Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States.
J Anxiety Disord. 2011 Apr;25(3):335-9. doi: 10.1016/j.janxdis.2010.10.006. Epub 2010 Oct 28.
Alcohol dependence (AD) is more likely to occur among individuals with rather than without an anxiety disorder. Self-medication theory (SMT) holds that drinking behavior is negatively reinforced when alcohol temporarily reduces anxiety and that the resulting escalation of drinking increases the risk for AD. We set out to empirically scrutinize SMT using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) dataset. We found that only a minority (about 20%) of anxiety disordered individuals endorsed drinking to control anxiety symptoms. This minority drank more alcohol, had a higher cross-sectional rate of AD, and was at higher risk for developing new AD over four years compared to anxiety disordered non-self-medicators and individuals with no anxiety disorder. Consistent with SMT, increased prospective risk for AD among self-medicators is partially mediated by an increased level of alcohol use. Understanding the processes that promote and inhibit self-medication should be a priority for anxiety disorder researchers.
酒精依赖（AD）更可能发生在有焦虑障碍的个体中，而不是没有焦虑障碍的个体中。自我药物治疗理论（SMT）认为，当酒精暂时减轻焦虑时，饮酒行为会受到负强化，而由此导致的饮酒量增加会增加 AD 的风险。我们使用国家酒精和相关条件流行病学调查（NESARC）数据集，旨在对 SMT 进行实证研究。我们发现，只有少数（约 20%）有焦虑障碍的人表示会通过饮酒来控制焦虑症状。与没有焦虑障碍的个体相比，这些少数饮酒者饮酒量更多，AD 的横断面发生率更高，在四年内新发 AD 的风险也更高。与 SMT 一致的是，自我药物治疗者的 AD 前瞻性风险增加部分是由饮酒量增加所导致的。理解促进和抑制自我药物治疗的过程应该是焦虑障碍研究人员的优先事项。
