Social Phobia: The Role of In-Situation Safety Behaviors in Maintaining Anxiety and Negative Beliefs – Republished Article☆,☆☆
Section snippets
Subjects
Eight patients (five female) meeting DSM-III-R (APA, 1987) criteria for social phobia as operationalized by the Structured Clinical Interview for DSM-111-R (Spitzer, Williams, & Gibbons, 1987) were selected for the study. (Although diagnostic reliability data are unavailable, SCID interviews were all conducted by A. W., who had received training in the use of the instrument and had four years subsequent experience.) Patients' ages ranged from 24 to 53 years. None met criteria for avoidant
Results
The patients' main fears and associated safety behaviors are shown in Table 1. Four patients were concerned with symptoms of shaking and interpreted these as a sign of "loss of control," two patients were concerned with "talking funny," one was concerned with "vomiting" and the other with "collapsing." A wide range of in-situation safety behaviors were elicited, and patients' belief in the feared outcomes ranged from 50 to 1000% just before exposures to the feared situation on the first
Discussion
The results of this initial study were as predicted. One session of exposure with decreased safety behaviors and appropriate information-processing rationale was significantly more effective than exposure of equivalent duration with no change in safety behaviors and an extinction rationale. For most patients, both types of exposure produced decrements in anxiety and belief. However, the mean decrement was greater in the decrease condition. In addition, although all patients showed improvements
Conflict of Interest Statement
The authors declare that there are no conflicts of interest.
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This research was supported by grants from the Medical Research Council of the United Kingdom and the Welcome Trust. Correspondence concerning this article should be addressed to Adrian Wells, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, U.K.
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This article is a reprint of a previously published article. For citation purposes, please use the original publication details; Behavior Therapy, 29 (1998), pp 357–370.