Enhancing Exposure Therapy for Snake and Spider Phobias

NCT02160470 | Completed Phase 1

• 2 other identifiers: 2011-10-00121F31MH100760-01
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

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.

Conditions

Specific Phobia

Outcome Measures

Primary Outcomes (1)

• Change in peak subjective fear (0 - 100), behavioral approach (0 - 4), and heart rate reactivity to a live snake/spider not used during treatment (generalization context) from pre-treatment to follow-up

  pre-treatment (window of 1-14 days prior to treatment); follow-up (window of 6-14 days after treatment)

Secondary Outcomes (9)

• Change in peak subjective fear (0 - 100), behavioral approach (0 - 4), and heart rate reactivity to a live snake/spider not used during treatment (generalization context) from pre-treatment to post-treatment.

  pre-treatment (window of 1-14 days prior to treatment); post-treatment (directly after the treatment procedure is completed)

• Change in peak subjective fear (0 - 100), behavioral approach (1 - 8), and heart rate reactivity to a live snake/spider used during treatment (treatment context) from pre-treatment to follow-up

  pre-treatment (window of 1-14 days prior to treatment); follow-up (window of 6-14 days after treatment)

• Change in peak subjective fear (0 - 100), behavioral approach (1 - 8), and heart rate reactivity to a live snake/spider used during treatment (treatment context) from pre-treatment to post-treatment

  pre-treatment (window of 1-14 days prior to treatment); post-treatment (directly after the treatment procedure is completed)

• Change in Fear of Snakes/Spiders Questionnaire from pre-treatment to follow-up

  pre-treatment (window of 1-14 days prior to treatment); follow-up (window of 6-14 days after treatment)

• Change in Snake/Spider Belief Questionnaire from pre-treatment to follow-up

  pre-treatment (window of 1-14 days prior to treatment); follow-up (window of 6-14 days after treatment)

Study Arms (4)

Exposure with Retrieval

EXPERIMENTAL

Exposure Therapy with Retrieval

Behavioral: Exposure Therapy with Retrieval

Exposure with Compounding

EXPERIMENTAL

Exposure Therapy with Compound Extinction

Behavioral: Exposure Therapy with Compound Extinction

Exposure with Retrieval and Compounding

EXPERIMENTAL

Exposure Therapy with Retrieval and Compound Extinction

Behavioral: Exposure Therapy with Retrieval and Compound Extinction

Therapist-Guided Exposure Therapy

ACTIVE COMPARATOR

Therapist-guided Exposure Therapy

Behavioral: Therapist-guided Exposure Therapy

Interventions

Exposure Therapy with Retrieval 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 Retrieval

Exposure Therapy with Compound Extinction 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 Compounding

Exposure Therapy with Retrieval and Compound Extinction 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.

Exposure with Retrieval and Compounding

Therapist-guided Exposure Therapy BEHAVIORAL

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

Therapist-Guided Exposure Therapy

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 to 65.
• Speaks English fluently.
• A score of 70 or higher on the Fear of Snakes/Spiders Questionnaire.
• 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).

You may not qualify if:

• Unstable dose of psychotropic medications during the 4 weeks prior to baseline assessment.
• Currently receiving exposure-based treatment for snake/spider phobia.
• Currently at risk for suicide.

Sponsors & Collaborators

• University of Texas at Austin: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

University of Texas at Austin

Austin, Texas, 78712, United States

Location

Related Publications (1)

• 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.

  PMID: 33096291 DERIVED

MeSH Terms

Conditions

Phobia, Specific

Interventions

Implosive Therapy

Intervention Hierarchy (Ancestors)

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

Study Officials

• Michael J Telch, PhD

  University of Texas at Austin

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• 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: June 10, 2014
• Study Start: August 1, 2012
• Primary Completion: December 1, 2019
• Study Completion: December 1, 2019
• Last Updated: December 8, 2020

Record last verified: 2020-12

Locations

US (1)