Flipbook

CHAPTER 1 16 effects of safety behaviors depend critically on whether they preclude the occurrence of threat has never been directly tested. An anomaly to this hypothesis are three experiments that investigated the effect of exposure with the use of cleaning safety behavior on feelings of contamination, fear, danger, and disgust (Rachman, Shafran, Radomsky, & Zysk, 2011; van den Hout, Engelhard, Toffolo, & van Uijen, 2011; van den Hout, Reininghaus, van der Stap, & Engelhard, 2012). In these studies, healthy volunteers repeatedly touched a contaminant, either while abstaining from any form of safety behavior, or with the use of disinfectant wipes after each instance of exposure (i.e., cleaning safety behavior). At the post-test measurement, participants were not allowed to clean themselves. The most remarkable finding was that the reduction in feelings of contamination, fear, danger, and disgust was comparable for both groups. It is hard to see how the cleaning behavior could not have interfered with extinction learning, because it prevents the occurrence of contamination and illness. The explanation for the positive effects of using cleaning safety behavior during exposure to a contaminant remains unclear. INTERMEDIATE SUMMARY Safety behavior can be detrimental to the beneficial effects of exposure, because it causes a misattribution of safety to the safety behavior, and prevents the occurrence of disconfirming learning experiences. Additionally, safety behavior can decrease the discrepancy between the expected and actual outcome of exposure, and thereby hamper inhibitory learning. Safety behavior is therefore traditionally eliminated during exposure therapy. However, empirical findings are inconsistent, and show detrimental, neutral, and beneficial effects of using safety behavior during exposure therapy. A hypothesis for this inconsistency is that the negative effects of safety behavior depend on whether they preclude the occurrence of an expected