ArticleAlcohol, clinical & experimental research2023
Evidence for an alcohol-related "harm paradox" in individuals with internalizing disorders: Test and replication in two independent community samples.
Article in Alcohol, clinical & experimental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Comparing behavioral economic and internalizing symptom predictors of drinking trajectories over 3 years during emerging adulthood.Journal of psychopathology and clinical science · 2026Article
- Sociocultural factors influencing alcohol use among Korean immigrant women: A scoping review.PloS one · 2026Article
- Assessment of alcohol and tobacco use in psychotherapy: validation of the german self-report ASSIST alcohol and tobacco subscales in an outpatient setting.Addictive behaviors reports · 2025Article
- Shared Genetic Architecture and Neurobiological Pathways of Problematic Alcohol Use and Anxiety Disorders.medRxiv : the preprint server for health sciences · 2025Article
- Drinking to Cope is Uniquely Associated with Less Specific and Bleaker Future Goal Generation in Young Hazardous Drinkers.Journal of psychopathology and behavioral assessment · 2023Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundInternalizing (anxiety and mood) disorders (INTD) commonly co-occur (are "comorbid") with alcohol use disorder (AUD). The literature suggests that excessive alcohol use aimed at coping with INTD symptoms is, at best, a partial explanation for the high comorbidity rates observed. We hypothesized that individuals with INTD experience greater susceptibility to developing AUD symptoms due to the partially shared neurobiological dysfunctions underlying both conditions. We probe this hypothesis by testing the prediction that, after accounting for the volume of alcohol intake, individuals with INTD experience higher levels of alcohol-related symptoms.
methodsData from the National Epidemiological Survey on Alcohol-Related Conditions (NESARC) Wave 3 were used for the primary analyses, and NESARC Wave 1 data were used for independent replication analyses. Individuals who reported any alcohol use in the prior year were categorized as: (1) never having had an INTD diagnosis ("INTD-Never"); (2) having a remitted INTD diagnosis only ("INTD-Remitted"); or (3) having current INTD diagnosis ("INTD-Current"). Between-group contrasts of alcohol-related symptoms controlled for total alcohol intake (past year), drinking pattern (e.g., binging) and variables previously shown to mark exaggerated AUD symptoms relative to drinking amount (e.g., SES, gender, and family history).
resultsWith all covariates in the model, individuals in the INTD-Current group and the INTD-Remitted group reported significantly greater alcohol-related symptoms than those in the INTD-Never group but did not themselves differ in level of alcohol-related symptoms. These results were replicated in the NESARC 1 dataset.
conclusionsIndividuals with INTD experience more alcohol-related symptoms than those who drink at the same level. While considering other explanations, we argue that this "harm paradox" is best explained by the view that INTD confers a neurobiologically mediated susceptibility to the development of AUD symptoms.
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