Evidence for a Shared Vulnerability to Both Anxiety/Depression ("Internalizing") Disorder and Alcohol-Related...

Theory and evidence indicate that some of the key dysregulations in the brain's stress and mood systems induced by substance use and resulting in addiction are also evident in those with anxiety and depression ("internalizing") disorder (INTD). Based on this, we hypothesized that those with INTD develop alcohol-related symptoms with greater neurobiological efficiency (i.e., with less alcohol use) than others. In support of this hypothesis, we reported earlier that, after controlling for level of alcohol use, drinkers with a current INTD experience a greater number of alcohol-related symptoms than those without INTD. However, the cross-sectional design employed in that study circumscribed the conclusions that could be drawn concerning our hypothesis. The present study extends the earlier work in a prospective nationally representative dataset.

Using the NESARC waves 1 and 2 datasets (the same individuals assessed approximately 3 years apart), we evaluated the association of INTD status at both waves to alcohol symptom count at wave 1, while controlling typical daily drinking level and other relevant demographic and clinical variables.

Those with INTD at wave 2 but not at or before wave 1 experienced more alcohol-related symptoms relative to their drinking level at wave 1 than did those who did not have INTD at either wave. The magnitude of this effect was greater when INTD was also present at wave 1.

These findings are consistent with a shared vulnerability for the development of INTD and alcohol-related problems, which may, in part, account for their common co-occurrence.