Individuals who are socially anxious often use alcohol or marijuana to calm
their nerves. But can social anxiety actually predispose people to marijuana
or alcohol dependence? The answer seems to be yes, a large prospective study
by N.B. Schmidt, Ph.D., a professor of psychology at Florida State University,
and colleagues suggests. Their report is in press with the Journal of
Some 1,700 high school students with an average age of 17 were assessed for
a lifetime history of DSM-IV Axis I disorders and for a lifetime
history of alcohol- or marijuana-use disorders. Of those 1,700, 816 were
followed until age 30 to determine whether they developed alcohol or marijuana
dependence. Then the researchers looked to see whether those subjects with a
history of social anxiety disorder at age 17 were more likely to later
experience alcohol and marijuana dependence than were subjects without such a
When possibly confounding variables such as having a lifetime history of
another affective disorder besides social anxiety disorder or having already
experienced an alcohol- or marijuana-use disorder by age 17 were taken into
account, having a lifetime history of social anxiety disorder at age 17 was
significantly linked with the development of alcohol or marijuana dependence
by age 30.
Moreover, having a history of social anxiety disorder at age 17 was linked
with a fivefold risk of developing alcohol dependence and with a sevenfold
greater risk of developing marijuana dependence, compared with peers who did
not have such a history at that age.
Finally, the investigators evaluated whether having a lifetime history of
anxiety disorder other than social anxiety disorder at age 17 likewise
predicted the later development of alcohol or marijuana dependence, but they
found no such link. They also failed to find a link between a lifetime history
of a mood disorder at age 17 and later alcohol or marijuana dependence.
Thus, "among the internalizing disorders, social anxiety disorder
appears to serve as a unique risk factor for the subsequent onset of cannabis
and alcohol dependence," Schmidt and his group concluded.
The results have implications for clinical psychiatrists, Schmidt told
Psychiatric News. "I think it is relevant to consider assessing
for cannabis use among patients with social anxiety disorder, which might tend
to be overlooked.... Also, we need to do a good job of educating social
anxiety disorder patients regarding utilization of alcohol and cannabis to
help them cope with their anxiety because of their high risk for problematic
use of these substances."
Schmidt and his team will continue to follow their study cohort to see if
future assessments can shed more light on the link between social anxiety and
alcohol and marijuana dependence. For instance, it might possibly answer the
question of whether subjects' social anxiety declines as they mature, and if
so, whether their alcohol and marijuana dependence eases as well. Also, one of
Schmidt's graduate students has received a grant from the National Institute
on Drug Abuse to examine some of the mechanisms involved in the relationship
between social anxiety and marijuana use.
"It may be that treatment of adolescent anxiety disorder could reduce
the incidence of adult substance use disorders," Schmidt and his team
The study was funded by the National Institutes of Health and the John
Simon Guggenheim Foundation.
An abstract of "Specificity of Social Anxiety Disorder as a
Risk Factor for Alcohol and Cannabis Dependence" can be accessed at<www.sciencedirect.com>
by clicking on "J" under "Browse by title," then"
Journal of Psychiatric Research." ▪