Journal
JOURNAL OF ANXIETY DISORDERS
Volume 55, Issue -, Pages 14-21Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.janxdis.2018.03.004
Keywords
Avoidance; Anxiety; Fear; Exposure; Therapy; Coping
Categories
Funding
- Alexander von Humboldt Foundation
- NIH/NCCIH [R01AT007257]
- NIH/NIMH [R01MH099021, U01MH108168]
- James S. McDonnell Foundation 21st Century Science Initiative in Understanding Human Cognition - Special Initiative
- National Center for Complementary & Integrative Health [R01AT007257] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [R01MH099021, U01MH108168, R34MH099311] Funding Source: NIH RePORTER
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Avoidance is typically considered a maladaptive behavioral response to excessive fear and anxiety, leading to the maintenance of anxiety disorders. Exposure is a core element of cognitive-behavioral therapy for anxiety disorders. One important aspect of this treatment is repeated and prolonged exposure to a threat while discouraging patients from using avoidance strategies, such as escape or safety behaviors. We will first revisit the role of avoidance learning in the development and maintenance of anxiety disorders, including important insights from the neuroscience literature. Next, we will consider both the negative and positive aspects of avoidance for therapeutic interventions. Finally, we will explore the application of adaptive avoidance in exposure therapy for anxiety disorders. We will argue that there are occasions when avoidance behaviors can serve as effective coping strategies to enhance the person's perception of control over the environment and the potential threat. We conclude that avoidance behaviors can be a valuable therapeutic element, depending on the function of these behaviors.
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