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CHAPTER 3 82 We regard the finding that cleaning SB after exposure did not prevent a reduction in threat beliefs as unusually curious for various reasons. A theoretical reason is that cleaning SB logically prevents the acquisition of information that disconfirms inaccurate threat beliefs associated with contamination and illness (Salkovskis, 1991), and impedes inhibitory learning by preventing the maximal violation of negative expectancies (Craske, Treanor, Conway, Zbozinek, & Vervliet, 2014). An empirical reason is that several studies have shown unfavorable effects of using SB during exposure compared to ERP (for an overview, see Meulders et al., 2016; and Blakey & Abramowitz, 2016). SBs in and by itself even appear sufficient to induce threat beliefs (Engelhard, van Uijen, van Seters, & Velu, 2015; van Uijen & Toffolo, 2015), health anxiety (Olatunji, Etzel, Tomarken, Ciesielski, & Deacon, 2011), and contamination fear (Deacon & Maack, 2008). How can we reconcile these findings, and explain the decrease in threat belief ratings in the E+SB condition? The common denominator in the E+RP and E+SB condition was repeated exposure to the contaminant and to the subsequent feelings of contamination and disgust this induced, albeit short in the E+SB condition. It seems unlikely that expectancies about a feared future catastrophe were violated in this short period of exposure. However, it is possible that expectancies about the acute feelings of contamination evoked by touching the contaminant, the amount of distress, and the ability to tolerate this distress were violated, which caused inhibitory learning (Blakey & Abramowitz, 2016). CFDD ratings remained relatively low at the post-test when participants no longer used SB, which suggests that the inhibitory associations generalized to exposure without SB. Future studies that assess negative expectancies about immediate consequences of exposure to a contaminant are needed to give insight into the role of inhibitory learning in the reduction of CFDD and associated threat beliefs in E+SB. Additionally, it may be relevant that the role of SB was examined in the context of contaminated objects that give rise to disgust. In the case of fear, a stimulus (e.g., heart palpitations in panic disorder) evokes fear, because it activates an expectancy of