There is a debate among researchers and clinicians as to whether the judicious use of safety behaviours (SBs) during exposure therapy is helpful or detrimental. Central to this debate is the premise that SBs may interfere with one’s ability to gather disconfirmatory evidence. However, no study to date has assessed: 1) how SB use may interact with cognitive mechanisms at play during an exposure-like task, or 2) whether it is SBs themselves, or rather, beliefs about SBs that are most important. The two studies outlined in this dissertation sought to investigate the cognitive, emotional, behavioural, and psychophysiological underpinnings and consequences of exposure with SBs. In Study 1, speech anxious participants (N = 111) were randomly assigned to deliver an evaluated speech with or without SBs. Self-reported anxiety ratings and psychophysiological arousal measures were recorded at baseline, in anticipation of the speech, and following the speech. Measures of working memory capacity, ability to gather disconfirmatory evidence, and speech task acceptability were administered. Results demonstrated no differences between conditions on most outcomes. However, condition did influence willingness to deliver future speeches, such that participants in the SB condition were less willing than those in the NoSB condition to deliver a future speech without SBs. In Study 2, speech anxious participants (N = 144) were given divergent information on the helpfulness of SBs. Participants were randomly assigned to one of three conditions and were told either that SBs are: helpful (decrease anxiety), unhelpful (counterproductive and increase anxiety), or were provided with no information on the anxiolytic effects of SBs (control condition). Self-reported anxiety ratings were recorded at baseline, in anticipation of the speech, and following the speech. Similar to Study 1, measures of working memory capacity, ability to gather disconfirmatory evidence, and speech task acceptability were administered. Results demonstrated that participants in the helpful condition perceived the exposure as being more likely to succeed in helping them reduce their anxiety. Moreover, exposure expectancy mediated the relationship between the helpful condition (but not the unhelpful condition) and willingness to engage in future exposure exercises. There were no differences between conditions on most other outcomes. Taken together, these findings suggest that SB use may not necessarily be detrimental to outcomes on an exposure-like task, as individuals were able to gather disconfirmatory evidence (one of the proposed primary mechanisms underlying exposure success) across conditions in both studies. However, clients may believe SBs to be more helpful than they actually are, and clinicians should work collaboratively with clients to identify whether judicious SB use may be appropriate and helpful (or inappropriate and detrimental) in achieving their treatment goals. The current research program has the potential to improve our understanding of the consequences of SB use and identify the ways in which cognitive behavioural therapies could be improved.

Contemporary cognitive theories argue that socially anxious individuals adopt self-protective behavioural strategies under conditions of perceived social threat in order to prevent or diminish the likelihood of negative social outcomes. When performed in an anxiety-provoking but otherwise innocuous situation, however, safety behaviours are posited to facilitate biased processing of threat-relevant information, disrupt behavioural performance, elicit negative social responses, and ultimately prevent disconfirmation of fear-relevant beliefs. This dissertation project was designed to evaluate the effects of safety behaviour reduction strategies on a number of the core processes relevant to the persistence of pathological social fear. Two studies were conducted to address the following issues: Do safety behaviour reduction strategies influence socially anxious individuals’ (1) self- and social-judgments, (2) social performance, (3) the interpersonal reactions of oneself and others, and (4) appraisals of future social events. In study 1, in vivo safety behaviours were manipulated in a sample of 50 socially anxious students during a laboratory social interaction. Participants were randomly assigned to either a safety behaviour reduction (SB, n = 25) or exposure alone (control, n = 25) condition, and subsequently took part in two conversations with a trained experimental assistant. Results revealed that participants in the SB group displayed more accurate self-judgments of anxiety-related behaviour, improved social performance, and evoked more positive partner reactions. Study 2 was designed to replicate and extend the findings of study 1 in a sample of 80 patients seeking treatment for social anxiety disorder (SAD). Following a baseline conversation, participants were randomly assigned to the graduated exposure (GE, n = 40) or safety behaviour reduction condition (SB, n = 40). Consistent with the findings of study 1, the SB group displayed more accurate self-judgments about visible displays of anxiety, more effective social behaviour, and were better liked by their interaction partner relative to GE participants. Moreover, relative to controls, participants in the SB group made less negative judgments about the likelihood of previously identified feared outcomes pertaining to future social events. Implications of the present findings for elucidating the role of safety behaviours in the maintenance of SAD, and its treatment outcome will be considered.

