Situation-specific Prosocial Behaviors Predict Substance Use and Anxiety Symptoms in Psychiatric Disorders

Background. Deficits in social behaviors have been suggested as a promising treatment target for psychiatric disorders. While social context influences prosocial behavior in healthy individuals, its role in the development of psychiatric disorders remains unclear. We hypothesized that situation-specific prosocial behaviors would predict long-term psychiatric symptoms in individuals with common psychiatric disorders. Method. In a 1-year longitudinal cohort study (n = 4484 at baseline), we followed a population sample with self-reported psychiatric disorders to investigate if six situation-specific prosocial behavior subtypes were associated with and predictive of alcohol use, substance use, and symptoms of anxiety and depression. Prosocial behaviors were assessed at baseline, while psychiatric symptoms were measured at baseline and monthly. Multiple regression and latent class linear mixed models were used to identify associations and predictions.Results. Reduced anonymous prosociality at baseline was associated with (β = -.250, p = .007) and predictive of (β = -.025, p = .005) later alcohol use. Increased public prosociality was associated with (β = .226, p = .011) and predictive of later substance use (β = .024, p = .002), and increased emotional prosociality was associated with (β = 1.17, p < .001) and predictive of later anxiety symptoms (β = -.128, p < .001). No predictive effects were found for depressive symptoms.Conclusions. Situation-specific prosocial behaviors predict subsequent alcohol use, substance use, and anxiety symptoms in psychiatric disorders. Our findings suggest that prosocial subtypes may inform both risk and resilience factors and can guide prevention efforts and mental health treatments.