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CHAPTER 4 96 subsequent shock) to a safety cue (a stimulus that had never been paired with shock) subsequently had higher threat expectations to this cue than participants who were not given the opportunity to avoid. Thus, safety behavior seems to increase anxiety not only by misattributing safety to the execution of this behavior, but also by directly attributing danger to safe situations. The possibility that safety behavior exerts a causal influence on anxiety was recently investigated in two studies. First, Deacon and Maack (2008) investigated the effects of safety behavior on the fear of contamination in healthy participants with either high or low levels of contamination fear. After a week-long baseline period, participants spent one week actively engaging in a wide range of contamination- related safety behaviors on a daily basis (e.g., washing and disinfecting hands excessively, trying to avoid touching public door handles), followed by a second week-long baseline period. Independent of initial levels of contamination fear, participants reported increased contamination anxiety following the safety behavior manipulation. However, because this study lacked a control condition that did not perform any safety behavior, it remained unclear what the effect of the manipulation was. Therefore, in a subsequent study, healthy participants were divided in two groups, a safety behavior group and a monitor-control group (Olatunji, Etzel, Tomarken, Ciesielski, & Deacon, 2011). In between two week-long baseline periods in which both groups monitored their normal use of safety behaviors, participants in the safety behavior condition were asked to spent one week engaging in a large array of health-related safety behaviors on a daily basis, whereas participants in the control condition kept monitoring their usual safety behavior. Results showed that, compared to the control condition, participants in the safety behavior condition reported higher levels of health anxiety, hypochondriacal beliefs and avoidant responses to health related behavioral tasks. Thus, even in healthy individuals, the mere act of engaging in health-related safety behaviors for one week increased health anxiety.