Clinical trial NCT07009444: The Role of Mental Imagery on Approach Motivation and Behavioral Engagement in Social Anxiety
Official title: The Role of Mental Imagery on Approach Motivation and Behavioral Engagement in Social Anxiety
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Social Anxiety
Social Phobia
Lead sponsor: Philipps University Marburg
Sponsor class: OTHER
First posted: 2025-06-06
Enrollment: 136
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 online intervention aimed at enhancing both approach motivation and behavioral engagement in facing anxiety-provoking social situations among individuals with heightened social anxiety is investigated. Upon receiving psychoeducation, participants will either undergo a prospective mental-imagery task or no additional task. The intervention's efficacy will be assessed by ratings of experienced and expected pleasure, approach motivation as well as self-reported engagement with feared situation one week later.

Detailed description: Although exposure therapy is widely considered the gold standard for treating anxiety disorders, its effectiveness is often hindered by treatment discontinuation. Many individuals avoid facing feared situations, yet exposure is crucial for successful extinction learning. Therefore, there is a need for strategies to enhance both approach motivation and behavioral engagement in anxiety-provoking situations. Within the depression literature, imagery-based interventions have already gained some support in increasing motivation and behavioral engagement in pleasurable activities through enhancement of reward anticipation as well as anticipatory and anticipated pleasure ('motivational amplifier' hypothesis). Considering that social anxiety is characterized by disruptions in motivational and reward processes, prospective mental imagery may strengthen approach motivation and behavioral engagement in exposure to socially feared situations. Thus, the present online study will investigate the effect of a prospective mental-imagery task on approach motivation and behavioral engagement in socially anxious individuals. Following psychoeducation, participants in the experimental group will vividly imagine having successfully mastered the fear-provoking situation. The control group will receive only psychoeducation. Approach motivation as well as reward anticipation, anticipated and anticipatory pleasure will be assessed before and after the psychoeducation and imagery task. Engagement with the feared social situation will be assessed one week later. The aim of this randomized controlled trial in healthy individuals with heightened social anxiety is to investigate whether prospective mental imagery is effective in enhancing self-reported motivation and engagement with feared situation compared to a psychoeducation-only control group. In an exploratory analysis, we will investigate whether individuals' levels of reward sensitivity and anhedonia influence the effectiveness of prospective imagery training.

Eligibility criteria: Inclusion Criteria:

* Elevated score on Mini-Social Phobia Inventory (Mini-SPIN) \> 6

Exclusion Criteria:

-

Primary outcomes:
measure: Anticipatory Pleasure
timeFrame: Baseline (prior to the assigned intervention) and immediately post-intervention (following prospective mental imagery or psychoeducation)
measure: Anticipated Pleasure
timeFrame: Baseline (prior to the assigned intervention) and immediately post-intervention (following prospective mental imagery or psychoeducation)
measure: Reward Anticipation
timeFrame: Baseline (prior to the assigned intervention) and immediately post-intervention (following prospective mental imagery or psychoeducation)
measure: Motivation
timeFrame: Baseline (prior to the assigned intervention) and immediately post-intervention (following prospective mental imagery or psychoeducation)
measure: Frequency of Exposure
timeFrame: Post-treatment (i.e., 7 days after baseline)
Secondary outcomes:
measure: Social Phobia Inventory (SPIN)
timeFrame: Change from baseline to post-treatment (i.e., 7 days)
measure: Liebowitz Social Anxiety Scale (LSAS)
timeFrame: Change from baseline to post-treatment (i.e., 7 days)
measure: Patient Health Questionnaire-9 (PHQ-9)
timeFrame: Change from baseline to post-treatment (i.e., 7 days)
measure: Positive and Negative Affect Schedule (PANAS)
timeFrame: Change from baseline to post-treatment (i.e., 7 days)
measure: BIS/BAS Scales
timeFrame: Baseline
measure: Temporal Experience of Pleasure Scale (TEPS)
timeFrame: Baseline
measure: Vividness of Mental Imagination
timeFrame: Immediately after prospective mental imagery at baseline
Other outcomes:
Locations:
city: Marburg
country: Germany
facility: Germany Philipps University
Study officials:
References:
citation: Hallford DJ, Farrell H, Lynch E. Increasing anticipated and anticipatory pleasure through episodic thinking. Emotion. 2022 Jun;22(4):690-700. doi: 10.1037/emo0000765. Epub 2020 Jun 18.
citation: Renner F, Werthmann J, Paetsch A, Bar HE, Heise M, Bruijniks SJE. Prospective Mental Imagery in Depression: Impact on Reward Processing and Reward-Motivated Behaviour. Clin Psychol Eur. 2021 Jun 18;3(2):e3013. doi: 10.32872/cpe.3013. eCollection 2021 Jun.
citation: Renner F, Murphy FC, Ji JL, Manly T, Holmes EA. Mental imagery as a "motivational amplifier" to promote activities. Behav Res Ther. 2019 Mar;114:51-59. doi: 10.1016/j.brat.2019.02.002. Epub 2019 Feb 5.
citation: Ji JL, Geiles D, Saulsman LM. Mental imagery-based episodic simulation amplifies motivation and behavioural engagement in planned reward activities. Behav Res Ther. 2021 Oct;145:103947. doi: 10.1016/j.brat.2021.103947. Epub 2021 Aug 15.