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Augmentation of Exposure Using Positive Mental Rehearsal in Individuals With Increased Social Anxiety

NCT ID: NCT06564402

Last Updated: 2025-12-30

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

RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-28

Study Completion Date

2026-03-01

Brief Summary

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Efficacy of an optimized exposure therapy training is investigated in individuals with heightened social anxiety. Participants will undergo a one-session standardized exposure training, followed by either standard or positive mental rehearsal of the exposure experience. The efficacy is measured by symptom improvement according to subjective ratings one week later.

Detailed Description

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Exposure therapy is widely recognized as the gold-standard treatment for anxiety disorders, but its clinically significant response rates remain around 50%. Thus, innovative approaches are needed to improve the efficacy of exposure therapy. One strategy is the mental rehearsal of exposure treatment as a way of supporting the retrieval and consolidation of the exposure memory, which has been demonstrated to be an effective supplement to exposure therapy in a recent study. New conceptualizations also emphasize the role of reward processing and its importance in extinction learning. Several strategies have been proposed to target these reward processes to improve the outcomes of exposure therapy. The present study will examine the use of a positive-focused rehearsal strategy. Participants in the optimized exposure group will engage in an imaginal recounting task focusing on the positive aspects (i.e. emotions, thoughts, behavior) of the exposure. Rehearsal of the positive aspects may increase positive affect, with positive mood thought to be associated with deeper mental rehearsal of stored information. Therefore, the efficacy of using positive mental rehearsal (i.e., imaginal recounting) post-exposure will be investigated, with the use of standard mental rehearsal as an active control group. Participants will be asked to repeat the rehearsal experience at home at two-day intervals. Post-treatment assessment will be conducted one week later. The study will be conducted on healthy participants with an elevated level of social anxiety. The aim of this randomized controlled trial in healthy individuals with increased social anxiety is to investigate whether optimized exposure training (exposure + positive mental rehearsal) is more effective in reducing fear of social interaction compared to an active control group (exposure + mental rehearsal).

Conditions

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Social Anxiety Social Phobia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Exposure + Positive Mental Rehearsal

Mental rehearsal of the positive aspects of exposure experience

Group Type EXPERIMENTAL

Positive Mental Rehearsal

Intervention Type BEHAVIORAL

After exposure trial, participants are asked about the positive aspects of their exposure experience (e.g., thoughts, feelings), based on which an imagination script is formulated and recounted

Exposure

Intervention Type BEHAVIORAL

All participants complete exposure exercises (i.e., talking on the phone and talking with a stranger) before positive mental rehearsal is executed

Exposure + Mental rehearsal

Mental rehearsal of the exposure experience

Group Type ACTIVE_COMPARATOR

Mental Rehearsal

Intervention Type BEHAVIORAL

After exposure, participants are asked about what happened during the exposure experience and whether their central concerns/expected outcome actually occurred during exposure

Exposure

Intervention Type BEHAVIORAL

All participants complete exposure exercises (i.e., talking on the phone and talking with a stranger) before positive mental rehearsal is executed

Interventions

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Positive Mental Rehearsal

After exposure trial, participants are asked about the positive aspects of their exposure experience (e.g., thoughts, feelings), based on which an imagination script is formulated and recounted

Intervention Type BEHAVIORAL

Mental Rehearsal

After exposure, participants are asked about what happened during the exposure experience and whether their central concerns/expected outcome actually occurred during exposure

Intervention Type BEHAVIORAL

Exposure

All participants complete exposure exercises (i.e., talking on the phone and talking with a stranger) before positive mental rehearsal is executed

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Elevated score on Social Interactions Anxiety Scale (SIAS) \> 26

Exclusion Criteria

* Current psychotherapeutic/psychiatric treatment
* Plans to start psychotherapeutic/psychiatric treatment in upcoming weeks
* Current suicidal intent
* Severe cardiovascular, respiratory or neurological diseases
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Philipps University Marburg

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Germany Philipps University

Marburg, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Andrea Stoliarov, M.Sc.

Role: CONTACT

Phone: +4964212826991

Email: [email protected]

Christoph Benke, PhD

Role: CONTACT

Phone: +4964212824091

Email: [email protected]

Facility Contacts

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Christoph Benke, PhD

Role: primary

Andrea Stoliarov, M.Sc.

Role: backup

References

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Rosenberg BM, Barnes-Horowitz NM, Zbozinek TD, Craske MG. Reward processes in extinction learning and applications to exposure therapy. J Anxiety Disord. 2024 Aug;106:102911. doi: 10.1016/j.janxdis.2024.102911. Epub 2024 Jul 29.

Reference Type BACKGROUND
PMID: 39128178 (View on PubMed)

McGlade AL, Craske MG. Optimizing exposure: Between-session mental rehearsal as an augmentation strategy. Behav Res Ther. 2021 Apr;139:103827. doi: 10.1016/j.brat.2021.103827. Epub 2021 Feb 11.

Reference Type BACKGROUND
PMID: 33607459 (View on PubMed)

Craske MG, Meuret AE, Echiverri-Cohen A, Rosenfield D, Ritz T. Positive affect treatment targets reward sensitivity: A randomized controlled trial. J Consult Clin Psychol. 2023 Jun;91(6):350-366. doi: 10.1037/ccp0000805. Epub 2023 Mar 9.

Reference Type BACKGROUND
PMID: 36892884 (View on PubMed)

Craske MG, Meuret AE, Ritz T, Treanor M, Dour H, Rosenfield D. Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia. J Consult Clin Psychol. 2019 May;87(5):457-471. doi: 10.1037/ccp0000396.

Reference Type BACKGROUND
PMID: 30998048 (View on PubMed)

Other Identifiers

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APEX_SOCIALANX

Identifier Type: -

Identifier Source: org_study_id