Avoidance is a hallmark symptom and a primary maintaining factor in anxiety disorders. Theories of anxiety disorders have focused not only on overt avoidance, but also on more subtle avoidance known as ‘safety behaviours’. Safety behaviours involve behaviours which aim to reduce anxiety or prevent a feared outcome from occurring. In the long-term, however, these behaviours prevent the disconfirmation of threat because safety is incorrectly attributed to the safety behaviour, thus perpetuating anxiety. As a result, reducing or eliminating safety behaviours is an important target for many cognitive behaviourally oriented treatments. Notably, despite the relevance of anxiety to people with chronic health problems, the role of safety behaviours is rarely discussed in these contexts. Further, safety behaviours among those with chronic health problems pose a particularly complex problem. Distinguishing adaptive safety precautions from maladaptive safety behaviours can be a difficult task. In this paper, we discuss the role of safety behaviours in maintaining and treating anxiety problems in healthy adults, and whether these same principles apply to those with chronic illness. We propose a functional and contextual model of differentiating between safety behaviours and safety precautions amongst those with chronic physical illness. Lastly, we propose methods for adapting the treatment of anxiety disorders in the context of chronic physical illness.

回避是焦虑症的标志性症状和主要维持因素。焦虑症的理论不仅关注公开的回避，还关注被称为“安全行为”的更微妙的回避。安全行为涉及旨在减少焦虑或防止可怕结果发生的行为。然而，从长远来看，这些行为阻止了对威胁的确认，因为安全被错误地归因于安全行为，从而使焦虑持续存在。因此，减少或消除安全行为是许多认知行为导向治疗的重要目标。值得注意的是，尽管焦虑与患有慢性健康问题的人有关，但在这些情况下很少讨论安全行为的作用。更远，患有慢性健康问题的人的安全行为是一个特别复杂的问题。将适应性安全预防措施与适应不良的安全行为区分开来可能是一项艰巨的任务。在本文中，我们讨论了安全行为在维持和治疗健康成人焦虑问题中的作用，以及这些相同的原则是否适用于慢性病患者。我们提出了一个功能和上下文模型，用于区分慢性身体疾病患者的安全行为和安全预防措施。最后，我们提出了在慢性身体疾病背景下调整焦虑症治疗的方法。我们讨论了安全行为在维持和治疗健康成人焦虑问题中的作用，以及这些相同的原则是否适用于慢性病患者。我们提出了一个功能和上下文模型，用于区分慢性身体疾病患者的安全行为和安全预防措施。最后，我们提出了在慢性身体疾病背景下调整焦虑症治疗的方法。我们讨论了安全行为在维持和治疗健康成人焦虑问题中的作用，以及这些相同的原则是否适用于慢性病患者。我们提出了一个功能和上下文模型，用于区分慢性身体疾病患者的安全行为和安全预防措施。最后，我们提出了在慢性身体疾病背景下调整焦虑症治疗的方法。