Alcohol Use and Anxiety Disorders

The relationship between anxiety and alcohol use is a topic of great theoretical and practical interest for both scientists interested in the nature and causes of psychopathology and practitioners working with anxious and/or alcohol abusing clients. Although it has been clearly established that anxiety disorders and alcohol use disorders are highly ‘‘comorbid’’ or co-occurring conditions (e.g., see Kushner, Abrams&Borchardt, 2000a for a review), the relationship between the symptoms or behaviors involved in each disorder (e.g., feelings of anxiety and levels of alcohol use) has not been as extensively reviewed. This chapter will review recent empirical evidence linking anxiety and alcohol at both the behavioral and disorder level to determine if similar conclusions can be derived regarding their relationship from data at both of these levels of enquiry. We will first briefly describe epidemiological studies linking anxiety disorders and alcohol use disorders. Then we will examine some of the etiological theories of the relationship between anxiety and alcohol use and their disorders, with a review of the empirical evidence supporting each theory. Next, some specific factors moderating and mediating the relationship between anxiety and alcohol use will be explored, with an emphasis on individual differences and specific processes involved in the relationship. A brief discussion of the differences between factors affecting onset, maintenance, and relapse in the anxiety and alcohol relationship will follow. The latest empirical evidence and thoughts about treating both alcohol use and anxiety related problems will also be reviewed. Finally, we conclude the chapter with some remarks about where the field stands and directions that future research in this area might profitably take.