Abstract
College alcohol drinking is a public health concern worldwide. A line of research indicates that higher social anxiety is associated with more severe college drinking. However, other studies reveal a protective role of social anxiety against alcohol drinking in college students. Attempting to reconcile contradictory findings, we examined the hypothesis that there are multiple antagonistic pathways that could explain the social anxiety-college drinking relationship. In addition, there may be individual difference variables that moderate these processes. Furthermore, it was expected that the processes could vary as a function of the alcohol drinking outcomes examined. Expectancy theory emphasizes the role of alcohol outcome expectancies in alcohol drinking. Thus, in the present study we tested whether global positive and negative alcohol outcome expectancies partially mediate the relationship between social anxiety, alcohol consumption, and alcohol-related problems in a sample of 245 university students. We also examined the moderating role of gender in these mediating processes. Results revealed parallel but oppositional processes. Higher social anxiety was associated with heavier alcohol drinking and more serious alcohol-related problems via stronger positive alcohol outcome expectancies. However, the mediating role of positive alcohol outcome expectancies varied as a function of gender. It appears that in female students the mediating effect of positive alcohol outcome expectancies was stronger than in male students. On the other hand, higher social anxiety had a protective role against alcohol consumption but not against alcohol-related problems via stronger negative alcohol outcome expectancies. Finally, there was an inverse direct relationship between social anxiety and alcohol consumption.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alden, L. E., & Taylor, C. T. (2004). Interpersonal processes in social phobia. Clinical Psychology Review, 24(7), 857–882. https://doi.org/10.1016/j.cpr.2004.07.006.
Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). AUDIT: The alcohol use disorders identification test—guidelines for use in primary care (2nd ed.). Geneva: World Health Organization.
Baer, J. S. (2002). Student factors: Understanding individual variation in college drinking. Journal of Studies on Alcohol, S14, 40–53. https://doi.org/10.15288/jsas.2002.s14.40.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/0022-3514.51.6.1173.
Beidel, D., Borden, J., Turner, S., & Jacob, R. (1989). The social phobia and anxiety inventory: Concurrent validity with a clinic sample. Behavioral Research and Therapy, 27(5), 573–576. https://doi.org/10.1016/0005-7967(89)90093-4.
Bruch, M. A., Heimberg, R. G., Harvey, C., McCann, M., & Slavkin, S. L. (1992). Shyness, alcohol expectancies, and alcohol use: Discovery of a suppressor effect. Journal of Research in Personality, 26(2), 137–149. https://doi.org/10.1016/0092-6566(92)90050-E.
Buckner, J. D., Heimberg, R. G., Ecker, A. H., & Vinci, C. (2013). A biopsychosocial model of social anxiety and substance use. Depression and Anxiety, 30(3), 276–284. https://doi.org/10.1002/da.22032.
Buckner, J. D., Schmidt, N. B., & Eggleston, A. M. (2006). Social anxiety and problematic alcohol consumption: The mediating role of drinking motives and situations. Behavior Therapy, 37(4), 381–391. https://doi.org/10.1016/j.beth.2006.02.007.
Buckner, J. D., & Shah, S. M. (2015). Fitting in and feeling fine: Conformity and coping motives differentially mediate the relationship between social anxiety and drinking problems for men and women. Addiction Research and Theory, 23(3), 231–237. https://doi.org/10.3109/16066359.2014.978304.
Buckner, J. D., & Turner, R. J. (2009). Social anxiety disorder as a risk factor for alcohol use disorders: A prospective examination of parental and peer influences. Drug and Alcohol Dependence, 100(1–2), 128–137. https://doi.org/10.1016/j.drugalcdep.2008.09.018.
Conger, J. J. (1956). Alcoholism: Theory, problem, and challenge II: Reinforcement theory and the dynamics of alcoholism. Quarterly Journal of Studies on Alcohol, 17(2), 291–324.
Crum, R. M., & Pratt, L. A. (2001). Risk of heavy drinking and alcohol use disorders in social phobia: A prospective analysis. American Journal of Psychiatry, 158(10), 1693–1700. https://doi.org/10.1176/appi.ajp.158.10.1693.