Insomnia is a common health complaint that often becomes a persistent problem. The theoretical frameworks for understanding and treating insomnia have mostly been behavioural, yet the importance of cognitive processes has received greater attention over the years. The overall aim of this dissertation was to expand the knowledge on the processes from the Cognitive Model of Insomnia by investigating them in novel contexts. Study I examined the outcomes from cognitive therapy for insomnia on adolescents. Study II explored the relationship between cognitive processes and the association with remission and persistence of insomnia in the general population. Lastly, Study III investigated if cognitive processes mediated between cognitive behavioural therapy for insomnia (CBT-I) and outcomes of insomnia and depressive severity in a sample of people with insomnia comorbid with depressive problems. The findings show that cognitive therapy for insomnia affected sleep for adolescents, thus this is a promising treatment option for this age group. Further, it was found that cognitive processes distinguished between adults with normal sleep and persistent insomnia. For people with insomnia, elevated sleep-related worry at baseline increased the risk of reporting persistent insomnia later on, whereas a lowering of selective attention and monitoring, and safety behaviours over time increased the likelihood of remission from insomnia. This has clinical implications for insomnia assessment and treatment, as well as theoretical implications, and warrants further research. CBT-I was associated with greater reductions in dysfunctional beliefs and sleep-related safety behaviours compared to control treatment. Dysfunctional beliefs mediated between CBT-I and insomnia severity and depressive severity respectively. This supports the importance of negative thought content in both insomnia and depression.

While the literature surrounding the negative effects of stress on health and well-being is plentiful, there is a distinct lack of research applying stress frameworks to an organisational safety context. This study investigated the impact of stressors and strains on safety in the workplace, using the Job Demand-Control model as a research framework. In order to maintain a proactive approach to safety management, safety climate, safety compliance and safety participation were used as study variables as they have been established as antecedents to accidents and injuries in the workplace. From questionnaire data from employees with regular safety issues it was found that a positive relationship exists between safety climate and safety behaviours. Satisfaction was found to mediate the relationship between safety climate and one dimension of the safety compliance measure used. Providing support for the buffer hypothesis of the Job Demand-Control model, safety control moderated the relationship between safety climate and safety participation. Control over work scheduling, and decision latitude moderated the relationship between safety climate and safety participation but were indicative of an enhancing effect, rather than a buffering effect. The results suggest that control is an important variable to consider in terms of safety.

Insomnia is a common health complaint that often becomes a persistent problem. The theoretical frameworks for understanding and treating insomnia have mostly been behavioural, yet the importance of cognitive processes has received greater attention over the years. The overall aim of this dissertation was to expand the knowledge on the processes from the Cognitive Model of Insomnia by investigating them in novel contexts. Study I examined the outcomes from cognitive therapy for insomnia on adolescents. Study II explored the relationship between cognitive processes and the association with remission and persistence of insomnia in the general population. Lastly, Study III investigated if cognitive processes mediated between cognitive behavioural therapy for insomnia (CBT-I) and outcomes of insomnia and depressive severity in a sample of people with insomnia comorbid with depressive problems. The findings show that cognitive therapy for insomnia affected sleep for adolescents, thus this is a promising treatment option for this age group. Further, it was found that cognitive processes distinguished between adults with normal sleep and persistent insomnia. For people with insomnia, elevated sleep-related worry at baseline increased the risk of reporting persistent insomnia later on, whereas a lowering of selective attention and monitoring, and safety behaviours over time increased the likelihood of remission from insomnia. This has clinical implications for insomnia assessment and treatment, as well as theoretical implications, and warrants further research. CBT-I was associated with greater reductions in dysfunctional beliefs and sleep-related safety behaviours compared to control treatment. Dysfunctional beliefs mediated between CBT-I and insomnia severity and depressive severity respectively. This supports the importance of negative thought content in both insomnia and depression.

The unequal gender distribution in the construction industry is a verifiable truth and previous research indicates that there may be a connection between this inequality and the work environment. Therefore, this report will address gender equality and its correlation with the work environment in the construction industry. The questions of the report aims to further investigate the said connection and understand which factors may need to be improved in the areas of gender equality, gender distribution and work environment. These are further investigated with a survey poll and interviews, conducted at five of the larger construction companies in Sweden, alongside with a literature study which in turn serves/function as the basis for the survey. the five interviewed companies consist of JM AB, JME, NCC Sverige AB, Skanska Sverige AB and Peab Sverige AB.The purpose of this bachelor thesis is to explore and illustrate the current problems linked to gender distribution within the construction industry and thus investigate the benefits of a more equal gender distribution. This is in conclusion completed from a work environment point of view. The goal of the project is hence to gain increased knowledge regarding gender equality related to the work environment at a construction site. Furthermore, this report is limited to examining the subject within construction sites and mainly with gender equality from a gender distribution point of view.The results of the surveys indicate that there is a connection between gender distribution and the work environment. It is, furthermore, indicated that the work environment can be improved with a more equal gender distribution. There is also a desire for a more equal treatment between both genders which some of the correspondents are not currently experiencing. Additionally, it is believed that current norms and macho cultures can affect the work environment and safety work in a negative way to a large extent. This can also have an impact on women ́s propensity to apply to the construction industry. Furthermore, these results indicate that there are several factors that need to be improved in the construction industry linked to gender equality, gender distribution and the work environment. One factor is thus to include both men and women in the gender equality work, which in turn can lead to an overall improvement of the industry for everyone involved. In conclusion, the framework of this report provides an industry perspective, although not allowing for a conclusion to be drawn from it. To do so a more comprehensive investigation would be required and therefore the result of this project only gives an indication on the branch perspective.