Reducing safety behaviors to prevent anxious symptoms: A pre-registered prevention intervention study

Do you ever check your car or house doors to make sure they’re locked?  Do you over-plan for every day events?  Do you sometimes ask others for reassurance about a decision? Your answer is probably yes. That is because most of us engage in these kinds “safety behaviors.” We use these behaviors to reduce our anxiety. These behaviors make us feel safe, hence the name. However, it is possible to overuse safety behaviors. Research shows that the excessive use of safety behaviors can make anxiety worse in the longterm. 

Given the potential for safety behaviors to increase risk for anxiety, we created an easy-to-use, 4-week, online safety behavior workbook prevention intervention. The workbook focused on teaching people the safety behavior model with a focus on the different manifestations of these behaviors, how they increase anxiety, and the variety of methods on how to reduce them. We then conducted a study with 130 American college students to test two pre-registered hypotheses: 1) participants randomly assigned to the safety behavior reduction workbook condition would report using fewer safety behaviors post-intervention than those assigned to an active control condition; 2) participants randomly assigned to the safety behavior workbook condition would report lower levels of anxious symptoms post-intervention than those assigned to an active control condition.

The results showed that both of our hypotheses were wrong. Participants in the safety behavior workbook condition did not use fewer safety behaviors and did they have lower levels of anxiety post-intervention than participants in the active control condition. This suggests that safety behaviors are difficult to change using online interventions, even for those who may really need it.  

However, exploratory analyses revealed interesting finding —  participants in the safety behavior workbook condition who decreased their use of safety behaviors reported similar post-intervention anxiety levels to those who reported no change or increased safety behavior use. In contrast, those in the control condition who decreased their safety behavior use reported significantly less anxiety than those reporting no change or an increase in safety behaviors. These results suggest that encouraging non-clinical samples to focus on, and reduce, safety behavior may actually maintain anxiety (at least initially). In other words, forcing people who do not suffer from clinically signifiant anxiety to change their safety behavior use may backfire. We look forward to continued work in this area to determine when it is appropriate and useful to reduce safety behaviors.

Read the full paper here: Gorman, E. L., Goodson, J. T., & Haeffel, G. J. (2023). Reducing safety behaviors to prevent anxious symptoms: A pre-registered prevention intervention study, Cognitive Behaviour Therapy. https://doi.org/10.1080/16506073.2023.2237671

Featured photo: kateed

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