Department of Psychology, Louisiana State University, Baton Rouge, LA, USA.
Depress Anxiety. 2013 Mar;30(3):276-84. doi: 10.1002/da.22032. Epub 2012 Dec 13.
Emerging prospective work suggests that individuals with social anxiety disorder (SAD) may be at particular risk for developing substance use disorders (SUD). Yet, little is known about why this may be so. Most research has utilized existing theories of substance use (e.g. tension reduction-based theories) to understand SAD-SUD relations. However, these theories do not address why individuals with social anxiety, in particular, experience such high rates of substance-related problems. A possible explanation may lie in the nature of social anxiety itself, which is characterized not only by chronically elevated negative affective states, but by low positive affect, fear of scrutiny, and social avoidance. These aspects of social anxiety may work in concert to place these especially vulnerable individuals at risk for SUD. The current paper presents a biopsychosocial model of SAD-SUD comorbidity that focuses on several specific facets of social anxiety that may be especially related to SUD risk. The utility of this model is evaluated via a review of the literature on the relations between SAD and substance-related behaviors.
新兴的前瞻性研究表明，患有社交焦虑症（SAD）的个体可能特别容易患上物质使用障碍（SUD）。然而，目前尚不清楚为什么会这样。大多数研究都利用了现有的物质使用理论（例如基于缓解紧张的理论）来理解 SAD-SUD 之间的关系。然而，这些理论并没有解释为什么患有社交焦虑症的个体，特别是会经历如此高的与物质相关的问题。一个可能的解释可能在于社交焦虑本身的性质，它不仅表现为慢性升高的消极情绪状态，还表现为低积极情绪、对审查的恐惧和社交回避。社交焦虑的这些方面可能协同作用，使这些特别脆弱的个体面临 SUD 的风险。本文提出了一个社交焦虑症与物质使用障碍共病的生物心理社会模型，该模型侧重于社交焦虑症的几个特定方面，这些方面可能与 SUD 风险特别相关。通过回顾社交焦虑症与物质相关行为之间的关系文献，评估了该模型的实用性。