Eggleston, A. M., Woolaway-Bickel, K., & Schmidt, N. B. (2004). Social anxiety and alcohol use: Evaluation of the moderating and mediating effects of alcohol expectancies. Journal of Anxiety Disorders, 18(1), 33–49. https://doi.org/10.1016/j.janxdis.2003.07.005.
Fehm, L., Pelissolo, A., Furmark, T., & Wittchen, H.-U. (2005). Size and burden of social phobia in Europe. European Neuropsychopharmacology, 15(4), 453–462. https://doi.org/10.1016/j.euroneuro.2005.04.002.
Fenigstein, A., Scheier, M. F., & Buss, A. H. (1975). Public and private self-consciousness: Assessment and theory. Journal of Consulting and Clinical Psychology, 43(4), 522–527. https://doi.org/10.1037/h0076760.
Field, A. (2005). Discovering statistics using SPSS. London: Sage.
Furmark, T. (2002). Social phobia: Overview of community surveys. Acta Psychiatrica Scandinavica, 105(2), 84–93. https://doi.org/10.1034/j.1600-0447.2002.1r103.x.
Goldman, M., Brown, S. A., & Christiansen, B. (1987). Expectancy theory: Thinking about drinking. In H. T. Blane & K. Leonard (Eds.), Psychological theories of drinking and alcoholism (1st ed., pp. 181–226). New York: The Guilford Press.
Ham, L. S. (2009). Positive social alcohol outcome expectancies, social anxiety, and hazardous drinking in college students. Cognitive Therapy and Research, 33(6), 615–623. https://doi.org/10.1007/s10608-009-9248-8.
Ham, L. S., Bacon, A. K., Carrigan, M. H., Zamboanga, B. L., & Casner, H. G. (2016). Social anxiety and alcohol use: The role of alcohol expectancies about social outcomes. Addiction Research and Theory, 24(1), 9–16. https://doi.org/10.3109/16066359.2015.1036242.
Ham, L. S., & Hope, D. A. (2003). College students and problematic drinking: A review of the literature. Clinical Psychology Review, 23(5), 719–759. https://doi.org/10.1016/S0272-7358(03)00071-0.
Ham, L. S., & Hope, D. A. (2006). Incorporating social anxiety into a model of college problem drinking: Replication and extension. Psychology of Addictive Behaviors, 20(3), 348–355. https://doi.org/10.1037/0893-164X.20.3.348.
Ham, L. S., Zamboanga, B. L., Bacon, A. K., & Garcia, T. A. (2009). Drinking motives as mediators of social anxiety and hazardous drinking among college students. Cognitive Behaviour Therapy, 38(3), 133–145. https://doi.org/10.1080/16506070802610889.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.
Holroyd, K. A. (1978). Effects of social anxiety and social evaluation on beer consumption and social interaction. Journal of Studies on Alcohol, 39(5), 737–744. https://doi.org/10.15288/jsa.1978.39.737.
Hope, D., & Heimberg, R. (1988). Public and private self-consciousness and social phobia. Journal of Personality Assessment, 52(4), 626–639. https://doi.org/10.1207/s15327752jpa5204_3.
Isaak, M. I., Perkins, D. R., & Labatut, T. R. (2011). Disregulated alcohol related behavior among college drinkers: Associations with protective behaviors, personality, and drinking motives. Journal of American College Health, 59(4), 282–288. https://doi.org/10.1080/07448481.2010.509379.
Jones, B. T., Corbin, W., & Fromme, K. (2001). A review of expectancy theory and alcohol consumption. Addiction, 96(1), 57–72. https://doi.org/10.1080/09652140020016969.
Kashdan, T. B. (2007). Social anxiety spectrum and diminished positive experiences: Theoretical synthesis and meta-analysis. Clinical Psychology Review, 27(3), 348–365. https://doi.org/10.1016/j.cpr.2006.12.003.
Kashdan, T. B., & Steger, M. F. (2006). Expanding the topography of social anxiety: An experience-sampling assessment of positive emotions, positive events, and emotion suppression. Psychological Science, 17(2), 120–128. https://doi.org/10.1111/j.1467-9280.2006.01674.x.
