Effects of alcohol on the processing of social threat-related stimuli in socially phobic women.

BACKGROUND Social phobics are at a higher risk of developing alcohol problems. The mechanism promoting this association is not clear. According to Sayette (1993b), alcohol attenuates anxiety responses by disrupting initial appraisal of threatening stimuli. We used the emotional Stroop test and an implicit memory test to investigate whether alcohol hinders appraisal of social threat words in patients diagnosed with social phobia. PROCEDURE Thirty-two women with social phobia (DSM-IV) and 32 female controls performed an emotional Stroop test either after drinking alcohol resulting in a blood alcohol levels (BAL) of 0.6%. or after drinking a non-alcoholic beverage. The emotional Stroop test contained social anxiety-related and neutral stimuli. Implicit memory for the words presented was tested with a word-stem completion test. RESULTS Without alcohol, both controls and socially-phobic participants took longer to name the colour of socially-threatening stimuli than of neutral stimuli. Alcohol levelled response latencies to the two stimulus categories only in controls. Socially-phobic participants responded more slowly to social anxiety-related stimuli than to neutral stimuli, irrespective of their BAL. In contrast to controls, social phobics showed an implicit memory bias for social threat words. This bias was attenuated by alcohol. DISCUSSION Alcohol disrupts appraisal of social anxiety-related stimuli in controls but not in social phobics; in these it hinders the consolidation of memory. This also suggests that social phobics experience similar anxiety with and without alcohol, but remember this experienced anxiety less precisely. This effect might act as a reinforcer for the use of alcohol for the purpose of self-medication in future situations.