Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T17:42:17.645Z Has data issue: false hasContentIssue false
  • English
  • Français

Exploring the impact of safety behaviour use on cognitive, psychophysiological, emotional and behavioural responses during a speech task

Published online by Cambridge University Press:  17 April 2020

Jessica S. Tutino ,
Allison J. Ouimet  and
Ryan J. Ferguson
Jessica S. Tutino
Affiliation:
School of Psychology, University of Ottawa, OttawaCanada
Allison J. Ouimet*
Affiliation:
School of Psychology, University of Ottawa, OttawaCanada
Ryan J. Ferguson
Affiliation:
School of Psychology, University of Ottawa, OttawaCanada
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

There is a debate among researchers and clinicians regarding whether the judicious use of safety behaviours (SBs) during exposure therapy is helpful or detrimental. Central to this debate is the premise that SBs may interfere with one’s ability to gather disconfirmatory evidence.

Aims:

No study to date has assessed how SB use may impact cognitive mechanisms implicated during an exposure-like task. We investigated multiple cognitive, emotional, psychophysiological and behavioural underpinnings of exposure with and without SBs.

Method:

Speech anxious participants (n = 111) were randomly assigned to deliver an evaluated speech with or without SBs. Self-reported anxiety ratings and psychophysiological arousal measures were recorded at baseline, in anticipation of the speech, and following the speech. Measures of working memory, ability to gather disconfirmatory evidence, speech duration, objective and subjective speech performance, and speech task acceptability were administered.

Results:

There were no differences between conditions on working memory, self-reported anxiety, psychophysiological arousal, ability to gather disconfirmatory evidence, speech duration, or objective and subjective speech performance. All participants were able to gather disconfirmatory evidence. However, condition did influence willingness to deliver future speeches. Our sample was largely female undergraduate students, and we offered only a small number of specific safety behaviours.

Conclusions:

Judicious SB use may not necessarily be detrimental, but clients may believe them to be more helpful than they actually are.

