In the Journals

Adolescents with social anxiety disorder, addiction benefit from treatment using service participation

Recent study findings suggest that addiction treatment that uses service participation has significant benefits for adolescents with social anxiety disorder, as they are more likely to partake and have reduced risk for relapse and incarceration 6 months post-treatment.

“Social instincts and developmental tasks during adolescence can intersect in ways that increase risk of [alcohol and other drug] use disorders. The need to fit in, the prominence of peers, establishing an identify independent of parents, and the tendency for drinking to organize social activities are forefront in this developmental stage,” study researcher Maria E. Pagano, PhD, of Case Western Reserve University, and colleagues wrote.

To examine how social anxiety disorder affected 12-step engagement patterns during treatment and treatment outcomes, researchers assessed data for 195 adolescents aged 14 to 18 years who were referred to residential treatment by court. Study participants met DSM-5 criteria for marijuana dependency or comorbid alcohol dependency. Data were from interviews, youth reports, clinician reports, medical chart review and electronic court records.

Forty-two percent of participants had a continual fear of being humiliated or scrutinized in social situations and 15% met diagnostic criteria for social anxiety disorder.

Social anxiety disorder was associated with a greater history of incarceration, lifetime use of heroin, polysubstance use and earlier age at first use.

The majority of study participants completed 2 months of treatment. Percentage of days abstinent significantly improved overall (P < .001), though 50% were abstinent throughout the treatment period.

Participation in the 12-step program significantly improved regarding meeting attendance (P < .001), peer-helping (P < .001) and the proportion of participants who had a sponsor at discharge (P < .001).

Study participants with social anxiety disorder had significantly higher levels of peer-helping and high helping compared with participants who did not have the disorder (43% vs. 30%; P < .05).

Six months after treatment, high helping was associated with a lower risk for incarceration post-treatment.

Study participants with social anxiety disorder and those who had high levels of high helping during treatment were less likely to relapse. This association may be due to a mediational effect of peer-helping.

“The low-intensity service activities in [Alcoholics Anonymous] offer youths — and those with [social anxiety disorder] in particular — a nonjudgmental, task-focused venue for social connectedness, reduce self-preoccupation and feeling like a misfit, and transform a troubled past into usefulness with others,” Pagano and colleagues wrote. “Given finite treatment resources and the reality that addiction is lifelong, [Alcoholics Anonymous-related helping] should be encouraged for socially anxious youths in particular.” – by Amanda Oldt

Disclosure: The study was partly funded by grants from the National Institute on Alcohol Abuse and Alcoholism. Please see the full study for a list of all other authors’ relevant financial disclosures.