Cited by 548Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and AssessmentsPsychotherapy Techniques and Applications

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Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs

Wells, Adrian, Clark, David M., Salkovskis, Paul, Ludgate, John, Hackmann, Ann, Gelder, Michael·1995·Behavior Therapy

DOI 10.1016/s0005-7894(05)80088-7

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“Exposure interventions with specific instructions to abandon safety behaviours have been found to be more efficacious than exposure therapy without instructions to refrain from such behaviours (Wells et al., 1995).”
Background
A cognitive perspective in social phobia
Clark, D. M. (1997) · Biological Psychiatry · doi:10.1016/s0006-3223(97)87445-8 · Cited by 36
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“An important reason why SAD is maintained in the presence of repeated exposure to social cues is because individuals with SAD engage in a variety of avoidance and safety behaviors to reduce the risk of rejection (e.g.,Wells et al., 1995).”
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Prognostic indices with brief and standard CBT for panic disorder: I. Predictors of outcome
Dow, M., Kenardy, J., Johnston, D., Newman, M. G., Taylor, C., & Thomson, A. (2007) · Psychological Medicine · doi:10.1017/s0033291707000670 · Cited by 29
“Moreover, the presence of safety cues during situational and interoceptive exposure and drug-related attributions of improvement may have impaired adaptive cognitive reappraisal (Basoglu et al. 1994; Wells et al. 1995; Otto & Gould, 1996).”
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The effect of distraction on within-session anxiety reduction during brief in vivo exposure for mild blood-injection fears
Penfold, K., & Page, A. C. (1999) · Behavior Therapy · doi:10.1016/s0005-7894(99)80028-8 · Cited by 33
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“As a result, socially anxious individuals engage in avoidance and safety behaviour, preventing opportunities in which the negative beliefs can be disconﬁrmed (Wells et al. 1995).”
Behavior as information about threat in anxiety disorders: A comparison of patients with anxiety disorders and non-anxious controls
van den Hout, M., Gangemi, A., Mancini, F., Engelhard, I. M., Rijkeboer, M. M., van Dams, M., & Klugkist, I. G. (2014) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2014.07.002 · Cited by 31
“That is, the absence of a negative outcome after confrontation with the feared stimulus may be attributed to the positive effects of the safety behavior rather than to the stimulus being innocuous (Wells et al., 1995).”
Background
Speech and Anxiety Management With Persistent Stuttering: Current Status and Essential Research
Lowe, R., Menzies, R. G., Onslow, M., Packman, A., & O’Brian, S. (2021) · Journal of Speech Language and Hearing Research · doi:10.1044/2020_jslhr-20-00144 · Cited by 41
“With social anxiety disorder, a common safety behavior is avoidance, for example, avoiding eye contact with others, avoiding situations, or talking to specific people (Clark & Wells, 1995; Marks, 1969; Ohman, 1986; Wells & Clark, 1997; Wells et al., 1995).”
BackgroundMethod
The relationship between the maladaptive self-beliefs characteristic of social anxiety and avoidance
Wong, Q. J. J., & Moulds, M. L. (2010) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2010.11.004 · Cited by 31
“In addition, there is evidence that individuals diagnosed with social phobia engage in more subtle forms of avoidance of a feared consequence (typically negative evaluation) by performing within-situation safety behaviours (Cuming et al., 2009; Wells et al., 1995).”
Background
Appearing Socially Competent: The Effects of a Friend's Presence on the Socially Anxious
Pontari, B. A. (2008) · Personality and Social Psychology Bulletin · doi:10.1177/0146167208328063 · Cited by 31
“…they expect to incur, people high in social anxiety utilize self-presentation strategies that are protective (Arkin, 1981; Laux & Weber, 1991; Renner, Laux, Schütz, & Tedeschi, 2004; Shepperd & Arkin, 1990; Wolfe, Lennox, & Cutler, 1986) or “safe” (e.g., Clark & Wells, 1995; Wells et al., 1995).”
Background
An exploration of the relationship between use of safety‐seeking behaviours and psychosis: A systematic review and meta‐analysis
Tully, S., Adrian Wells, A., & Morrison, A. P. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2099 · Cited by 31
“(1996) showed that one session of exposure coupled with decreasing safety behaviours produced greater reductions in anxiety and negative beliefs than one session of exposure alone (Wells et al., 1996).”
