Descriptive statistics and correlations between the variables
Before conducting structural equation modeling analyses, we administered descriptive statistics and correlation analysis between the variables.
Among the participants, approximately 25% scored higher than the clinical cut-off scores of the Korean version of the SIAS and the SPS, respectively. Also, 22.6% of the total participants scored higher than the clinical cut-off score of the Korean version of the AUDIT (Table 1).
Table 2. Descriptive statistics and correlations of the variables
|
SIAS
|
SPS
|
FNE
|
Social
avoidance
|
Concerns over physiological symptoms
|
DERS
|
DMQ-R
|
Conformity motives
|
Coping motives
|
AUDIT
|
Alcohol related problems
|
SIAS
|
1
|
|
|
|
|
|
|
|
|
|
|
SPS
|
.76**
|
1
|
|
|
|
|
|
|
|
|
|
FNE
|
.65**
|
.64**
|
1
|
|
|
|
|
|
|
|
|
Social avoidance
|
.73**
|
.63**
|
.49**
|
1
|
|
|
|
|
|
|
|
Concerns over physiological symptoms
|
.56**
|
.57**
|
.61**
|
.48**
|
1
|
|
|
|
|
|
|
DERS
|
.55**
|
.46**
|
.50**
|
.47**
|
.45**
|
1
|
|
|
|
|
|
DMQ-R
|
.06
|
.14**
|
.20**
|
.06
|
.22**
|
.22**
|
1
|
|
|
|
|
Conformity motives
|
.22**
|
.22**
|
.29**
|
.16**
|
.25**
|
.27**
|
.56**
|
1
|
|
|
|
Coping motives
|
.13**
|
.15**
|
.21**
|
.11**
|
.26**
|
.32**
|
.66**
|
.27**
|
1
|
|
|
AUDIT
|
-.08*
|
.01
|
-.01
|
-.08*
|
.06
|
.07
|
.48**
|
.24**
|
.35**
|
1
|
|
Alcohol related problems
|
.03
|
.11**
|
.06
|
.02
|
.15**
|
.17**
|
.39**
|
.25**
|
.35**
|
.90**
|
1
|
M
|
29.40
|
19.22
|
35.49
|
20.54
|
7.02
|
81.01
|
46.01
|
4.51
|
7.83
|
8.39
|
2.81
|
SD
|
14.66
|
13.72
|
8.32
|
10.45
|
5.08
|
20.15
|
14.21
|
2.04
|
3.82
|
5.88
|
3.70
|
Skew
|
0.29
|
0.91
|
-0.15
|
0.29
|
-0.03
|
0.51
|
0.21
|
1.65
|
1.03
|
1.00
|
2.03
|
Kurtosis
|
-0.48
|
0.82
|
-0.57
|
-0.42
|
0.71
|
0.20
|
-0.14
|
2.56
|
0.53
|
1.35
|
5.27
|
Note. SIAS: Social Interaction Anxiety Scale, SPS: Social Phobia Scale; FNE: Fear of Negative Evaluation Scale; DERS: Difficulties in Emotion Regulation Scale; DMQ-R: Drinking Motives Questionnaire-Revised; AUDIT: Alcohol Use Disorders Identification Test.
* p < .05. ** p < .01.
|
The SIAS and SPS had positive correlations with fear of negative evaluation, social avoidance, concerns over physiological symptoms and DERS. The SIAS and SPS were positively correlated with conformity motives and coping motives. However, SIAS showed a negative correlation with the total score of the AUDIT. SPS did not show a significant relationship with the total score of the AUDIT, r = .01, p = .86. The SIAS did not show significant correlation with alcohol related problems, r = .03, p = .49, while the SPS had a positive correlation with alcohol related problems. The fear of negative evaluation, social avoidance, concerns over physiological symptoms and DERS had positive correlations with conformity motives and coping motives. Alcohol related problems did not show significant correlations with either fear of negative evaluation or social avoidance, all ps > .05. While concerns over physiological symptoms and DERS showed positive correlations with alcohol related problems.
Before we began the analysis of structural equation modeling, skew and kurtosis of each variable were inspected to test the normality. Results revealed that all variables were normally distributed (skew ≤ 3.0; Kurtosis ≤ 10) [54]. Refer to Table 2.
Relationship between social anxiety and alcohol-related problems: Mediational effect of cognitive-behavioral-physiological characteristics of social anxiety and coping and conformity motives moderated by difficulties in emotion regulation
We examine the moderated mediational effects of the clinical characteristics of social anxiety and coping and conformity motives in the relationship between social anxiety and alcohol related problems, based on the biopsychosocial model of SAD and substance use disorders [9] (Buckner et al., 2013). In our research model, the clinical characteristics of social anxiety: fear of negative evaluation, social avoidance and concerns over physiological symptoms were hypothesized to predict alcohol related problems with the mediation of coping and conformity motives. Furthermore, we supposed that difficulties in emotion regulation would moderate the relationship between cognitive-behavioral-physiological characteristics of social anxiety and coping and conformity motives.
