Exploring the impact of safety behaviour use on cognitive, psychophysiological, emotional and behavioural responses during a speech task

Abstract

Background: There is a debate among researchers and clinicians regarding whether the judicious use of safety behaviours (SBs) during exposure therapy is helpful or detrimental. Central to this debate is the premise that SBs may interfere with one’s ability to gather disconfirmatory evidence. Aims: No study to date has assessed how SB use may impact cognitive mechanisms implicated during an exposure-like task. We investigated multiple cognitive, emotional, psychophysiological and behavioural underpinnings of exposure with and without SBs. Method: Speech anxious participants (n = 111) were randomly assigned to deliver an evaluated speech with or without SBs. Self-reported anxiety ratings and psychophysiological arousal measures were recorded at baseline, in anticipation of the speech, and following the speech. Measures of working memory, ability to gather disconfirmatory evidence, speech duration, objective and subjective speech performance, and speech task acceptability were administered. Results: There were no differences between conditions on working memory, self-reported anxiety, psychophysiological arousal, ability to gather disconfirmatory evidence, speech duration, or objective and subjective speech performance. All participants were able to gather disconfirmatory evidence. However, condition did influence willingness to deliver future speeches. Our sample was largely female undergraduate students, and we offered only a small number of specific safety behaviours. Conclusions: Judicious SB use may not necessarily be detrimental, but clients may believe them to be more helpful than they actually are.

Can you believe it? Examining the influence of safety behavior beliefs on speech task outcomes

“…Therefore, it may not be so much about exactly how we prepare clients for exposure therapy, but rather, what the experience is actually like for them. Consistent with our previous suggestion (Tutino et al, 2020), we contend that people believe that SBs are more helpful than they actually experience them to be. Conversely, researchers previously found that individuals with high social anxiety may indeed be aware that SBs are counterproductive, and worry that others (i.e., audience members) evaluate them negatively as a result (Vassilopoulos, 2009).…”

“…In this modified version, all items were modified to the past tense (e.g., "I got tongue-tied"). In our previous study (Tutino et al, 2020), modified SATI scores demonstrated excellent internal consistency at Time 1 (a ¼ .94 and Time 2; a ¼ .97).…”

“…In our previous study (Tutino et al, 2020), we found no effect of SB versus no-SB use conditions on WMC, pre-to-post speech predictions, psychophysiological arousal, subjective anxiety, or objective or subjective performance among a sample of speech anxious participants who engaged in a stressful speech task. The only difference found was that individuals in the no-SB condition were more willing to deliver an additional speech without the SBs compared to the SB condition.…”

“…The SATI demonstrated excellent internal consistency (α = .95), acceptable test-retest reliability after a 4-week period ( r = .71), good convergent and discriminant validity with related and unrelated measures, respectively (Cho et al, 2004). Similar to Tutino et al (2020) and for the purposes of this study, we added 2 items to the SATI to facilitate measuring speech predictions and learning: “My anxiety will last the whole speech” and “I will shake, tremble, or blush noticeably when I give my speech.”…”

“…The EDTS is a 4-item measure we created previously (Tutino et al, 2020). Participants rated how distressing they found the speech, how tolerable they found the speech, how willing they were to deliver another speech with SBs, and how willing they were to deliver another speech without SBs.…”