Clinical Research
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Year 2025, Volume: 7 Issue: 3, 730 - 7, 09.09.2025
https://doi.org/10.37990/medr.1734672

Abstract

References

  • Virtanen S, Kuja-Halkola R, Mataix-Cols D, et al. Comorbidity of substance misuse with anxiety-related and depressive disorders: a genetically informative population study of 3 million individuals in Sweden. Psychol Med. 2020;50:1706-15.
  • Villarosa-Hurlocker MC, Madson MB. A latent profile analysis of social anxiety and alcohol use among college students. Addict Behav. 2020;104:106284.
  • Single A, Bilevicius E, Ho V, et al. Cannabis use and social anxiety in young adulthood: a meta-analysis. Addict Behav. 2022;129:107275.
  • Giberson ER, Olthuis JV, Connell EM. Investigating the relation between anxiety sensitivity and substance use: what are the roles of social anxiety and outcome expectancies?. Subst Use Misuse. 2023;58:1634-42.
  • Stathopoulou G, Gold AK, Hoyt DL, et al. Does anxiety sensitivity predict addiction severity in opioid use disorder?. Addict Behav. 2021;112:106644.
  • Smit T, Rogers AH, Garey L, et al. Anxiety sensitivity and pain intensity independently predict opioid misuse and dependence in chronic pain patients. Psychiatry Res. 2020;294:113523.
  • Buckner JD, Morris PE, Abarno CN, et al. Biopsychosocial model social anxiety and substance use revised. Curr Psychiatry Rep. 2021;23:35.
  • Buckner JD, Bonn-Miller MO, Zvolensky MJ, Schmidt NB. Marijuana use motives and social anxiety among marijuana-using young adults. Addict Behav. 2007;32:2238-52.
  • Lovibond SH, Lovibond PF. Depression Anxiety Stress Scales (DASS--21, DASS--42) [Database record]. APA PsycTests. 1995. doi: 10.1037/t01004-000.
  • Yılmaz Ö, Boz H, Arslan A. The validity and reliability of Depression Stress And Anxiety Scale (dass21) Turkish short form. Finans Ekonomi ve Sosyal Araştırmalar Dergisi. 2017;2:78-91.
  • Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour research and therapy. 1986;24:1-8.
  • Ayvaşık HB. Kaygı duyarlığı indeksi: geçerlik ve güvenirlik çalışması. Türk Psikoloji Dergisi. 2000;15:43-57.
  • Berman AH, Bergman H, Palmstierna T, Schlyter F. Evaluation of the Drug Use Disorders Identification Test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample. Eur Addict Res. 2004;11:22-31.
  • Evren C, Ovali E, Karabulut V, Cetingok S. Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) in heroin dependent adults and adolescents with drug use disorder. Bulletin of Clinical Psychopharmacology. 2014;24:39-46.
  • Evren C, Ogel K, Evren B, Bozkurt M. Psychometric properties of the Turkish versions of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in the prison setting. J Psychoactive Drugs. 2014;46:140-6.
  • Kline RB. Principles and practice of structural equation modeling: Guilford publications, New York, 2023.
  • Stewart SH, Kushner MG. Introduction to the special issue on “Anxiety Sensitivity and Addictive Behaviors”. Addict Behav. 2001;26:775-85.
  • Comeau N, Stewart SH, Loba P. The relations of trait anxiety, anxiety sensitivity, and sensation seeking to adolescents' motivations for alcohol, cigarette, and marijuana use. Addict Behav. 2001;26:803-25.
  • Stewart SH, Pihl RO. Effects of alcohol administration on psychophysiological and subjective-emotional responses to aversive stimulation in anxiety-sensitive women. Psychology of Addictive Behaviors. 1994;8:29-42.
  • Conrod PJ, Pihl RO, Vassileva J. Differential sensitivity to alcohol reinforcement in groups of men at risk for distinct alcoholism subtypes. Alcohol Clin Exp Res. 1998;22:585-97.
  • Moe FD, Erga A, Bjornestad J, Dettweiler U. The interdependence of substance use, satisfaction with life, and psychological distress: a dynamic structural equation model analysis. Front Psychiatry. 2024;15:1288551.
  • Darharaj M, Hekmati I, Mohammad Ghezel Ayagh F, et al. Emotional dysregulation and craving in patients with substance use disorder: the mediating role of psychological distress. International Journal of Mental Health and Addiction. 2024;22:2997-3012.
  • Lemyre A, Gauthier-Légaré A, Bélanger RE. Shyness, social anxiety, social anxiety disorder, and substance use among normative adolescent populations: a systematic review. The American Journal of drug and alcohol abuse. 2019;45:230-47.
  • Baker TB, Piper ME, McCarthy DE, et al. Addiction motivation reformulated: an affective processing model of negative reinforcement. Psychol Rev. 2004;111:33-51.
  • Ray LA, Meredith LR, Kiluk BD, et al. Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: a systematic review and meta-analysis. JAMA Netw Open. 2020;3:e208279.
  • Witkiewitz K, Bowen S. Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. J Consult Clin Psychol. 2010;78:362-74.