Keywords

anxietycognitive behavioural therapyexposure therapysafety behaviours
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 5 , September 2020 , pp. 557 - 571
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abramowitz, J. S., & Moore, E. (2007). An experimental analysis of hypochondriasis. Behaviour Research and Therapy, 45, 413–424. https://doi.org/10.1016/j.brat.2006.04.005CrossRefGoogle ScholarPubMed
Ashcraft, M. H., & Kirk, E. P. (2001). The relationships among working memory, math anxiety, and performance. Journal of Experimental Psychology: General, 130, 224–237. https://doi.org10.1037/0096-3445.130.2.224CrossRefGoogle Scholar
Baddeley, A. (2000). The episodic buffer: a new component of working memory? Trends in Cognitive Sciences, 4, 417–423. https://doi.org/10.1016/S1364-6613(00)01538-2CrossRefGoogle Scholar
Baddeley, A. D., & Hitch, G. (1974). Working memory. Psychology of Learning and Motivation, 8, 47–89. https://doi.org/10.1016/S0079-7421(08)60452-1CrossRefGoogle Scholar
Blakey, S. M., & Abramowitz, J. S. (2019). Dropping safety aids and maximizing retrieval cues: two keys to optimizing inhibitory learning during exposure therapy. Cognitive and Behavioral Practice, 26, 166–175.CrossRefGoogle Scholar
Cacioppo, J. T., Tassinary, L. G., & Berntson, G. (eds) (2007). Handbook of Psychophysiology. New York, NY: Cambridge University Press.Google Scholar
Carrillo, E., Moya-Albiol, L., González-Bono, E., Salvador, A., Ricarte, J., & Gómez-Amor, J. (2001). Gender differences in cardiovascular and electrodermal responses to public speaking task: the role of anxiety and mood states. International Journal of Psychophysiology, 42, 253–264. https://doi.org/10.1016/S0167-8760(01)00147-7CrossRefGoogle ScholarPubMed
Cho, Y., Smits, J. A., & Telch, M. J. (2004). The Speech Anxiety Thoughts Inventory: scale development and preliminary psychometric data. Behaviour Research and Therapy, 42, 13–25. https://doi.org/10.1016/S0005-7967(03)00067-6CrossRefGoogle ScholarPubMed
Chu, B. C., Colognori, D. B., Yang, G., Xie, M., Bergman, R. L., & Piacentini, J. (2015). Mediators of exposure therapy for youth obsessive-compulsive disorder: specificity and temporal sequence of client and treatment factors. Behavior Therapy, 46, 395–408.CrossRefGoogle ScholarPubMed
Clark, D. A., & Beck, A. T. (2011). Cognitive Therapy of Anxiety Disorders: Science and Practice. New York, USA: Guilford Press.Google Scholar
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In Heimberg, R. G., Liebowitz, M. R., Hope, D. A. & Schneier, F. R. (eds), Social Phobia: Diagnosis, Assessment, and Treatment (pp. 69–93). New York, NY, USA: Guilford Press.Google Scholar
Connor, K. M., Davidson, J. R., Churchill, L. E., Sherwood, A., Weisler, R. H., & Foa, E. (2000). Psychometric properties of the Social Phobia Inventory (SPIN): new self-rating scale. The British Journal of Psychiatry, 176, 379–386.CrossRefGoogle ScholarPubMed
Conway, A. R., Kane, M. J., Bunting, M. F., Hambrick, D. Z., Wilhelm, O., & Engle, R. W. (2005). Working memory span tasks: a methodological review and user’s guide. Psychonomic Bulletin & Review, 12, 769–786.CrossRefGoogle ScholarPubMed
Cornwell, B. R., Johnson, L., Berardi, L., & Grillon, C. (2006). Anticipation of public speaking in virtual reality reveals a relationship between trait social anxiety and startle reactivity. Biological Psychiatry, 59, 664–666. https://doi.org/10.1016/j.biopsych.2005.09.015CrossRefGoogle ScholarPubMed
Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008). Optimizing inhibitory learning during exposure therapy. Behaviour Research and Therapy, 46, 5–27. https://doi.org/10.1016/j.brat.2007.10.003CrossRefGoogle ScholarPubMed
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: an inhibitory learning approach. Behaviour Research and Taherapy, 58, 10–23.CrossRefGoogle ScholarPubMed
Cumming, S., Rapee, R. M., Kemp, N., Abbott, M. J., Peters, L., & Gaston, J. E. (2009). A self-report measure of subtle avoidance and safety behaviors relevant to social anxiety: development and psychometric properties. Journal of Anxiety Disorders, 23, 879–883. https://doi.org/10.1016/j.janxdis.2009.05.002CrossRefGoogle Scholar