Background
Social anxiety and cognitive expectancy of aversive outcome in avoidance conditioning
Ly, V., & Karin Roelofs, A. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.06.015 · Cited by 30
“…we implemented a subsequent extinction like procedure to the paradigm containing aspects of exposure therapy with decreased safety behavior (Wells et al., 1995): encounter a feared situation (CS associated with US) with the believe that a feared outcome would occur (expectation of US),…”
Method
Reassurance seeking in the anxiety disorders and OCD: Construct validation, clinical correlates and CBT treatment response
Rector, N. A., Katz, D. E., Quilty, L. C., Laposa, J. M., Collimore, K. C., & Kay, T. (2019) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2019.102109 · Cited by 29
Do people with elevated social anxiety respond differently to digital and face-to-face communications? Two daily diary studies with null effects
Doorley, J. D., Volgenau, K. M., Kelso, K. C., Kashdan, T. B., & Shackman, A. J. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.07.069 · Cited by 30
“impairments and negative cognitive biases across a wide range of social and evaluative situations (e.g., Clark and Wells, 1995; Kashdan et al., 2013; 2014; Kim, 2005; Mellings and Alden, 2000; Pineles and Mineka, 2005; Wells et al., 1995).”
BackgroundInfluential
Avoidance of social threat: Evidence from eye movements during a public speaking challenge using 360°- video
Rubin, M., Minns, S. A., Muller, K., Tong, M. H., Hayhoe, M., & Telch, M. J. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103706 · Cited by 30
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“Safety behaviours are central to cognitive conceptualisations of anxiety disorders (e.g., Ehlers & Clark, 2000), an emphasis that is supported by evidence for their role in disorder maintenance (e.g., Salkovskis, Clark, Hackmann, Wells, & Gelder, 1999; Wells et al., 1995).”
Background
Social Anxiety Disorder
Emge, T. M., & Hope, D. A. (2009) · Springer eBooks · doi:10.1007/978-0-387-09757-2_29 · Cited by 26
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“[10–14] With the development of pharmacological agents that should acutely enhance learning from exposure, the opportunity presents itself to adapt such behavioral tests for rapid detection of the effects of agents of interest.”
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“Clients need to confront the feared situations without relying on their usual responses to feel safe (Wells et al., 1995).”
Background
COGNITIVE-BEHAVIORAL THERAPY FOR SOCIAL ANXIETY DISORDER
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“Reliance upon safety behaviours can be maladaptive and research has linked their use to worse therapy outcomes [15, 84, 106], with Wells et al. finding that socially anxious patients who underwent exposure experienced better outcomes when decreasing their use of varied safety behaviours [139].”
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“These two criteria have been found to be independent from each other, so that the leader’s position on one dimension does not predict the leader’s position on the other dimension (Fleishman, 1953; Weissenberg and Kavanagh, 1972).”
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The Reduction of Fear of Movement-related Pain: Does Motivational Context Matter?
Volders, S., Meulders, A., Peuter, S. D., & Vlaeyen, J. (2015) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000187 · Cited by 25
Anxiety and cognition
Wells, A., & Matthews, G. (1996) · Current Opinion in Psychiatry · doi:10.1097/00001504-199611000-00011 · Cited by 15
Maladaptive Self-Beliefs During Cognitive Behavioural Therapy for Social Anxiety Disorder: A Test of Temporal Precedence
Gregory, B., Wong, Q., Marker, C., & Peters, L. (2018) · Cognitive Therapy and Research · doi:10.1007/s10608-017-9882-5 · Cited by 21
“2001), and by teaching patients to reduce their ruminative processing (Wong and Moulds 2009) and minimise safety behaviour use (Wells et al. 1995).”
