The Relationship Between Social Anxiety and Alcohol and Marijuana Use Outcomes Among Concurrent Users: A Motivational Model of Substance Use

Background College students with more social anxiety symptoms are particularly vulnerable to problematic alcohol and marijuana use given their susceptibility for elevated anxiety symptoms in social settings combined with the normative nature of substance use. Existing research has established substance use as coping motivated for these students when examining alcohol and marijuana use problems separately. The next step is to determine whether students with more social anxiety who use both substances do so for similar or different reasons. The current study tested a comprehensive (i.e., all variables in the same model) motivational model of alcohol/marijuana use in a sample of college students from 10 universities across the United States who endorsed both past-month alcohol and marijuana use. Methods College students were recruited through psychology department participant pools and completed an online survey assessing mental health symptoms, substance use motives, and substances use behaviors. Current sample comprised concurrent alcohol/marijuana users (n = 2,034), 29.6% of whom endorsed clinically indicated levels of social anxiety and nearly one-fourth exceeded the cutoff for hazardous drinking (23.2%) and hazardous marijuana use (21.9%). Results Across both substances, coping motives significantly mediated the positive relationship between social anxiety symptoms and substance use problems. Unique to alcohol, conformity motives mediated the association between social anxiety symptoms and alcohol-related problems. Conclusions Taken together, students with more social anxiety who are focused on anxiety management may use either alcohol or marijuana; however, these students may experience more alcohol-related problems when drinking to fit in with peers.