Assessment of strategies to manage or avoid perceived threats among panic disorder patients: the Texas Safety Maneuver Scale (TSMS)

Safety maneuvers are defined as strategies people use to manage or avoid their perceived threats. The present study presents the development of the Texas Safety Maneuver Scale (TSMS), an instrument that assesses the pattern and extent of use of safety maneuvers in formerly treated panic patients. Ex-patients (N=105), who had completed cognitive behavioral treatment at the Anxiety Disorders Laboratory of the University of Texas retrospectively rated their use of safety maneuvers at the time of their intake evaluation. Scores on measures of anxiety, fear of fear, agoraphobic avoidance and depression from intake records were used to examine the reliability and validity of the TSMS. Exploratory factor analysis and alpha reliability analyses indicated high internal consistency, and revealed meaningful subscales. The pattern of correlations between the TSMS and the selected self-report measures supported its convergent and discriminant validity. Use of safety maneuvers is negatively associated with perceived ability to cope with panic attacks, supporting the proposed detrimental nature of use of safety maneuvers. Patients with mild agoraphobic avoidance frequently rely on more subtle forms of within-situation avoidance behaviors that need to be addressed in treatment.