Background
The Anxiety and Depression Association of America defines social anxiety disorder, also called social phobia, as “intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation.” (ADAA, 2016) According to the National Institute of Mental Health, 12.1% of the US adult population experience social anxiety disorder at some point in life. An estimated 9.1% of US adolescence had social anxiety disorder in the year 2017. Of those affected, prevalence is higher among females in all age groups. (NIMH, 2017) Alcohol use disorder is a problematic drinking that results in “a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake and a negative emotional state when not using.” The National Institute of Alcohol Abuse and Alcoholism estimated that in 2015 623,000 adolescence ages 12-17 had Alcohol Use Disorder. Appriximately 15.1 adults 18 and older had Alchohol Use Disorder in 2015. (NIAAA, n.d.)
Introduction
It is well known that social anxiety disorder and alcohol use disorders frequently occur. However, the mechanisms involved in hazardous drinking among college age students and its relation to social anxiety is not well understood. The current study being reviewed is the first known study to test how positive and negative alcohol outcome expectancies (AOE) specific to social situations impact the association between hazardous drinking and social anxiety among undergraduates. In this study the authors findings showed a positive indirect effect of social anxiety through positive social alcohol outcome expectancies and a negative indirect effect of social anxiety through negative social alcohol outcome expectancies on hazardous drinking outcomes. Additionally, “findings suggest that there could be competing pathways for increasing (positive social AOE) and decreasing (negative AOE) risk for hazardous alcohol use in socially anxious college students.” (Ham, Carrigan, Bacon, Zamboanga, & Casner, 2015)
About the Study
The Study Social anxiety and alcohol use: The role of alcohol expectancies about social outcomes, by Lindsay S. Ham, Amy K. Bacon, Maureen H. Carrigan, Byron L. Zamboanga, and Hilary G. Casner, appeared in the Informa Healthcare journal on Addiction Research and Theory in 2015. This study is investigating the linkage between social anxiety and hazardous alcohol use among college students. It is the first known study to test how both positive and negative alcohol outcome expectancies specific to social situations impact the connection between social anxiety and the incidence of hazardous alcohol use. (Ham, Carrigan, Bacon, Zamboanga, & Casner, 2015) The authors hypothesized that positive social alcohol outcome expectancies would be positively associated with the incidence of hazardous drinking, and that negative social alcohol outcome exectancies would be associated with lower levels of hazardous drinking indices.
Methods Used
The study particiants included 718 undergraduate volunteers between the ages of 18 and 25. The participants were recruited from introductory psychology courses at a large Midwestern university. Students who were interested were previded with a link to the consent form. Following the submission of the consent form, partcipants were redirected to an annonymous online survey. Upon completion of the study, participants were provided a debriefing page and recieved compensation with course research credit. 61% of the particpants were female, and 80% were under the age of 21. 85% of the participants were White, 4% Black, 3% Asian, 2% Hispanic/Latino, 1% American Indian, 4% other, and 1% did not report ethnicity. The only exlcusion criteria was that all participants must be 18 or older. To measure social alchohol outcome expectancies, the authors used a 30 item measure called the SEAS. The seas is the Social Expectancies of Alcohol Scale developed to assess postive and negative alcohol outcome expectancies specific to social outcomes on a one to five scale; One being not at all likely and five being very likely. The SEAS consists of 15 positive AOE’s such as “ I would feel at ease in social situations.” Or 15 negagative AOE’s such as “ I would make a fool of myself.” (Ham, Carrigan, Bacon, Zamboanga, & Casner, 2015). To measure social anxiety related to social interactions, the researches utilized the 19 item Social Interaction Anxiety Scale (SIAS). This scale measures the levels of social anxiety surrounding a social interaction on a scale of one to four; One being “not at all true of me” and four being “extremely true of me.” (Ham, Carrigan, Bacon, Zamboanga, & Casner, 2015) The 10-item AUDIT was used to assess past-year hazardous drinking. The AUDIT, also known as Alcohol Use Disorders Identification Test, was used to measure the alcohol use among undergraduates and determine was is considered hazzardous. Each response is scored on a 0–4 scale.