Deacon, B., & Maack, D. J. (2008). The effects of safety behaviors on the fear of contamination: an experimental investigation. Behaviour Research and Therapy, 46, 537–547. https://doi.org/10.1016/j.brat.2008.01.010CrossRefGoogle Scholar
E-Prime (2017 version 2.0.8.22) [computer software]. Pittsburgh, PA: Psychology Software Tools.Google Scholar
Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: attentional control theory. Emotion, 7, 336–346. https://doi.org/10.1037/1528-3542.7.2.336CrossRefGoogle ScholarPubMed
Foa, E. B., Liebowitz, M. R., Kozak, M. J., Davies, S., Campeas, R., Franklin, M. E., … & Simpson, H. B. (2005). Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. American Journal of Psychiatry, 162, 151–161.CrossRefGoogle ScholarPubMed
Hook, J. N., Smith, C. A., & Valentiner, D. P. (2008). A short-form of the Personal Report of Confidence as a Speaker. Personality and Individual Differences, 44, 1306–1313. https://doi.org/10.1016/j.paid.2007.11.021CrossRefGoogle Scholar
Judah, M. R., Grant, D. M., Lechner, W. V., & Mills, A. C. (2013). Working memory load moderates late attentional bias in social anxiety. Cognition & Emotion, 27, 502–511.CrossRefGoogle ScholarPubMed
Larson, M. R., Ader, R., & Moynihan, J. A. (2001). Heart rate, neuroendocrine, and immunological reactivity in response to an acute laboratory stressor. Psychosomatic Medicine, 63, 493–501. https://doi.org/10.1097/00006842-200105000-00020CrossRefGoogle Scholar
Levy, H. C., & Radomsky, A. S. (2014). Safety behaviour enhances the acceptability of exposure. Cognitive Behaviour Therapy, 43, 83–92. https://doi.org/10.1080/16506073.2013.819376CrossRefGoogle ScholarPubMed
Mancebo, M. C., Eisen, J. L., Sibrava, N. J., Dyck, I. R., & Rasmussen, S. A. (2011). Patient utilization of cognitive-behavioral therapy for OCD. Behavior Therapy, 42, 399–412.CrossRefGoogle ScholarPubMed
McManus, F., Sacadura, C., & Clark, D. M. (2008). Why social anxiety persists: an experimental investigation of the role of safety behaviours as a maintaining factor. Journal of Behavior Therapy and Experimental Psychiatry, 39, 147–161. https://doi.org/10.1016/j.jbtep.2006.12.002CrossRefGoogle ScholarPubMed
McMillan, D., & Lee, R. (2010). A systematic review of behavioral experiments vs. exposure alone in the treatment of anxiety disorders: a case of exposure while wearing the emperor’s new clothes? Clinical Psychology Review, 30, 467–478.CrossRefGoogle ScholarPubMed
Milosevic, I., & Radomsky, A. S. (2008). Safety behaviour does not necessarily interfere with exposure therapy. Behaviour Research and Therapy, 46, 1111–1118. https://doi.org/10.1016/j.brat.2008.05.011CrossRefGoogle Scholar
Milosevic, I., & Radomsky, A. S. (2013). Incorporating the judicious use of safety behavior into exposure-based treatments for anxiety disorders: a study of treatment acceptability. Journal of Cognitive Psychotherapy, 27, 155–174. https://doi.org/10.1891/0889-8391.27.2.155CrossRefGoogle ScholarPubMed
Moran, T. P. (2016). Anxiety and working memory capacity: a meta-analysis and narrative review. Psychological Bulletin, 142, 831–864. https://doi.org/10.1037/bul0000051CrossRefGoogle ScholarPubMed
Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioral Practice, 16, 123–134.CrossRefGoogle Scholar
Olatunji, B. O., Cisler, J. M., & Deacon, B. J. (2010). Efficacy of cognitive behavioral therapy for anxiety disorders: a review of meta-analytic findings. Psychiatric Clinics, 33, 557–577.Google ScholarPubMed
Ouimet, A. J., & Ashbaugh, A. R. (2017). Anxiety. In Practical Strategies and Tools to Promote Treatment Engagement, ed. O’Donohue, W., James, L. & Snipes, C., pp. 253–275. Springer International Publishing, Switzerland.CrossRefGoogle Scholar
Oswald, F. L., McAbee, S. T., Redick, T. S., & Hambrick, D. Z. (2015). The development of a short domain-general measure of working memory capacity. Behavior Research Methods, 47, 1343–1355. https://doi.org/10.3758/s13428-014-0543-2CrossRefGoogle Scholar
Powers, M. B., Smits, J. A., & Telch, M. J. (2004). Disentangling the effects of safety-behavior utilization and safety-behavior availability during exposure-based treatment: a placebo-controlled trial. Journal of Consulting and Clinical Psychology, 72, 448.CrossRefGoogle ScholarPubMed
