Clinical implications of risk aversion: An online study of risk-avoidance and treatment utilization in pathological anxiety

Previous research suggests that the pervasive tendency to avoid perceived risks (i.e., the safety bias) may be implicated in the maintenance of pathological anxiety. These studies have not explored, however, the potential clinical implications of such a bias, such as the influence of risk aversion on treatment seeking. The aim of this study was to investigate how risk-avoidance is related to willingness to seek treatment in an online sample of clinically anxious individuals with social phobia (SP), obsessive–compulsive disorder (OCD) and generalized anxiety disorder (GAD). Healthy control participants (n = 117) and those endorsing criteria for one or more anxiety disorder(s) (n = 92; SP, n = 33; OCD, n = 19; GAD, n = 40) were recruited from various online sources. Respondents completed an online survey comprised of a validated diagnostic interview, self-report measures assessing for symptom severity, risk-taking across various domains, a generalized index of risk-taking and treatment utilization. Consistent with hypotheses, SP and GAD individuals reported significantly more risk-avoidance when compared to non-clinical controls. Furthermore, willingness to seek treatment was found to be positively associated with social risk-taking and generalized risk-taking orientation in clinically anxious individuals who had never sought treatment. These results suggest that certain individual cognitive factors may contribute to the decision to seek treatment and may provide an interesting avenue of future investigation for increasing service utilization and treatment seeking in anxious populations.

► Avoiding perceived risks may be implicated in the maintenance of pathological anxiety.
► We explore how risk-avoidance is related to treatment seeking in clinical anxiety.
► SP and GAD individuals reported more risk-avoidance when compared to controls.
► Treatment seeking was positively associated with aspects of risk-taking.
► We conclude that risk-avoidance may contribute to the decision to seek treatment.