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Behav Res Ther. 2017 Sep;96:3-13. doi: 10.1016/j.brat.2017.04.004. Epub 2017 Apr 19.

Pathways towards the proliferation of avoidance in anxiety and implications for treatment.

Author information

1
University of Southern California, United States. Electronic address: inna.arnaudova@gmail.com.
2
University of Amsterdam, The Netherlands.
3
University of California, Los Angeles, United States.
4
KU Leuven, Belgium.

Abstract

Avoidance is a key symptom of anxiety disorders. Maladaptive avoidance impairs general functioning acutely and maintains chronic anxiety. A better understanding of the mechanisms that elicit and maintain excessive avoidance might provide opportunities to improve treatment. Here, we discuss pathways through which avoidance might get amplified in the context of anxiety disorders: 1) increased threat appraisal; 2) enhanced threat avoidance tendencies; 3) impaired regulation of avoidance; 4) habitual avoidance; and 5) attempts at increasing psychological distance. Novel strategies for reducing avoidance are considered. These include memory reconsolidation interference, retraining of avoidance tendencies, mindfulness training and habit disruption approaches. Throughout the paper, we highlight a number of suggestions for future research on avoidance and how to achieve lasting behavior change.

KEYWORDS:

Anxiety; Avoidance; Fear; Treatment

PMID:
28457483
DOI:
10.1016/j.brat.2017.04.004
[Indexed for MEDLINE]

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