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CHAPTER 1 10 Petermann, 2010). The scope of safety behavior encompasses full avoidance of feared situations (Salkovskis, 1991), and subtle behavioral tricks or aids that are carried out within a specific situation (Rachman et al., 2008; Meulders et al., 2016). Although the definition of safety behavior was originally limited to actions intended to avoid an expected catastrophe (i.e., safety-seeking behavior; Salkovskis, 1991), more recent reviews of the literature also include actions aimed at preventing, escaping, or reducing distress that is associated with the perceived threat in the definition of safety behavior (Blakey & Abramowitz, 2016; Goetz, Davine, Siwiec, & Lee, 2016; Helbig- Lang & Petermann, 2010; Telch & Lancaster, 2012). PATHOLOGICAL ANXIETY Safety behaviors are common in anxiety-related psychopathology, such as anxiety disorders, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and illness anxiety disorder (Blakey & Abramowitz, 2016). Although PTSD, OCD, and illness anxiety disorder are not classified as anxiety disorders in the current edition of the Diagnostics and Statistical Manual of Mental Disorders (i.e., the DSM-5; American Psychiatric Association, 2013), there appears to be quite some overlap between these disorders and anxiety disorders (Deacon & Abramowitz, 2008; McManus, Shafran, & Cooper, 2010). Additionally, despite the distinct characteristics of the safety behaviors associated with these disorders, the role that safety behaviors may play in the persistence of these disorders is expected to be functionally equivalent (Blakey & Abramowitz, 2016; Rachman 2002; Telch & Lancaster, 2012). Anxiety disorders are characterized by debilitating fears that are irrational and cause substantial suffering and/or substantial impairment (American Psychiatric Association, 2014). They are the most prevalent disorders in mental health care, with an estimated lifetime prevalence of 30% and a 12-month prevalence of 18% in the USA and 19% in the Netherlands (De Graaf, ten Have, & van Dorsselaer, 2010;