Background
Presentation and Correlates of Hoarding Behaviors in Children with Autism Spectrum Disorders and Comorbid Anxiety or Obsessive-Compulsive Symptoms
Buissonnière-Ariza, V. L., Wood, J. J., Kendall, P. C., McBride, N. M., Cepeda, S. L., Small, B. J., Lewin, A. B., Kerns, C. M., & Storch, E. A. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3645-3 · Cited by 24
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Philipp, R., Kriston, L., Kühne, F., Härter, M. C., & Meister, R. (2019) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-019-00333-3 · Cited by 25
“Based on his experiences in the treatment of patients with generalized anxiety disorder (GAD) and the importance of worry for this disorder (Wells 1995), Wells follows Flavell’s definition as he describes metacognitions as thoughts or beliefs (Wells’ term for knowledge) about cognition and further…”
Background
Cyberbullying Victimization and Social Anxiety: Mediating Effects with Moderation
Xia, T., Liao, J., Deng, Y., & Lin-li, L. (2023) · Sustainability · doi:10.3390/su15139978 · Cited by 35
Effects of Safety Behaviour On the Maintenance of Anxiety and Negative Belief Social Anxiety Disorder
Okajima, I., Kanai, Y., Chen, J., & Sakano, Y. (2009) · International Journal of Social Psychiatry · doi:10.1177/0020764008092191 · Cited by 27
“…I make a speech’) • 13 items were included in Inhibition of Emotional Expression factor (IEE) (e.g. ‘I tightly grip the glass or dish when I go to eat with anyone’) The contents of the scale conform to descriptions of safety behaviour in previous studies (Clark & Wells, 1995; Wells et al., 1995).”
BackgroundMethodResultInfluential
Recent advances in the psychosocial treatment of social anxiety disorder
Hofmann, S. G. (2010) · Depression and Anxiety · doi:10.1002/da.20771 · Cited by 23
“It has been shown that CBT with specific instructions to abandon safety behaviors are more effective than therapy without instructions to refrain from such behaviors.([11])”
Background
Altered time course of amygdala activation during speech anticipation in social anxiety disorder
Davies, C. D., Young, K., Torre, J. B., Burklund, L. J., Goldin, P. R., Brown, L. A., Niles, A. N., Lieberman, M. D., & Craske, M. G. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.11.014 · Cited by 21
“Exaggerated anticipatory anxiety can lead socially anxious individuals to avoid social situations or engage in safety behaviors, thus maintaining SAD symptoms by preventing new learning and reinforcing the maladaptive belief that social apprehension is warranted (Hofmann, 2007; Wells et al., 1995).”
Background
The effects of preventive and restorative safety behaviors on a single-session of exposure therapy for contamination fear
Goetz, A. R., & Lee, H. (2014) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2014.10.003 · Cited by 22
“However, a number of investigations have also found detrimental outcomes for SBs (Deacon & Maack, 2008; Olatunji, Etzel, Tomarken, Ciesielski, & Deacon, 2011; Powers, Smits, & Telch, 2004; Sloan & Telch, 2002; Wells et al., 1995).”
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Applying DBT Mindfulness Skills to the Treatment of Clients with Anxiety Disorders
Gratz, K. L., Tull, M. T., & Wagner, A. W. (2007) · Springer eBooks · doi:10.1007/0-387-25989-9_6 · Cited by 24
“Ost, 1996) and increased self-focused attention ( Wells et al., 1995 ).”
Mechanisms of Change in CBT Treatment
Teachman, B. A., Beadel, J. R., & Steinman, S. A. (2014) · Wiley eBooks · doi:10.1002/9781118775349.ch40 · Cited by 22
Measurement invariance of the Liebowitz Social Anxiety Scale‐Self‐Report
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Reward Processes in Extinction Learning and Applications to Exposure Therapy
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“In addition, previous research has found that individuals who are unable to reach their promotion goals effectively are at risk for depression (Scott & O'Hara, 1993 ; Strauman, 2002 ), and that a prototypical prevention behavior, avoidance, may maintain or lead to anxiety (Wells et al, 1995 ).”
Background
The Effects of Alcohol on Safety Behaviors in Socially Anxious Individuals
Battista, S. R., MacDonald, D., & Stewart, S. H. (2012) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2012.31.10.1074 · Cited by 21
“Indeed, in treatment, an idiographic approach is typically used where clients identify the safety behaviors that are most relevant to them and then try to reduce using these behaviors during exposures (Wells et al., 1995).”
BackgroundResult
Developing and disseminating effective psychological treatments: Science, practice and economics.
