Talk:Safety behaviors (anxiety)

Undue weight

I have tagged this article because it fails to give any attention to the fact that safety behaviour is expected in normal society and often a legal requirement. For example,

1. Motorists and other road users are expected to drive safely rather than recklessly
2. Employees and management are expected to behave safely at all times in the workplace
3. Safety behaviour is an important element of many pastimes such as climbing, boating, exercise, &c.

Instead, the article focuses exclusively on psychological conditions without much regard to whether they are appropriate or not. A complete restructure of the topic seems needed which would start with a clear understanding that the world is indeed a dangerous place and that determining appropriate and sensible safety behaviour is then a matter of risk assessment and cost-benefit analysis. As examples of the sort of sources which discuss this in detail, see Impact of Behavior-based Safety Techniques and Human Safety and Risk Management. I have added another project which may be able to help with this and am pinging the corresponding Wikipedian. Andrew D. (talk) 12:41, 30 April 2015 (UTC)

Regarding undue weight, this article is a different topic

The safety behaviors you are discussing are a different topic than the safety behaviors discussed in this article. We likely should change the title to avoid such confusion (e.g., Safety Behaviors in Anxiety). The safety behaviors in this article are focused on a particular class of behaviors that are used to reduce anxiety and fear in those with anxiety related disorders. They are an important topic in risk for anxiety, maintenance of anxiety, and tx of anxiety. The safety behaviors you note in your response above are related to workplace and societal issues of safety of citizens. These are not behaviors that are related to anxiety, but rather safety of people in general. The name "safety behavior" is the same, but the topics are entirely different. Kind of like a topic on depression (the mood disorder), but saying that the article does not discuss the definition of depression that means a low spot or indentation. It would seem the best course of action would be to make the title more specific or to make clear at the top that if people are interested in citizen safety or safety measures that protect people, then they should see these other topics (whatever they may be, and then link to them). Thanks. Prof Haeffel (talk) 15:47, 30 April 2015 (UTC)

• I have reverted the bold move to safety behaviors (anxiety) as we have only just started discussion and so there is not yet consensus. I disagree that there is a fundamental difference in the nature of the topic. People naturally have anxieties about dangers and these form a spectrum from serious risks to imaginary or highly unlikely. For example, someone might be worried about terrorism and, to mitigate this risk, they may avoid crowded places or air travel. Is this "safety behaviour" a normal response or a medical problem? This seems to be a matter of opinion rather than a hard fact. See The medicalisation of shyness as an example of a source which shows some appreciation of this. The current page does not seem to show any such awareness. Andrew D. (talk) 16:52, 30 April 2015 (UTC)

• I think you bring up an excellent point. In your example, the behavior (of avoiding crowded places) actually should lead to the outcomes described by the research cited in this article. This avoidance reinforces and thus, strengthens, the anxiety about terrorism leading to more anxiety (which may or may not be at a clinical level). The behaviors themselves are not being medicalized. These are behaviors that are often used by lots of people, but it's about their impact on risk for anxious symptoms and their tx. The article you site about shyness is an opinion piece (there is not meta analysis, and it simply provides support for the authors opinion) rather than a empirical study. The citations in support of the text of this article, tend to be actual research studies which provide quite a bit of strong support for the idea that safety behaviors may facilitate future anxiety (regardless of normal or non-normal anxiety conditions). The citations include experiments and longitudinal designs which show that these behaviors precede and predict anxiety in clinical and non-clinical populations. So, I'm not sure it's accurate to make this about normal vs. abnormal (anxiety can be on a continuum as you say). The ideas presented are rooted decades of research on basic learning principles (reinforcement, operant conditioning, etc.). So, as a researcher, I would say there is pretty good consensus about the possible role of these factors in anxiety (and not necessarily only clinically significant anxiety). I think the example about terrorism is a good one that you bring up. And I think what is written in the article would apply to that situation. My original response was more about the original issue you had brought up was with regard to safety rules and regulations; this does seem quite different as people do many of these behaviors because of obeying the law, taught be family members, etc. ...and not because of alleviating their own personal anxiety per se. Thanks for the interesting discussion on this. Prof Haeffel (talk) 20:42, 30 April 2015 (UTC)

Definitions

I looked at the current sources in the article and there are there seems to be only one review which states, "The systematic integration of findings is hampered by the variety of concepts used to describe safety behavior, and methodological differences in empirical studies. This article provides a definition and classification of safety behavior in contrast to adaptive coping strategies." So, this indicates a need for clear definitions, which we may have difficulty finding. Here's a link to a source which is based on the perspective of the safety consultant:

