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.