Anxiety Disorders

Compared to depressive disorder, it is usually easier to determine whether or not an anxiety disorder is independent of alcohol use. For example, posttrau-matic stress disorder (PTSD) does require a specific traumatic event. Panic attacks are typically clearly recalled by individuals and are therefore easier to separate from possible anxiety symptoms that have resulted from alcohol use, intoxication, or withdrawal. There is a strong comorbidity between alcohol use disorders and anxiety disorders; nearly 37% of individuals with alcohol dependence have met criteria for an anxiety disorder during the previous year. Generalized anxiety disorder accounts for 11.6%, panic disorder for 3.9%, and PTSD for 7.7%. Another way to appreciate these comorbidities is that the alcohol-dependent person is 4.6 times more likely to have generalized anxiety disorder, 2.2 times more likely to have PTSD, and 1.7 times more likely to have panic disorder than the non-alcoholic-dependent individual. The prevalence of social anxiety disorder has been found to range from 2 to 13%, with the latter figure determined through the NCS. Typically, social anxiety disorder (social phobia) is present before the development of an alcohol use disorder, because individuals with social phobia are typically shy or behaviorally inhibited as small children. Conservative estimates of co-occurring social anxiety disorder and alcohol use disorders indicate that 15% of people receiving alcoholism treatment have both disorders, and 20% of patients seeking treatment for social anxiety disorder also have a comorbid alcohol use disorder (Randall, Thomas, & Thevos, 2001). Generally, anxiety disorders develop prior to an alcohol use disorder, and alcohol is typically seen to achieve, at least briefly, tension reduction.

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