, levels of social anxiety exist on a continuum from mild to severe. A clinical diagnosis of social anxiety disorder, also referred to as social phobia,1 is assigned only when the social anxiety results in significant fear when faced with the situation, impairment of performance, or avoidance of anxietyprovoking situations. People with high levels of social anxiety typically report that alcohol helps them feel more comfortable in social situations. Thus, it is not surprising that individuals with clinically diagnosed social anxiety disorder have a higher incidence of alcohol-- related problems than does the general population. This article explores the diagnosis and prevalence of social anxiety disorder and reviews studies evaluating the relationship between alcohol consumption and social anxiety. In addition, the article summarizes treatment approaches for social anxiety disorder alone as well as in combination with alcohol-related problems.


According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IM (1994), social anxiety disorder is defined as excessive fear in social situations in which the person believes he or she will do something embarrassing or have anxiety symptoms (e.g., blushing or sweating) that will be humiliating. The feared situations can vary from interpersonal social interactions in small groups to talking to strangers. Performance fears, such as speaking in public, also are common. People with social anxiety disorder either avoid feared situations or experience them with extreme anxiety. Most individuals with the disorder have the more severe, "generalized" type, in which the person has other social fears in addition to the common fear of public speaking. The complete criteria set for an official diagnosis of social anxiety disorder is detailed in the textbox.

Typically, social anxiety disorder begins in the teenage years and does not improve without treatment. The mechanisms or causes underlying the disease are unknown but may involve multiple predisposing factors. These potential factors include genetic background, traumatic early emotional learning experiences, observation and modeling of parental behaviors, and biological irregularities in brain chemical systems. People with the disorder often report having been shy or behaviorally inhibited as small children and, in severe cases, a child with social anxiety may not want to go to school (Beidel 1998). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)


1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

Cited article

Social Anxiety Disorder and Alcohol Use


Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.