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The role of safety behaviors in exposure-based treatment for panic disorder and agoraphobia : Associations to symptom severity, treatment course, and outcome

Helbig-Lang, Sylvia and Richter, Jan and Lang, Thomas and Gerlach, Alexander L. and Fehm, Lydia and Alpers, Georg W. and Ströhle, Andreas and Kircher, Tilo and Deckert, Jürgen and Gloster, Andrew T. and Wittchen, Hans-Ulrich. (2014) The role of safety behaviors in exposure-based treatment for panic disorder and agoraphobia : Associations to symptom severity, treatment course, and outcome. Journal of anxiety disorders, Vol. 28, H. 8. pp. 836-844.

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Official URL: http://edoc.unibas.ch/dok/A6337584

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Abstract

The potentially detrimental effects of safety behaviors during exposure therapy are still subject to debate. Empirical findings are inconsistent, and few studies have investigated effects of idiosyncratic safety behavior manifestations during exposure or in everyday life. These limitations might be due to a lack of appropriate measures that address individual safety behaviors. We examined psychometric properties and predictive value of the Texas Safety Maneuver Scale (TSMS), a questionnaire specifically targeting safety behaviors in panic disorder and agoraphobia. Effects of safety behavior use, both during everyday life and during therapy, were examined using data from a multicenter RCT of N=268 patients that aimed at evaluating efficacy and mechanisms of action of two variants of an exposure-based therapy. The TSMS total score demonstrated good internal consistency (α=0.89), and it showed significant correlations with selected measures of baseline anxiety and impairment. The proposed factor structure could not be replicated. Frequent safety behavior use at baseline was associated with actual safety behavior during exposure exercises. Pronounced in-situ safety behavior, but not baseline safety behavior was associated to detrimental treatment outcome. The results underline the relevance of a rigorous safety behavior assessment in therapy. The actual relationship between safety behavior use and treatment outcome is yet to determine.
Faculties and Departments:07 Faculty of Psychology > Departement Psychologie > Forschungsbereich Klinische Psychologie und Neurowissenschaften > Klinische Psychologie und Epidemiologie (Lieb)
UniBasel Contributors:Gloster, Andrew
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Elsevier
ISSN:0887-6185
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:06 Feb 2015 09:59
Deposited On:06 Feb 2015 09:59

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