Manipulating Alcohol Expectancies in Social Anxiety: A Focus on Beliefs About Losing Control

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ORIGINAL ARTICLE

Manipulating Alcohol Expectancies in Social Anxiety: A Focus on Beliefs About Losing Control Jean‑Philippe Gagné1 · Adam S. Radomsky1   · Roisin M. O’Connor1 Accepted: 7 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Background  Social anxiety is associated with increased and decreased alcohol use. Alcohol expectancies may help explain these inconsistencies. For example, a fear of losing control in front of others could motivate avoidance of alcohol. Similarly, cognitive models propose that individuals with elevated social anxiety believe they are at risk of behaving inappropriately and embarrassing themselves, indicating that beliefs about losing control over one’s behaviour may be involved in social anxiety. This experiment aimed to manipulate negative alcohol expectancies about losing control to assess their impact on symptoms and processes associated with social anxiety. Methods  Ninety-three undergraduate participants (i.e., non-clinical sample) were randomly assigned to an alcohol, placebo, or control condition and were ‘informed’ that alcohol makes people lose control over their actions/speech. They then completed a ‘getting to know you’ task. Results  Participants in the placebo and alcohol (versus control) conditions experienced greater anxiety before and during the task and engaged in more post-event processing 24 h later. However, the physiological effects of alcohol influenced results: participants in the alcohol (versus placebo) condition experienced lower anticipatory anxiety, perceived themselves as making a better first impression, and demonstrated a lower reliance on safety behaviour. Conclusions  Although this experiment used a non-clinical sample, beliefs about losing control may be important to consider when conceptualizing social anxiety and treating associated symptoms from a cognitive-behavioural framework. Keywords  Social anxiety · Alcohol · Beliefs · Losing control · Post-event processing · Safety behaviour

Introduction Social anxiety disorder (SAD) is characterized by elevated fear of situations in which being scrutinized or evaluated by others is possible (American Psychiatric Association [APA] 2013). Individuals with SAD fear behaving in a way or showing signs of anxiety that might lead to embarrassment, humiliation, and/or rejection (APA 2013). According to epidemiological surveys, the lifetime prevalence rate of SAD is 13% (Kessler et al. 2012). SAD is also associated with the development of other problems, including substance use (e.g., Schneier et al. 2010) and mood disorders (e.g., Koyuncu et al. 2014), and with substantial impairment in social and occupational domains (e.g., Aderka et al. 2012). * Adam S. Radomsky [email protected] 1



Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC H4B 1R6, Canada

Nonetheless, experiences associated with SAD fall on a continuum. Research on subclinical social anxiety has shown that 50% to 61% of individuals report being socially a