Safety behaviour: a reconsideration

There is ample evidence that the use of safety behaviour can interfere with the progress of therapy, particularly if exposure is involved. As a result, it is widely asserted that safety behaviour is anti-therapeutic. However, an unqualified rejection of safety behaviour should be reconsidered because we now have theoretical justification, experimental evidence and clinical observations showing that the judicious use of safety behaviour, especially in the early stages of treatment, can be facilitative. Experiments in which escape behaviour facilitated fear reduction, and others in which the use of safety gear facilitated fear reduction, are reviewed. It also appears that safety behaviour does not necessarily prevent disconfirmatory experiences. We propose that additional investigations of the judicious use of safety behaviour will help to elucidate therapeutic uses of safety behaviour in the treatment of anxious and related types of psychopathology.     

Do fears summate?—III

The primary purpose of this investigation was to learn whether fears summate. Thirty Ss who reported and displayed fear in response to a snake and to a spider were shown each stimulus separately and then both stimuli simultaneously, in order to see if their fear responses would summate. They did, overall; however, if Stimulus 1 provoked greater fear than Stimulus 2, the simultaneous presentation of both stimuli was followed by a subtraction. Summation occurred when the second stimulus produced a larger fear response than the first stimulus, and the two were then presented simultaneously.     

Mobility,Cognitions, and panic

Responses to the Mobility Inventory for Agoraphobia and the Cognitions Questionnaire were compared from samples of agoraphobics, social phobics, senior citizens, students, and students' relatives. The data illustrate the occurrence of avoidant behavior and panic in groups other than agoraphobics. The Mobility Inventory was shown to have good discriminative power, but the Cognitions Questionnaire failed to discriminate between agoraphobics and social phobics. The relationship of panic to mobility and cognitions is considered.     

Fearful distortions

Clinical observations suggesting that perceptual distortions can take place during episodes of fear are described, and two hypotheses are set out: (1) perceptual distortions occur during episodes of fear, and (2) such distortions decline after reduction of the pertinent fear.

An experiment in which fearful subjects were asked to report their perceptions of a feared object during episodes of fear, and then again after fear-reduction, was carried out. Snake-phobic and spider-phobic subjects showed evidence of some distortions in the activity of the pertinent fear object, but no distortions of size. After the reduction of the relevant fear, the subjects reported significant declines in the activity of the pertinent animal. The two hypotheses received partial support.     

Anxiety disorders: Some emerging theories

The influential Miller-Mowrer theory of fear and avoidance served well for over 30 years, but the need for revisions is now irresistible. The evidence in support of the first part of the theory, the conditioned acquisition of fear, is reviewed briefly and the major weaknesses of the theory are identified. The insufficiency of the second part of the theory, which deals with the persistence of avoidance behavior, is noted. Six emerging themes and theories of anxiety are described and briefly compared: Lang's bioinformational theory, Gray's neuropsychological theory, Beck's cognitive theory, Eysenk's neobehavioristic theory, emotional processing, and Bandura's self-efficacy theory. Attention is given to the 3 pathways to fear acquisition hypothesis, and to the role of safety signals in maintaining avoidance behavior. This subject is undergoing a period of healthy ferment, and significant advances in understanding can be expected to occur in the near future.     

The modification of agoraphobic avoidance behaviour: some fresh possibilities

A reconsideration of the theoretical basis of the therapy provided for agoraphobic people is warranted on three grounds. Although current methods of behavioural treatment are moderately effective, many patients are left with significant residual problems. Secondly, consideration of the theoretical basis of current behavioural treatments has been neglected and thirdly, there has been insufficient curiosity about the nature of agoraphobia.Three approaches to the problem of persistent avoidance behaviour and/or fear were selected as being of particular promise: Seligman and Johnston's cognitive theory of avoidance behaviour. Gray's elaboration of the safety signal hypothesis and Bandura's self-efficacy theory. Proposals for two new forms of therapy were formulated from an examination of these theories. The most promising possibilities are ‘therapy by repeated disconfirmation’ and ‘safety-signal therapy’. The general lines of these new forms of therapy are set out, examples provided and suggestions put forward for assessment procedures.It is suggested that in many agoraphobic cases, the control of panic attacks is a target of central importance and renewed attempts to find dependable ways of controlling panic attacks by psychological methods should be made. It is also recommended that self-efficacy estimates should be included in experimental investigations of the therapy provided for people with agoraphobic problems.