Clark, D. M. (2013) · Canadian Psychology/Psychologie canadienne · doi:10.1037/a0031258 · Cited by 24
“Wells et al. (1995) provided a particularly clear demonstration that safety behaviours play a key role in maintaining social anxiety by asking patients to use, or avoid using, their usual safety behaviours during a stressful social interaction.”
BackgroundSelf-citation
General in-situation safety behaviors are uniquely associated with post-event processing
Mitchell, M. A., & Schmidt, N. B. (2013) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2013.11.001 · Cited by 21
“In-situation safety behaviors (Salkovskis, Clark, & Gelder, 1996) are used to “prevent or minimize a feared catastrophe” in the feared situation (Clark, 1999, p. 7) and prevent disconfirmation of maladaptive beliefs (Salkovskis, 1991; Wells et al., 1995).”
BackgroundInfluential
Enhancing extinction with response prevention via imagery-based counterconditioning: Results on conditioned avoidance and distress
Hendrikx, L. J., Krypotos, A., & Engelhard, I. M. (2020) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2020.101601 · Cited by 20
Safety aid use and social anxiety symptoms: The mediating role of perceived control
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Dropping Safety Aids and Maximizing Retrieval Cues: Two Keys to Optimizing Inhibitory Learning During Exposure Therapy
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Cognitive-Behavioral Therapy for Social Anxiety Disorder: Supporting Evidence and Future Directions
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“…AS may result in the development of panic attacks or panic disorder (Schmidt, Lerew, & Jackson, 1997), IS may contribute to the development of health anxiety–related conditions including chronic pain (Carleton, Park, & Asmundson, 2006), and NES may result in social phobia (Wells et al., 1995).”
Background
Exposure to social anxiety words: Treatment for social phobia based on the stroop paradigm
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“…mental or behavioural operations) in which patients engage to prevent imagined catastrophes from occurring (OCD; Deacon and Maack, 2008; PTSD: Dunmore et al., 1999; Social phobia: Kim, 2005; Wells et al., 1995; Salkovskis et al., 1999; Salkovskis et al., 2000; GAD: Woody and Rachman, 1994).”
Background
Developing and Testing a Novel, Computerized Insomnia and Anxiety Intervention to Reduce Safety Aids Among an at-Risk Student Sample: A Randomized Controlled Trial
Short, N. A., & Schmidt, N. B. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.05.012 · Cited by 23
Treatment of pain-related fear in chronic (persistent) pain: the role of safety-seeking behaviour and imagery
Jamani, N., & Clyde, Z. (2008) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x08000032 · Cited by 16
“…disorders such as panic disorder (Salkovskis et al. 1996; Thwaites & Freeston, 2005) and social phobia (Clark & Wells, 1995; Thwaites & Freeston, 2005), and empirical evidence supports the central role of safety-seeking behaviour in these disorders (Wells et al. 1995; Salkovskis et al. 1999).”
Background
Cognitive Therapy for Delusions in Schizophrenia: Models, Benefits, and New Approaches
Cather, C., Penn, D. L., Otto, M. W., & GOFF, D. C. (2004) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.18.3.207.65650 · Cited by 15
“Similar to the prevailing cognitive-behavioral models of anxiety disorder (Wells et al., 1995) avoidance and safety behaviors are thought to play an important role in the maintenance of delusional beliefs by blocking exposure to disconfirmatory evidence (Morrison, 1998).”
Background
Fear of Negative Evaluation and Rapid Response to Treatment During Cognitive Behaviour Therapy for Social Anxiety Disorder
Auyeung, K. W., Hawley, L. L., Grimm, K. J., McCabe, R. E., & Rowa, K. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10077-5 · Cited by 16
“Research supports the notion that social anxiety is derived in part from fears of perceived negative evaluation (Clark and Wells 1995; Rapee and Heimberg 1997; e.g., Burton et al.”
Background
Understanding online shopping hate in social commerce context: antecedents and consequences of psychological reactance
Jamal, Y., Islam, T., & Shahid, Z. (2022) · Kybernetes · doi:10.1108/k-11-2021-1093 · Cited by 13
The role of fear of negative evaluation on the effects of self-control on affective states and life satisfaction: a moderated mediation analysis
Lee, A., Chan, W., & Ng, J. C. K. (2022) · Current Psychology · doi:10.1007/s12144-022-04130-7 · Cited by 13
“As a result, they typically engaged in avoidance behaviors, including excessive nodding, or looking for validation, expressing very little, or trying to divert attention by questioning others (Clark & Wells, 1995).”
