A BIOPSYCHOSOCIAL MODEL OF SOCIAL ANXIETY AND SUBSTANCE USE
Version of Record online: 13 DEC 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 30, Issue 3, pages 276–284, March 2013
How to Cite
Buckner, J. D., Heimberg, R. G., Ecker, A. H. and Vinci, C. (2013), A BIOPSYCHOSOCIAL MODEL OF SOCIAL ANXIETY AND SUBSTANCE USE. Depress. Anxiety, 30: 276–284. doi: 10.1002/da.22032
- Issue online: 6 MAR 2013
- Version of Record online: 13 DEC 2012
- Manuscript Accepted: 8 NOV 2012
- Manuscript Revised: 30 OCT 2012
- Manuscript Received: 12 SEP 2012
- social anxiety;
- social phobia;
- substance use disorders;
Emerging prospective work suggests that individuals with social anxiety disorder (SAD) may be at particular risk for developing substance use disorders (SUD). Yet, little is known about why this may be so. Most research has utilized existing theories of substance use (e.g. tension reduction-based theories) to understand SAD–SUD relations. However, these theories do not address why individuals with social anxiety, in particular, experience such high rates of substance-related problems. A possible explanation may lie in the nature of social anxiety itself, which is characterized not only by chronically elevated negative affective states, but by low positive affect, fear of scrutiny, and social avoidance. These aspects of social anxiety may work in concert to place these especially vulnerable individuals at risk for SUD. The current paper presents a biopsychosocial model of SAD-SUD comorbidity that focuses on several specific facets of social anxiety that may be especially related to SUD risk. The utility of this model is evaluated via a review of the literature on the relations between SAD and substance-related behaviors.