Social anxiety and motives for alcohol use among adolescents.

Social anxiety (SA) evidences significant comorbidity with alcohol use problems among both adolescents and adults (Grant et al., 2005; Morris, Stewart, & Ham, 2005; Zimmerman et al., 2003). In an effort to better understand this co-occurrence, researchers are beginning to evaluate specific drinking-related factors, including alcohol use motives, in relation to SA (Ham, Bonin, & Hope, 2007; Thomas, Randall, & Book, 2008). Cooper’s (1994) model of drinking motives suggests four reasons for alcohol use: 1) enhancement (i.e., increasing positive affect), 2) social (i.e., enhancing social situations), 3) conformity (i.e., avoiding peer rejection), and 4) coping (i.e., reducing or avoiding negative affect and anxiety). Of these, coping- and conformity-related motives have been most consistently linked with SA (Ham, Zamboanga, Bacon, & Garcia, 2009; Stewart, Morris, Mellings, & Komar, 2006; Thomas et al., 2008). From a theoretical perspective, individuals with SA may be expected to use alcohol to manage anxiety experienced during, and in anticipation of, social situations. Indeed, research conducted with adult samples indicates that elevated SA is related to the deliberate consumption of alcohol in an effort to cope with anxiety and negative mood states (Schneier et al., 1989; Thomas, Randall, & Carrigan, 2003). For example, Thomas and colleagues (2008) found among 42 adults presenting with comorbid SA disorder and alcohol use disorders, in an effort to minimize anxiety approximately 50% reported drinking prior to a social event, 80% reported drinking during such events, and 80% reported avoidance of social situations in which alcohol use was not possible. Further, in a large sample of undergraduate students, Lewis and colleagues (2008) found that both coping and conformity-related drinking motives related positively to several features of SA, including interaction anxiety, social avoidance, and social fears. Although promising, this literature is limited by the fact that no research to date has examined this relation among youth, despite the high prevalence of adolescent SA (e.g., 12.7%; DeWit et al., 1999), and the fact that alcohol use typically begins in adolescence (Newes-Adeyi, Chiung, Williams, & Faden, 2005). Further, adolescence is a unique developmental period, and risk factor processes observed in adults cannot be assumed to function identically among youth (Cicchetti & Rogosch, 2002), particularly in relation to the use of alcohol (Dunn & Mezzich, 2007). Indeed, research suggests that adolescents evidence attenuated sensitivity to many of the negative effects of alcohol (e.g., motor impairment, dysphoria), along with heightened sensitivity to some of the positive effects (e.g., social facilitation; Windle et al., 2008); accordingly, the relation between particular reasons for alcohol use and SA may be exaggerated among youth as compared to adults. For example, although adult SA has been linked to alcohol use in response to social pressure (Buckner, Schmidt, & Eggelston, 2006), and conformity motives generally, the majority of this work indicates that coping motives evidence the strongest relation with SA (Lewis et al., 2008; Stewart et al., 2006). In this vein, the relative insensitivity to negative effects and increased social facilitation associated with alcohol use among youth as compared to adults (Windle et al., 2008), in concert with heightened anxiety elicited by the social context among those with SA may enhance the learning of coping-related drinking specifically among socially anxious youth as compared to non-anxious and adult populations. Alternatively, youth who do not want to drink may learn to avoid situations in which they may feel pressured to do so; a task that is much more difficult for college students given increased availability and exposure to alcohol across social situations. In a similar vein, adolescent SA prospectively predicts an alcohol use disorder diagnosis in adulthood (Buckner et al., 2008), and youth have been found to progress more rapidly from initial use to substance-related problems as compared to adults (Deas, Riggs, Langenbucher, Goldman, & Brown, 2000). Furthermore, although the majority of youth report social motives as their primary reason for alcohol use, work with adolescents has found that coping motives are associated with an increased risk for problematic alcohol use and alcohol-related problems (e.g., truancy; Kuntsche et al., 2005; Kuntsche, Stewart, & Cooper, 2008). It is therefore important to identify subgroups of youth who may be inclined to use alcohol to manage negative affective states. With this backdrop, the current study was designed to examine alcohol use motives among youth as a function of SA, above and beyond other related variables (i.e., age, gender, alcohol use frequency, affective problems; Kuntsche et al., 2005). Based on theoretical (e.g., biopsychosocial effects of alcohol on youth; Windle et al., 2008) and empirical (e.g., strength of the SA-coping motives relation; Stewart et al., 2006) precedent, it was hypothesized that SA would be uniquely related to coping-related motives for alcohol use (cf., enhancement, social, or conformity motives).