Effects of alcohol on ratings of emotional facial expressions in social phobics.

Social phobics have an increased risk of alcoholism. The mechanism behind this co-morbidity is not well understood. According to the appraisal-disruption model [Sayette, M. A. (1993). An appraisal-disruption model of alcohol's effects on stress responses in social drinkers. Psychological Bulletin, 114, 459-476], alcohol disrupts appraisal of threat stimuli unless the stimuli are easy to process. We investigated whether alcohol alters the judgment of emotional facial expressions in social phobics and controls. We also tested the judgment of emotionally ambiguous faces which should be more difficult to process. Forty social phobics and controls rated faces depicting five emotional expressions on an animosity rating scale. For two ambiguous facial expressions, angry, respectively, happy faces were blended with neutral faces. Half of the participants consumed alcohol. Socially phobic participants rated neutral and happy facial expressions as less friendly than controls, irrespective of alcohol consumption. In both groups, consuming alcohol reduced the perceived rejection of angry faces. In line with current theories of social phobia, patients interpreted neutral facial expressions as more rejecting than controls. The rejection perceived in explicitly angry facial expressions was less after drinking alcohol. This reduction of the adversity of socially threatening stimuli by alcohol might act as negative reinforcement and thus contributes to alcohol problems.