Safety Behaviour in the Maintenance of Anxiety and Social Anxiety Disorder

[David Baxter PhD]

Effects of Safety Behaviour On the Maintenance of Anxiety and Negative Belief Social Anxiety Disorder
by Isa Okajima, Yoshihiro Kanai, Junwen Chen, and Yuji Sakano
International Journal of Social Psychiatry, Vol. 55, No. 1, 71-81 (2009) DOI: 10.1177/0020764008092191

Background: Safety behaviour¹ plays an important role in the maintenance of social anxiety disorder (SAD). SAD patients engage in various safety behaviours in social situations in order to decrease the risk of negative evaluations from others.

Aims: The present study examined the effect of safety behaviour on the maintenance of anxiety and negative belief in SAD by using Structural Equation Modelling (SEM).

Methods: Participants were a healthy group (442) and a SAD group (46) who met the SAD criteria for DSM-IV and who had high scores of SAD symptoms. In the assumed maintenance model, independence variables were safety and avoidance behaviour and dependence variables were anxiety and negative belief.

Results: This result showed that the SAD group significantly has more high scores than the healthy group in all scales of anxiety, negative belief and avoidance behaviour, expect for safety behaviour. The result of the multiple-group procedure indicated that safety behaviour contributes more strongly to anxiety and negative belief in the SAD group than in the healthy group.

Conclusions: It is speculated that the SAD group have a stronger link between safety behaviour and negative belief than the healthy group, whereas frequency of the use of safety behaviour is equivalent between two groups. These results support the findings of previous studies.

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¹ Safety behavior is behavior undertaken to reduce anxious thoughts, or to keep yourself 'safe' from imagined threats, or to hide your anxious state from others. Examples include constant monitoring of breathing or heart rate, shopping during quiet retail hours, taking precautionary tranquillizers "just in case," taking circuitous routes to avoid highways or bridges when driving, sitting close to exits, avoiding eye contact, playing with keys to hide trembling hands.

 

[Mari]

1 Safety behavior is behavior undertaken to reduce anxious thoughts, or to keep yourself 'safe' from imagined threats, or to hide your anxious state from others. Examples include constant monitoring of breathing or heart rate, shopping during quiet retail hours, taking precautionary tranquillizers "just in case," taking circuitous routes to avoid highways or bridges when driving, sitting close to exits, avoiding eye contact, playing with keys to hide trembling hands.

I engage in all of those behaviors and more but did not know that they were referred to as 'safety behavior' and I am having great difficulty understanding the rest if the conclusion is that safety behavior is equivalent between the two groups. Can a speculation be part of a conclusion? Mari

 

[Daniel E.]

I am having great difficulty understanding the rest if the conclusion is that safety behavior is equivalent between the two groups.

Here is an example from the article:

For example, SAD patients who are worried that what they say may not make sense and will sound stupid often report memorizing what they have said and comparing it with what they are about to say while speaking. If everything goes well, patients are likely to think, ‘It only went well because I did all the memorizing and checking (safety behaviour). If I had just been myself people would have realized how stupid I was’ (Clark, 2001 (Chap. 18)). It is speculated that the link between safety behaviour and negative belief is more precise in SAD patients than healthy people, whereas frequency in the use
of safety behaviours is equivalent in both groups.

For more info, here is the chapter by Clark referenced above:

A Cognitive Perspective on Social Phobia

 

[David Baxter PhD]

To add to what Daniel said, the purpose of safety behavior is anxiety prevention. But this serves to perpetuate the anxiety cycle - if you never get to fully experience and confront the anxiety (and I'm not saying it has to be the cold-turkey forced response prevention type of confrontation necessarily, which I don't believe is helpful to some clients), you don't have the opportunity to learn how to manage that anxiety.

 

[Daniel E.]

A Psychologist Explains How to Beat Social Anxiety

Alden and Taylor challenged people to drop their safety behaviors to see what would happen. When they did that, their conversation partner in this experiment rated the people who dropped these behaviors as more likable and more authentic. We become the way we are naturally with our closest friends.

These behaviors take up a lot of bandwidth. If you’re thinking about how you come across, and there is very little room left over to just be our authentic, friendly self. When we drop our safety behaviors, the gaps are naturally filled in with listening and curiosity and interest and we come across as more genuine and therefore our conversation partners like us more.