Beyon Miloyan

This study assessed the association between subclinical social fears and a 12-month diagnosis of Social Anxiety Disorder (SAD) at baseline and the risk of incident Alcohol Use Disorder (AUD) at follow-up, compared to those without subclinical social fears and a 12-month diagnosis of SAD. We performed an individual participant meta-analysis based on data from two national longitudinal surveys. Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) was conducted in 2001–2002 in a sample of 43,093 adults and Wave 2 was conducted in 2004–2005 in 34,653 of the original respondents. Wave 1 of the National Comorbidity Survey was conducted in 1990–1992 in a sample of 8098 respondents and Wave 2 was conducted in 2001–2002 in 5001 of the original respondents. Binary logistic regression analyses were performed independently in each study and then the effect estimates were combined using random-effects meta-analysis. Neither subclinical social fears nor 12-month SAD at baseline were associated with incident AUD at follow-up. These findings conflict with reports of previous studies that a diagnosis of SAD is a risk factor for AUD in adults, and suggest that subclinical social fears are not associated with differential risk of incident AUD.

The future harbours the potential for myriad threats to the fitness of organisms, and many species prepare accordingly based on indicators of hazards. Here, we distinguish between defensive responses on the basis of sensed cues and those based on autocues generated by mental simulations of the future in humans. Whereas sensed threat cues usually induce specific responses with reference to particular features of the environment or generalized responses to protect against diffuse threats, autocues generated by mental simulations of the future enable strategic preparation for hazards that may not require an immediate response. The overlap of these mechanisms makes defence effective and versatile, yet can manifest as contemporary anxiety disorders in humans.

Social Anxiety Disorder (SAD) and Alcohol Use Disorder (AUD) are highly prevalent and frequently co-occur. The results of population studies suggest that SAD tends to precede AUD, and the results of laboratory studies suggest that alcohol use facilitates social behaviors in socially anxious individuals. Therefore, we posited that, in a modern context, a tendency to consume alcohol may be positively selected for among socially anxious individuals by its effect on the likelihood of finding a partner and reproducing. We tested the hypothesis that a higher proportion of individuals with a lifetime diagnosis of SAD and AUD reproduce (i.e., have at least one child) relative to individuals with SAD absent AUD in an individual participant meta-analysis based on over 65,000 adults derived from four nationally representative cross-sectional samples. We then cross-validated these findings against the results of a 10-year follow up of one of these surveys. Lifetime history of SAD was not associated with reproduction whereas lifetime history of AUD was positively associated with reproduction. There was no statistically detectable difference in the proportion of individuals with a lifetime history of SAD with or without AUD who reproduced. There was considerable heterogeneity in all of the analyses involving SAD, suggesting that there are likely to be other pertinent variables relating to SAD and reproduction that should be delineated.