نقش انگیزه آشامیدنی در اضطراب اجتماعی و مصرف الکل

Although social anxiety and problem drinking commonly co-occur, the relationship between social anxiety and drinking among college students is not well understood. The current study examined the relationship between drinking motives, or reasons for drinking, and social anxiety in 239 volunteers. Contrary to hypotheses, high (n = 83), moderate (n = 90), and low (n = 66) social anxiety groups did not differ in endorsement of coping and conformity drinking motives. Further, social anxiety was negatively related to weekly alcohol use and unrelated to alcohol-related problems. Post hoc hierarchical multiple regression analyses conducted for each social anxiety group indicated that coping motives were related to greater alcohol use and problems for those in the high and moderate social anxiety groups, but not for the low social anxiety group. It appears that drinking motives, particularly coping motives, have promise in providing a greater understanding of the social anxiety–drinking relationship. Drinking motives could aid in identification of socially anxious students at risk for alcohol problems and inform intervention strategies.

Social anxiety disorder (also called social phobia), which is characterized by persistent fear of negative evaluation in social situations (American Psychiatric Association, 2000), is the fourth most common psychiatric disorder with a lifetime prevalence of 12.1 percent (Kessler, Berghund, Demler, Jin, & Walters, 2005). The resulting distress and avoidance related to social situations from social anxiety disorder can have debilitating effects on the individual's social, academic, and vocational success (Davidson, Hughes, George, & Blazer, 1993; Sanderson, DiNardo, Rapee, & Barlow, 1990). In addition, social anxiety disorder is comorbid with alcohol use disorders at high rates (i.e., 19–28 percent; e.g., Davidson et al., 1993; Kushner, Abrams, & Borchardt, 2000; Van Ameringen, Mancini, Styan, & Donison, 1991), with socially anxious individuals being at least twice as likely to have had an alcohol use disorder than the general population (Kushner et al., 2000). National studies reveal that problem drinking among college students is highly prevalent, with at least 40 percent of students reporting heavy episodic or “binge” drinking (i.e., consuming five or more standard drinks in one sitting for men and four or more drinks for women; O’Malley & Johnston, 2002; Wechsler, Dowdall, Maenner, Gledhill-Hoyt, & Lee, 1998). The majority of students report alcohol consumption, with the annual prevalence rate of alcohol use exceeding 80 percent (Johnson, O’Malley, & Bachman, 2000). Although many college students do not meet full criteria for an alcohol use disorder or eventually “mature out” of problem drinking behaviors (e.g., Weingardt et al., 1998), many students engage in risky drinking that can lead to negative personal and social consequences during college years (e.g., Hingston, Heeren, Zakocs, Kopstein, & Wechsler, 2002; Wechsler, Davenport, Dowdall, Moeykens, & Castillo, 1994). Given the variety of novel social situations faced by incoming college students, alcohol may be viewed by students as an easily accessible method to cope with feelings of anxiety related to social interactions. However, recent work has found some inconsistencies in the relationship between social anxiety and drinking in college samples—with some showing negative relationships or no relationship at all (e.g., Eggleston, Woolaway-Bickel, & Schmidt, 2004; Ham & Hope, 2005; Tran, Haaga, & Chambless, 1997). It could be that social anxiety alone does not determine risk for problem alcohol use, but that an additional variable plays a role in determining the heightened risk or protective aspects of social anxiety on drinking. Alcohol outcome expectancies (Goldman, Del Boca, & Darkes, 1999), or the effects that one expects to experience from drinking, have been identified as a potential links between social anxiety and drinking. Alcohol outcome expectancies are related to drinking behavior (e.g., Goldman et al., 1999) and sociability and tension reduction expectancies are associated with drinking for socially anxious individuals in clinical and community samples (e.g., Ham, Hope, White, & Rivers, 2002; Tran & Haaga, 2002). Unfortunately, alcohol outcome expectancies alone have been largely unsuccessful as moderators or mediators in the social anxiety–drinking relationship among college students (Eggleston et al., 2004; Ham & Hope, 2005; Tran et al., 1997). The motivational model of drinking proposes that an individual's reasons for drinking are most important in the initiation and maintenance of drinking behavior. “Drinking motives” refer to the basic psychological motivations, or reasons, for using alcohol (Cooper, 1994). While alcohol outcome expectancies include anticipated effects that may or may not be desired, the drinking motives construct focuses on the desired effects that the individual perceives as driving their alcohol use. According to Cronin (1997), reasons for drinking were better predictors of alcohol use and alcohol-related problems