Behavior as information: “If I avoid, then there must be a danger”

Background and objectivesCognitive models of anxiety disorders view safety-seeking behaviors (i.e., avoidance, washing, etc.) as playing a crucial role in the maintenance of irrational fear. An explanation of how these behaviors may contribute to the maintenance of unrealistic beliefs is that patients use their safety behaviors as a source of information about the situation (behavior as information): the behavior is clear evidence of the danger. This study investigates whether, relative to non-clinical control participants, anxious participants actually infer danger on the basis of their safety behaviors, rather than on the basis of objective information.MethodsThree groups of individuals affected by anxiety disorders (31 obsessive-compulsive participants, 22 panic participants, and 17 participants with social phobia) and a group (31) of non-clinical controls rated the danger perceived in scripts in which information about objective safety vs. objective danger, and safety behavior vs. no-safety behavior were systematically varied.ResultsAs expected, anxious participants were influenced by both objective danger information and safety behavior information, while the non-clinical controls were mainly influenced by objective danger but not by safety behavior information. The effect was disturbance specific, but only for individuals with social phobia and obsessive-compulsive disorder.ConclusionsThe tendency to infer danger on the basis of the use of safety behavior may play a role in the development and maintenance of anxiety disorders.

► Safety behavior may serve as information from which anxious patients infer threat. ► Anxiety patients and controls rated scripts about threat and safety behaviors. ► Danger estimates in patients were inflated when safety behavior was present. ► Danger estimates in controls were mainly affected by the presence of threat. ► The effect was disturbance specific in social phobics and OCD patients.