• The Psychology of Safety Handbook - The eyes of the beholder

Andrew D. (talk) 17:44, 30 April 2015 (UTC)

• I'll have to look more closely at the citations, but my impression is that there is at least some consensus in the empirical literature on a definition of safety behaviors (particularly given the growing body of work on this). There are 4 existing measures of safety behaviors, which tend to overlap and correlate. This would indicate the scales are measuring the same construct, which means researchers are agreeing on what types of behaviors are "counting" as safety behaviors. Again, will have to look at the articles more closely. Perhaps the author of the article will be able to chime in here as well. Thanks! Prof Haeffel (talk) 21:04, 30 April 2015 (UTC)

• Hello! Below is a list of quotes from references from the cited articles that talk about safety behaviors. The authors are quite consistent in the types of behaviors that are considered safety behaviors. There also appears to be consensus that safety behaviors are designed to mitigate anxiety by avoiding or managing a perceived threat. Does this help reduce confusion on the definition? GoldenCirclet (talk) 01:48, 1 May 2015 (UTC)
  1. A cognitive model of posttraumatic stress disorder. “Among the strategies that prevent a change in the appraisal of the traumatic event or its sequelae are safety behaviours. These are actions individuals take to prevent or minimize anticipated further catastrophes (Salkovskis, 1996). Safety behaviours prevent disconfirmation of the belief that the feared catastrophe will occur if one does not engage in preventative action.”
  2. Assessment of strategies to manage or avoid perceived threats among panic disorder patients: The Texas Safety Maneuver Scale (TSMS). “Safety maneuvers then, are defined as strategies people use to manage or avoid perceived threats associated with panic or anxiety. Common safety maneuvers are trying to stay busy, avoiding conflict, sitting close to exits in public places, scanning the environment for safety signals, or other ritualistic behaviors such as carrying around tokens that are believed to `magically' prevent anxiety. This study examines the concept of safety maneuvers in the context of panic disorder, but clinical experience suggests that safety-seeking behaviors are prevalent in other anxiety disorders as well (e.g. social phobia, obsessive compulsive disorder, specific phobia).”
  3. The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. “...safety seeking behaviour arises out of, and is logically linked to, the perception of serious threat. Such behaviour may be anticipatory (avoidant) or consequent (escape)”
  4. A self-report measure of subtle avoidance and safety behaviors relevant to social anxiety: Development and psychometric properties. “The term “safety behavior” is generally used to refer to a range of strategies that can be employed prior to or during social situations. The strategies are logically linked to the nature of the individual's feared social consequences (e.g., attracting attention, performing poorly, making a bad impression, displaying visible signs of anxiety), and are designed to reduce the likelihood of negative evaluation by others… Safety behaviors are hypothesised to be triggered by the unrealistic beliefs that are activated when a socially anxious individual enters a feared social situation, and are intended to prevent or minimize the feared social catastrophe.”
  5. Social phobia: The role of in-situation safety behaviors in maintaining anxiety and negative beliefs. “…in-situation safety behaviors play an important role in the maintenance of anxiety because they prevent phobic people from experiencing an unambiguous disconfirmation of their unrealistic beliefs about feared catastrophes.”
  6. Safety behaviour: A reconsideration. “It is widely asserted by clinicians and researchers, and recommended in textbooks and treatment manuals, that safety behaviour is counter-therapeutic and should be extinguished… It has been accepted that at best, safety behaviour provides temporary relief, but it is a major cause of persisting anxiety and avoidance.”
  7. Understanding and treating obsessive—compulsive disorder. “...the therapist then turns their attention to helping the patient understand and deal with responses which are involved in the maintenance of their negative beliefs. These factors fall into several broad categories, including selective attention and vigilance, the effects of mood (anxiety and depression), physiological arousal, neutralising behaviours and other counter-productive safety-seeking strategies (including overt avoidance, thought suppression and cognitive avoidance, reassurance-seeking, the use of inappropriate criteria for stopping a behaviour and so on).”
  8. The effect of the decreased safety behaviors on anxiety and negative thoughts in social phobics. “Safety behaviors have played an important role in the maintenance of anxiety. Social phobics engage in various safety behaviors in social situations in order to decrease risk of negative evaluations from others. Typical examples of safety behaviors include trying to avoid drawing attention of others to self, avoiding eye-contact, monitoring one’s speech, and avoiding pauses while talking. In many cases, there is a definite relationship between one’s safety behaviors and the feared outcome. For example, those who fear that stopping in the middle of one’s speech causes others to see them as being anxious and to rate them negatively will rehearse in detail what to say and will speak it very fast. For those who fear that their hands may shake when they drink, they will hold their cups more tightly.”
  9. An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia. “The cognitive theory suggests that, in phobic anxiety, safety-seeking behaviour is particularly important in the maintaining perceived threat…Patients are often unaware of the anxiety maintaining effects of their avoidant behaviour (described here as safety-seeking behaviour)…Cognitive theory predicts that safety-seeking behaviours have the effect of maintaining anxiety-generating beliefs because patients infer that they have prevented the occurrence of feared catastrophes by their behaviour.”
  10. The effects of safety behaviors on the fear of contamination: An experimental investigation. “Actions intended to detect, avoid, or escape a feared outcome, known as ‘‘safety behaviors’’ …whereas the judicious use of safety behaviors in the presence of actual threat is essential for survival, such behaviors are often employed in the absence of objective danger by individuals with anxiety disorders (Clark, 1999; Salkovskis, 1991).”
  11. Acting on persecutory delusions: The importance of safety seeking. “Individuals who feel threatened often carry out actions designed to prevent their feared catastrophe from occurring; this has been termed ‘safety behaviour’ (Salkovskis, 1991). When the perceived threat is a misperception, such as in anxiety disorders and paranoia, there are important consequences. Individuals fail to attribute the absence of catastrophe to the incorrectness of their threat beliefs. Rather, they believe that the threat was averted only by their safety behaviours (e.g. ‘The reason I wasn’t attacked was because I left the street in time and made it back home’).”
  12. The observer perspective: effects on social anxiety and performance. “Second, socially anxious individuals engage in “safety behaviours” such as avoiding eye contact so that they will not see disapproval in other people’s expressions, which they believe to be helpful, but in fact often exacerbate the problem, for example, they appear less friendly. Safety behaviours also serve to maintain the belief that social situations are dangerous, as the absence of the feared social catastrophe is attributed to the safety behaviour.”
  13. Self-portrayal concerns and their relation to safety behaviors and negative affect in social anxiety disorder. “Here, as elsewhere (Moscovitch, 2009), we conceptualize SA[social anxiety]-related safety behaviors as strategic responses designed to suppress or conceal perceived self-flaws within anxiety-provoking social contexts."