than alcohol outcome expectancies among university students. Drinking motives have been found to mediate the relationship between alcohol expectancies and drinking in a clinical sample (Galen, Henderson, & Coovert, 2001). Therefore, drinking motives are worth investigating in relation to social anxiety. According to Cooper's (1994) model, there are four distinct drinking motives: (1) social, (2) enhancement, (3) coping, and (4) conformity. “Social” drinking motives refer to consuming alcohol to obtain positive social rewards, whereas “enhancement” motives refer to drinking to enhance mood or well-being (both positive reinforcement motives). “Coping” motives refer to drinking to reduce or regulate negative affect, whereas “conformity” motives involve drinking to avoid social censure (both negative reinforcement motives). The four drinking motives have unique associations with alcohol use behavior. Social motives appear to be related to nonproblematic “social drinking,” in which there may be slight increases in drinking quantity, but not alcohol-related problems (e.g., Cooper, 1994; Kassel, Jackson, & Unrod, 2000). Both enhancement and coping motives are related to heavier drinking and alcohol-related problems, although coping motives continue to be related to alcohol-related problems when controlling for usual alcohol use (e.g., Cooper, 1994; Cooper, Russell, Skinner, & Windle, 1992). Conformity motives appear to be positively related to alcohol-related problems, but have a small negative correlation with heavy drinking (Cooper, 1994). Thomas, Randall, and Carrigan (2003) found that socially anxious individuals were more likely to report using alcohol to cope with social situations than normal controls. Despite the promising implications of these findings, we are aware of only one published study that directly investigated the relationship between social anxiety and drinking motives. Buckner et al. (2006) found a small positive correlation between social anxiety and enhancement motives (r = .18), but not between social anxiety and other drinking motives. However, Buckner et al. (2006) employed the previous version of the Drinking Motives Questionnaire ( Cooper et al., 1992) that lacks the conformity motives construct and used a briefer measure of social anxiety (i.e., Social Interaction Anxiety Scale; Mattick & Clarke, 1998). Several researchers have examined the relationships between anxiety, personality traits, and drinking motives. More specifically, anxiety sensitivity (i.e., the tendency to fear anxiety-related sensations) was related to greater coping motives and conformity motives ( Comeau, Stewart, & Loba, 2001; Stewart & Zeitlin, 1995) and anxiety-related traits were associated with coping and conformity motives ( Comeau et al., 2001; Stewart, Zvolensky, & Eifert, 2002). Similarly, high neuroticism, a construct correlated with anxiety, was related to coping motives ( Stewart & Devine, 2000; Stewart, Loughlin, & Rhyno, 2001) and conformity motives ( Stewart & Devine, 2000). Conformity and coping motives were found to be inversely related to extraversion and conformity motives appeared to be related to self-consciousness ( Stewart & Devine, 2000). On the other hand, enhancement motives and social motives were related to low levels of neuroticism and conscientiousness ( Stewart & Devine, 2000; Stewart et al., 2001) and unrelated to high anxiety sensitivity or trait anxiety ( Comeau et al., 2001; Stewart & Zeitlin, 1995). Extending these findings to social anxiety, drinking to reduce anxiety (i.e., coping motives) and to address concerns of “fitting in” and avoiding negative evaluation (i.e., conformity motives) would be of particular relevance to socially anxious individuals. Although there was not a significant association between social anxiety and coping motives in the Buckner et al. (2006) study, other results indicated that social anxiety was positively correlated with drinking in situations involving unpleasant emotions, conflict with others, and social pressure to drinking, situations that would appear to be related to coping and conformity motives. Social anxiety and problem drinking are both important concerns in the college student population given the high exposure to and availability of alcohol, as well as number of novel social situations faced by college students that may result in drinking to reduce discomfort. Despite the promise for drinking motives in understanding this relationship, there is a lack of knowledge regarding the role of drinking motives in social anxiety and drinking in college students. Therefore, the aim of the current study was to examine social anxiety and drinking motives among college students. It was hypothesized that the high social anxiety group would provide the greatest endorsements of negative reinforcement motives for drinking (i.e., coping and conformity), the low social anxiety group the reporting the lowest scores, and the moderate social anxiety group with negative reinforcement motives scores falling in between the two groups. The groups were not expected to differ in social and enhancement motives (positive reinforcement motives).