Brett J Deacon

Brett J Deacon
Illawarra Anxiety Clinic

Ph.D.

About

119
Publications
139,218
Reads
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12,268
Citations
Introduction
I am a clinical psychologist. I work in private practice and conduct research, provide supervision, and write in my spare time. My research interests are in the nature and exposure-based treatment of anxiety as well as critical analysis of the validity and utility of biomedical approaches to psychological problems. More information about my research, clinical work, and other activities can be found at http://www.illawarraanxietyclinic.com.au.
Additional affiliations
June 2018 - present
UNSW Sydney
Position
  • Professor (Associate)
December 2016 - present
Illawarra Anxiety Clinic
Position
  • Managing Director
Description
  • http://www.illawarraanxietyclinic.com.au
May 2014 - December 2016
University of Wollongong
Position
  • Professor (Associate)

Publications

Publications (119)
Article
Exposure therapy is consistently indicated as the first-line treatment for anxiety-related disorders. Unfortunately, therapists often deliver exposure therapy in an overly cautious, less effective manner, characterized by using their own ‘therapist safety behaviours’. Cognitive behavioural models postulate that beliefs about therapist safety behavi...
Article
Background: Safety behaviours are ubiquitous across anxiety disorders and are associated with the aetiology, maintenance and exacerbation of anxiety. Cognitive behavioural models posit that beliefs about safety behaviours directly influence their use. Therefore, beliefs about safety behaviours may be an important component in decreasing safety beha...
Article
Avoidance has long been viewed as an etiological mechanism of anxiety disorders. Of more recent focus within this literature is the distinction between avoidance that is trait-based (experiential avoidance) versus contextual (safety behaviors). Whereas both experiential avoidance and safety behaviors have been studied within anxiety research, no kn...
Article
This study re-analyzes data from Sy and colleagues (2011; Behaviour Research and Therapy, 49, 305–314) comparing safety behavior availability (SBA) to safety behavior utilization (SBU) during exposure therapy for claustrophobic concerns. The present investigation assessed differential rates of inhibitory learning (i.e. change in danger expectancy a...
Article
Full-text available
Background: While exposure therapy effectively reduces anxiety associated with specific phobias, not all individuals respond to treatment and some will experience a return of fear after treatment ceases. Aims: This study aimed to test the potential benefit of increasing the intensity of exposure therapy by adding an extra step that challenged un...
Article
In recent years, with scientific advances and growing understanding of neurobiological processes, biomedical explanations of psychiatric disorders, including obsessive-compulsive disorder (OCD), have become more prominent in research and in clinical care. Patient perceptions of biomedical models of OCD have been understudied, particularly in how th...
Article
Behavior performed by parents to assist a youth in avoiding or alleviating anxiety, known as accommodation, is ubiquitous among pediatric anxiety disorders and strongly related to poor treatment outcome. According to cognitive-behavioral theory, the beliefs parents hold regarding accommodation should predict parental accommodating behavior. Unfortu...
Research
Full-text available
Blog post published at Mad in America (https://www.madinamerica.com/2017/08/house-fire-mental-health-literacy-parable/) addressing common yet problematic beliefs and practices in the mental health system, critiqued using a fictitious client-therapist dialogue following a catastrophic fire. Issues covered include mental health literacy, the DSM-base...
Chapter
Full-text available
Antidepressants are recommended first-line treatments for major depressive disorders in clinical practice guidelines based on reviews of the clinical trials literature. In 1987, the United States Food and Drug Administration (FDA) approved fluoxetine (Prozac) for the treatment of major depression in adults. Consistent with promotion of the serotoni...
Article
Full-text available
Owing to concerns about the safety and tolerability of exposure therapy, many clinicians deliver the treatment in an overly cautious manner, which may limit its effectiveness. Although didactic training in exposure reduces clinician concerns about the treatment to a moderate extent, improved training strategies are needed to minimize these concerns...
Article
Full-text available
This study examines the impact of three different etiological explanations on self stigmatizing attitudes among individuals with clinical symptom levels of either major depressive disorder (MDD; n = 144) or social anxiety disorder (SAD; n = 175). Participants were randomly assigned to view an audiovisual presentation describing their symptoms as be...
Article
Full-text available
Perceptions of danger often arise in the context of feared threat cues, but individuals also rely on other heuristics that lead them to infer danger in ambiguous situations. For example, individuals may interpret their own anxiety or safety-seeking behaviors as indicators of threat. Another potential source of danger information is the mere availab...
Article
Individuals with social anxiety disorder (SAD) commonly experience panic attacks and evidence increased anxiety sensitivity (AS) specific to noticeable anxiety sensations. Interoceptive exposure (IE) is an effective treatment for reducing AS, but few IE tasks target fears of blushing, sweating, or trembling, which are incorporated within AS social...
Article
Ninety-two young adults were randomly assigned to watch two episodes of The OCD Project, a reality television program depicting the treatment of obsessive-compulsive disorder using exposure therapy, or two episodes of another reality television program (Big Brother). Participants in The OCD Project condition (n = 35) endorsed significantly fewer ne...
Article
Although the chemical imbalance theory is the dominant causal explanation of depression in the United States, little is known about the effects of this explanation on depressed individuals. This experiment examined the impact of chemical imbalance test feedback on perceptions of stigma, prognosis, negative mood regulation expectancies, and treatmen...
