Biopsychosocial Model Social Anxiety and Substance Use Revised

Curr Psychiatry Rep. 2021 Apr 17;23(6):35. doi: 10.1007/s11920-021-01249-5.


Purpose of review: To review data published in the past 5 years to evaluate the utility of our biopsychosocial model of social anxiety's relation to substance misuse to evaluate the model's utility and update it.

Recent findings: Data support the utility of our revised model-e.g., socially anxious persons report using substances to manage subjective anxiety, despite evidence that some substances may not have a direct effect on physiological responding. Other factors with promise include social influence, cognitive processes (e.g., post-event processing), and avoidance. Data highlight the importance of context as socially anxious persons use some substances more in some high-risk situations, despite lack of relation between social anxiety and use generally. Sociocultural factors remain understudied. This updated model is a theory- and data-driven model of the relations between social anxiety and substance misuse that can inform future work to improve substance-related outcomes among this especially vulnerable group.

Keywords: Alcohol; Biopsychosocial approach; Cannabis; Social anxiety; Substance use disorder.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Anxiety
  • Anxiety Disorders
  • Humans
  • Models, Biopsychosocial*
  • Substance-Related Disorders* / epidemiology