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QUESTION-326: Does reducing safety behaviours lower symptoms, and instructed increases raise them, in diagnosed anxiety disorders, in pre-registered trials with active controls and masked rationale or a larger meta-analysis, once publication bias and expectancy are accounted for?

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Properties4
StatusOpen
Tagspsychopathology-and-treatment
Linewill-organization
Cited as “bears on” byTHEORY-903 — In a 2026 meta-analysis of standalone safety-behaviour manipulations outside exposure, mostly with young non-clinical or subclinical adults and mostly on appearance concerns and social anxiety, reducing safety behaviours lowered symptoms relative to control (d = 0.43, about 0.31 after adjustment for publication bias), and instructed increases raised them (d = 0.65, five studies)

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Why it is a question

THEORY-903 holds Goodson et al.’s estimates, mostly from young non-clinical or subclinical samples concerned with appearance or social anxiety. Egger’s test was significant for the reduction effect, the increase studies could not be tested for bias, and every treatment trial gave a rationale.

What would answer it

THEORY-903’s former promote_when, unchanged:

The version of record read and found to report the same estimates, and either a later meta-analysis of standalone safety-behaviour manipulations with more studies, or pre-registered trials in diagnosed samples with active controls and masked rationale, finding a symptom reduction from reducing safety behaviours that survives bias adjustment and a symptom increase from instructed increases. It is weakened if bias-adjusted estimates fall to zero as studies accumulate, or if the reduction effect disappears when expectancy is controlled. Whether safety behaviours maintain anxiety through belief or through some other route is not carried by this THEORY.

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