Effects of alcohol on anxiety-relevant cognitions in individuals with social phobia

There is substantial evidence that alcohol can attenuate anxiety responding under some circumstances; however, the mechanisms supporting this effect remain a matter of speculation. One possibility involves the effect of alcohol on the salience of cognitions that either promote or inhibit anxiety in response to anxiety-related cues. We tested this view from a phenomenological perspective by asking individuals with social phobia to record up to 6 thoughts they experienced during 2 public speaking challenges, 1 before and 1 after consuming either an alcoholic, placebo or control beverage. After assigning the thoughts listed by participants to rationally based categories, we found that the pharmacological and expectancy effects of alcohol, in combination, were associated with an increase in positive thoughts and a decrease in negative thoughts experienced while speaking. Subsequent analyses showed that the impact of alcohol on subjective anxiety was substantially mediated by these changes in cognitions. These findings shed light on why social phobia and alcoholism frequently co-occur.