The relation between alcohol problems and the anxiety disorders

Abstract

The idea that people suffering from anxiety have a proclivity to consume alcohol to relieve their symptoms is supported by reports showing high comorbidity rates of alcohol and anxiety problems. The authors reviewed relevant epidemiologic surveys, family studies, and field studies and conclude that the relationship between alcohol problems and anxiety appears to be variable among the anxiety disorders. In agoraphobia and social phobia, alcohol problems appear more likely to follow from attempts at self-medication of anxiety symptoms, but panic disorder and generalized anxiety disorder may be more likely to follow from pathological alcohol consumption. Simple phobia does not appear to be related to alcohol problems in any meaningful way.

Relationship between ethanol-induced activity and anxiolysis in the open field, elevated plus maze, light-dark box, and ethanol intake in adolescent rats

“…An association between increased anxiety states and ethanol abuse has been inferred in human studies [48] and animal studies [43, 49, 50], but several preclinical reports indicated an opposite relationship [51, 52, 53]. For example, it has been found that selectively bred low-anxiety behavior (LAB) rats drank more than high-anxiety behavior (HAB) counterparts [52].…”

Paternal autonomy restriction, neighborhood safety, and child anxiety trajectory in community youth

“…Anxiety disorders in childhood can seriously disrupt the course of children’s development, impairing school functioning and family and social relationships (Essau, Conradt, & Petermann, 2000; Ezpeleta, Keeler, Erkanli, Costello, & Angold, 2001; Strauss, Frame, & Forehand, 1987). Moreover, the presence of an anxiety disorder in childhood is associated with an increased risk for the development of additional anxiety disorders, depression, and substance abuse in adolescence and adulthood (Kim-Cohen et al, 2003; Kovacs, Gastsonis, Laulauskas, & Richards, 1989; Kushner, Sher, & Beitman, 1990). Left untreated, anxiety disorders persisting into adulthood are associated with considerably reduced health-related quality of life and serious occupational impairments (Comer et al, 2011; Merikangas et al, 2007).…”

No Reliable Evidence That Emotional Disorders Are Proximal Antecedents, Concomitants, or Short-Term Consequences of First Episode Alcohol Use Disorders in a Representative Community Sample

“…Findings obtained in this research suggest limitations of influential models of alcohol addiction, including the self-medication model (Khantzian, 1985;Quitkin et al, 1972), the substance-induced enhancement model (Kushner et al, 1990;Zvolensky et al, 2003), and the allostatic model (Koob & Le Moal, 2005;2008), each of which imply causal associations between emotional disorders and AUDs. All of the ORs for the reported contrasts fell within the small-to-moderate effect range for dichotomous predictors (Lipsey & Wilson, 2001) except for the OR resulting from the between-groups contrast for the I1 interval for anxiety disorders, which denoted a moderate-to-large effect.…”

“…Alternatively, emotional disorders may be concomitants or consequences of prob-lematic alcohol use (Fergusson et al, 2009;Merikangas et al, 1996;Swendsen et al, 1998) and, perhaps, have a role in AUD maintenance and relapse (Blume et al, 2000;Brown et al, 2008;Kushner et al, 2000). The allostatic (Koob & Le Moal, 2005, 2008 and substance-induced enhancement models of addiction (Kushner et al, 1990;Zvolensky et al, 2003), for example, suggest that multiple intoxication and withdrawal experiences increase susceptibility to anxious and depressed moods, and that these negative mood states, in turn, occasion subsequent substance use. Findings from retrospective (Falk et al, 2008;Merikangas et al, 1998) and prospective (Fergusson et al, 2009;Kushner et al, 1999;Zimmermann et al, 2003) studies as well as conclusions from literature reviews (e.g., Boden & Fergusson, 2011;Brown et al, 2008;Conner, 2011;Kushner et al, 2000;Raimo & Schuckit, 1998;Sher et al, 2005;Swendsen & Merikangas, 2000) further imply that emotional disorders may have complex relationships with AUDs that are, in part, influenced by maturational processes (e.g., changes in alcohol consumption patterns over the lifetime), cultural factors (e.g., cultural variations in patterns of alcohol consumption), and psychiatric history complexity (e.g., other co-occurring psychiatric disorders or the aggregation of disorders over the lifetime).…”