Flipbook

6 APPROACH BEHAVIOR AS INFORMATION 147 INTRODUCTION Patients with anxiety disorders experience fear and display avoidance behavior in the absence of actual danger. According to cognitive theory, this is because they misinterpret a situation or stimulus as a sign of threat and expect that a catastrophe will follow (Salkovskis, Clark, & Gelder, 1996). Additionally, there is increasing evidence that anxious individuals infer danger from physiological, subjective, and behavioral (e.g., avoidance) anxiety response information. This study assessed whether anxious individuals also infer safety from opposing behavioral response information, in other words, from approach behavior. To start with, studies have shown that patients with anxiety disorders tend to use physiological responses as information. Ehlers, Margraf, Roth, Taylor, and Birbaumer (1988) found that false feedback of an increased heart rate induced anxiety and physiological arousal in patients with panic disorder, but not in healthy controls. Additionally, individuals with a fear of snakes showed more approach to a live snake after Valins and Ray (1967) led them to believe that their heart rate did not increase while viewing pictures of snakes. Furthermore, anxious individuals infer danger on the basis of a subjective fear response, that is, they tend to engage in emotional reasoning. In a study by Arntz, Rauner, and van den Hout (1995), four groups of patients with anxiety disorders and a group of healthy controls rated the danger they perceived in scenarios. The scenarios described situations in which information about objective safety versus objective danger and information about an anxiety response versus no anxiety response were varied. Patients with anxiety disorders, but not healthy controls, perceived more danger in scenarios with an anxiety response than in scenarios without an anxiety response. This effect was not disorder-specific and was similar for scenarios with objective danger information and objective safety information (Arntz et al., 1995). Emotional reasoning has been associated with posttraumatic stress disorder (PTSD; Engelhard, Macklin, McNally, van den Hout, & Arntz, 2001), fear of