Alcohol is often referred to as “liquid courage,” with good reason. Individuals who are nervous in social settings may find the relaxing effects of alcohol helpful. They may feel more at ease and comfortable when they drink. In fact, many people with anxiety, social phobia, and panic issues drink as way to alleviate their stress levels. Unfortunately, these individuals are at heightened risk for developing an alcohol use problem (AUD). Treating individuals with anxiety and AUD is tricky and not always effective. Few approaches target anxiety and focus instead on drinking behaviors. But Matt G. Kushner of the Department of Psychiatry at the University of Minnesota thought that perhaps targeting the anxiety could indirectly decrease the motivation to drink.
To test his theory, Kushner assessed 344 individuals participating in an inpatient AUD treatment program. All of the participants had symptoms of panic, social phobia, or generalized anxiety in addition to AUD. They were randomized to a progressive muscle relaxation training (PMRT) program or a cognitive behavior therapy (CBT) condition designed to address anxiety and decrease the motivation to drink. Four months later, Kushner evaluated 247 of the participants and found that those in the CBT condition had drastically lower levels of alcohol use than the control participants in the PMRT condition.
When Kushner looked at anxiety, he discovered that both groups had similar outcomes with significant reductions in symptoms of anxiety immediately following treatment. However, the CBT participants did have slightly lower levels of anxiety at the four month follow-up. These results suggest that a treatment approach that focuses on reducing anxiety as a means of diminishing motivation to drink may be most beneficial to people with both anxiety and AUD. Also, Kushner believes that neurobiological processes play a role in the outcome of treatment for this segment of the population and that future research should explore this factor in depth. “We envision that advances in our knowledge of treatment and prevention strategies for AUDs among those with anxiety disorders will be furthered by approaches that integrate both psychological and emerging neurobiological perspectives,” said Kushner.
Kushner, M. G., Maurer, E. W., Thuras, P., Donahue, C., Frye, B., Menary, K. R., Hobbs, J., Haeny, A. M., and Van Demark, J. (2012). Hybrid cognitive behavioral therapy versus relaxation training for co-occurring anxiety and alcohol disorder: A randomized clinical trial. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a003130
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