In‐situation safety behaviors among patients with panic disorder: Descriptive and correlational study
Open accessAbstract
Aim: In‐situation safety behaviors play an important role in the maintenance of anxiety because they prevent patients from experiencing unambiguous disconfirmation of their unrealistic beliefs about feared catastrophes. Strategies for identifying particular safety behaviors, however, have not been sufficiently investigated. The aims of the present study were to (i) develop a comprehensive list of safety behaviors seen in panic disorder and to examine their frequency; and (ii) correlate the safety behaviors with panic attack symptoms, agoraphobic situations and treatment response. Methods: The subjects consisted of 46 consecutive patients who participated in group cognitive behavioral treatment (CBT) for panic disorder. All the patients completed a S afety B ehavior L ist that was developed based on experiences with panic disorder patients. Results: Carrying medications, distracting attention, carrying a plastic bottle, and drinking water were reported by more than half of the patients. The strongest correlations between panic symptoms and safety behaviors were found between symptoms of derealization and listening to music with headphones, paresthesia and pushing a cart while shopping, and nausea and squatting down. The strongest association between agoraphobic situations and safety behaviors was found between the fear of taking a bus or a train alone and moving around. Staying still predicted response to the CBT program, while concentrating on something predicted lack of response. Conclusion: An approximate guideline has been developed for identifying safety behaviors among patients with panic disorder and should help clinicians use CBT more effectively for these patients.
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The SAFE-A is a 40-item questionnaire that assesses the frequency of subtle avoidance behavior in agoraphobia.
“The SAFE-A is a 40-item questionnaire to assess the frequency of subtle avoidance behavior in agoraphobia [74, 75]”
From Eye movement desensitization and reprocessing (EMDR) therapy or supportive counseling prior to exposure therapy in patients with panic disorder: study protocol for a multicenter randomized controlled trial (IMPROVE) (2023) · cites this paper as [74]
Our copy does not mention SAFE-A or describe a 40-item questionnaire (searched: “SAFE-A” and “40-item subtle avoidance behavior”). The Safety Behavior List section instead describes a 25-item yes/no list, while the Fear Questionnaire–Agoraphobic Subscale section describes ratings of five situations. Neither establishes what SAFE-A measures. (LLM, conf=0.74)
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“(SAFE‐A): The SAFE-A is a 40-item questionnaire to assess the frequency of subtle avoidance behavior in agoraphobia [74, 75], using a 5-point Likert scale (0 = never, 5 = always) and when safety behavior is performed on a 3-point Likert scale (1 = before the situation, 2 = during the situation, 3 = during a panic atta…”
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- Authors
- Funayama, T., Furukawa, T. A., Nakano, Y., Noda, Y., Ogawa, S., Watanabe, N., Chen, J., & Noguchi, Y.
- Affiliations
- Nagoya City University (JP)
- Kyoto University (JP)
- Flinders University (AU)
- Corresponding author
- Funayama, Tadashi
- Venue
- Psychiatry and Clinical Neurosciences
- Publisher
- Wiley
- Published
- 2013-06-18
- Volume
- 67
- Issue
- 5
- Pages
- 332-339
- ISSN
- 1323-1316 (ISSN-L)
- 1440-1819
- OpenAlex
- W1575727165
- Cited by
- 12
- References
- 22
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatry and Clinical Neurosciences (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Funders
- University of New South Wales
- 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 › Obsessive-Compulsive Spectrum Disorders
- Keywords
- panic disorder, safety behavior, group cognitive behavioral therapy, agoraphobia, treatment response, derealization
- MeSH terms
- Adult, Agoraphobia, Antidepressive Agents, Anxiety, Fear, Female, Humans, Male, Middle Aged, Music, Nausea, Paresthesia, Predictive Value of Tests, Surveys and Questionnaires, Safety, Anti-Anxiety Agents, Cognitive Behavioral Therapy, Panic Disorder, Treatment Outcome, Motor Vehicles, Diagnostic and Statistical Manual of Mental Disorders
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