Adverse life events and the onset of anxiety disorders
- Authors: Miloyan, Beyon , Bienvenu, Oscar , Brilot, Ben , Eaton, William
- Date: 2018
- Type: Text , Journal article
- Relation: Psychiatry Research Vol. 259, no. (2018), p. 488-492
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- Description: This study tested the hypothesis that adverse events are associated with increased risk of onset of anxiety disorders. Data from Waves 1 (N = 43,093; 2001–2002) and 2 (N = 34,653; 2004–2005) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) were used to assess whether adverse events at baseline are associated with increased risk of anxiety disorder onset over three years of follow up. Sixty-six percent (SE: 1.0) of respondents with an anxiety disorder in the intervening period between Waves 1 and 2 had experienced an adverse life event in the year prior to the Wave 1 interview. In logistic regression models adjusted for sociodemographic and psychiatric characteristics, adverse life events at baseline were associated with anxiety disorder onset within the three-year follow up period. The pattern of association between adverse events and anxiety disorder onset was similar across sub-types, and injury, illness or death of family or close friends consistently had the strongest association with anxiety disorder onset. These findings suggest that adverse life events play a role in the onset of anxiety disorders.
An evolutionary perspective on the co-occurrence of social anxiety disorder and alcohol use disorder
- Authors: Bulley, Adam , Miloyan, Beyon , Brilot, Ben , Gullo, Matthew , Suddendorf, Thomas
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 196, no. (2016), p. 62-70
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- Description: Social Anxiety Disorder (SAD) commonly co-occurs with, and often precedes, Alcohol Use Disorder (AUD). In this paper, we address the relationship between SAD and AUD by considering how natural selection left socially anxious individuals vulnerable to alcohol use, and by addressing the underlying mechanisms. We review research suggesting that social anxiety has evolved for the regulation of behaviors involved in reducing the likelihood or consequences of threats to social status. The management of potential threats to social standing is important considering that these threats can result in reduced cooperation or ostracism - and therefore to reduced access to coalitional partners, resources or mates. Alcohol exerts effects upon evolutionarily conserved emotion circuits, and can down-regulate or block anxiety (or may be expected to do so). As such, the ingestion of alcohol can artificially signal the absence or successful management of social threats. In turn, alcohol use may be reinforced in socially anxious people because of this reduction in subjective malaise, and because it facilitates social behaviors - particularly in individuals for whom the persistent avoidance of social situations poses its own threat (i.e., difficulty finding mates). Although the frequent co-occurrence of SAD and AUD is associated with poorer treatment outcomes than either condition alone, a richer understanding of the biological and psychosocial drives underlying susceptibility to alcohol use among socially anxious individuals may improve the efficacy of therapeutic interventions aimed at preventing or treating this comorbidity. © 2016 Elsevier B.V. All rights reserved.