anxiety

Despite the central status of avoidance in explaining the etiology and maintenance of anxiety disorders, surprisingly little behavioral research has been conducted on human avoidance. In the present paper, first we provide a brief review of the empirical literature on avoidance. Next, we describe the implications of research on derived relational responding and the transformation of functions for a contemporary behavioral account of avoidance, before providing several illustrative research examples of laboratory-based analogues of key clinical treatment processes. Finally, we suggest some challenges and opportunities that lie ahead for behavioral research on anxiety and avoidance.

Fear generalization, in which conditioned fear responses generalize or spread to related stimuli, is a defining feature of anxiety disorders. The behavioral consequences of maladaptive fear generalization are that aversive experiences with one stimulus or event may lead one to regard other cues or situations as potential threats that should be avoided, despite variations in physical form. Theoretical and empirical interest in the generalization of conditioned learning dates to the earliest research on classical conditioning in nonhumans. Recently, there has been renewed focus on fear generalization in humans due in part to its explanatory power in characterizing disorders of fear and anxiety.

Social anxiety in adolescence can have severe consequences including underachievement and school drop-out, psychopathology, and substance use disorders. The development of social anxiety in adolescents is a complex and poorly understood process. Temperamental predispositions such as behavioural inhibition are significant risk factors but the specific path leading from behavioural inhibition to social anxiety remains unclear. One potential pathway is that temperament leads to social anxiety through learned self-regulation strategies and cognitive predispositions, a hypothesis that has not yet been investigated in adolescents.

Only two trials have compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (tCBT) in the treatment of social anxiety disorder (SAD), with both finding no significant differences. These trials did not examine effects on observer-rated behavioral outcomes and did not explicitly quantify the dose of exposure therapy within each treatment. In a replication trial, one hundred and two individuals with SAD (per DSM-IV criteria) were randomized to 12 sessions of ACT (n = 49) or tCBT (n = 53) controlling for exposure dose and assessing behavioral outcomes.