Article
Analogue samples are often used to study obsessive-compulsive (OC) symptoms and related phenomena. This approach is based on the hypothesis that results derived from such samples are relevant to understanding OC symptoms in individuals with a diagnosis of obsessive-compulsive disorder (OCD). Two decades ago, Gibbs (1996) reviewed the available lite...
Article
Cognitive-behavioral theories suggest that anxiety is maintained in part by estimates of the probability and cost of feared negative outcomes. Social phobia may be unique among the anxiety disorders in that it is characterized by overestimates of the cost of events that are objectively noncatastrophic (e.g., committing social mishaps). As such, tre...
Article
Anxiety sensitivity (AS) refers to the fear of anxiety-related sensations based on beliefs about their harmful consequences. Despite a wealth of research demonstrating an association between AS and panic-related psychopathology, direct experimental evidence that AS causes panic symptoms, as hypothesized in cognitive models of panic disorder, is lac...
Article
Cognitive behavioral theorists have suggested that breathing retraining may be used as a safety behavior. Safety behaviors are acts aimed at preventing or minimizing feared catastrophe and may maintain pathologic anxiety by hindering resolution of maladaptive cognitive processes. An opposing position is that breathing retraining is an effective cop...
Article
Full-text available
Although exposure-based cognitive-behavioral therapy (CBT) has been recommended as the first line of treatment for anxiety disorders, it is rarely implemented by clinicians in practice. In part, issues with dissemination of this treatment can explain this occurrence; however, even clinicians who have received training in exposure-based CBT are not...
Article
Despite the well-established effectiveness of exposure-based cognitive-behavioral therapy (CBT) in the treatment of anxiety disorders, therapists have been slow to adopt CBT into their clinical practice. The present study was conducted to examine the utilization of psychotherapy techniques for anxiety disorders among community practitioners in a ru...
Article
Cognitive accounts of obsessive-compulsive disorder (OCD) propose that an individual's early experiences contribute to the development of different belief domains, which in turn represent fertile ground for the development of the disorder (e.g., Salkovskis, Shafran, Rachman, & Freeston, 1999). This study examined the proximal relationship between s...
Chapter
Full-text available
Exposure-based cognitive-behavioral therapy (CBT) is the most empirically supported psychological treatment for the anxiety disorders. However, few therapists provide exposure therapy to their clients. Although the poor dissemination of exposure-based treatments may be partially attributable to a shortage of suitably trained therapists, exposure th...
Article
Full-text available
Paruresis, characterized by the difficulty or inability to urinate in a variety of social contexts, is a scientifically under-studied phenomenon. One reason for this state of affairs is the paucity of reliable and valid measures for assessing this problem. The present article attempted to address this limitation by investigating the psychometric pr...
Article
Full-text available
Within traditional cognitive therapy, cognitive restructuring is often used to challenge the veracity of dysfunctional thoughts. In contrast, acceptance and commitment therapy (ACT) uses “cognitive defusion” techniques to change the function of negative thoughts rather than modify their content. Previous research has shown that a cognitive defusion...
Article
The present study examined the extent to which safety behaviors exacerbate symptoms of hypochondriasis (severe health anxiety). Participants were randomized into a safety behavior (n=30) or control condition (n=30). After a baseline period, participants in the safety behavior condition spent one week actively engaging in a clinically representative...
Article
Numerous clinical trials have supported the efficacy of cognitive behavioral therapy (CBT) for the treatment of anxiety disorders. Accordingly, CBT has been formally recognized as an empirically supported treatment for anxiety-related conditions. This article reviews the evidence supporting the efficacy of CBT for anxiety disorders. Specifically, c...
Article
Social phobia is maintained in part by cognitive biases concerning the probability and cost of negative social events. More specifically, individuals with social phobia tend to believe that negative social events are extremely likely to occur, and that if such events were to happen, the consequences would be awful or unbearable. The aim of the pres...
Article
[Clin Psychol Sci Prac 17: 104–106, 2010] Otto, McHugh, and Kantak (2010) have crafted a model to account for the observation that pharmacologic treatments do not reliably add to the effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders. In this commentary, we discuss the nature of anxiety and its disorders and review three appr...
Article
Anxiety sensitivity, or the fear of anxiety sensations, has been implicated in the etiology of anxiety disorders, particularly panic disorder. Recently, inconsistent findings have been reported regarding the latent structure of anxiety sensitivity. Whereas some taxometric studies of anxiety sensitivity have reported evidence of categorical latent s...
Article
Full-text available
Although several measures of obsessive-compulsive (OC) symptoms exist, most are limited in that they are not consistent with the most recent empirical findings on the nature and dimensional structure of obsessions and compulsions. In the present research, the authors developed and evaluated a measure called the Dimensional Obsessive-Compulsive Scal...
Article
Cognitive-behavioral theory suggests that social phobia is maintained, in part, by overestimates of the probability and cost of negative social events. Indeed, empirically supported cognitive-behavioral treatments directly target these cognitive biases through the use of in vivo exposure or behavioral experiments. While cognitive-behavioral theorie...
