Alcohol abuse and anxiety sensitivity are linked in different but mutually reinforcing ways, finds study

Anxiety sensitivity—the fear of anxiety-related sensations—has a long and not very healthy relationship with alcohol use and abuse. People who display high levels of AS are more likely to drink heavily and use alcohol as a coping method or to reduce tensions. For young adults, who drink the most, high AS can put them at risk for drinking to cope, which poses risks for long-term consequences on their personal and professional lives, including underemployment and addiction.

A new study published in the journal Psychology of Addictive Behaviors, led by Ph.D. candidate Charlotte Corran, looks at the influences of AS on alcohol consumption in young adults through the bidirectional influences of alcohol-related cognitions (i.e., reasons for drinking).

The data was compiled from almost 200 students, who completed questionnaires over a 12-month span. Consequently, the researchers have found that motives and expectations around drinking were often mutually reinforcing both on average (trait-level) and at specific instances (state-level). These results help to explain the risk AS poses for problematic alcohol use.

"We know that anxiety sensitivity is a risk factor for alcohol-related problems in the long term, but the association is not always straightforward," says Corran, the paper's primary author.

"The goal was to clarify the effect of AS on alcohol use and problems through this unfolding bidirectional cognitive process."

Roisin O'Connor, a professor of psychology in the Faculty of Arts and Science, supervised the study. Christian Hendershot of the University of North Carolina at Chapel Hill also contributed to the project.

Different reasons and different outcomes

The researchers recruited final-year CEGEP students to fill out three questionnaires at six-month intervals. In addition to anxiety sensitivity, they measured:

• drinking motives such as the desire to drink to cope with anxiety or for enhancement, i.e., drinking to increase positive emotions
• alcohol expectancies (tension reduction, increased sociability or "liquid courage"), and
• alcohol use and problems

At the trait level, drinking motives and alcohol expectancies were positively associated with one another, which the researchers expected. In other words, people who drink to cope also frequently drink with the expectation that alcohol will reduce their tension. Additionally, drinking motives were positively associated with sociability, or "liquid courage."

At the state level, which is occasion-specific, they found that AS positively predicted drinking to cope and alcohol use. The expectation that drinking reduces tension predicted drinking to cope and sociability/liquid courage expectancy. These expectancies were found, in turn, to predict alcohol use.

"There seems to be quite a lot of interplay between cognitions that can help us understand alcohol use risk in young adults," Corran notes. "Motives and reasons for drinking impact expectancies, and vice versa—they all feed into one another."

No straight lines

Corran points out that while the connection between AS and alcohol use has been researched extensively, this study is the first to look at the phenomenon from multiple directions.

"We have already seen studies that put these factors in sequential order. Anxiety sensitivity predicts drinking to cope, which predicts tension reduction expectancies, which predicts alcohol use. We looked at it differently," she says. "Maybe expectancies reinforce motives, but motives may also reinforce expectancies."

Corran says this study stands apart from existing research in several important ways. First, it is longitudinal while most others are cross-sectional.

"Also, the statistical analysis model used was unique as we were able to look at both global/overall and occasion-specific associations," she says.

"This paper points to both the importance of challenging specific beliefs about alcohol and also helping young people build confidence in using alternative, healthier coping strategies," says O'Connor. "It can become commonplace for us to condone drinking after 'a bad day,' but research in our lab points to the potential problematic cycle of drinking that this can perpetuate for some people, especially those high in anxiety and looking for ways to cope."