Psychological Predictors of Addiction Severity in Substance Users: The Roles of Stress, Social Anxiety, and Anxiety Sensitivity

Year 2025, Volume: 7 Issue: 3, 730 - 7, 09.09.2025
https://doi.org/10.37990/medr.1734672

Abstract

Aim: This study investigated the relationships between social anxiety, anxiety sensitivity, general distress, and addiction severity in individuals undergoing treatment for substance use disorders.
Material and Method: A total of 145 participants diagnosed with substance use disorder were recruited from the Alcohol and Drug Treatment Center (AMATEM) of Ankara Training and Research Hospital.
Results: When examining the results of the current study, anxiety sensitivity and general distress were found to be significantly and positively correlated with addiction severity, whereas social anxiety was not significantly associated. Hierarchical regression analyses revealed that anxiety sensitivity initially predicted addiction severity; however, this effect diminished once general distress was included in the model, underscoring general distress as the stronger and more robust predictor.
Conclusion: These findings suggest that broad emotional distress—encompassing symptoms of depression, anxiety, and stress—may be more influential in driving substance use severity than the specific fear of anxiety-related sensations. The study also discussed theoretical models explaining anxiety sensitivity’s role in substance use through moderator and mediator mechanisms, but emphasized that general distress accounted for much of the variance related to addiction severity. Contrary to some previous literature, social anxiety did not contribute significantly, potentially due to the clinical nature of the sample and the treatment-seeking status of participants. The results highlight the importance of addressing transdiagnostic emotional vulnerabilities, particularly general distress, in substance use treatment. Interventions such as emotion regulation training, cognitive-behavioral therapy, and mindfulness-based approaches may be effective in reducing reliance on substances to cope with negative affective states. Overall, the study highlights the need for integrated treatment strategies targeting broad emotional difficulties to mitigate addiction severity.

Ethical Statement

The study protocol was approved by the Ankara Training and Research Hospital ethics committee (decision date and number: 17.04.2025, E-25-479), ensuring compliance with the principles outlined in the Declaration of Helsinki.

