Risky Alcohol Use in Individuals With Anxiety Disorders: Relationships and Predictors Based on Early Maladaptive Schemas and Attachment Styles

BACKGROUND AND AIM: This study aims to evaluate the differences between the groups with and without risky alcohol use (RAU) in terms of sociodemographic characteristics, anxiety level, adult attachment styles (AASs) and early maladaptive schemas (EMSs) in individuals diagnosed with anxiety disorders (ADs). Furthermore, we aim to investigate whether RAU in individuals with ADs can be predicted by EMS or AAS. METHODS: In this prospective study, a total of 128 individuals diagnosed with ADs were divided into two groups based on the Michigan Alcoholism Screening Test (MAST) cut-off score (≥ 5). Scores from the Adult Attachment Style Scale, Young Schema Questionnaire and Beck Anxiety Inventory (BAI), as well as demographic and clinical variables, were analysed. RESULTS: The RAU group showed higher rates of suicide history and higher scores on the abandonment and unrelenting standards (US) schemas. Higher scores on abandonment and US schemas were associated with a greater likelihood of RAU. MAST scores positively correlated with emotional deprivation, failure to achieve, pessimism, social isolation, AS, dependence, abandonment, vulnerability schema scores and BAI scores in individuals with RAU. Hierarchical regression showed that attachment and schema subscales accounted for 42% of the variance in MAST scores. The higher scores on emotional inhibition, defectiveness, vulnerability schemas and anxious attachment style significantly predicted MAST scores. CONCLUSION: These findings support the theoretical basis for attachment-based and schema therapy-based interventions, highlighting the importance of assessing especially abandonment, US, defectiveness, vulnerability schemas and anxious attachment style.