Clinical trial NCT06564402: Augmentation of Exposure Using Positive Mental Rehearsal in Individuals With Increased Social Anxiety
Official title: Augmentation of Exposure Using Positive Mental Rehearsal in Individuals With Increased Social Anxiety
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Social Anxiety
Social Phobia
Lead sponsor: Philipps University Marburg
Sponsor class: OTHER
First posted: 2024-08-21
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Efficacy of an optimized exposure therapy training is investigated in individuals with heightened social anxiety. Participants will undergo a one-session standardized exposure training, followed by either standard or positive mental rehearsal of the exposure experience. The efficacy is measured by symptom improvement according to subjective ratings one week later.

Detailed description: Exposure therapy is widely recognized as the gold-standard treatment for anxiety disorders, but its clinically significant response rates remain around 50%. Thus, innovative approaches are needed to improve the efficacy of exposure therapy. One strategy is the mental rehearsal of exposure treatment as a way of supporting the retrieval and consolidation of the exposure memory, which has been demonstrated to be an effective supplement to exposure therapy in a recent study. New conceptualizations also emphasize the role of reward processing and its importance in extinction learning. Several strategies have been proposed to target these reward processes to improve the outcomes of exposure therapy. The present study will examine the use of a positive-focused rehearsal strategy. Participants in the optimized exposure group will engage in an imaginal recounting task focusing on the positive aspects (i.e. emotions, thoughts, behavior) of the exposure. Rehearsal of the positive aspects may increase positive affect, with positive mood thought to be associated with deeper mental rehearsal of stored information. Therefore, the efficacy of using positive mental rehearsal (i.e., imaginal recounting) post-exposure will be investigated, with the use of standard mental rehearsal as an active control group. Participants will be asked to repeat the rehearsal experience at home at two-day intervals. Post-treatment assessment will be conducted one week later. The study will be conducted on healthy participants with an elevated level of social anxiety. The aim of this randomized controlled trial in healthy individuals with increased social anxiety is to investigate whether optimized exposure training (exposure + positive mental rehearsal) is more effective in reducing fear of social interaction compared to an active control group (exposure + mental rehearsal).

Eligibility criteria: Inclusion Criteria:

* Elevated score on Social Interactions Anxiety Scale (SIAS) \> 26

Exclusion Criteria:

* Current psychotherapeutic/psychiatric treatment
* Plans to start psychotherapeutic/psychiatric treatment in upcoming weeks
* Current suicidal intent
* Severe cardiovascular, respiratory or neurological diseases

Primary outcomes:
measure: Social Interaction Anxiety Scale (SIAS)
timeFrame: Change from baseline to post-treatment (i.e., 7-9 days)
measure: Liebowitz Social Anxiety Scale (LSAS)
timeFrame: Change from baseline to post-treatment (i.e., 7-9 days)
measure: Communication Anxiety Inventory (CAI) - Trait Version
timeFrame: Change from baseline to post-treatment (i.e., 7-9 days)
Secondary outcomes:
measure: Communication Anxiety Inventory (CAI) - State Version
timeFrame: Baseline
measure: Positive and Negative Affect Schedule (PANAS)
timeFrame: Change from baseline to post-treatment (i.e., 7-9 days)
measure: Post-Event Processing Inventory (PEPI) - Trait Version
timeFrame: Change from baseline to post-treatment (i.e., 7-9 days)
measure: Post-Event Processing Inventory (PEPI) - State Version
timeFrame: Post-treatment
measure: Plymouth Sensory Imagery Questionnaire (PSI-Q)
timeFrame: Baseline
measure: Snaith-Hamilton-Pleasure-Scale (SHAPS)
timeFrame: Change from baseline to post-treatment (i.e., 7-9 days)
Other outcomes:
Locations:
city: Marburg
country: Germany
facility: Germany Philipps University
Study officials:
References:
citation: Rosenberg BM, Barnes-Horowitz NM, Zbozinek TD, Craske MG. Reward processes in extinction learning and applications to exposure therapy. J Anxiety Disord. 2024 Aug;106:102911. doi: 10.1016/j.janxdis.2024.102911. Epub 2024 Jul 29.
citation: McGlade AL, Craske MG. Optimizing exposure: Between-session mental rehearsal as an augmentation strategy. Behav Res Ther. 2021 Apr;139:103827. doi: 10.1016/j.brat.2021.103827. Epub 2021 Feb 11.
citation: Craske MG, Meuret AE, Echiverri-Cohen A, Rosenfield D, Ritz T. Positive affect treatment targets reward sensitivity: A randomized controlled trial. J Consult Clin Psychol. 2023 Jun;91(6):350-366. doi: 10.1037/ccp0000805. Epub 2023 Mar 9.
citation: Craske MG, Meuret AE, Ritz T, Treanor M, Dour H, Rosenfield D. Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia. J Consult Clin Psychol. 2019 May;87(5):457-471. doi: 10.1037/ccp0000396.