tDCS-Augmented Exposure Therapy for Pathological Fear

NCT ID: NCT03095482

Last Updated: 2020-12-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

49 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-01

Study Completion Date

2018-09-06

Brief Summary

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This double-blind randomized controlled clinical trial aims to test whether transcranial direct current stimulation (tDCS) can be used to modulate fear extinction learning during exposure therapy for pathological fear, including fear of spiders, snakes, or germs / contamination. Participation takes place over three laboratory visits, including (1) a pre-treatment visit, (2) a treatment and post-treatment visit, and (3) a 1 month follow-up visit. During treatment, participants will receive either 20 minutes of active or sham tDCS, followed by 30 minutes of in vivo exposure therapy.

Detailed Description

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In a trans-diagnostic sample with marked pathological fear and behavioral avoidance, this study aims to: (1) evaluate whether excitatory tDCS of the mPFC and inhibitory tDCS of right dlPFC enhances exposure therapy relative to sham tDCS; (2) determine whether tDCS effects are moderated by baseline negative prognostic indicators; and (3) determine whether tDCS effects are mediated by pre-post changes in vigilance to threat, in-session fear reduction, and contextual memory for the exposure context. If successful, the project may discover a potentially effective exposure therapy augmentation, and may enhance knowledge of the behavioral, cognitive, affective, and neurobiological factors that moderate and mediate acute treatment response and maintenance of treatment gains. This knowledge may inform treatment development efforts for more debilitating forms of pathological fear.

Conditions

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Specific Phobias

Keywords

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Arachnophobia (fear of spiders) Ophidophobia (fear of snakes) Germaphobia (fear of germs, dirtiness, and contamination)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomly assigned to receive either (a) excitatory tDCS of the medial prefrontal cortex and inhibitory tDCS of right dorsolateral prefrontal cortex, or (b) sham tDCS
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Participants, treatment administrators, and outcome assessors will be blind to tDCS condition.

Study Groups

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Active tDCS + In Vivo Exposure

Participants assigned to this condition will receive excitatory transcranial direct current stimulation (tDCS) of the left medial prefrontal cortex (lmPFC) and inhibitory tDCS of right dorsolateral prefrontal cortex (rdlPFC). tDCS will be administered for 20 minutes at 1.7 mA, followed by 30 minutes of in vivo exposure therapy.

Group Type ACTIVE_COMPARATOR

Transcranial Direct Current Stimulation (tDCS)

Intervention Type DEVICE

Participants will receive 20 minutes of either active or sham tDCS prior to in vivo exposure to feared targets.

In vivo exposure therapy

Intervention Type BEHAVIORAL

Participants will receive 30 minutes of in vivo exposure to feared targets following either active or sham tDCS

sham tDCS + In Vivo Exposure

Participants assigned to this condition will receive sham transcranial direct current stimulation (tDCS), which will consist of 30 seconds of stimulation at the beginning and end of tDCS administration. Electrode positioning will be counterbalanced across participants (i.e., either mPFC+ or mPFC-, with same electrode positioning as the active comparators). Sham tDCS will be administered for 20 minutes, followed by 30 minutes of in vivo exposure therapy.

Group Type SHAM_COMPARATOR

In vivo exposure therapy

Intervention Type BEHAVIORAL

Participants will receive 30 minutes of in vivo exposure to feared targets following either active or sham tDCS

Interventions

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Transcranial Direct Current Stimulation (tDCS)

Participants will receive 20 minutes of either active or sham tDCS prior to in vivo exposure to feared targets.

Intervention Type DEVICE

In vivo exposure therapy

Participants will receive 30 minutes of in vivo exposure to feared targets following either active or sham tDCS

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Age 18-65.
2. Fluent in English.
3. A score on at least 1 fear domain-specific prescreen measure \> 2 SDs above the subject pool prescreen mean. These measures include (a) FSQ, and (b) OCI-R.
4. Peak fear ≥ 50 on BATs 1 and 2.

Exclusion Criteria

1. Currently receiving treatment for the primary fear domain (based on clinical interview).
2. Unstable dose of psychotropic medications within 6 weeks prior to baseline assessment (based on the DMQ; see measures).
3. Medical condition that would contraindicate participation in treatment or assessment activities (e.g., cardiovascular problems; based on the DMQ; see measures).
4. Pregnancy (based on the DMQ; see measures).
5. Current major depressive disorder (based on MINI; see measures).
6. Current, or history of bipolar disorder (based on MINI; see measures).
7. Current, or history of psychotic symptoms (based on MINI; see measures).
8. Serious suicidal risk, as determined by self-report (C-SSRS, BDI-II) and clinical interview (MINI; see measures).
9. Active neurological conditions, including seizures, stroke, unexplained loss of consciousness or concussion (based on DMQ and tDCS Safety Screening Form; see measures)
10. Contraindications for tDCS: Metal in the head or implanted brain medical devices.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Texas at Austin

OTHER

Sponsor Role lead

Responsible Party

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Michael J. Telch

Professor of Psychology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Adam R. Cobb, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

The University of Texas at Austin

Michael J. Telch, PhD

Role: STUDY_DIRECTOR

The University of Texas at Austin

Locations

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Laboratory for the Study of Anxiety Disorders

Austin, Texas, United States

Site Status

Countries

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United States

Related Links

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http://UTanxiety.com

Website for the Laboratory for the Study of Anxiety Disorders

Other Identifiers

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2016-02-0024

Identifier Type: -

Identifier Source: org_study_id