College students with social anxiety disorder (SAD) experience more alcohol-related negative consequences, regardless of the amount of alcohol they consume. A new study examined within-group differences in alcohol-related negative consequences of students who met or exceeded clinically indicated social anxiety symptoms. More specifically, the study tested a sequential mediation model of the cognitive (i.e., fear of negative evaluation) and behavioral (protective behavioral strategies) mechanisms for the link between social anxiety disorder subtypes (i.e., interaction and performance-type) and alcohol-related negative consequences. Participants were college students (N = 412), who were aged 18 to 24 years and received credit for partial fulfillment of a class research requirement. In order to be included, participants had to have consumed alcohol in the past month and endorsed clinically indicated levels of SAD (SIAS ≥ 34 and/or SPS ≥ 24). Measures included Social Interaction Anxiety Scale (SIAS) to assess interaction SAD, Brief Fear of Negative Evaluation Scale (BFNE-S) to measure evaluation fears, Protective Behavioral Strategy Scale-revised (PBSS) to assess protective behavioral strategies (PBS), Rutgers Alcohol Problem Index (RAPI) to assess negative drinking consequences and the Daily Drinking Questionnaire (DDQ) was used to assess typical weekly alcohol consumption. To test within-group differences in the relationship among SAD, fear of negative evaluation, PBS, and alcohol-related negative consequences, while controlling for alcohol consumption, all variables were treated as continuous and a sequential mediation analysis was performed through a structural equation model framework using Mplus 7.11. Results showed that interaction SAD predicted alcohol-related negative consequences (p < 0.05). Furthermore, fear of negative evaluation and serious harm reduction PBS independently mediated the relationship between interaction SAD and alcohol-related negative consequences. Specifically, fear of negative evaluation (p < 0.05) accounted for 41% of the mediated effect and serious harm reduction PBS (p < 0.05) accounted for 42% of the mediated effect. Additionally, fear of negative evaluation and serious harm reduction PBS sequentially mediated the relationship between interaction SAD and alcohol-related negative consequences (p = 0.11), accounting for 13% of the variance. Interaction SAD predicted more fear of negative evaluation (p < 0.001), which predicted more serious harm reduction PBS (p = 0.05), which predicted fewer alcohol-related negative consequences (p < 0.001).
Take away: College students with more severe social anxiety symptoms, of the interaction subtype, reported more fear of negative evaluation, which was related to more serious harm reduction strategies, which in turn predicted fewer alcohol-related negative consequences.