The Link Between Mental Imagery and the Reduction of Fear in Imaginal Extinction

Not Applicable

Completed

• Conditions: Healthy Subjects

• Registration Number: NCT03989518
• Lead Sponsor: Uppsala University

Brief Summary

Imaginal exposure is a widely used psychological treatment technique. Imaginal extinction is an experimental analogue of imaginal exposure, that allows the study of this treatment technique under controlled circumstances (Agren, Björkstrand, \& Fredrikson, 2017). During imaginal extinction, experimentally induced fear is diminished through repeated exposure to mental imagery of the feared (conditioned) stimulus. However, it is not known to what extent fear reduction depends on the mental imagery produced during this procedure. A better understanding of the mechanisms driving the effects of imaginal exposure and the factors moderating fear reduction could have significant clinical utility, by suggesting mechanistically informed ways to improve this treatment.

Detailed Description

The study takes part over three consecutive days, with fear conditioning to visual stimuli on day 1, imaginal extinction on day 2, and a fear reinstatement procedure, again to visual stimuli, on day 3. Skin conductance is used to measure fear responses.

Participants' are randomized to receive conditioning, extinction and reinstatement with either complex or simple stimuli. During imaginal extinction, imagery of each experimental stimulus is prompted through different verbal instructions.

Study Timeline

• Study Start: 2019-02-25
• Study First Submitted: 2019-06-13
• Study First Submitted QC: 2019-06-13
• Study First Posted: 2019-06-18
• Status Verified: 2019-10
• Primary Completion: 2019-10-30
• Study Completion: 2019-10-30
• Last Update Submitted: 2019-10-31
• Last Update Posted: 2019-11-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

Age 18 or over

Fluent in Swedish

Willing and able to provide informed consent and complete study procedures

Exclusion Criteria

Current psychiatric disorder

Use of psychotropic medication within 6 months prior to study start

Receiving psychological treatment within 6 months prior to study start

Current neurological condition

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Skin conductance response (SCR)	Day 3 (48 h after day 1)	SCR is used as a measure of physiological fear responses.Differences in fear response are used to assess return of fear during reinstatement, and to explore main effects and interactions between return of fear, stimulus complexity and capacity for mental imagery.

Secondary Outcome Measures

Name	Time	Method
The Vividness of Visual Imagery Questionnaire	Day 2 (24 h after day 1)	This is a self-rated questionnaire measuring vividness of visual mental imagery. Only eyes open section is administered. Higher scores indicate higher level of vividness (range 0-80)
Expectancy ratings	Day 3 (48 h after day 1)	After the reinstatement procedure, participants are asked to rate to what extent they believed that electric shocks would be delivered during the procedure on a scale ranging from 0 - 100 %
State-Trait Anxiety Inventory	Day 1	This is a self-rated questionnaire measuring trait anxiety. Higher scores indicate higher level of trait-anxiety (range 20-80)
Fear ratings	Day 3 (48 h after day 1)	Ratings of subjective fear during the experimental procedure. Scale: 0 -100 (no fear at all - extreme fear)
Difficulties in emotion regulation scale	Day 1	This is a self-rated questionnaire measuring difficulties in emotion regulation. Higher scores indicate higher level of difficulties in emotion regulation (range 36-180)
Vividness of mental imagery during imaginal extinction	Day 2 (24 h after day 1)	Scale: 1-5; no image at all - image as clear and vivid as real life
The Plymouth Sensory Imagery Questionnaire	Day 2 (24 h after day 1)	This is a self-rated questionnaire measuring vividness of mental imagery across different sensory modalities. Higher scores indicate higher level of vividness. (range 0-70)
Spontaneous use of imagery scale	Day 2 (24 h after day 1)	This is a self-rated questionnaire measuring spontaneous use of imagery. Higher scores higher levels use of spontaneous use of imagery (range 12- 60)

Trial Locations

Locations (1)

Uppsala University, Departement of Psychology; 🇸🇪 Uppsala, Sweden