Kushner M G, Abrams K, Thuras P, Thuras P, Hanson K L
Department of Psychiatry, Fairview Hospital, University of Minnesota, Minneapolis 55454, USA.
Alcohol Clin Exp Res. 2000 Apr;24(4):448-58.
Alcohol problems co-occur with anxiety disorders at a rate that far exceeds chance ("comorbidity"). One view suggests that risk for developing a comorbid alcohol use disorder is increased when alcohol is used routinely to cope with anxiety symptoms ("self-medication"). Indicating that this view is overly broad, however, the literature suggests that only a subgroup of anxiety-disordered individuals tend to drink to manage their symptoms. Therefore, we set out to identify psychological characteristics that might mark those for whom drinking to cope with anxiety is most likely. Our survey of the literature identified several possibilities, including anxiety-related personality traits (anxiety sensitivity, self-consciousness and Trait Anxiety); higher-order personality dimensions (Harm Avoidance, Reward Dependence, and Novelty Seeking); and, finally, alcohol outcome expectancies (specifically, those related to tension-reducing effects from alcohol).
In a sample of nonproblem drinkers with panic disorder, we regressed predictor variables on several alcohol use measures, including drinking aimed at the control of anxiety symptoms ("self-medication").
Although each variable related positively to a self-medicating style of drinking, expectancies for tension reduction from alcohol use accounted for about twice as much variance as did the other predictors. With simultaneous entry in a step-wise regression analysis, only tension-reduction alcohol outcome expectancies and the Harm Avoidance personality dimension were retained as significant predictors.
Findings suggest that development of a self-medicating style of drinking among individuals with panic disorder is predicated, in part, on specific psychological characteristics of the individual. Alcohol outcome expectancies emerged as the single most important predictor of drinking behavior in this anxiety-disordered sample.
酒精问题与焦虑症同时出现的几率远远超过偶然情况（“共病”）。一种观点认为，当人们经常饮酒来应对焦虑症状（“自我药疗”）时，患酒精使用障碍共病的风险会增加。然而，文献表明只有一部分焦虑症患者倾向于通过饮酒来缓解症状，这说明该观点过于宽泛。因此，我们着手确定那些可能标志着最有可能通过饮酒来应对焦虑的人的心理特征。我们对文献的调查发现了几种可能性，包括与焦虑相关的人格特质（焦虑敏感性、自我意识和特质焦虑）；高阶人格维度（回避伤害、奖赏依赖和寻求新奇）；最后是酒精结果预期（特别是那些与酒精减轻紧张作用相关的预期）。
在一个患有惊恐障碍的非问题饮酒者样本中，我们将预测变量对几种饮酒量度进行回归分析，包括旨在控制焦虑症状的饮酒行为（“自我药疗”）。
尽管每个变量都与自我药疗饮酒方式呈正相关，但酒精减轻紧张的预期解释的方差约为其他预测变量的两倍。在逐步回归分析中同时纳入变量时，只有酒精减轻紧张的结果预期和回避伤害人格维度被保留为显著预测变量。
研究结果表明，惊恐障碍患者自我药疗饮酒方式的形成部分取决于个体的特定心理特征。在这个焦虑症样本中，酒精结果预期是饮酒行为的最重要单一预测因素。
