The University of Manchester, Manchester, UK.
The Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Prestwich, UK.
Clin Psychol Psychother. 2017 Nov;24(6):1384-1405. doi: 10.1002/cpp.2099. Epub 2017 Jun 21.
Safety-seeking behaviours are responses employed to protect against perceived threat. In relation to anxiety disorders, safety-seeking behaviours have been implicated in both the formation and maintenance of distress. Several studies have highlighted similar findings in relation to psychosis; however, this literature has not yet been synthesized. This review is, therefore, being conducted in order to synthesize the literature on safety seeking in people with psychosis to increase the understanding of this relationship. A systematic search identified and included 43 studies comprising 2,592 participants, published between 1995 and 2015. The results indicated that people experiencing psychosis commonly respond to their experiences with behavioural and cognitive strategies intended to manage their difficulties. In relation to safety seeking, avoidance, and resistance, there was a pattern that these responses are associated with increased distress and appraisals of threat. The results relating to engagement response styles showed the opposite pattern. These results provide support for cognitive models of safety seeking and psychosis with many of the meta-analyses reported here showing a clear pattern of association between behavioural responses and distress. However, the results reported within individual studies are mixed. This appears to be particularly true with the response style of distraction, with our analyses unable to clarify this relationship. It is possible that the mixed results could reflect the complexities in defining safety seeking and distinguishing it from coping in this population. The clinical implications of this are discussed.
寻求安全行为是为了防范感知到的威胁而采取的应对措施。在焦虑障碍方面，寻求安全行为与痛苦的形成和维持都有关联。有几项研究强调了精神病学方面的类似发现；然而，该文献尚未被综合。因此，进行本综述是为了综合关于精神病患者寻求安全的文献，以增进对这种关系的理解。系统检索确定并纳入了 43 项研究，共包含 2592 名参与者，发表时间在 1995 年至 2015 年之间。结果表明，经历精神病的人通常会对他们的经历做出反应，采取行为和认知策略来应对困难。就寻求安全、回避和抵制而言，存在一种模式，即这些反应与增加的痛苦和威胁评估有关。与参与反应风格相关的结果则呈现出相反的模式。这些结果为寻求安全和精神病的认知模型提供了支持，这里报告的许多元分析显示出行为反应与痛苦之间存在明显的关联模式。然而，个别研究报告的结果存在差异。对于分心的反应模式尤其如此，我们的分析无法澄清这种关系。混合结果可能反映了在该人群中定义寻求安全并将其与应对区分开来的复杂性。讨论了其临床意义。
