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Social Anxiety Disorder Ups Alcohol Use Disorder Risk

March 26, 2019

Unlike other types of anxiety disorders, social anxiety disorder appears to have a causal influence on the risk for alcohol use disorder, according to a study published online in Depression & Anxiety.

“Many individuals with social anxiety are not in treatment. This means that we have an underutilized potential, not only for reducing the burden of social anxiety, but also for preventing alcohol problems,” said lead author Fartein Ask Torvik, PhD, of the Norwegian Institute of Public Health. “Cognitive behavioral therapy with controlled exposure to the feared situations has shown good results.”

Dr. Torvik and colleagues came to their findings after interviewing 2801 adult twins in Norway and assessing alcohol use disorder, social anxiety disorder, generalized anxiety disorder, panic disorder, agoraphobia, and other specific phobias.

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Social anxiety disorder, they found, had the strongest association with alcohol use disorder, predicted it over and above the effect of other anxiety disorders. In addition, social anxiety disorder was associated with a higher risk of later developing alcohol use disorder, according to the study. Other anxiety disorders were not.

According to researchers, biometric models demonstrated that the link between social anxiety and alcohol use disorders was best explained by influences from social anxiety to alcoholism. Meanwhile, positive correlations with other anxiety disorders and alcohol use disorder could be explained solely by shared genetic risk factors.

“In clinical settings, it is important to assess if a patient with social anxiety disorder uses alcohol as a coping strategy and to discuss the dangers of self‐medication with alcohol,” researchers wrote. “Although alcohol use disorder does not seem to be a strong influence on the new onset of social anxiety disorder, alcohol use disorder could worsen the course of social anxiety disorder. This is particularly relevant when alcohol is naturally present in the feared situations.”

—Jolynn Tumolo


Torvik FA, Rosenström TH, Gustavson K, et al. Explaining the association between anxiety disorders and alcohol use disorder: A twin study. Depression & Anxiety. 2019 March 5;[Epub ahead of print].

Social anxiety disorder may increase risk of alcoholism [press release]. Hoboken, New Jersey: Wiley; March 6, 2019.

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