Mediation model analysis
Among the research variables in the study, the fear of negative evaluation, social avoidance, and difficulties in emotion regulation were made into latent variables via item parcelling [55].
Results from the mediation model analysis showed that the research model fits our data well, χ2 (234, N = 647) = 581.313, TLI = .953, CFI = .960, RMSEA = .048 (90% CI = .043 - .053). Social anxiety was positively correlated with the fear of negative evaluation, social avoidance and concerns over physiological symptoms. The fear of negative evaluation predicted conformity motives, while the path from fear of negative evaluation to coping motives was not significant. Social avoidance did not significantly predict conformity motives and coping motives. Concerns over physiological symptoms positively predicted coping motives. However, it did not significantly predict conformity motives. Both conformity motives and coping motives positively predicted alcohol related problems. Meanwhile, a direct path from social anxiety to alcohol related problems was not significant. In addition, direct paths from social anxiety to conformity motives and coping motives were not significant, respectively. For the details, refer to Figure 3.
Considered collectively, results from mediation analysis suggest that social anxiety does not directly predict alcohol related problems, but it indirectly predicts alcohol related problems. Social anxiety predicts coping and conformity motives via the mediation of cognitive and physiological symptoms. In turn, cognitive and physiological symptoms of social anxiety predict alcohol related problems with the mediation of coping and conformity motives.
To examine the significance of indirect effects of social anxiety, bootstrapping was conducted according to the suggestions of Shrout and Bolger [56]. The indirect effects were estimated from 10,000 samples that were randomly drawn from the raw data and were tested in the 95% confidence interval. Results showed that direct effect of social anxiety on alcohol related problems was not significant, while the indirect effect was significant. The indirect effect of concerns over physiological symptoms on alcohol related problems was significant. Also, the indirect effect of fear of negative evaluation on alcohol related problems was significant. However, social avoidance did not show a significant direct effect on either conformity motives or coping motives. It also did not show a significant indirect effect on alcohol related problems. Direct, indirect and total effects are presented in Table 3.
Table 3. Direct, indirect and total effects between variables in the mediation model
Path
|
Direct effect
|
Indirect effect
(confidence Interval)
|
Total effect
|
Social anxiety → Social avoidance
|
.82***
|
-
|
.82***
|
Social anxiety → Concerns over physiological symptoms
|
.69***
|
-
|
.69***
|
Social anxiety → Fear of negative evaluation
|
.77***
|
-
|
.77***
|
Social anxiety → Coping motives
|
-.16
|
.33( .05-.63)
|
.17**
|
Social anxiety → Conformity motives
|
.08
|
.23(-.08-.53)
|
.31***
|
Social avoidance → Coping motives
|
.05
|
-
|
.05
|
Social avoidance → Conformity motives
|
-.05
|
-
|
-.05
|
Concerns over physiological symptoms → Coping motives
|
.24**
|
-
|
.24**
|
Concerns over physiological symptoms → Conformity motives
|
.12
|
-
|
.12
|
Fear of negative evaluation → Coping motives
|
.16
|
-
|
.16
|
Fear of negative evaluation → Conformity motives
|
.24*
|
-
|
.24*
|
Social anxiety → Alcohol related problems
|
-.07
|
.13( .07-.20)
|
.06
|
Social avoidance → Alcohol related problems
|
-
|
.01(-.11-.11)
|
.01
|
Concerns over physiological symptoms → Alcohol related problems
|
-
|
.11( .04-.20)
|
.11**
|
Fear of negative evaluation → Alcohol related problems
|
-
|
.11( .01-.22)
|
.11*
|
Coping motives → Alcohol related problems
|
.34***
|
-
|
.34***
|
Conformity motives → Alcohol related problems
|
.23**
|
-
|
.23**
|
* p < .05. ** p < .01. *** p < .001.
|
Moderated model analysis
We tested moderated models under the suggestions of Preacher et al.[51]. We examined the moderation effect of difficulties in emotion regulation on 1) the path between fear of negative evaluation and conformity motives and 2) the path between concerns over physiological symptoms and coping motives. Ping’s method [57] was applied to test the significance of the model fit and moderation effects.
Results showed a good model fit to the data. The model fit of the moderation model of difficulties in emotion regulation on the relationship between fear of negative evaluation and conformity motives (moderation model 1) was good, χ2 (39, N = 647) = 102.999, TLI = .977, CFI = .984, RMSEA = .050 (90% CI = .039 -.062). A direct path from the interaction variable (fear of negative evaluation x difficulties in emotion regulation) to conformity motives was also significant, β = .06, p < .01. In addition, the moderation model of difficulties in emotion regulation on the relationship between concerns over physiological symptoms and coping motives (moderation model 2) fits the data well, χ2 (35, N = 647) = 266.024, TLI = .959, CFI = .967, RMSEA = .057 (90% CI= .050 - .065). Also, a direct path from the interaction variable (concerns over physiological symptoms x difficulties in emotion regulation) to coping motives was significant, β = .12, p < .01.
