December 18, 2018

Dear Colleagues,

The National Social Anxiety Center (NSAC) provides information about relevant and current research in service of disseminating and promoting evidence-based treatment for social anxiety. This month’s update focuses on the paradoxical effect of substance use in individuals with social anxiety.

A recent study (Marsh et al., 2018) showed that among social drinkers, those with high levels of shyness were more likely to experience a rebound effect of increased anxiety the day after drinking. The authors identified this predisposition to “hangxiety” as a risk factor for alcohol use disorders. I could also see it significantly increasing certain SAD components such as post-event rumination. Similarly, studies show that while low-dose cannabis use can have an anxiolytic effect, higher doses can be anxiety inducing (Witkin et al., 2005).

Do others commonly see such rebound or paradoxical effects in your socially anxious patients who use substances? How do you go about identifying them and working towards a shared conceptualization of them with your patients?

Beth Marsh, Molly Carlyle, Emily Carter, Paige Hughes, Sarah McGahey, Will Lawn, Tobias Stevens, Amy McAndrew, Celia J.A. Morgan. Shyness, alcohol use disorders and ‘hangxiety’: A naturalistic study of social drinkers. Personality and Individual Differences, v. 139, March 1, 2019, pp. 131-8. Link to abstract.

Robert Yeilding, Psy.D.
Clinical Psychologist

Representative of NSAC Newport Beach / Orange County
(Anxiety and Depression Center)