Alcohol abuse in individuals with social phobia: Roles of coping responses and alcohol expectancies

Abstract

The current study examined personal variables that may contribute to alcohol abuse by individuals with social phobia. Two major research questions were addressed: What increases social phobics' vulnerability to maladaptive behaviors? What distinguishes socially phobic alcohol abusers from non-abusers?; Consistent with Beck and Emery's (1985) cognitive theory, it was hypothesized that less effective coping in social situations and negative self-evaluation increase social phobics' vulnerability to maladaptive behaviors. Based on Abrams and Niaura's (1987) social-learning theory of alcohol abuse, it was hypothesized that less effective coping in alcohol-specific situations, high positive alcohol expectancies of tension reduction, and low negative alcohol expectancies of impairment distinguish socially phobic alcohol abusers from non-abusers. Research hypotheses were tested with a community sample of social phobics with alcohol abuse (SPAs, n = 19), social phobics without alcohol abuse (SPs, n = 19), and normal controls without psychiatric disorders (NCs, n = 21). As predicted, SP participants reported less problem-focused coping than NCs in non-alcohol social situations and rated themselves as less skillful in interpersonal roleplays. However, contrasting the research hypothesis, observers did not rate SPs as less ARM in interpersonal situations. Given that most daily activities involve social situations, these results suggest that social phobics' less effective coping and negative self-evaluations in social situations can increase their vulnerability to maladaptive behaviors. Comparison of SPAs and SPs on self-report problem-focused coping and observed coping skills showed the predicted situation-specific effects for alcohol versus non-alcohol situations. Compared to SPs, SPAs reported less problem-focused coping during alcohol-accessible social situations, but not during alcohol-inaccessible social situations. Similarly, observers rated SPAs as less skillful than SPs on their alcohol-abstinent skills, but not their social skills. As hypothesized, SPAs reported higher positive alcohol expectancies than SPs. However, contrasting study predictions, SPAs and SPs did not differ in negative alcohol expectancies and self-rated coping in alcohol situations. In summary, the present results mostly support cognitive and social-learning theories of social phobia and alcohol abuse, respectively, and highlight methodological issues for assessment of coping skills and negative alcohol expectancies. The current findings may also have implications for treating individuals with comorbid social phobia and alcohol abuse.