Price, M., & Anderson, P. L. (2011). Latent growth curve analysis of fear during a speech task before and after treatment for social phobia. Behaviour Research and Therapy, 49, 763–770. https://doi.org/10.1016/j.brat.2011.08.004CrossRefGoogle ScholarPubMed
Rachman, S., Craske, M., Tallman, K., & Solyom, C. (1986). Does escape behavior strengthen agoraphobic avoidance? A replication. Behavior Therapy, 17, 366–384. https://doi.org/10.1016/S0005-7894(86)80069-7CrossRefGoogle Scholar
Rachman, S., Radomsky, A. S., & Shafran, R. (2008). Safety behaviour: a reconsideration. Behaviour Research and Therapy, 46, 163–173.CrossRefGoogle ScholarPubMed
Rapee, R. M., & Lim, L. (1992). Discrepancy between self-and observer ratings of performance in social phobics. Journal of Abnormal Psychology, 101, 728–738. https://doi.org/10.1037/0021-843X.101.4.728CrossRefGoogle ScholarPubMed
Rowa, K., Paulitzki, J. R., Ierullo, M. D., Chiang, B., Antony, M. M., Mccabe, R. E., & Moscovitch, D. A. (2015). A false sense of security: safety behaviors erode objective speech performance in individuals with social anxiety disorder. Behavior Therapy, 46, 304–314. https://doi.org/10.1016/j.beth.2014.11.004CrossRefGoogle ScholarPubMed
Salkovskis, P. M. (1991). The importance of behavior in the maintenance of anxiety and panic: a cognitive account. Behavioural Psychotherapy, 19, 6–19. https://doi.org/10.1017/S0141347300011472CrossRefGoogle Scholar
Salkovskis, P. M., Clark, D. M., Hackmann, A., Wells, A., & Gelder, M. G. (1999). An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia. Behaviour Research and Therapy, 37, 559–574.CrossRefGoogle ScholarPubMed
Schmidt, S., & Walach, H. (2000). Electrodermal activity (EDA) – state-of-the-art measurement and techniques for parapsychological purposes. Journal of Parapsychology, 64, 139–164.Google Scholar
Schweizer, S., Satpute, A. B., Atzil, S., Field, A., Feldman-Barrett, L., & Dalgleish, T. (2019). The impact of affective information on working memory: a pair of meta-analytic reviews of behavioral and neuroimaging evidence. Psychological Bulletin, 145, 566–609.CrossRefGoogle ScholarPubMed
Sloan, T., & Telch, M. J. (2002). The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation. Behaviour Research and Therapy, 40, 235–251. https://doi.org/10.1016/s0005-7967(01)00007-9CrossRefGoogle Scholar
Sy, J. T., Dixon, L. J., Lickel, J. J., Nelson, E. A., & Deacon, B. J. (2011). Failure to replicate the deleterious effects of safety behaviors in exposure therapy. Behaviour Research and Therapy, 49, 305–314. https://doi.org/10.1016/j.brat.2011.02.005CrossRefGoogle ScholarPubMed
Thyer, B., Papsdorf, J., Davis, R., & Vallecorsa, S. (1984). Autonomic correlates of the subjective anxiety scale. Journal of Behavior Therapy & Psychiatry, 15, 3–7. https://doi.org/10.1016/0005-7916(84)90115-0CrossRefGoogle ScholarPubMed
van den Hout, M. A., Engelhard, I. M., Toffolo, M. B., & van Uijen, S. L. (2011). Exposure plus response prevention versus exposure plus safety behaviours in reducing feelings of contamination, fear, danger and disgust. An extended replication of Rachman, Shafran, Radomsky & Zysk (2011). Journal of Behavior Therapy and Experimental Psychiatry, 42, 364–370. https://doi.org/10.1016/j.jbtep.2011.02.009CrossRefGoogle Scholar
van Uijen, S. L., van den Hout, M. A., Schiphorst, A. T. K., Knol, E. S., & Engelhard, I. M. (2017). Disconfirming contamination-related threat beliefs by exposure plus safety behavior. Journal of Behavior Therapy and Experimental Psychiatry, 55, 25–32. https://doi.org/10.1016/j.jbtep.2016.11.005CrossRefGoogle ScholarPubMed
Vassilopoulos, S. P. (2009). Interpretations for safety behaviours in high and low socially anxious individuals. Behavioural and Cognitive Psychotherapy, 37, 167–178.CrossRefGoogle ScholarPubMed
Wolpe, J. (1958). Psychotherapy by Reciprocal Inhibition. Oxford, UK: Stanford University Press.Google Scholar
Supplementary material: File

Tutino et al. supplementary material

Tutino et al. supplementary material

Download Tutino et al. supplementary material(File)
File 19.8 KB
Submit a response

Comments

No Comments have been published for this article.