Anti-phobic and Safety Behaviors in the Treatment of Acrophobia

NCT02085343 | Unknown

• 1 other identifier: 2013-02-0023
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

This study tests whether a single session of exposure therapy may be enhanced by the addition of anti-phobic actions beyond the mere fading of safety behaviors. A total of 100 acrophobic participants will be randomly assigned to receive standard exposure therapy (EXP), exposure therapy with safety behavior fading (EXP + SBF), exposure with safety behavior fading and anti-phobic actions (EXP + SBF + AA), or to a wait-list control group (WL).

Conditions

Specific Phobia

Keywords

Exposure therapy; Specific phobia; Fear of heights; Acrophobia; Safety behavior fading; Anti-phobic Actions

Outcome Measures

Primary Outcomes (1)

• Peak subjective fear (0 - 100) upon exposure to heights in the generalization context.

  Peak subjective fear ratings (0 - 100).

  Pre-treatment (1 week before treatment), treatment (1 week after pre-treatment), post-treatment (immediately following treatment), and follow-up (1 month after treatment).

Secondary Outcomes (4)

• Acrophobia Questionnaire - Modified (Cohen, 1977; Wolitzky & Telch, 2009)

  Pre-treatment (1 week before treatment), treatment (1 week after pre-treatment), post-treatment (immediately following treatment), and follow-up (1 month after treatment).

• Height estimation task

  Pre-treatment (1 week before treatment), treatment (1 week after pre-treatment), post-treatment (immediately following treatment), and follow-up (1 month after treatment).

• Heart rate

  Pre-treatment (1 week before treatment), treatment (1 week after pre-treatment), post-treatment (immediately following treatment), and follow-up (1 month after treatment).

• Treatment Process Questionnaire

  Treatment (1 week following pre-treatment assessment)

Study Arms (4)

EXP + SBF + AA

EXPERIMENTAL

Exposure therapy (EXP) with safety behavior fading (SBF) and anti-phobic action (AA)

Behavioral: EXP; Behavioral: EXP + SBF; Behavioral: EXP + SBF + AA

EXP + SBF

ACTIVE COMPARATOR

Exposure therapy (EXP) with safety behavior fading (SBF)

Behavioral: EXP; Behavioral: EXP + SBF

EXP

ACTIVE COMPARATOR

Standard therapist-guided in vivo exposure therapy (EXP)

Behavioral: EXP

Wait-list control

NO INTERVENTION

Subjects assigned to this arm will undergo assessments at Weeks 0, Week 1, and Week 5, but will not receive any interventions.

Interventions

EXP BEHAVIORAL

Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement throughout supporting efforts at exposure. An instructional set will be provided prior to treatment presenting the rationale for exposure as an effective means of reducing pathological fear.

Also known as: Standard Therapist-Guided In Vivo Exposure Therapy (EXP)

EXP; EXP + SBF; EXP + SBF + AA

EXP + SBF BEHAVIORAL

Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement supporting efforts at exposure. An instructional set will be provided prior to treatment explaining how safety behaviors serve to maintain fear, and how their elimination may enhance fear reduction. Additionally, the therapist will identify safety behaviors and prompt participants to reduce their utilization of them during treatment.

Also known as: Exposure Therapy with Safety Behavior Fading (EXP + SBF)

EXP + SBF; EXP + SBF + AA

EXP + SBF + AA BEHAVIORAL

Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement supporting efforts at exposure. An instructional set will be provided explaining the rationale for eliminating safety behaviors, and how engagement in anti-phobic actions may enhance fear reduction. Additionally, the therapist will identify safety behaviors and prompt participants to reduce their utilization of them during treatment, and will instruct participants to enact a series of progressively challenging anti-phobic actions which oppose the prototypical fear response.

Also known as: Exposure with Safety Behavior Fading and Anti-Phobic Actions

EXP + SBF + AA

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 to 65.
• Fluent in English (written and spoken). This is required because assessment instruments are validated only in English.
• Meet DSM-IV criteria for specific phobia, natural environment type, with acrophobic concerns, based on the Composite International Diagnostic Interview (CIDI-Auto; World Health Organization, 1997).
• Report moderate fear or avoidance (i.e., a score of 30 or higher) on a modified version of the Acrophobia Questionnaire (AQ; Cohen, 1977).
• Exhibit at least moderate fear (i.e., a fear score of 50 or higher, where 0 = no fear and 100 = extreme fear) during two behavioral approach tests (BATs) consisting of ascending two moderately challenging flights of stairs.

You may not qualify if:

• \. Medical condition(s) which may prevent safely climbing or descending stairs or walking for more than 15 minutes at a time (It will be necessary to walk to different sites for the behavioral approach tests).

Sponsors & Collaborators

• University of Texas at Austin: lead

Study Sites (1)

The University of Texas at Austin

Austin, Texas, 78712, United States

RECRUITING

MeSH Terms

Conditions

Phobia, Specific; Acrophobia

Interventions

Implosive Therapy

Intervention Hierarchy (Ancestors)

Desensitization, Psychologic; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Adam R. Cobb, MA

  The University of Texas at Austin

  STUDY DIRECTOR

• Michael J. Telch, PhD

  The University of Texas at Austin

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Adam R. Cobb, MA

CONTACT

325-201-4228; adamrcobb@utexas.edu

Michael J. Telch, PhD

CONTACT

512-471-3722; telch@austin.utexas.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: January 22, 2014
• First Posted: March 12, 2014
• Study Start: February 1, 2013
• Primary Completion: March 1, 2018
• Study Completion: May 1, 2018
• Last Updated: November 14, 2017

Record last verified: 2017-11

Data Sharing

• IPD Sharing: Will share

Locations

US (1)