Understanding social anxiety as a risk for alcohol use disorders: fear of scrutiny, not social interaction fears, prospectively predicts alcohol use disorders.

Increasing evidence indicates that social anxiety may be a premorbid risk factor for alcohol use disorders (AUD). The aim of this study was to replicate and extend previous work examining whether social anxiety is a risk factor for AUD by evaluating both the temporal antecedence and non-spuriousness of this relationship. We also examined whether social anxiety first-order factors (social interaction anxiety, observation anxieties) served as specific predictors of AUD. A non-referred sample of 404 psychologically healthy young adults (i.e. free from current or past Axis I psychopathology) was prospectively followed over approximately two years. Social anxiety (but not depression or trait anxiety) at baseline significantly predicted subsequent AUD onset. The relationship between social anxiety and AUD remained even after controlling for relevant variables (gender, depression, trait anxiety). Further, social anxiety first-order factors differentially predicted AUD onset, such that observation anxieties (but not social interaction anxiety) were prospectively linked to AUD onset. This study provides further support that social anxiety (and fear of scrutiny specifically) appears to serve as an important and potentially specific AUD-related variable that deserves serious attention as a potential vulnerability factor.