Keys, K. M., Grant, B. F., & Hasin, D. S. (2008). Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population. Drug & Alcohol Dependence, 93(1–2), 21–29. https://doi.org/10.1016/j.drugalcdep.2007.08.017.
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244. https://doi.org/10.3109/10673229709030550.
Kidorf, M., & Lang, A. R. (1999). Effects of social anxiety and alcohol expectancies on stress-induced drinking. Psychology of Addictive Behaviors, 13(2), 134–142. https://doi.org/10.1037/0893-164X.13.2.134.
Kidorf, M., Sherman, M. F., Johnson, J. G., & Bigelow, G. E. (1995). Alcohol expectancies and changes in beer consumption of first-year college students. Addictive Behaviors, 20(2), 225–231. https://doi.org/10.1016/0306-4603(94)00067-0.
Kokotailo, P. K., Egan, J., Gangnon, R., Brown, D., Mundt, M., & Fleming, M. (2004). Validity of the alcohol use disorders identification test in college students. Alcoholism: Clinical and Experimental Research, 28(6), 914–920. https://doi.org/10.1097/01.ALC.0000128239.87611.F5.
Kushner, M. G., & Sher, K. J. (1993). Comorbidity of alcohol and anxiety disorders among college students: Effects of gender and family history of alcoholism. Addictive Behaviors, 18(5), 543–552. https://doi.org/10.1016/0306-4603(93)90070-p.
LaBrie, J., Pedersen, E. R., Neighbors, C., & Hummer, J. F. (2008). The role of self-consciousness in the experience of alcohol-related consequences among college students. Addictive Behaviors, 33(6), 812–820. https://doi.org/10.1016/j.addbeh.2008.01.002.
Leary, M. R. (1983). Social anxiousness: The construct and its measurement. Journal of Personality Assessment, 47(1), 66–75. https://doi.org/10.1207/s15327752jpa4701_8.
Leigh, B. C., & Stacy, A. W. (1993). Alcohol outcome expectancies: Scale construction and predictive utility in higher order confirmatory models. Psychological Assessment, 5(2), 216–229. https://doi.org/10.1037/1040-3590.5.2.216.
Lewis, B. A., & O’Neill, H. K. (2000). Alcohol expectancies and social deficits relating to problem drinking among college students. Addictive Behaviors, 25(2), 295–299. https://doi.org/10.1016/S0306-4603(99)00063-5.
Lewis, M. A., Hove, M. C., Whiteside, U., Lee, C. M., Kirkeby, B. S., Oster-Aaland, L., et al. (2008). Fitting in and feeling fine: Conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking. Psychology of Addictive Behaviors, 22(1), 58–67. https://doi.org/10.1037/0893-164X.22.1.58.
Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36(4), 455–470. https://doi.org/10.1016/S0005-7967(97)10031-6.
Morris, E. P., Stewart, S. H., & Ham, L. S. (2005). The relationship between social anxiety disorder and alcohol use disorders: A critical review. Clinical Psychology Review, 25(6), 734–760. https://doi.org/10.1016/j.cpr.2005.05.004.
Moussas, G., Dadouti, G., Douzenis, A., Poulis, E., Tzelembis, A., Bratis, D., Christodoulou, C., & Lykouras, L. (2009). The alcohol use disorders identification test (AUDIT): Reliability and validity of the Greek version. Annals of General Psychiatry, 8(11), 1–5. https://doi.org/10.1186/1744-859X-8-11.
Nolen-Hoeksema, S. (2004). Gender differences in risk factors and consequences for alcohol use and problems. Clinical Psychology Review, 24(8), 981–1010. https://doi.org/10.1016/j.cpr.2004.08.003.
Norberg, M. M., Norton, A. R., Olivier, J., & Zvolensky, M. J. (2010). Social anxiety, reasons for drinking, and college students. Behavior Therapy, 41(4), 555–566. https://doi.org/10.1016/j.beth.2010.03.002.
