Mindfulness training for clinically elevated social anxiety: The impact on peak drinking

Social anxiety is related to more drinking in high-risk drinking situations and to more drinking-related problems. Given the rise in mindfulness-based interventions for social anxiety, it is important to test whether drinking impacts outcomes among individuals with clinically elevated social anxiety. Undergraduates with clinically elevated social anxiety were randomly assigned to mindfulness training (n = 29) or thinking-as-usual control (n = 29). They were encouraged to practice mindfulness or thinking-as-usual in response to social events daily for two-weeks following baseline. Follow-up measures were completed one month post-baseline. The interaction of baseline peak estimated blood alcohol content (eBAC) X condition predicted one-month follow-up peak eBAC such that among those with greater (but not lower) baseline eBAC, mindfulness was related to lower follow-up eBAC compared to control. Similarly, mindfulness training resulted in less post-training anxiety among those with greater (but not lower) baseline eBAC. However, this effect was not evident during a two-week practice period nor at one-month follow-up. Rather, at one-month follow-up, the interaction of baseline eBAC X condition predicted follow-up mindfulness (non-reactivity); among those with higher (but not lower) baseline eBAC, mindfulness training was associated with less follow-up mindfulness than the control condition. Results indicate that among those with greater baseline peak eBAC, mindfulness practice resulted in lower follow-up eBAC compared to control among those with clinically elevated social anxiety. However, although mindfulness training may result in less anxiety in the short-term among heavy drinkers with social anxiety, this effect did not last longer-term. Rather, heavier drinkers evinced poorer longer-term mindfulness-related outcomes.