Universität zu Köln

Helbig-Lang, Sylvia, Richter, Jan ORCID: 0000-0002-7127-6990, Lang, Thomas, Gerlach, Alexander L. ORCID: 0000-0001-6794-5349, Fehm, Lydia ORCID: 0000-0002-0825-8466, Alpers, Georg W. ORCID: 0000-0001-9896-5158, Stroehle, Andreas, Kircher, Tilo ORCID: 0000-0002-2514-2625, Deckert, Juergen, Gloster, Andrew T. and Wittchen, Hans-Ulrich ORCID: 0000-0002-6311-7711 (2014). The role of safety behaviors in exposure-based treatment for panic disorder and agoraphobia: Associations to symptom severity, treatment course, and outcome. J. Anxiety Disord., 28 (8). S. 836 - 845. OXFORD: PERGAMON-ELSEVIER SCIENCE LTD. ISSN 1873-7897

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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 (alpha=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. (C) 2014 Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Helbig-Lang, Sylvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Richter, Jan UNSPECIFIED orcid.org/0000-0002-7127-6990 UNSPECIFIED Lang, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerlach, Alexander L. UNSPECIFIED orcid.org/0000-0001-6794-5349 UNSPECIFIED Fehm, Lydia UNSPECIFIED orcid.org/0000-0002-0825-8466 UNSPECIFIED Alpers, Georg W. UNSPECIFIED orcid.org/0000-0001-9896-5158 UNSPECIFIED Stroehle, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kircher, Tilo UNSPECIFIED orcid.org/0000-0002-2514-2625 UNSPECIFIED Deckert, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Gloster, Andrew T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittchen, Hans-Ulrich UNSPECIFIED orcid.org/0000-0002-6311-7711 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-422536
DOI:	10.1016/j.janxdis.2014.09.010
Journal or Publication Title:	J. Anxiety Disord.
Volume:	28
Number:	8
Page Range:	S. 836 - 845
Date:	2014
Publisher:	PERGAMON-ELSEVIER SCIENCE LTD
Place of Publication:	OXFORD
ISSN:	1873-7897
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RANDOMIZED CONTROLLED-TRIAL; ANXIETY DISORDER; SEEKING BEHAVIORS; SOCIAL PHOBIA; STRATEGIES; AVOIDANCE; SCALE; MAINTENANCE; THERAPY; CBT Multiple languages Psychology, Clinical; Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42253