Background: Research has repeatedly demonstrated the importance of decreasing safety behavior (SB) usage for optimal anxiety treatment outcome. Cognitive-behavioral theory predicts that beliefs about SBs are directly related to their use. Unfortunately, little is known about the beliefs individuals hold about SBs, as there exists no validated, transdiagnostic measure of this construct. Firstly, the present study developed and psychometrically evaluated the Safety Behavior Scale (SBS), a transdiagnostic measure assessing SB usage and the beliefs individuals hold about SBs. Secondly, the relationship between beliefs about SBs and SB frequency was examined.
Methods: Participants (N = 254) recruited via an online crowdsourcing market were screened for clinical-level anxiety related to negative evaluation of others, social anxiety (SA; n = 145), and anxiety related to physiological sensations of anxiety, anxiety sensitivity (AS; n = 109). The mean age of the sample was 36.7 years (SD =10.0), and most participants were women (66.5%) and Caucasian (79.9%). The sample completed the SBS and validated measures of SB usage, anxiety severity, distress tolerance, and quality of life.
Results: A principal components analysis using an oblique (oblimin) rotation yielded two clear factors, accounting for 65.1% of the variance in SBS scores. Items on Factor 1 assessed the frequency of SB usage (all loadings ≥ .72). Items on Factor 2 assessed the beliefs individuals hold regarding SBs (all loadings ≥ .79). Subscales based on Factor 1 (SBS-Behavior) and Factor 2 (SBS-Belief) demonstrated high internal consistency (α = .88 and .93, respectively) and good convergent validity with measures of distress tolerance, SB usage, and anxiety severity. Positive beliefs about SBs were significantly correlated with all measures of SB frequency in both the AS and SA group.
Conclusion: The present study supports the SBS as a psychometrically sound measure with potential utility in both clinical and research settings. Positive beliefs about SBs are associated with their increased use and other negative outcomes. The SBS may be used in clinical settings to facilitate personalized anxiety treatment.
Johanna Meyer– PhD Candidate, University of Wollongong, Wollongong, New South Wales, Australia
Alex Kirk– Doctoral Student, The University of Colorado at Boulder, Broomfield, Colorado
Joanna Arch– Assistant Professor, The University of Colorado at Boulder, Boulder, Colorado
Peter Kelly– University of Wollongong
Brett Deacon– Director, Illawarra Anxiety Clinic, Mount Pleasant, New South Wales, Australia
University of Wollongong
Wollongong, New South Wales, Australia