Oei, T. P., & Jardim, C. L. (2007). Alcohol expectancies, drinking refusal self-efficacy and drinking behaviour in Asian and Australian students. Drug and Alcohol Dependence, 87(2–3), 281–287. https://doi.org/10.1016/j.drugalcdep.2006.08.019.
Panayiotou, G., & Kokkinos, C. M. (2006). Self-consciousness and psychological distress: A study using the Greek SCS. Personality and Individual Differences, 41(11), 83–93. https://doi.org/10.1016/j.paid.2005.10.025.
Panayiotou, G., Michaelides, M. P., Theodorou, M., & Neophytou, K. (2017). Identifying sub-categories of social fears using an alternative factor analytic structure of the Social Phobia and Anxiety Inventory. Psychiatry Research, 251, 304–311. https://doi.org/10.1016/j.psychres.2017.02.040.
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments & Computers, 36(4), 717–731. https://doi.org/10.3758/BF03206553.
Ruscio, A. M., Brown, T. A., Chiu, W. T., Sareen, J., Stein, M. B., & Kessler, R. C. (2008). Social fears and social phobia in the USA: Results from the National Comorbidity Survey Replication. Psychological Medicine, 38(1), 15–28. https://doi.org/10.1017/S0033291707001699.
Saunders, J. B., Aasland, O. G., Babor, T. F., De La Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. Addiction, 88(6), 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x.
Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7(2), 147–177. https://doi.org/10.1037/1082-989X.7.2.147.
Schry, A. R., & White, S. W. (2013). Understanding the relationship between social anxiety and alcohol use in college students: A metaanalysis. Addictive Behaviors, 38(11), 2690–2706. https://doi.org/10.1016/j.addbeh.2013.06.014.
Shields, A. K., Guttmannova, K., & Caruso, J. C. (2004). An examination of the factor structure of the alcohol use disorders identification test in two high-risk samples. Substance Use and Misuse, 39(7), 1161–1182. http://dx.doi.org/10.1081/JA-120038034.
Sinha, R., Robinson, J., & O’Malley, S. (1998). Stress response dampening: Effects of gender and family history of alcoholism and anxiety disorders. Psychopharmacology, 137(4), 311–320. https://doi.org/10.1007/s002130050624.
Stewart, S. H., Morris, E., Mellings, T., & Komar, J. (2006). Relations of social anxiety variables to drinking motives, drinking quantity and frequency, and alcohol-related problems in undergraduates. Journal of Mental Health, 15(6), 671–682. https://doi.org/10.1080/09638230600998904.
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Pearson Education Inc.
Turrisi, R., Wiersma, K. A., & Hughes, K. K. (2000). Binge-drinking-related consequences in college students: Role of drinking beliefs and mother–teen communications. Psychology of Addictive Behaviors, 14(4), 342–355. https://doi.org/10.1037/0893-164X.14.4.342.
Wall, A., McKee, S. A., & Hinson, R. E. (2000). Assessing variation in alcohol outcome expectancies across environmental context: An examination of the situational-specificity hypothesis. Psychology of Addictive Behaviors, 14(4), 367–375. https://doi.org/10.1037//0893-164X.14.4.36.
Yoder-Strahan, E., Panayiotou, G., Clements, R., & Scott, J. (2011). Beer, wine, and social anxiety: Testing the ‘‘self-medication hypothesis’’ in the US and Cyprus. Addiction Research & Theory, 19(4), 302–311. https://doi.org/10.3109/16066359.2010.545152.
Funding
There was no funding for this study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Harilaos Papachristou, Evi Aresti, Marios Theodorou and Georgia Panayiotou declares that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Animal Rights
This article does not contain any studies with animals performed by any of the authors.
Rights and permissions
About this article
Cite this article
Papachristou, H., Aresti, E., Theodorou, M. et al. Alcohol Outcome Expectancies Mediate the Relationship Between Social Anxiety and Alcohol Drinking in University Students: The Role of Gender. Cogn Ther Res 42, 289–301 (2018). https://doi.org/10.1007/s10608-017-9879-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10608-017-9879-0