Background
Social Anxiety and the Self
Alden, L. E., Auyeung, K. W., & Plasencia, L. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-394427-6.00018-2 · Cited by 17
Cognitive Processes during Acute Psychosis: The Role of Heightened Responsibility and Catastrophic Misinterpretations
Luzón, O., Harrop, C. E., & Nolan, F. (2009) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465809990191 · Cited by 14
Unpacking Social Avoidance and Substance Use in Social Anxiety: Does Extraversion Explain Behavior Variability?
Aurora, P., & Coifman, K. G. (2020) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-020-09844-1 · Cited by 18
“…with social anxiety often use in-situation avoidance behaviors (e.g., substance use, avoiding eye contact; using a cell phone; talking to specific individuals) to attenuate distress (Wells et al. 1995; Kashdan et al. 2008; Piccirillo et al. 2016; Clark and Wells 1995; Stevens et al. 2014).”
Background
Allelic Variation of Risk for Anxiety Symptoms Moderates the Relation Between Adolescent Safety Behaviors and Social Anxiety Symptoms
Thomas, S. A., Weeks, J. W., Dougherty, L. R., Lipton, M. F., Daruwala, S. E., Kline, K. V., & Reyes, A. D. L. (2015) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-015-9488-8 · Cited by 16
“…behaviors much more frequently than other individuals during exposure to social situations, and 2) the use of safety behaviors during exposures impedes treatment gains (Hedtke et al. 2009; Helbig-Lang and Petermann 2010; Kim 2005; Schmidt et al. 2012; Taylor and Alden 2010; Wells et al. 1995).”
Influential
Safety behaviors and speech treatment for adults who stutter.
Helgadottir, F., Menzies, R., Onslow, M., Packman, A., & O'Brian, S. (2014) · Journal of Speech, Language and Hearing Research · doi:10.1044/2014_jslhr-s-13-0041 · Cited by 13
Exposure Therapy
Telch, M. J., Cobb, A. R., & Lancaster, C. L. (2014) · Wiley eBooks · doi:10.1002/9781118775349.ch35 · Cited by 14
Social anxiety and work: a qualitative investigation in a low-income, minority sample
Himle, J. A., Weaver, A., Levine, D. S., Steinberger, E., Bybee, D., Vlnka, S., Miller, R., Laviolette, W. T., & Nicoll, K. L. (2020) · Social Work in Mental Health · doi:10.1080/15332985.2020.1742850 · Cited by 13
“Strategies like these, sometimes called “safety behaviors,” are theorized to interfere with the learning processes associated with exposure to anxiety evoking situations (Wells et al., 1995).”
Background
Effects of safety behavior fading on social anxiety and emotional disclosure
Stentz, L. A., & Cougle, J. R. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104165 · Cited by 14
The relationship between adverse childhood experiences and social anxiety disorder symptoms: the mediating role of rumination
Kurtoğlu, M. B., Yücel, D., Coşkun, E., & Katar, K. (2024) · Current Psychology · doi:10.1007/s12144-024-06021-5 · Cited by 14
“The role of rumination after adverse experiences in the past in SAD becoming chronic has been proven by various studies (Abbott & Rapee, 2003; Wells et al., 1995; Mellings & Alden, 2000).”
Behind the mask: Stuttering, anxiety, and communication dynamics in the era of COVID‐19
Karimi, H., Jokar, A. H. R., Salehi, S., & Aghadoost, S. (2024) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.13096 · Cited by 13
Exploring the construct validity of the Camouflaging Autistic Traits Questionnaire: A factor analytic study
McKinnon, K., Bougoure, M., Zhuang, S., Tan, D. W., & Magiati, I. (2024) · Autism · doi:10.1177/13623613241287964 · Cited by 15
“Like autistic people, socially anxious people typically develop emotional, behavioural and/or social ‘strategies’ to avoid negative evaluation (Wells et al., 1995): these may include intense self-monitoring and a range of safety behaviours to endure or escape social interactions, such as avoidance…”
Perpetuating factors of social anxiety: a serial mediation model
Carnahan, N. D., Carter, M. M., & Herr, N. R. (2019) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465819000638 · Cited by 14
“The impact of safety behaviour usage While temporarily useful by reducing anxiety, SB use can lead to a misattribution of the absence of a feared catastrophe, consequently reinforcing the belief that one is staving off social danger (Wells et al., 1995).”
