Zaninotto, Francesca G. (2020) The effects of alcohol on cognitive processes related to social anxiety. (PhD thesis), Kingston University, .
Abstract
Social anxiety is generally characterised by the features of excessive fear of negative evaluation in social situations and it is often associated with alcohol use and misuse. Socially-anxious individuals may consider alcohol to be a confidence-enhancer and may use it as self-medication to alleviate anxiety symptoms arising during social situations. However, the relationship between social anxiety and alcohol use is not linear and it involves several cognitive processes. This thesis presents a series of studies investigating the relationship between social anxiety and the effects of alcohol. The aim was to explore the effects of alcohol on attentional and other cognitive processes, as well as individual characteristics, that might be important to better understand the complex relationship between social anxiety, cognition and alcohol use. First, the effects of alcohol on attention were tested in a non-clinical sample of high socially-anxious (HSA) and low socially-anxious (LSA) individuals’ by examining their eye movements using a series of eye tracking tasks. The first eye tracking task examined how alcohol influenced participants’ attention using a dot probe paradigm; the second and the third eye tracking tasks measured the influence of alcohol on involuntary (antisaccade task) and voluntary (prosaccade task) eye movements. The second set of tasks (4-5) investigated decision-making processes and attentional biases in a similar sample of HSA and LSA individuals under the effects of alcohol. Task 4 used a modified Iowa Gambling Task (IGT) paradigm to assess the effects of alcohol on participants’ decision-making processes under ambiguity; task 4 also used the “Game of Dice” (GDT) paradigm to measure the influence of alcohol on participants’ risk-taking behaviours during a non-ambiguous Task; task 5 consisted of a dot probe task to measure the effects of alcohol on participants’ attentional biases using a shorter stimulus presentation time than previously adopted. The final study was a survey comprising several questionnaires looking at the relationships between social anxiety and drinking behaviours, motives, attentional styles and mindfulness traits. Results 3 strongly indicated that HSA participants drink alcohol as a coping strategy and to regulate their negative emotions. The eye tracking tasks showed that alcohol influenced social anxiety by increasing vigilance via longer dwell times, especially when shown emotional faces (angry or happy) compared to neutral facial expressions. Overall, alcohol impaired reaction times, accuracy and speed; error rates increased in both groups, regardless of their levels of social anxiety. There was an effect of alcohol on decision-making in situations of risk under ambiguity when emotional content was shown (IGT) but not in a situation where risks were explicit and no emotional content was shown (GDT). On the IGT, HSA participants shifted from selecting fewer advantageous choices to selecting more advantageous choices after consuming alcohol compared with LSA participants. Finally, the survey showed that high levels of social anxiety and drinking-related behaviours are associated with lower mindfulness abilities. Overall, these findings demonstrate a complex interaction between alcohol use and social anxiety that is mediated by several cognitive factors, such as attention and decision-making processes. The findings imply an important role for cognitive processes in clinical interventions designed to address problematic alcohol use in social anxiety.
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