title: Behavior as information about threat in anxiety disorders: a comparison of patients with anxiety disorders and non-anxious controls.
abstract: Gangemi, Mancini, and van den Hout (2012) argued that anxious patients use safety behaviors as information that the situation in which the safety behaviors are displayed is dangerous, even when that situation is objectively safe. This was concluded from a vignette study in which anxious patients and non-clinical controls rated the dangerousness of scripts that were safe or dangerous and in which the protagonist did or did not display safety behaviors. Patients were more likely to take safety behavior as evidence that the situation was dangerous, especially in safe situations. Their non-clinical group may not have been psychologically naïve. We critically replicated the Gangemi et al. study using a psychologically non-informed control group.
  
  
  
  The same materials were used and patients (Obsessive Compulsive Disorder, Panic Disorder, Social Phobia; n = 30 per sub-group) were compared to matched non-patients. Using Bayesian statistics, data from the Gangemi et al. samples and the present groups were (re-)analyzed testing the hypothesis relative to non-patients, patients infer threat from safety behaviors, especially if displayed in safe situations.
  
  
  
  The Gangemi et al. data yielded a Bayes factor of 3.31 in support of the hypothesis. The present Bayes Factor was smaller (2.34), but strengthened the support for the hypothesis expressed by an updated Bayes factor of 3.31 × 2.34 = 7.75.
  
  
  
  The finding that anxious patients infer threat from safety behaviors, in particular in safe contexts, was corroborated, suggesting one way in which safety behaviors are involved in the maintenance of anxiety disorders.
authors.affiliation: Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands; Dipartimento di Scienze Cognitive, University of Messina, Messina, Italy; Scuola di Specializzazione in Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva (APC), Rome, Italy; Academic Anxiety Centre Altrecht, Altrecht Mental Health Centre, Utrecht, The Netherlands. Electronic address: m.vandenhout@uu.nl.
authors.forename: Marcel
authors.initials: M
authors.lastname: van den Hout
authors.affiliation: Dipartimento di Scienze Cognitive, University of Messina, Messina, Italy; Scuola di Specializzazione in Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva (APC), Rome, Italy.
authors.forename: Amelia
authors.initials: A
authors.lastname: Gangemi
authors.affiliation: Scuola di Specializzazione in Psicoterapia Cognitiva, Associazione di Psicologia Cognitiva (APC), Rome, Italy; Guglielmo Marconi University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mancini
authors.affiliation: Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands; Academic Anxiety Centre Altrecht, Altrecht Mental Health Centre, Utrecht, The Netherlands.
authors.forename: Iris M
authors.initials: IM
authors.lastname: Engelhard
authors.affiliation: Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands.
authors.forename: Marleen M
authors.initials: MM
authors.lastname: Rijkeboer
authors.forename: Marcel
authors.initials: M
authors.lastname: van Dam
authors.affiliation: Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands.
authors.forename: Marcel
authors.initials: M
authors.lastname: van Dams
authors.affiliation: Methodology and Statistics, Utrecht University, The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: Klugkist
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology*; D001499:Bayes Theorem; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012919:Social Behavior
keywords: Anxiety disorders; Behavior as information; Obsessive-compulsive disorder; Panic disorder; Safety-seeking behaviors; Social phobia