• Here are some other sources that I did not cite in my article (but could include as external links if useful) but refer to safety behaviors in terms of this article's definition:
  1. Bennett-Levy, J. (2003). Mechanisms of change in cognitive therapy: The case of automatic thought records and behavioural experiments. Behavioural and Cognitive Psychotherapy, 31(03), 261-277. doi:10.1017/S1352465803003035 “An important category of behaviours in this respect are safety seeking behaviours (Salkovskis, 1996), which are actions taken by individuals to prevent or minimize anticipated further catastrophes. Safety seeking behaviours prevent disconfirmation of prevailing beliefs (e.g. ‘‘I’ll faint if I go into the supermarket’’), since individuals attribute the absence of further catastrophe to their apparently preventative actions (e.g. squeezing shopping trolley handle tightly to ‘‘prevent fainting’’)”
  2. Safety behaviors in social anxiety | Psychology Today “People with anxiety often perform "safety behaviors" during anxiety provoking situations. These safety behaviors make the person feel more comfortable in the situation by providing temporary relief from anxiety. However, safety behaviors have been described as the major cause of persisting anxiety and the reason why people don't feel relief during exposures (Wells, Clark, Salkovskis, Ludgate, Hackmann, & Gelder, 1995).”
  3. Safety Behaviors - Social Anxiety Disorder “People who suffer with social anxiety disorder (SAD) often engage in "safety behaviors". These are those things that you do to try and avoid embarrassment in front of others. Although it may seem like doing these things helps to reduce your anxiety, in the long run what you are doing is actually maintaining your fear.”

Dispute resolution

Requested a dispute resolution here for an outside opinion: https://en.wikipedia.org/wiki/Wikipedia:Dispute_resolution_noticeboard#Talk:Safety_behaviors GoldenCirclet (talk) 02:40, 13 May 2015 (UTC)