Citation

Blakey SM, Abramowitz JS, Buchholz JL, Jessup SC, Jacoby RJ, Reuman L, Pentel KZ. Behav. Res. Ther. 2018; 112: 28-35.

Affiliation

University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, NC, 27599-3270, United States.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.brat.2018.11.010

PMID

30481681

Abstract

Safety behaviors-actions performed to prevent, escape from, or reduce the severity of perceived threat-are typically eliminated during exposure therapy for clinical anxiety. Yet some experts have called for the strategic and "judicious use" of safety behaviors during exposure to improve treatment acceptability/tolerability without diminishing its efficacy. Empirical findings regarding this debate are mixed and existing work is subject to several methodological limitations. The current randomized controlled trial incorporated longitudinal design and multimethod assessment to compare the efficacy of traditional exposure with the elimination of safety behaviors (E/ESB) and exposure with judiciously used safety behaviors (E/JU). Adults with clinically significant spider fear (N = 60) were randomized to four twice-weekly sessions of E/ESB or E/JU. Self-report and behavioral measures were administered at pretreatment, posttreatment, and 1-month follow-up. Participants exhibited large effects on all measures from pretreatment to posttreatment, with no change from posttreatment to follow-up. There were no significant group differences in treatment outcome or treatment acceptability/tolerability. Exploratory analyses were used to compare behavioral and inhibitory learning processes between conditions. Clinical implications, study limitations, and future directions are discussed in terms of inhibitory learning theory.

Copyright © 2018 Elsevier Ltd. All rights reserved.

Language: en

Keywords

Anxiety; Exposure therapy; Inhibitory learning; Phobia; Safety behaviors