PubMed · 10171679
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S P Kaplan. Through the labyrinth.. https://pubmed.ncbi.nlm.nih.gov/10171679/
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Individuals with social phobia are at an increased risk for alcohol problems. Individuals with social phobia could increase their risk for pathological alcohol use if they drink as a means of coping with anxiety-provoking social situations. Providing a circumscribed test of this view, we evaluate the effect of alcohol on the intensity of social phobia anxiety responses. Sixty-one individuals with social phobia gave two speech challenges in front of a group ('social anxiety challenge'), one occurring before and one after they consumed either: (a) an alcoholic drink they were told contained alcohol ('alcohol group'), (b) a non-alcoholic drink they were told contained alcohol ('placebo group'), or, (c) a non-alcoholic drink they were told contained no alcohol ('control group'). Both the alcohol group and the placebo group showed greater reduction in performance anxiety from the first to the second speech challenge than did the control group. Further, there was a strong trend in the data for the alcohol group to show greater reduction in performance anxiety from the first to the second speech challenge than did the placebo group. We concluded from these findings that the pharmacologic effects of alcohol and the belief that one consumed alcohol decrease social performance anxiety in an additive fashion. These results provide direct support for the negatively reinforcing properties of alcohol and are consistent with the view that symptom reduction may motivate alcohol use among socially phobic individuals.
Despite the frequency with which physicians encounter bereaved patients, medical training offers little guidance in the provision of bereavement ("after") care. Physicians are often uncertain of how to distinguish between normal and pathological grief reactions in their bereaved patients, and how to manage their health care. Bereavement is associated with declines in health, inappropriate health service use, and increased risk of death. Identifying and intervening on behalf of bereaved patients could help address those increased risks. We examine the experience of a woman widowed for 2 years to illustrate distinctions between symptoms and outcomes of uncomplicated and complicated grief, recommend approaches to physician interactions with bereaved patients, and offer guidelines for professional intervention in aftercare.
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