Enhancing Exposure Therapy for Snake and Spider Phobias

NCT ID: NCT02160470

Last Updated: 2020-12-08

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 120 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-08-31
• Study Completion Date: 2019-12-31

Brief Summary

This study tests whether exposure therapy for fear of snakes or spiders is enhanced by the addition of a brief fear retrieval trial prior to treatment, and the use of compound extinction during treatment. The goal of the study is to determine whether these behavioral techniques enhance the efficacy of exposure therapy, one of the most empirically supported treatments for anxiety disorders.

Detailed Description

This study tests whether exposure therapy for fear of snakes or spiders is enhanced by the addition of a brief fear retrieval trial prior to treatment, and the use of compound extinction during treatment. The goal of the study is to determine whether these behavioral techniques enhance the efficacy of exposure therapy, one of the most empirically supported treatments for anxiety disorders. Individuals between the ages of 18-65 with elevated fear of spiders or fear of snakes are randomly assigned to one of four treatment conditions (1) standard exposure therapy, (2) exposure therapy with fear retrieval augmentation, (3) exposure therapy with compound extinction augmentation, and (4) exposure therapy with fear retrieval and compound extinction augmentations. All participants undergo an online prescreen and a face-to-face screening assessment to determine eligibility and baseline (pre-treatment) symptom severity. Participants additionally complete assessments directly after treatment (post-treatment), and approximately one week after treatment (follow-up). The pre-treatment assessment occurs 1-14 days prior to treatment, the post-treatment assessment occurs during the treatment visit as soon as the treatment procedure is complete, and the follow-up assessment occurs within a window of 6-14 days after the completion of treatment. Participants complete two behavioral approach tests (in the treatment context and in the generalization context) at pre-treatment, post-treatment, and follow-up. Participants complete a battery of self-report questionnaires at pre-treatment and follow-up.

Conditions

Specific Phobia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Exposure with Retrieval

Exposure Therapy with Retrieval

Group Type: EXPERIMENTAL

Exposure Therapy with Retrieval

Intervention Type: BEHAVIORAL

Participants will receive one-session exposure therapy (up to 92 minutes) for fear of spiders or fear of snakes. Thirty minutes prior to exposure therapy, participants will receive a fear retrieval trial, which is a brief exposure to the feared stimulus (snake or spider). Based on recent basic science research, the fear retrieval trial is expected to enhance the efficacy of exposure therapy.

Exposure with Compounding

Exposure Therapy with Compound Extinction

Group Type: EXPERIMENTAL

Exposure Therapy with Compound Extinction

Intervention Type: BEHAVIORAL

Participants will receive one-session exposure therapy (up to 92 minutes) for fear of spiders or fear of snakes. As a component of therapy, participants will receive compound extinction, which consists of exposure to two feared stimuli simultaneously (two spiders or two snakes). Based on recent basic science research, compound extinction is expected to enhance the efficacy of exposure therapy.

Exposure with Retrieval and Compounding

Exposure Therapy with Retrieval and Compound Extinction

Group Type: EXPERIMENTAL

Exposure Therapy with Retrieval and Compound Extinction

Intervention Type: BEHAVIORAL

Participants will receive one-session exposure therapy (up to 92 minutes) for fear of spiders or fear of snakes. Thirty minutes prior to exposure therapy, participants will receive a brief fear retrieval trial. As a component of therapy, participants will also receive compound extinction.

Therapist-Guided Exposure Therapy

Therapist-guided Exposure Therapy

Group Type: ACTIVE_COMPARATOR

Therapist-guided Exposure Therapy

Intervention Type: BEHAVIORAL

Participants will receive one-session exposure therapy (up to 92 minutes) for fear of spiders or fear of snakes.

Interventions

Exposure Therapy with Retrieval

Participants will receive one-session exposure therapy (up to 92 minutes) for fear of spiders or fear of snakes. Thirty minutes prior to exposure therapy, participants will receive a fear retrieval trial, which is a brief exposure to the feared stimulus (snake or spider). Based on recent basic science research, the fear retrieval trial is expected to enhance the efficacy of exposure therapy.

Intervention Type: BEHAVIORAL

Exposure Therapy with Compound Extinction

Participants will receive one-session exposure therapy (up to 92 minutes) for fear of spiders or fear of snakes. As a component of therapy, participants will receive compound extinction, which consists of exposure to two feared stimuli simultaneously (two spiders or two snakes). Based on recent basic science research, compound extinction is expected to enhance the efficacy of exposure therapy.

Intervention Type: BEHAVIORAL

Exposure Therapy with Retrieval and Compound Extinction

Participants will receive one-session exposure therapy (up to 92 minutes) for fear of spiders or fear of snakes. Thirty minutes prior to exposure therapy, participants will receive a brief fear retrieval trial. As a component of therapy, participants will also receive compound extinction.

Intervention Type: BEHAVIORAL

Therapist-guided Exposure Therapy

Participants will receive one-session exposure therapy (up to 92 minutes) for fear of spiders or fear of snakes.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

1. Age 18 to 65.

2. Speaks English fluently.

3. A score of 70 or higher on the Fear of Snakes/Spiders Questionnaire.

4. Demonstrates avoidance during behavioral approach tests (defined as inability to put palm flat on the bottom of a tank containing a snake/spider, and inability to touch a snake/spider with a bare finger).

Exclusion Criteria

1. Unstable dose of psychotropic medications during the 4 weeks prior to baseline assessment.

2. Currently receiving exposure-based treatment for snake/spider phobia.

3. Currently at risk for suicide.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute of Mental Health (NIMH)

NIH

Sponsor Role: collaborator

University of Texas at Austin

OTHER

Sponsor Role: lead

Responsible Party

Michael J. Telch

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Michael J Telch, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Texas at Austin

Locations

University of Texas at Austin

Austin, Texas, United States

Countries

United States

References

Lancaster CL, Monfils MH, Telch MJ. Augmenting exposure therapy with pre-extinction fear memory reactivation and deepened extinction: A randomized controlled trial. Behav Res Ther. 2020 Dec;135:103730. doi: 10.1016/j.brat.2020.103730. Epub 2020 Sep 19.

Reference Type: DERIVED

PMID: 33096291 (View on PubMed)

Other Identifiers

1F31MH100760-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2011-10-0012

Identifier Type: -

Identifier Source: org_study_id