BackgroundMethod
The Medium is the Message: Effects of Mediums of Communication on Perceptions and Emotions in Social Anxiety Disorder
Oren-Yagoda, R., & Aderka, I. M. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102458 · Cited by 13
Preventative and restorative safety behaviors: Effects on exposure treatment outcomes and risk for future anxious symptoms.
Goodson, J., & Haeffel, G. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22635 · Cited by 14
Latent Growth Curve Analysis of Fear during a Speech Task before and after Treatment for Social Phobia
Price, M. S., & Anderson, P. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.08.004 · Cited by 16
“Safety behaviors are maladaptive coping strategies that are used to ineffectively reduce anxiety when encountering a feared stimulus (Wells et al., 1996).”
Clinical Manual of Anxiety Disorders
(2004) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615377138 · Cited by 13
Understanding and Treating Social Phobia
Curtis, R. C., Kimball, A., & Stroup, E. L. (2004) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2004.tb00279.x · Cited by 12
In‐situation safety behaviors among patients with panic disorder: Descriptive and correlational study
Funayama, T., Furukawa, T. A., Nakano, Y., Noda, Y., Ogawa, S., Watanabe, N., Chen, J., & Noguchi, Y. (2013) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12061 · Cited by 12
“Patients cannot learn to reduce their anxiety sufficiently in fearful situations.(4) Salkovskis et al.”
Background
Mediation effect of cognitive flexibility between fear of negative evaluation and interaction anxiety
Kırca, B., Saruhan, V., Aydoğdu, B. N., & Avcu, A. (2023) · Current Psychology · doi:10.1007/s12144-023-04495-3 · Cited by 12
“As can be seen, the fear of negative evaluation triggers interaction anxiety and prevents social behaviors by creating discomfort in the person (Kashdan, 2004; Adams et al., 2011; Wells et al., 1995).”
Influential
Event‐related potentials during the ultimatum game in people with symptoms of depression and/or social anxiety
Nicolaisen‐Sobesky, E., Paz, V., Constantino, F. C., Fernández‐Theoduloz, G., Pérez, A., Martínez‐Montes, E., Kessel, D., Cabana, Á., & Gradin, V. B. (2023) · Psychophysiology · doi:10.1111/psyp.14319 · Cited by 12
Erythrophobie: Störungswissen und Verhaltenstherapie
Chaker, S., & Hoyer, J. (2007) · Verhaltenstherapie · doi:10.1159/000105103 · Cited by 12
Within-person process-outcome Relationships in Residential Cognitive and Interpersonal Psychotherapy for Social Anxiety Disorder: A Reanalysis Using Disaggregated Data
Hoffart, A., Borge, F., & Clark, D. M. (2016) · Journal of Experimental Psychopathology · doi:10.5127/jep.056116 · Cited by 12
Self-citation

Authors: Wells, A., Clark, D. M., Salkovskis, P., Ludgate, J., Hackmann, A., & Gelder, M.
Affiliations: University of Oxford (GB)
ORCID: Clark, David M.
Salkovskis, Paul
Venue: Behavior Therapy
Publisher: Elsevier BV
Published: 1995
Volume: 26
Issue: 1
Pages: 153-161
ISSN: 0005-7894 (ISSN-L)
DOI: 10.1016/s0005-7894(05)80088-7
OpenAlex: W2151136747
Cited by: 548
References: 22
Citations by year: 2026: 16 · 2025: 13 · 2024: 29 · 2023: 18 · 2022: 19 · 2021: 26 · 2020: 13 · 2019: 21 · 2018: 23 · 2017: 18 · 2016: 23 · 2015: 21 · 2014: 35 · 2013: 22 · 2012: 27
FWCI: 11.55
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behavior Therapy (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: social anxiety disorder, safety behavior, exposure therapy, anxiety maintenance

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