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Explaining the association between anxiety disorders and alcohol use disorder: A twin study
Author(s) -
Torvik Fartein Ask,
Rosenström Tom Henrik,
Gustavson Kristin,
Ystrom Eivind,
Kendler Kenneth S.,
Bramness Jørgen G.,
Czajkowski Nikolai,
ReichbornKjennerud Ted
Publication year - 2019
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22886
Subject(s) - anxiety , alcohol use disorder , generalized anxiety disorder , clinical psychology , panic disorder , psychology , agoraphobia , anxiety disorder , psychiatry , specific phobia , psychological intervention , social anxiety , alcohol , biochemistry , chemistry
Background It is unknown whether social anxiety disorder (SAD) has a unique association with alcohol use disorder (AUD) over and beyond that of other anxiety disorders, how the associations develop over time, and whether the associations are likely to be causal. Methods Diagnoses of AUD, SAD, generalized anxiety disorder, panic disorder, agoraphobia, and specific phobias were assessed twice using the Composite International Diagnostic Interview among 2,801 adult Norwegian twins. The data were analyzed using logistic regression analyses and multivariate biometric structural equation modeling. Results SAD had the strongest association with AUD, and SAD predicted AUD over and above the effect of other anxiety disorders. In addition, SAD was prospectively associated with AUD, whereas other anxiety disorders were not. AUD was associated with a slightly elevated risk of later anxiety disorders other than SAD. Biometric modeling favored a model where SAD influenced AUD compared to models where the relationship was reversed or due to correlated risk factors. Positive associations between AUD and other anxiety disorders were fully explained by shared genetic risk factors. Conclusions Unlike other anxiety disorders, SAD plausibly has a direct effect on AUD. Interventions aimed at prevention or treatment of SAD may have an additional beneficial effect of preventing AUD, whereas interventions aimed at other anxiety disorders are unlikely to have a similar sequential effect on AUD.