Treating Negative Mental Images and Memories in Social Anxiety

NCT03140839 | Completed

• 1 other identifier: ORE # 22071
• Study Type: interventional
• Target: 33
• Locations: 1 country
• Sites: 1

Brief Summary

The proposed research will study the effects of Imaginal Rescripting (IR) for social anxiety disorder (SAD). IR guides patients to change their memories of past socially painful events. Initial studies have found that a single session of IR significantly reduces SAD symptoms, however it is not yet clear how or why IR works and whether its effects are long lasting. To answer these questions, the investigators will randomly assign adults with SAD to receive either IR, or two other types of brief psychological interventions: Imaginal Exposure and Supportive Counselling. Changes in participants' memories, social anxiety symptoms, quality of life, negative beliefs, and social behaviour over the course of a 6-month period will be assessed. This study will provide valuable insight into the short- and long-term effects of IR and clarify the mechanisms through which IR works. Ultimately, this knowledge will enable the development of more effective treatments and prevention programs for SAD.

Conditions

Social Anxiety

Outcome Measures

Primary Outcomes (3)

• Change in self-reported social anxiety symptoms

  Social Phobia Inventory

  Pre-treatment, 1 week, 2 weeks, and 3 months after treatment

• Change in clinician-rated social anxiety symptoms

  Liebowitz Social Anxiety Scale-Clinician Rated Version

  Pre-treatment, 1 week, 2 weeks, and 3 months after treatment

• Change in memory narratives and appraisals

  Waterloo Images and Memories Interview

  Pre-treatment, 1 week, 2 weeks, and 3 months after treatment

Secondary Outcomes (2)

• Change in behavioral indices of social anxiety

  Pre-treatment, 1 week, 2 weeks, and 3 months after treatment

• Change in quality of life

  Pre-treatment, 1 week, 2 weeks, and 3 months after treatment

Study Arms (3)

Imaginal Rescripting

EXPERIMENTAL

Imaginal Rescripting (IR) targets imagery-based mental representations embedded within patients negative autobiographical memories related to social anxiety. In IR, patients progress through 3 distinct phases: (1) They "relive" a past negative event in their imagination, (2) are guided to actively change the original memory in their imagination to create more satisfying outcomes, and (3) relive the memory again while incorporating the new information. The IR intervention will be administered in one 90 minute session.

Behavioral: Imaginal Rescripting

Imaginal Exposure

ACTIVE COMPARATOR

Imaginal Exposure (IE) involves repeatedly "reliving" a negative autobiographical memory related to social anxiety from a first-person perspective and actively considering alternative meanings of the memory, but differs from IR in that the original memory itself is never explicitly modified in any way. The IE intervention will be administered in one 90 minute session.

Behavioral: Imaginal Exposure

Supportive Counselling

PLACEBO COMPARATOR

Supportive counselling (SC) provides patients with empathic support regarding a negative autobiographical memory related to social anxiety. The SC condition controls for non-specific clinical factors such as therapeutic attention and alliance. SC will be administered in one 60-90 minute session.

Other: Supportive Counselling

Interventions

Imaginal Rescripting BEHAVIORAL

A stand-alone single session intervention for social anxiety disorder

Also known as: Imagery Rescripting

Imaginal Rescripting

Imaginal Exposure BEHAVIORAL

A stand-alone single session intervention for social anxiety disorder

Imaginal Exposure

Supportive Counselling OTHER

Non-specific talk therapy focused on non-directive and empathic listening and on supporting patients' existing coping skills and strategies.

Supportive Counselling

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Principal diagnosis of social anxiety disorder (as per DSM-5)
• Endorsement of relevant images/memories associated with social situations.
• Participants currently undergoing stable drug treatment or psychological treatment for anxiety or mood difficulties may be included in the study if the treatment would not interfere with the study interventions.

You may not qualify if:

• Active suicidality, psychosis, or an actively-interfering alcohol/substance use disorder.
• Participant does not endorse mental images/memories

Sponsors & Collaborators

• University of Waterloo: lead
• Hebrew University of Jerusalem: collaborator
• University of Toronto: collaborator
• Baycrest: collaborator

Study Sites (1)

University of Waterloo Department of Psychology and Centre for Mental Health Research

Waterloo, Ontario, N2L 3G1, Canada

Location

Related Publications (2)

• Reimer SG, Moscovitch DA. The impact of imagery rescripting on memory appraisals and core beliefs in social anxiety disorder. Behav Res Ther. 2015 Dec;75:48-59. doi: 10.1016/j.brat.2015.10.007. Epub 2015 Nov 2.

  PMID: 26555157 BACKGROUND

• Moscovitch DA, Gavric DL, Merrifield C, Bielak T, Moscovitch M. Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: outcomes with a new measure. Behav Res Ther. 2011 Aug;49(8):505-17. doi: 10.1016/j.brat.2011.05.009. Epub 2011 May 26.

  PMID: 21683343 BACKGROUND

MeSH Terms

Interventions

Implosive Therapy

Intervention Hierarchy (Ancestors)

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

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants will be blind to the condition they receive
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will be randomized to receive one of three conditions, either Imaginal Rescripting, Imaginal Exposure, or Supportive Counselling

Study Record Dates

• First Submitted: April 21, 2017
• First Posted: May 4, 2017
• Study Start: May 10, 2017
• Primary Completion: August 23, 2018
• Study Completion: August 23, 2018
• Last Updated: January 16, 2019

Record last verified: 2018-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)