An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia
Abstract
This study evaluates the hypothesis that safety-seeking behaviours play an important role in maintaining anxiety because they prevent patients from benefiting from disconfirmatory experience. Patients suffering from panic disorder with agoraphobia carried out a behaviour test, closely followed by an experimental session, which included a brief (15 min) period of exposure during which participants either stopped or maintained within-situation safety-seeking behaviours. When the behaviour test was repeated within two days, patients who had stopped their safety-seeking behaviours during the experimental session showed a significantly greater decrease in catastrophic beliefs and anxiety than those who had maintained safety-seeking behaviour. This difference was also reflected in questionnaires measuring clinical anxiety. These results are consistent with the cognitive hypothesis.
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Elements of treatment can be used as 'safety seeking behaviours' that reduce efficacy of exposure and maintain the disorder by preventing disconfirmatory experiences concerning fears of bodily sensations.
“Our findings are consistent with this body of research, indicating that elements of treatment can be used as 'safety seeking behaviours' that reduce efficacy of exposure and maintain the disorder by preventing disconfirmatory experiences concerning fears of bodily sensations [42].”
From Helpful and hindering factors for remission in dysthymia and panic disorder at 9-year follow-up: A mixed methods study (2008) · cites this paper as [42]
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“Together with the studies of Sloan and Telch (2002) and Salkovskis et al. (1999), our data suggest that SB may influence danger expectations.”
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“This, in turn, reduces the likelihood of experiencing a situation that would have corrected the dysfunctional belief [20–22].”
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A comparison of the effect of attention training and relaxation on responses to pain
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“Similar concerns have been discussed in the anxiety literature, with the result that distraction is now viewed as a form of safety behaviour [24].”
BackgroundFailure to replicate the deleterious effects of safety behaviors in exposure therapy
Sy, J. T., Dixon, L. J., Lickel, J. J., Nelson, E. A., & Deacon, B. J. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.02.005 · Cited by 61 · see citing works
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“…of psychopathology in ways related to the phenomenology of the problem (Canvin et al ., 2016; Clark and Teasdale, 1982; Wild et al ., 2008) through to field experiments in which the controls are less precise but ecological validity is built in (Rachman et al ., 1976; Salkovskis et al ., 1999).”
Self-citationEmotion regulation strategies in cognitive behavioral therapy for panic disorder
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The Roles of Persistence and Perseveration in Psychopathology
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“…in different ways, consistent with the hypothesis that perseveration nventory and the Persistence, Perseveration and Perfectionism is a maladaptive/unhealthy trait (e.g., Salkovskis, 1996; Salkovskis et al., 1999), whereas persistence is an adaptive/healthy trait (e.g., Brandon et al., 2003).”
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Active-imaginal exposure: examination of a new behavioral treatment for cynophobia (dog phobia)
Rentz, T. O., Powers, M. B., Smits, J. A. J., Cougle, J. R., & Telch, M. J. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00041-x · Cited by 47 · see citing works
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“Because several studies evaluating the effects of safety behavior during exposure-based treatments have compared conditions of retained safety behavior under an extinction rationale with conditions of discouraged safety behavior under a cognitive rationale (e.g., McManus et al., 2008; Salkovskis et al., 1999; Sloan &…”
Background
- Authors
- Salkovskis, P. M., Clark, D. M., Hackmann, A., Wells, A., & Gelder, M. G.
- Affiliations
- Warneford Hospital (GB)
- Corresponding author
- Salkovskis, Paul M.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 1999-06
- Volume
- 37
- Issue
- 6
- Pages
- 559-574
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2064286008
- Cited by
- 310
- References
- 31
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 8 · 2023: 5 · 2022: 20 · 2021: 19 · 2020: 15 · 2019: 9 · 2018: 14 · 2017: 13 · 2016: 20 · 2015: 11 · 2014: 11 · 2013: 12 · 2012: 17
- FWCI
- 7.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (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
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- safety-seeking behavior, panic disorder with agoraphobia, anxiety maintenance, exposure therapy, anxiety reduction
- MeSH terms
- Adult, Agoraphobia, Anxiety, Attitude, Avoidance Learning, Desensitization, Psychologic, Female, Humans, Male, Middle Aged, Panic, Psychiatric Status Rating Scales, Panic Disorder
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