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J Anxiety Disord. 2019 May;64:9-15. doi: 10.1016/j.janxdis.2019.03.002. Epub 2019 Mar 5.

Safety behaviors, experiential avoidance, and anxiety: A path analysis approach.

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University of Colorado Boulder, 345 UCB, Boulder, CO, 80309, USA. Electronic address:
University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
University of Colorado Boulder, 345 UCB, Boulder, CO, 80309, USA.
University of New South Wales, 12 Alvan Parade, Mount Pleasant, NSW, 2519, Australia.


Avoidance has long been viewed as an etiological mechanism of anxiety disorders. Of more recent focus within this literature is the distinction between avoidance that is trait-based (experiential avoidance) versus contextual (safety behaviors). Whereas both experiential avoidance and safety behaviors have been studied within anxiety research, no known studies have evaluated the direct and indirect relationships of these forms of avoidance in predicting critical outcomes, particularly in conjunction with symptom severity. To address this gap, the current study assessed social anxiety and panic symptoms, experiential avoidance, use of preventive and restorative safety behaviors, and quality of life to determine the direct and indirect contributions of trait-based and contextual avoidance in predicting clinically relevant outcomes via path analysis. U.S. adults with elevated social anxiety or panic symptoms (nā€‰=ā€‰254) were recruited online. Results from path analysis showed that, across groups, the relationship between symptoms and quality of life was indirectly accounted for by use of preventive safety behaviors. Further, for participants with panic symptoms (but not for those with social anxiety symptoms), experiential avoidance predicted quality of life even after accounting for use of preventive safety behaviors. The results of this study indicate that trait-based and contextual avoidance contribute significantly to clinically relevant outcomes.


Anxiety; Avoidance; Experiential avoidance; Path analysis; Safety behaviors

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