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CHAPTER 8 196 the perceived severity of threat; Davey, 1997). Hence, safety behavior may contribute to the overestimation of threat that is hallmark to psychopathological anxiety. The finding presented in chapter 5, that safety behavior after fear extinction caused a return of fear, may be explained by contextual renewal (Treanor & Barry, 2017; van Uijen, Leer, et al., 2017; Vervliet & Indekeu, 2015). In chapter 5, inhibitory learning occurred without the availability of safety behavior. However, when safety behavior was available again after fear extinction, this may have caused a context shift and renewed fear (Vervliet & Indekeu, 2015). Clinical guidelines recommend eliminating all safety behaviors during exposure therapy (e.g., Abramowitz, Deacon, & Whiteside, 2011; Craske et al., 2014; Keijsers, van Minnen, & Hoogduin, 2011). Extinction learning during exposure therapy therefore occurs while patients inhibit their safety behaviors, which may represent a context for inhibitory learning. However, when safety behaviors are available again to the patient after exposure therapy, this may represent a context shift and cause contextual renewal. Apart from explanations in terms of learning theory, it may be noted that three other related explanations can be put forward for the causal effect of safety behavior on anxiety symptoms. First, safety behavior may directly activate the fear network (Lang, 1977), and thereby trigger danger perceptions. Second, individuals may infer danger from their use of safety behavior (safety behavior as information; Gangemi, Mancini, & van den Hout, 2012; van den Hout et al., 2014, 2017). Third, using safety behavior in relatively safe situations may induce cognitive dissonance, because the behavior is not in line with the perception of danger in that situation (Festinger, 1957; Festinger & Carlsmith, 1959). Individuals may reduce this dissonance by bringing their danger perception in line with their behavior. A discussion of the conceptual relatedness of these explanations and their commensurability with learning theory is beyond the scope of this chapter.

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