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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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“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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“There is evidence that the type of processes identi®ed in the present experiment generalise beyond panic to other anxiety problems where avoidance and safety behaviours are prominent such as social phobia (Wells et al., 1995; Clark, 1996).”
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“This may also be true in Obsessional problems (Salkovskis & Kirk, 1997), post-traumatic stress disorder (Ehlers & Steil, 1995) and speci®c phobias (Thorpe and Salkovskis, in press).”
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Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011) · Perspectives on Psychological Science · doi:10.1177/1745691611419671 · Cited by 3,024
Managing mental health challenges faced by healthcare workers during covid-19 pandemic
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Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective
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Toward a unified treatment for emotional disorders
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Metadata
- 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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