Abstract

Social anxiety disorder and alcohol use disorders are highly comorbid. It remains unclear, however, if and how alcohol influences attentional processes and physical symptoms in social anxiety. In a balanced-placebo-design, high and normally socially anxious participants gave a speech while performing a task, which simultaneously measures internal and external attention. Only high anxious participants showed a preferential processing of external probes, which was eliminated by alcohol or the mere expectation of drinking alcohol. Furthermore, alcohol reduced facial blushing as well as self-reported social anxiety during public speaking. Decreases in anxiety were significantly associated with a reduction of the external focus in the high anxious group. Understanding alcohol as a substance influencing cognitive processes as well as physiological symptoms of anxiety further contributes to our understanding of alcohol use as a safety behavior in social anxiety disorder.

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