Clinical trial NCT04470882: Use of Safety Behaviors in Exposure Therapy for Arachnophobia
Official title: Use of Safety Behaviors in Exposure Therapy for Arachnophobia
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Specific Phobia
Arachnophobia
Spider Phobia
Keywords: Exposure therapy
Safety behaviors
Arachnophobia
Spider phobia
Specific phobia
Lead sponsor: University of Nevada, Reno
Sponsor class: OTHER
First posted: 2020-07-14
Enrollment: 59
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study examines the impact of safety behaviors (i.e., unnecessary protective actions) on outcomes of exposure therapy for spider phobia. Researchers will compare exposure therapy with (a) no safety behaviors, (b) safety behaviors faded toward the end of treatment, and (c) unfaded safety behaviors.

Detailed description: Some studies suggest that safety behaviors might undermine the efficacy of exposure therapy (Powers et al., 2010), whereas other studies suggest that there is no difference in exposure therapy outcomes whether or not safety behaviors are used (Deacon et al., 2010). Mixed findings could be explained by the parameters of safety behaviors use, such as whether they are used throughout the full course of therapy or faded toward the end of therapy. This will be the first study to directly compare the impact of faded and unfaded safety behaviors on exposure therapy outcomes. Specifically, researchers will randomize participants with a fear of spiders to receive exposure therapy (a) without safety behavior use, (b) with faded safety behavior use, and (c) with un-faded safety behavior use. Researchers will compare each condition's impact on fear reduction and on the tolerability/acceptability of treatment.

Eligibility criteria: Inclusion Criteria:

* Fluent in English
* Displays sufficiently high fear of spiders, as indicated by responses on (a) a self report questionnaire (the Fear of Spiders Questionnaire) at prescreening, and (b) Behavioral Avoidance Tests at baseline

Exclusion Criteria:

* younger than 18 years old

Primary outcomes:
measure: Behavioral approach test (treatment context) - behavioral outcome
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Behavioral approach test (treatment context) - subjective outcome
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Behavioral approach test (treatment context) - physiological outcome
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Behavioral approach test (generalization context) - behavioral outcome
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Behavioral approach test (generalization context) - subjective outcome
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Behavioral approach test (generalization context) - physiological outcome
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Fear of Spiders Questionnaire (FSQ)
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Spider Phobia Beliefs Questionnaire (SBQ)
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Armfield and Mattiske Disgust Questionnaire (AMDQ)
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
measure: Anxiety Disorders Interview Schedule for DSM-5 (ADIS-5)
timeFrame: Change from baseline up to 4 weeks later (through follow up assessment)
Secondary outcomes:
measure: Treatment Acceptability/Adherence Scale (Modified version)
timeFrame: Measured just prior to beginning a one-session treatment
measure: Treatment Acceptability/Adherence Scale (Modified version)
timeFrame: Measured immediately after completing a one-session treatment
Other outcomes:
Locations:
city: Reno
country: United States
facility: University of Nevada, Reno
state: Nevada
Study officials:
References:
citation: Powers MB, Smits JA, Telch MJ. Disentangling the effects of safety-behavior utilization and safety-behavior availability during exposure-based treatment: a placebo-controlled trial. J Consult Clin Psychol. 2004 Jun;72(3):448-54. doi: 10.1037/0022-006X.72.3.448.
citation: Deacon BJ, Sy JT, Lickel JJ, Nelson EA. Does the judicious use of safety behaviors improve the efficacy and acceptability of exposure therapy for claustrophobic fear? J Behav Ther Exp Psychiatry. 2010 Mar;41(1):71-80. doi: 10.1016/j.jbtep.2009.10.004. Epub 2009 Oct 24.