To further examine the moderation effect of difficulties in emotion regulation, we divided participants into two groups: a high difficulties in emotion regulation group (+1 SD above the mean) and a low difficulties in emotion regulation group (-1 SD below the mean). Results supported that the level of difficulties in emotion regulation moderated the effect of fear of negative evaluation on conformity motives and the effect of concerns over physiological symptoms on coping motives, respectively. See Figure 4.
The high difficulties in emotion regulation group showed a larger moderation effect in the relationship between the fear of negative evaluation and conformity motives compared to the low difficulties in emotion regulation group, respectively, b = .07, p < .001, b = .03, p < .05. Also, the high difficulties in emotion regulation group showed a significant relationship between concerns over physiological symptoms and coping motives, b = .15, p < .001. While the low difficulties in emotion regulation group did not show a significant relationship between concerns over physiological symptoms and coping motives, b = .03, p > .05.
Moderated mediation model analysis
Lastly, we analyzed a moderated mediation model that included two interaction terms (fear of negative evaluation x difficulties in emotion regulation, concerns over physiological symptoms x difficulties in emotion regulation). The moderated mediation model fits the data well, χ2 (370, N = 647) = 1247.499, TLI = .913, CFI = .926, RMSEA = .061(90% CI = .057 - .064). See figure 5 for details.
We examined whether difficulties in emotion regulation moderate 1) the indirect effect of fear of negative evaluation on alcohol related problems via conformity motives, 2) the indirect effect of concerns over physiological symptoms on alcohol related problems via coping motives when using the bootstrapping method. Results showed that the indirect path from the interaction term of fear of negative evaluation and difficulties in emotion regulation to alcohol related problems with the mediation of conformity motives was significant. Also, the indirect path from the interaction term of concerns over physiological symptoms and difficulties in emotion regulation to alcohol related problems with the mediation of coping motives was significant. Refer to Table 4.
Table 4. Direct, indirect and total effects of variables in the moderated mediation model
Path
|
Direct Path
|
Indirect Path
(Confidential Interval)
|
Total Effect
|
Social anxiety → Difficulties in emotion regulation
|
.59***
|
-
|
.59***
|
Social anxiety → Social avoidance
|
.82***
|
-
|
.82***
|
Social anxiety → Concerns over physiological symptoms
|
.68***
|
-
|
.68***
|
Social anxiety → Fear of negative evaluation
|
.77***
|
-
|
.77***
|
Social anxiety → Coping motives
|
-.29*
|
.44(-.18-.72)
|
.15**
|
Social anxiety → Conformity motives
|
-.01
|
.30(-.01-.61)
|
.29***
|
Difficulties in emotion regulation * Concerns over physiological symptoms → Coping motives
|
.09*
|
-
|
.09*
|
Fear of negative evaluation * Difficulties in emotion regulation → Conformity motives
|
.14*
|
-
|
.14*
|
Difficulties in emotion regulation → Coping motives
|
.33***
|
-
|
.33***
|
Difficulties in emotion regulation → Conformity motives
|
.16*
|
-
|
.16*
|
Social avoidance → Coping motives
|
.03
|
-
|
-.03
|
Social avoidance → Conformity motives
|
-.06
|
-
|
-.06
|
Concerns over physiological symptoms → Coping motives
|
.17*
|
-
|
.17*
|
Concerns over physiological symptoms → Conformity motives
|
.09
|
-
|
.09
|
Fear of negative evaluation → Coping motives
|
.13
|
-
|
.13
|
Fear of negative evaluation → Conformity motives
|
.26*
|
-
|
.26*
|
Social anxiety → Alcohol related problems
|
-.11
|
.16( .08-.25)
|
.05
|
Concerns over physiological symptoms * Difficulties in emotion regulation → Alcohol related problems
|
-
|
.03( .00-.07)
|
.03*
|
Fear of negative evaluation * Difficulties in emotion regulation → Alcohol related problems
|
-
|
.03( .01-.08)
|
.03*
|
Difficulties in emotion regulation → Alcohol related problems
|
.08
|
.14( .09-.21)
|
.22**
|
Social avoidance → Alcohol related problems
|
-
|
-.00(-.11-.09)
|
-.00
|
Concerns over physiological symptoms → Alcohol related problems
|
-
|
.08( .01-.16)
|
.08*
|
Fear of negative evaluation → Alcohol related problems
|
-
|
.10( .00-.21)
|
.10*
|
Coping motives → Alcohol related problems
|
.33***
|
-
|
.33***
|
Conformity motives → Alcohol related problems
|
.22**
|
-
|
.22**
|
* p < .05. ** p < .01. *** p < .001.
|
|
|
|