People with social anxiety drink more in the presence of strangers

People who are more socially anxious may drink more alcohol when they are in situations where they do not know many people, according to new research. The study, published in the journal Addictive Behaviors, used a combination of smartphone surveys and alcohol sensors to measure how social anxiety and social context influenced drinking behaviors in everyday environments.

Social anxiety has been found to be a risk factor for alcohol use disorder, but the relationship between social anxiety and drinking behaviors in real-world settings is unclear. Previous studies have used different methods and measures that often do not reflect authentic social settings to examine this relationship. Consequently these studies have produced mixed results.

Hence, the study team led by Eddie P. Caumiant from the University of Illinois Urbana-Champaign aimed to investigate how social-contextual features of real-world drinking contexts, such as the familiarity of the people present, might influence the relationship between social anxiety and alcohol consumption in everyday settings.

The researchers recruited 48 heavy social drinkers (drinking an average of 2–3 times per week, with an average of 3.8 drinks per occasion). They were aged 21 to 28, and they completed a measure of social anxiety at the beginning of the study via the Liebowitz Social Anxiety Scale.

These participants self-reported their alcohol consumption for the next seven days, in addition to wearing a transdermal alcohol monitor as an ankle bracelet, which monitored their alcohol consumption by tracking the amount of alcohol diffusing through their skin.

An app was downloaded onto their smartphone which administered surveys at random times of the day, during which they provided photographs of their surroundings. Participants later reported on their levels of social familiarity with the people visible in the photographs and categorized their relationship with each person, e.g. “romantic partner” / “friend” / “coworker” / “stranger”.

After statistical analyses, the results demonstrated that social anxiety and social context interacted to predict drinking. Among participants who were higher in social anxiety, drinking increased as the familiarity of the people in their environment decreased. In other words, they drank more when they were surrounded by strangers than when they were with friends or family.

However, among participants who were lower in social anxiety, the familiarity of the people in their environment did not affect their drinking.

Together, these results suggest that the presence of strangers in a given environment may play a role in the drinking behavior of socially anxious individuals. The researchers explain that socially anxious individuals may drink more in unfamiliar settings to relieve the stress of social situations, generate positive mood, or to facilitate social interaction.

Caumiant and colleagues noted that their findings may help explain why previous studies have found mixed results regarding the question of whether socially anxious individuals consume alcohol in greater quantities, as they did not take into account the social context of drinking.

The authors concluded, “alcohol consumption does not occur in a vacuum, but instead represents a product of individuals’ motivations to drink and the broader environmental contexts in which they consume alcohol. Consequently, in seeking to develop effective strategies for protecting against the development of alcohol use disorder in socially anxious individuals, an approach that integrates a consideration of both person and environment is essential.”

The study had some limitations, such as the small sample of participants who collectively had low levels of social anxiety, as well as an imperfect social context measure (not all individuals present in a particular environment were captured in the photographs).

The study, “Social anxiety and alcohol consumption: The role of social context”, was authored by Eddie P. Caumiant, Catharine E. Fairbairn, Konrad Bresin, I. Gary Rosen, Susan E. Luczak and Dahyeon Kang.

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