Feasibility of an Online Modeled Exposure in Spider Fearful Individuals
- Conditions
- Spider FearArachnophobia
- Interventions
- Behavioral: online psychoeducation video + modeled exposureBehavioral: live psychoeducation video + modeled exposureBehavioral: group exposureBehavioral: mental retrieval cue
- Registration Number
- NCT06182709
- Lead Sponsor
- Philipps University Marburg
- Brief Summary
The effectiveness of an optimized group exposure treatment is investigated in spider-fearful individuals. Participants will undergo an optimized standardized exposure treatment. After receiving information about the treatment and the phobic stimulus (spider) through a psychoeducation video, participants will observe an exposure treatment of another fearful person, either live or by watching a movie of an exposure treatment online. Subsequently, participants will undergo a live in vivo exposure treatment conducted in a group setting. The effectiveness of the treatment is measured by symptom improvement according to online behavioral avoidance tests and subjective ratings immediately after training and one week later.
- Detailed Description
The treatment of various anxiety disorders often involves exposure therapy. However, a considerable number of patients do not benefit or experience a resurgence of anxiety following successful treatment. Vicarious safety learning (i.e., modeled exposure) presents a promising avenue to improve therapeutic outcome. Previous evidence indicates that vicarious safety learning can diminish previously acquired fear associations, thereby reducing behavioral avoidance. While single-session interventions have implemented modeled exposure, specific mechanisms of observational learning have not been extensively investigated. Due to high dropout rates in specific phobias, modeled exposure could be utilized as an additional treatment method, potentially yielding better outcomes trough additional learning experience.
This study aims to investigate the applicability of observational learning and its sustainability through mental retrieval cues. Specifically, the study is going to assess the feasibility of modeled exposure conveyed either live or online via video, offering a practical approach within a stepped-care framework. The modeled exposure treatment will be followed by a group exposure treatment to assess the influence of modeled exposure in spider-fearful individuals.
Physically healthy spider-fearful individuals will be either treated with an online or live modeled standardized exposure followed by a group exposure treatment. Half of the participants will receive a mental retrieval cue before the group exposure treatment one day after the modeled exposure treatment. The research aims to determine if long-term reduction of spider fear is achievable through online modeled exposure via video compared to in-person modeled exposure.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 36
- Elevated score on Spider Phobia Questionnaire (SPQ) >= 17
- Severe allergies to bees/spiders/insects
- Current psychiatric/psychotherapeutic treatment
- Past psychotherapeutic/psychiatric treatment due to anxiety problems
- Current or past psychotic symptoms
- Current suicidal intent
- Experience with exposure-based treatment
- Current psychopharmacological medication
- Severe respiratory, neurological or cardiovascular diseases
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description online modeled exposure + mental retrieval cue group exposure online psychoeducation video + modeled exposure online modeled exposure training followed by group exposure training, including mental retrieval cue with five standardized exposure steps online modeled exposure + mental retrieval cue group exposure mental retrieval cue online modeled exposure training followed by group exposure training, including mental retrieval cue with five standardized exposure steps live modeled exposure + standardized group exposure live psychoeducation video + modeled exposure live modeled exposure training followed by group exposure training with five standardized exposure steps live modeled exposure + mental retrieval cue group exposure live psychoeducation video + modeled exposure live modeled exposure training followed by group exposure training, including mental retrieval cue with five standardized exposure steps online modeled exposure + standardized group exposure group exposure online modeled exposure training followed by group exposure training with five standardized exposure steps online modeled exposure + mental retrieval cue group exposure group exposure online modeled exposure training followed by group exposure training, including mental retrieval cue with five standardized exposure steps online modeled exposure + standardized group exposure online psychoeducation video + modeled exposure online modeled exposure training followed by group exposure training with five standardized exposure steps live modeled exposure + mental retrieval cue group exposure group exposure live modeled exposure training followed by group exposure training, including mental retrieval cue with five standardized exposure steps live modeled exposure + standardized group exposure group exposure live modeled exposure training followed by group exposure training with five standardized exposure steps live modeled exposure + mental retrieval cue group exposure mental retrieval cue live modeled exposure training followed by group exposure training, including mental retrieval cue with five standardized exposure steps
- Primary Outcome Measures
Name Time Method Change in spider fear: Spider Anxiety Questionnaire (FSQ/SAF) Change from baseline to immediately post treatment 1 (after modeled exposure), immediately post treatment 2 (group exposure) and follow-up (7 days after group exposure - post treatment 2) 14-item questionnaire on a 7-point Likert-Scale (0 = "I don´t agree at all"; 6 = "I completely agree") to assess symptoms of arachnophobia. Total score can range from 0 to 98 Greater scores representing worse symptom severity of arachnophobia
Spider Phobia Questionnaire (SPQ) Change from baseline to immediately post treatment 1 (after modeled exposure), immediately post treatment 2 (group exposure) and follow-up (7 days after group exposure - post treatment 2) 31-Item true/false questionnaire assessing symptoms of arachnophobia. Scores range from 0 to 31, with greater scores representing greater subjective fear of spiders, where lower scores reflect low subjective fear of spiders
Change in avoidance behavior (online virtual Behavioral Approach Task, vBATon) Change from baseline to immediately post treatment 1 (after modeled exposure), immediately post treatment 2 (group exposure) and follow-up (7 days after group exposure - post treatment 2) Scores range from 0 ("participant refuses entering the room with the spider") to 12 ("participant holds the spider for at least 20 seconds")
- Secondary Outcome Measures
Name Time Method Change in spider phobia belief questionnaire (SBQ) Change from baseline to immediately post treatment 1 (after modeled exposure), immediately post treatment 2 (group exposure) and follow-up (7 days after group exposure -- post treatment 2) Assessment of spider phobia dysfunctional beliefs; 48 items on a scale from 0% ("no approval") to 100% ("full approval"); higher scores indicate more dysfunctional beliefs about the danger of spiders and own coping abilities regarding spiders
Global success rating (GSR) Change from immediately post treatment 1 (after modeled exposure) to immediately post-treatment 2 (after group exposure) and follow-up (7 days after group exposure- post treatment 2) Self-report measure of subjective state changes on a 7-likert scale from 1 ("much worse") to 7 ("much better")
Change in Spider Anxiety Screening (SAS) Change from baseline to immediately post treatment 1 (after modeled exposure), immediately post treatment 2 (group exposure) and follow-up (7 days after group exposure- post treatment 2) Assessment of the four criteria for specific phobia (DSM-IV) with 4 items on a scale from 0 ("does not apply at all") to 6 ("fully applies"), Total score range: 0 to 24, higher scores indicating worse severity of symptoms of arachnophobia
Trial Locations
- Locations (1)
Philipps-University Marburg
🇩🇪Marburg, Hesse, Germany