Individual differences predictive of drinking to manage anxiety among non-problem drinkers with panic disorder

Background: Alcohol problems co-occur with anxiety disorders at a rate that far exceeds chance ("comorbidity"). One view suggests that risk for develo ping a comorbid alcohol use disorder is Increased when alcohol is used rout inely to cope with anxiety symptoms ("self-medication"). Indicating that th is view is overly broad, however, the literature suggests that only a subgr oup of anxiety-disordered individuals tend to drink to manage their symptom s. Therefore, we set out to identify psychological characteristics that mig ht mark those for whom drinking to cope with anxiety is most likely. Our su rvey of the literature identified several possibilities, including anxiety- related personality traits (anxiety sensitivity, self-consciousness and Tra it Anxiety); higher-order personality dimensions (Harm Avoidance, Reward De pendence, and Novelty Seeking); and, finally, alcohol outcome expectancies (specifically, those related to tension-reducing effects from alcohol). Methods: In a sample of nonproblem drinkers with panic disorder, we regress ed predictor variables on several alcohol use measures, including drinking aimed at the control of anxiety symptoms ("self-medication"). Results: Although each variable related positively to a self-medicating sty le of drinking, expectancies for tension reduction from alcohol use account ed for about twice as much variance as did the other predictors. With simul taneous entry in a step-wise regression analysis, only tension-reduction al cohol outcome expectancies and the Harm Avoidance personality dimension wer e retained as significant predictors. Conclusions: Findings suggest that development of a self-medicating style o f 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 beh avior in this anxietydisordered sample.