Amie R. Schry

Understanding the relationship between social anxiety and alcohol use in college students: a meta-analysis.

Many college students use alcohol, and most of these students experience problems related to their use. Emerging research indicates that socially anxious students face heightened risk of experiencing alcohol-related problems, although the extant research on alcohol use and social anxiety in this population has yielded inconsistent findings. This meta-analysis was conducted to examine the relationship between social anxiety and alcohol variables in college students. A literature search was used to identify studies on college students that included measures of social anxiety and at least one of the alcohol variables of interest. All analyses were conducted using random effects models. We found that social anxiety was negatively correlated with alcohol use variables (e.g., typical quantity and typical frequency), but significantly positively correlated with alcohol-related problems, coping, conformity, and social motives for alcohol use, and positive and negative alcohol outcome expectancies. Several moderators of effect sizes were found to be significant, including methodological factors such as sample ascertainment approach. Given that social anxiety was negatively related to alcohol use but positively related to alcohol-related problems, research is needed to address why individuals high in social anxiety experience more problems as a result of their alcohol use. Avoidance of social situations among socially anxious students should also be taken into account when measuring alcohol use. The primary limitation of this study is the small number of studies available for inclusion in some of the analyses.

Measuring Social Anxiety in College Students: A Comprehensive Evaluation of the Psychometric Properties of the SPAI-23.

Social anxiety disorder (SAD) is 1 of the most prevalent psychological disorders, and among college students in particular, social anxiety has been associated with other problems such as substance use problems and increased vulnerability to other psychiatric disorders. The Social Phobia and Anxiety Inventory-23 (SPAI-23; Roberson-Nay, Strong, Nay, Beidel, & Turner, 2007) may be a useful, brief measure of problematic social anxiety in college students. Results from 4 studies (total n = 2,436) using the SPAI-23 with college student samples are presented. Scores on the SPAI-23 demonstrated strong convergent validity with other measures of social anxiety and discriminant validity as evidenced by lower correlations with measures of dissimilar constructs. Difference scores on the SPAI-23 also demonstrated adequate test-retest reliability over 5 ½ weeks (r = .72). Exploratory factor analysis suggested a two-factor structure: social anxiety and agoraphobia. Finally, differential item function analyses suggested that the items function similarly in men and women. In conclusion, the SPAI-23 demonstrated strong psychometric properties for use with college students.

Sexual Assertiveness Mediates the Effect of Social Interaction Anxiety on Sexual Victimization Risk among College Women.

Sexual victimization is prevalent among college women and is associated with adverse psychological consequences. Social anxiety, particularly related to interpersonal interaction, may increase risk of sexual victimization among college women by decreasing sexual assertiveness and decreasing the likelihood of using assertive resistance techniques. This study examined social interaction anxiety as a risk factor for sexual victimization. College women (n=672) completed online measures of social interaction anxiety, sexual assertiveness, and sexual victimization experiences. Social interaction anxiety was significantly positively related to likelihood of experiencing coerced sexual intercourse, and significant indirect effects, via decreased sexual refusal assertiveness, were found for both coerced sexual intercourse and rape. Social anxiety may be an important psychological barrier to assertive resistance during risky sexual situations, and developers of risk reduction programs for college women should consider including methods to help women overcome their social anxiety in order to successfully use assertive resistance techniques.

Social Worries and Difficulties: Autism and/or Social Anxiety Disorder?

In this chapter, we explore the phenotypic overlap between social anxiety disorder (SAD) and autism spectrum disorder (ASD), mechanisms through which social anxiety might arise in a person with ASD, and clinical considerations for differential and dual diagnosis. We consider social anxiety diagnostically as well as dimensionally, given the debate about the validity of co-occurring SAD in ASD, the fairly nascent state of the research on the topic, and recent explication in our diagnostic nosology on differentiation between and dual diagnosis of SAD and ASD (APA 2013). Social anxiety is a common clinical concern among people diagnosed with ASD; its presence is often inferred from behavioral manifestations rather than expressed cognitions (e.g., worries about failure or peer judgment). There are many unknowns with respect to how best to assess, diagnose, and treat social anxiety in individuals with ASD. Nonetheless, in summarizing the extant research, we provide specific recommendations for further research in this area and suggestions for evidence-based assessment and treatment.

Effects of Verbal Ability and Severity of Autism on Anxiety in Adolescents With ASD: One-Year Follow-Up After Cognitive Behavioral Therapy

There is evidence supporting the efficacy of cognitive-behavioral therapy for treatment of anxiety in youth with Autism Spectrum Disorders (ASD), but long-term course of anxiety after treatment and individual predictors of treatment response are unknown. To meet the demands for personalized mental health care, information on the fit between patient and treatment as well as treatment durability is needed. We evaluated change in anxiety symptoms during intervention and 1 year after completion of the treatment, and evaluated predictors of response using an advanced analytical design, with follow-up data from a randomized controlled trial of 22 adolescents (12–17 years) with ASD and 1 or more anxiety disorders. Reduction in anxiety was partially maintained during the year following treatment; greater ASD severity predicted better treatment response. Our finding that brief treatment is associated with sustained gains is promising, given the pervasive and chronic nature of ASD. Implications for the treatment of anxiety in higher functioning adolescents with ASD are considered.

Assessment of global functioning in adolescents with autism spectrum disorders: Utility of the Developmental Disability–Child Global Assessment Scale:

Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability–Child Global Assessment Scale in a sample of higher functioning adolescents with autism spectrum disorders and comorbid anxiety disorders enrolled in a randomized controlled trial (n = 30). Pretreatment Developmental Disability–Child Global Assessment Scale scores correlated with severity of autism spectrum disorders core symptoms (r = −.388, p = .034), pragmatic communication (r = .407, p = .032), and verbal ability (r = .449, p = .013) and did not correlate with severity of anxiety symptoms or with parent-reported adaptive behavior. Change in Developmental Disability–Child Global Assessment Scale scores during treatment was associated with autism spectrum disorders symptomatic improvement (r = .414, p = .040) and with improved general communication (r = .499, p = .013). Results support the importance of assessing global functioning in addition to symptom change and treatment response in clinical trials.

Social anxiety and alcohol-related sexual victimization: A longitudinal pilot study of college women

OBJECTIVE We sought to examine social anxiety as a risk factor for alcohol-related sexual victimization among college women. METHOD Women (Time 1: n = 574; Time 2: n = 88) who reported consuming alcohol at least once during the assessment timeframe participated. Social anxiety, alcohol use, alcohol-related consequences, and sexual victimization were assessed twice, approximately two months apart. Logistic regressions were used to examine social anxiety as a risk factor for alcohol-related sexual victimization at both time points. RESULTS Longitudinally, women high in social anxiety were approximately three times more likely to endorse unwanted alcohol-related sexual experiences compared to women with low to moderate social anxiety. CONCLUSIONS This study suggests social anxiety, a modifiable construct, increases risk for alcohol-related sexual victimization among college women. Implications for clinicians and risk-reduction program developers are discussed.

Gender Matters: The Relationship between Social Anxiety and Alcohol-Related Consequences

Background and Objectives Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. Methods In the present study, 573 undergraduate students (M age = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. Results After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. Discussion and Conclusions These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. Scientific Significance This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences.