BACKGROUND AND OBJECTIVES: Cognitive models of anxiety disorders view safety-seeking behaviors (i.e., avoidance, washing, etc.) as playing a crucial role in the maintenance of irrational fear. An explanation of how these behaviors may contribute to the maintenance of unrealistic beliefs is that patients use their safety behaviors as a source of information about the situation (behavior as information): the behavior is clear evidence of the danger. This study investigates whether, relative to non-clinical control participants, anxious participants actually infer danger on the basis of their safety behaviors, rather than on the basis of objective information. METHODS: Three groups of individuals affected by anxiety disorders (31 obsessive-compulsive participants, 22 panic participants, and 17 participants with social phobia) and a group (31) of non-clinical controls rated the danger perceived in scripts in which information about objective safety vs. objective danger, and safety behavior vs. no-safety behavior were systematically varied. RESULTS: As expected, anxious participants were influenced by both objective danger information and safety behavior information, while the non-clinical controls were mainly influenced by objective danger but not by safety behavior information. The effect was disturbance specific, but only for individuals with social phobia and obsessive-compulsive disorder. CONCLUSIONS: The tendency to infer danger on the basis of the use of safety behavior may play a role in the development and maintenance of anxiety disorders.
BACKGROUND AND OBJECTIVES: Cognitive models of anxiety disorders view safety-seeking behaviors (i.e., avoidance, washing, etc.) as playing a crucial role in the maintenance of irrational fear. An explanation of how these behaviors may contribute to the maintenance of unrealistic beliefs is that patients use their safety behaviors as a source of information about the situation (behavior as information): the behavior is clear evidence of the danger. This study investigates whether, relative to non-clinical control participants, anxious participants actually infer danger on the basis of their safety behaviors, rather than on the basis of objective information. METHODS: Three groups of individuals affected by anxiety disorders (31 obsessive-compulsiveparticipants, 22 panic participants, and 17 participants with social phobia) and a group (31) of non-clinical controls rated the danger perceived in scripts in which information about objective safety vs. objective danger, and safety behavior vs. no-safety behavior were systematically varied. RESULTS: As expected, anxious participants were influenced by both objective danger information and safety behavior information, while the non-clinical controls were mainly influenced by objective danger but not by safety behavior information. The effect was disturbance specific, but only for individuals with social phobia and obsessive-compulsive disorder. CONCLUSIONS: The tendency to infer danger on the basis of the use of safety behavior may play a role in the development and maintenance of anxiety disorders.
Authors: Youssef Shiban; Julia Diemer; Jana Müller; Johanna Brütting-Schick; Paul Pauli; Andreas Mühlberger Journal: BMC Psychiatry Date: 2017-01-18 Impact factor: 3.630