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.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/40926 |
| Date | 03 September 2020 |
| Creators | Tutino, Jessica |
| Contributors | Ouimet, Allison Jane |
| Publisher | Université d'Ottawa / University of Ottawa |
| Source Sets | Université d’Ottawa |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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