Article
Exposure therapy is traditionally conducted with an emphasis on the elimination of safety behaviors. However, theorists have recently suggested that the judicious use of safety behaviors may improve the tolerability of this treatment without reducing its efficacy. The present study tested this notion by randomly assigning participants with high cla...
Article
Full-text available
Significant advances have been made in understanding mind-brain relationships and the role of biological vulnerabilities in the development of mental disorders. However, we are concerned that the enthusiastic promotion of the brain disease model by NIMH and other prominent sources has far outstripped the available scientific data and may actually b...
Article
Although hypochondriasis is currently classified as a somatoform disorder, the underlying cognitive processes may be more consistent with an anxiety disorder. This observation has important implications for treatment and subsequent revisions of the diagnostic classification of hypochondriasis.
Article
Numerous studies have provided supportive evidence for the efficacy of exposure-based treatments for many psychological disorders. However, surprisingly few therapists use exposure therapy in the clinical setting. Although the limited use of exposure-based treatments may be partially attributable to a shortage of suitably trained therapists, exposu...
Article
Brain disease models of psychopathology, such as the popular chemical imbalance explanation of depression, have been widely disseminated in an attempt to reduce the stigma of mental illness. Ironically, such models appear to increase prejudicial attitudes among the general public toward persons with mental disorders. However, little is known about...
Article
This study examined the potential of 11 interoceptive exposure exercises to produce depersonalization and derealization among high anxiety-sensitive undergraduate students. Inspired by a February 2007 thread on the Association for Behavioral and Cognitive Therapies listserv, we identified nine exercises and compared their capacity to produce depers...
Article
Full-text available
Anxiety sensitivity has been implicated as a risk factor for the development and maintenance of panic and other anxiety disorders. Although researchers have generally assumed that anxiety sensitivity is a dimensional, rather than categorical, variable, recent taxometric research has raised questions concerning the accuracy of this assumption. The p...
Article
Although hypochondriasis (HC) is considered a somatoform disorder in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision), some authors have pointed out that the symptoms of HC overlap with certain anxiety disorders, namely, panic disorder (PD) and obsessive-compulsive disorder (OCD). Few studies have empirically addre...
Article
The strategies used by anxious individuals to prevent feared outcomes, known as safety behaviors, are thought to maintain pathological anxiety by preventing the disconfirmation of inaccurate threat beliefs. However, it is possible that safety behaviors might also contribute to the development and exacerbation of anxiety symptoms. The present study...
Article
Full-text available
Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance. Yet, the efficacy of the antidepressants may also depend on the severity of initial depression scores. The purpose of this analysis...
Article
This study examined the specificity of disgust sensitivity in predicting fear and disgust responses to exposure to a spider. Participants high (n=22) and low (n=28) in spider fear completed self-report measures of disgust sensitivity, contamination fear, anxiety, and negative affect. They then participated in a behavioral avoidance task (BAT) in wh...
Article
Individuals with panic disorder often seek medical care for their symptoms prior to receiving effective treatment. However, little is known about how often, and in what settings, patients with other anxiety disorders present for medical treatment. In the present study, utilization of general and specialty medical services was coded via electronic c...
Article
The Body Vigilance Scale (BVS) is a measure developed to assess one's conscious attendance to internal cues. The present report investigated the structure, correlates, and predictive utility of the BVS in nonclinical (N=442) and anxiety (N=135) disorder samples. The findings of Study 1 suggest that the BVS is 1-dimensional in a nonclinical sample,...
Article
This chapter focuses on the effects of pharmacotherapy on the effectiveness of exposure therapy. Exposure therapy is the psychological treatment of choice for the anxiety disorders. Exposure involves confronting feared stimuli while eliminating safety-seeking behaviors so that individuals learn the negative consequences they fear are unlikely to oc...
Article
Full-text available
Contemporary conceptualizations of hypochondriasis (HC) as severe health anxiety have led to the development of cognitive-behavioral approaches to understanding, assessing, and treating this problem. The Short Health Anxiety Inventory (SHAI) is a new instrument that measures cognitive factors associated with HC. In the present study, we examined th...
Article
Cognitive-behavioral therapy (CBT) is a highly effective treatment for panic disorder. However, few patients have access to this treatment, particularly those living in rural areas. In a pilot study, the author previously described the efficacy of a 2-day, intensive, exposure-based CBT intervention that was developed for the purpose of delivering C...
Article
This study examined the specificity of disgust sensitivity in predicting contamination-related anxiety and behavioral avoidance. Participants high (n=26) and low (n=30) in contamination fear completed self-report measures of disgust sensitivity, contamination cognitions (overestimation of the likelihood and severity of contamination from everyday o...
Article
Full-text available
Accumulating evidence suggests that anxiety sensitivity (fear of arousal-related sensations) plays an important role in many clinical conditions, particularly anxiety disorders. Research has increasingly focused on how the basic dimensions of anxiety sensitivity are related to various forms of psychopathology. Such work has been hampered because th...