References

  • Virtanen S, Kuja-Halkola R, Mataix-Cols D, et al. Comorbidity of substance misuse with anxiety-related and depressive disorders: a genetically informative population study of 3 million individuals in Sweden. Psychol Med. 2020;50:1706-15.
  • Villarosa-Hurlocker MC, Madson MB. A latent profile analysis of social anxiety and alcohol use among college students. Addict Behav. 2020;104:106284.
  • Single A, Bilevicius E, Ho V, et al. Cannabis use and social anxiety in young adulthood: a meta-analysis. Addict Behav. 2022;129:107275.
  • Giberson ER, Olthuis JV, Connell EM. Investigating the relation between anxiety sensitivity and substance use: what are the roles of social anxiety and outcome expectancies?. Subst Use Misuse. 2023;58:1634-42.
  • Stathopoulou G, Gold AK, Hoyt DL, et al. Does anxiety sensitivity predict addiction severity in opioid use disorder?. Addict Behav. 2021;112:106644.
  • Smit T, Rogers AH, Garey L, et al. Anxiety sensitivity and pain intensity independently predict opioid misuse and dependence in chronic pain patients. Psychiatry Res. 2020;294:113523.
  • Buckner JD, Morris PE, Abarno CN, et al. Biopsychosocial model social anxiety and substance use revised. Curr Psychiatry Rep. 2021;23:35.
  • Buckner JD, Bonn-Miller MO, Zvolensky MJ, Schmidt NB. Marijuana use motives and social anxiety among marijuana-using young adults. Addict Behav. 2007;32:2238-52.
  • Lovibond SH, Lovibond PF. Depression Anxiety Stress Scales (DASS--21, DASS--42) [Database record]. APA PsycTests. 1995. doi: 10.1037/t01004-000.
  • Yılmaz Ö, Boz H, Arslan A. The validity and reliability of Depression Stress And Anxiety Scale (dass21) Turkish short form. Finans Ekonomi ve Sosyal Araştırmalar Dergisi. 2017;2:78-91.
  • Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour research and therapy. 1986;24:1-8.
  • Ayvaşık HB. Kaygı duyarlığı indeksi: geçerlik ve güvenirlik çalışması. Türk Psikoloji Dergisi. 2000;15:43-57.
  • Berman AH, Bergman H, Palmstierna T, Schlyter F. Evaluation of the Drug Use Disorders Identification Test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample. Eur Addict Res. 2004;11:22-31.
  • Evren C, Ovali E, Karabulut V, Cetingok S. Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) in heroin dependent adults and adolescents with drug use disorder. Bulletin of Clinical Psychopharmacology. 2014;24:39-46.
  • Evren C, Ogel K, Evren B, Bozkurt M. Psychometric properties of the Turkish versions of the Drug Use Disorders Identification Test (DUDIT) and the Drug Abuse Screening Test (DAST-10) in the prison setting. J Psychoactive Drugs. 2014;46:140-6.
  • Kline RB. Principles and practice of structural equation modeling: Guilford publications, New York, 2023.
  • Stewart SH, Kushner MG. Introduction to the special issue on “Anxiety Sensitivity and Addictive Behaviors”. Addict Behav. 2001;26:775-85.
  • Comeau N, Stewart SH, Loba P. The relations of trait anxiety, anxiety sensitivity, and sensation seeking to adolescents' motivations for alcohol, cigarette, and marijuana use. Addict Behav. 2001;26:803-25.
  • Stewart SH, Pihl RO. Effects of alcohol administration on psychophysiological and subjective-emotional responses to aversive stimulation in anxiety-sensitive women. Psychology of Addictive Behaviors. 1994;8:29-42.
  • Conrod PJ, Pihl RO, Vassileva J. Differential sensitivity to alcohol reinforcement in groups of men at risk for distinct alcoholism subtypes. Alcohol Clin Exp Res. 1998;22:585-97.
  • Moe FD, Erga A, Bjornestad J, Dettweiler U. The interdependence of substance use, satisfaction with life, and psychological distress: a dynamic structural equation model analysis. Front Psychiatry. 2024;15:1288551.
  • Darharaj M, Hekmati I, Mohammad Ghezel Ayagh F, et al. Emotional dysregulation and craving in patients with substance use disorder: the mediating role of psychological distress. International Journal of Mental Health and Addiction. 2024;22:2997-3012.
  • Lemyre A, Gauthier-Légaré A, Bélanger RE. Shyness, social anxiety, social anxiety disorder, and substance use among normative adolescent populations: a systematic review. The American Journal of drug and alcohol abuse. 2019;45:230-47.
  • Baker TB, Piper ME, McCarthy DE, et al. Addiction motivation reformulated: an affective processing model of negative reinforcement. Psychol Rev. 2004;111:33-51.
  • Ray LA, Meredith LR, Kiluk BD, et al. Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: a systematic review and meta-analysis. JAMA Netw Open. 2020;3:e208279.
  • Witkiewitz K, Bowen S. Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. J Consult Clin Psychol. 2010;78:362-74.
There are 26 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Original Articles
Authors

Kübra Sezer Katar 0000-0001-7184-7960

Publication Date September 9, 2025
Submission Date July 4, 2025
Acceptance Date July 25, 2025
Published in Issue Year 2025 Volume: 7 Issue: 3

Cite

AMA Sezer Katar K. Psychological Predictors of Addiction Severity in Substance Users: The Roles of Stress, Social Anxiety, and Anxiety Sensitivity. Med Records. September 2025;7(3):730-7. doi:10.37990/medr.1734672

17741

Chief Editors

MD, Professor. Zülal Öner
İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Düzce University, Department of Anatomy, Düzce, Türkiye

Editors
Assoc. Prof. Serkan Öner
İzmir Bakırçay University, Department of Radiology, İzmir, Türkiye
 
E-mail: medrecsjournal@gmail.com

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