Psychological Predictors of Addiction Severity in Substance Users: The Roles of Stress, Social Anxiety, and Anxiety Sensitivity

Aim: This study investigated the relationships between social anxiety, anxiety sensitivity, general distress, and addiction severity in individuals undergoing treatment for substance use disorders. Material and Method: A total of 145 participants diagnosed with substance use disorder were recruited from the Alcohol and Drug Treatment Center (AMATEM) of Ankara Training and Research Hospital. Results: When examining the results of the current study, anxiety sensitivity and general distress were found to be significantly and positively correlated with addiction severity, whereas social anxiety was not significantly associated. Hierarchical regression analyses revealed that anxiety sensitivity initially predicted addiction severity; however, this effect diminished once general distress was included in the model, underscoring general distress as the stronger and more robust predictor. Conclusion: These findings suggest that broad emotional distress—encompassing symptoms of depression, anxiety, and stress—may be more influential in driving substance use severity than the specific fear of anxiety-related sensations. The study also discussed theoretical models explaining anxiety sensitivity’s role in substance use through moderator and mediator mechanisms, but emphasized that general distress accounted for much of the variance related to addiction severity. Contrary to some previous literature, social anxiety did not contribute significantly, potentially due to the clinical nature of the sample and the treatment-seeking status of participants. The results highlight the importance of addressing transdiagnostic emotional vulnerabilities, particularly general distress, in substance use treatment. Interventions such as emotion regulation training, cognitive-behavioral therapy, and mindfulness-based approaches may be effective in reducing reliance on substances to cope with negative affective states. Overall, the study highlights the need for integrated treatment strategies targeting broad emotional difficulties to mitigate addiction severity.