Clinical trial NCT03907345: Generalized Fear Extinction to Untreated Fear Stimuli in Specific Phobias After Exposure
Official title: Generalized Fear Extinction to Untreated Fear Stimuli in Specific Phobias After Exposure
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Fear of Spiders
Fear of Heights
Keywords: Exposure Therapy
Fear of Spiders
Fear of Heights
Anxiety Disorders
Generalization
Extinction
Specific Phobias
Lead sponsor: Ruhr University of Bochum
Sponsor class: OTHER
First posted: 2019-04-08
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study investigates whether a one-session exposure treatment for spider-related stimuli can lead to a generalization of extinguished fear to height-related stimuli in individuals with comorbid fear of spiders and fear of heights.

Detailed description: Exposure therapy has been proven to be effective in the treatment of specific phobias and in a variety of fear evoking situations and stimuli. However, since there is a high prevalence of comorbid fears, therapeutic interventions can get very extensive when each fearful situation and / or stimuli needs to be treated separately and over a repeated number of times. It has recently been shown, that exposure to one fearful stimuli (i.e., a spider), can also lead to a reduction of fear to another, perceptually and conceptually related, but untreated fearful stimulus (i.e., a cockroach) (Preusser, Margraf \& Zlomuzica, 2017). Potentially, this generalization of exposure effects might also be relevant for coexisting fears that do not share conceptually related fearful stimuli (e.g., fear of spiders and fear of heights). The present study aims to investigate whether successful exposure treatment to one fearful stimulus (i.e., a spider) can also lead to a reduction of fear to an untreated fear evoking stimulus (i.e., height).

Participants will be randomly assigned to the treatment or no-treatment condition. The entire experimental procedure will take place in three sessions. The first session incorporates spider and height fear related questionnaires and two Behavioral Approach Tests (BATs): One that involves a spider and one that involves height. These BATs are counterbalanced in each group with half of participants receiving the spider BAT first and the height BAT second, and vice versa. The second session takes place approximately seven days later. The treatment group receives a seven-step in vivo exposure with spiders (duration: 1,5 hours). Twenty-four hours later, session 3 takes place and involves the same measures that were applied in session 1. The treatment and no-treatment group receive an identical set of measures except that the no-treatment group will not be subjected to exposure. The effects of exposure-based anxiety reductions toward spiders (treated fear stimulus) and heights (untreated fear stimulus to assess generalization of treatment outcome) are assessed on the behavioral and subjective level at pretreatment and posttreatment (24 hours after exposure).

Eligibility criteria: Inclusion Criteria:

* Comorbid presence of fear of spiders and fear of heights \[Potential diagnosis of specific phobias (arachnophobia and acrophobia) assessed by application of the Diagnostic Short-Interview for Mental Disorders (Mini-Dips)\].

Exclusion Criteria:

* Any acute or chronic mental and / or somatic disease
* Psychological, psychiatric, neurological or pharmacological treatment (Application of the Mini-DIPS to screen for the presence of a psychological condition)
* Drug or alcohol abuse
* Pregnancy

Primary outcomes:
measure: Behavioral Approach Test (BAT) for Spiders
timeFrame: Change in BAT scores from pre- to posttreatment (across one week from pretreatment to posttreatment)
measure: Behavioral Approach Test (BAT) for Heights
timeFrame: Change in BAT scores from pre- to posttreatment (across one week from pretreatment to posttreatment)
Secondary outcomes:
measure: Fear of Spiders Questionnaire (FSQ)
timeFrame: Change in FSQ scores from pre- to posttreatment (across one week from pretreatment to posttreatment)
measure: Spider Fear Questionnaire (SPQ)
timeFrame: Change in SPQ scores from pre- to posttreatment (across one week from pretreatment to posttreatment)
measure: Spider Beliefs Questionnaire (SBQ)
timeFrame: Change in SBQ scores from pre- to posttreatment (across one week from pretreatment to posttreatment)
measure: Acrophobia Questionnaire (AQ)
timeFrame: Change in AQ scores from pre- to posttreatment (across one week from pretreatment to posttreatment)
Other outcomes:
measure: Fear and Disgust Rating
timeFrame: Change in Fear and Disgust Rating from pre- to posttreatment (across one week from pretreatment to posttreatment)
Locations:
city: Bochum
country: Germany
facility: Mental Health Research and Treatment Center
Study officials:
affiliation: Ruhr-University Bochum
name: Armin Zlomuzica, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Preusser F, Margraf J, Zlomuzica A. Generalization of Extinguished Fear to Untreated Fear Stimuli after Exposure. Neuropsychopharmacology. 2017 Dec;42(13):2545-2552. doi: 10.1038/npp.2017.119. Epub 2017 Jun 7.
citation: Margraf, J. & Cwik, J. C. (2017). Mini-DIPS Open Access: Diagnostic Short-Interview for Mental Disorders. [Mini-DIPS Open Access: Diagnostisches Kurzinterview bei psychischen Störungen]. Bochum: Forschungs- und Behandlungszentrum für psychische Gesundheit, Ruhr-Universität. doi:10.13154/rub.102.9