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Better safe than sorry? An examination of safety behaviour reduction interventions in social anxiety disorder Taylor, Charles Theodore

Abstract

Contemporary cognitive theories argue that socially anxious individuals adopt self-protective behavioural strategies under conditions of perceived social threat in order to prevent or diminish the likelihood of negative social outcomes. When performed in an anxiety-provoking but otherwise innocuous situation, however, safety behaviours are posited to facilitate biased processing of threat-relevant information, disrupt behavioural performance, elicit negative social responses, and ultimately prevent disconfirmation of fear-relevant beliefs. This dissertation project was designed to evaluate the effects of safety behaviour reduction strategies on a number of the core processes relevant to the persistence of pathological social fear. Two studies were conducted to address the following issues: Do safety behaviour reduction strategies influence socially anxious individuals’ (1) self- and social-judgments, (2) social performance, (3) the interpersonal reactions of oneself and others, and (4) appraisals of future social events. In study 1, in vivo safety behaviours were manipulated in a sample of 50 socially anxious students during a laboratory social interaction. Participants were randomly assigned to either a safety behaviour reduction (SB, n = 25) or exposure alone (control, n = 25) condition, and subsequently took part in two conversations with a trained experimental assistant. Results revealed that participants in the SB group displayed more accurate self-judgments of anxiety-related behaviour, improved social performance, and evoked more positive partner reactions. Study 2 was designed to replicate and extend the findings of study 1 in a sample of 80 patients seeking treatment for social anxiety disorder (SAD). Following a baseline conversation, participants were randomly assigned to the graduated exposure (GE, n=40) or safety behaviour reduction condition (SB, n=40). Consistent with the findings of study 1, the SB group displayed more accurate self-judgments about visible displays of anxiety, more effective social behaviour, and were better liked by their interaction partner relative to GE participants. Moreover, relative to controls, participants in the SB group made less negative judgments about the likelihood of previously identified feared outcomes pertaining to future social events. Implications of the present findings for elucidating the role of safety behaviours in the maintenance of SAD, and its treatment outcome will be considered.

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