Prior Research
Prior to conducting this study, the authors researched several other studies that investigate the connection between alcohol use and social anxiety. Ultimately, the authors found mixed results regarding the strength and direction between social anxiety and hazardous alcohol use. Some studies found a positive association (Buckner et al., 2011; Buckner, Eggleston, & Schmidt, 2006; Clerkin & Barnett, 2012; Stewart, Morris, Mellings, & Komar, 2006). They also found studies that resulted in no linear association. (Ham, Bonin, & Hope, 2007; Strahan, Panayiotou, Clements, & Scott, 2011; Tran, Anthenelli, Smith, Corcoran, & Rofey, 2004) As well as some that resulted in a negative association. (Clerkin & Barnett, 2012; Eggleston, Woolaway- Bickel, & Schmidt, 2004; Ham & Hope, 2005; Ham, Zamboanga, & Bacon, 2011). Additionally, the authors found a more recent meta-analysis which resulted in social anxiety being negatively associated with alcohol use and positively associated with alcohol related problems among college students. (Schry & White, 2013). Because of the mixed research results on this topic, the authors aimed to understand the mechanisms that alter risk for alcohol use and alcohol-related problems among socially anxious college students in order clarify the complex association between hazardous drinking and social anxiety.
Results
Upon completion of the study the researchers examined the data to ensure that there were no violations of statistical assumptions for the planned analyses. “Missing data were minimal (ranging from 0.0% to 4.0%), were found to be missing completely at random, and were subsequently imputed using expectation-maximization technique. Bootstrapping was used to address positive skew- ness present for the AUDIT subscales.” (Ham, Carrigan, Bacon, Zamboanga, & Casner, 2015) As the authors had expected, heightened social anxiety levels were associated with increased positive and negative social alcohol outcome expectancies. The authors found that for those who exhibited some degree of social anxiety and expected a positive alcohol outcome expectancies, there was a positive association with hazzardous alcohol use. Whereas in those that exhibited some levels of social anxiety and have negative alcohol outcome expectancies, there was a negative indirect association with hazzardous drinking; So in other words, those that believed alchohol would imporve their social situation tended to partake in hazardous drinking, while those who believed alcohol would make it worse, tended to avoid alchohol use. Additionally, the authors research suggested that there is a stronger association present for women but not for men. This led them to conduct a follow-up analysis examining gender as a moderator in each of models tested rather than a covariate. However, their results did not support gender moderation in the link between social anxiety and alcohol consumption and alcohol problems. (Ham, Carrigan, Bacon, Zamboanga, & Casner, 2015)
Strengths and Weaknesses
A major strength of this study is the sample size. The researched included 718 participants, which results in much more accurate findings, as opposed to a small group of participants. Another strength to this study is the thoroughness of the researchers. They used commonly known scales to measure their data and went through many steps to ensure their data was accurate before analyzing. There are however some notable weaknesses. As the authors discussed in the article, the study they conducted consisted of a predominantly under-21 college student with approximately one in five reporting no past-year drinking. Because of this, it is hard to say what extent the findings would translate to non-student samples, or samples of predominantly over-21 individuals. Additionally, the participants in this sample had relatively low levels of both alcohol use and social anxiety. Therefore, it is possible that the effects may be stronger in a sample that exhibits more hazardous drinking, and/or clinical diagnoses of social anxiety. The fact that the students involved were all form the same university could have also impacted the results. The participants were all from such a concentrated area so it is possible that this could have influenced the study in some way; for example, this university could have very strictly enforced alcohol policies in comparison to most others across the nation.
Theoretical Follow Up
If I were to conduct a theoretical study based off of the study Social anxiety and alcohol use: The role of alcohol expectancies about social outcomes I would be interested to see how the association between hazardous drinking and socially anxious college students translates into adulthood. If possible I would aim to include the same participants as the original study, as well as use similar, if not the same measurements tools for levels of social anxiety, alcohol use, and alcohol outcome expectancies. After conducting the research, I would compare it to the primary study the participants were involved in. The hypothesis I would be researching is whether or not there is a correlation between those who partake in hazardous drinking related to social anxiety in college years, and alcohol problems related to social anxiety as adults.
Conclusion
The primary contribution of this study was that it added to previous research on the topic of alcohol use and social anxiety. Additionally, it was the first study to test both positive and negative alcohol outcome expectancies within the same study. Because of this, it allowed for a side by side analysis in how the expected outcomes of alcohol use contributes to an individual’s alcohol consumption. This provided a glimpse of reasoning behind hazardous drinking among college students. The study conducted was informative, and backed previous research done on the topic, while adding more useful insight on the topic. Overall, I found that the study was very thorough and is one of the better ones out there, that analyzes the association between alcohol use and social anxiety. To conclude, I have always been an observational person; Throughout my college years, I continue to observe people in various social settings. Through my observations alone, I can see that there is a vast difference in levels of alcohol use among college students. I chose to research this topic because I am intrigued by how an individual’s personality, and level of comfort in social settings can influence their alcohol consumption.