Optimizing Exposure Therapy for Anxiety Disorders

NCT04048824 | Completed

• 1 other identifier: Optimizing Exposure
• Study Type: interventional
• Target: 89
• Locations: 1 country
• Sites: 1

Brief Summary

The study will compare the effects that two different approaches of exposure therapy have on reducing fear and anxiety in individuals with social anxiety disorder or panic disorder.

Conditions

Social Anxiety Disorder; Panic Disorder

Keywords

inhibitory learning; exposure; anxiety; habituation; social anxiety; panic

Outcome Measures

Primary Outcomes (2)

• Change in clinician-rated severity of social anxiety or panic disorder

  Clinician severity rating (0-8) of social anxiety or panic disorder using the Structured Clinical Interview for DSM-5 (SCID-5).

  Pre-treatment to post-treatment (10 weeks), to follow-up (24 weeks)

• Change in self-reported symptom severity of social anxiety or panic disorder

  Self-reported symptom severity of social anxiety disorder using the Liebowitz Social Anxiety Scale (LSAS) or panic disorder using the Panic Disorder Severity Scale-Self Report (PDSS-SR).

  Pre-treatment to post-treatment (10 weeks), to follow-up (24 weeks)

Secondary Outcomes (11)

• Change in fear extinction generalization as measured by expectancy of unconditional stimuli during conditional stimuli presentation.

  Pre-treatment to post-treatment (9 weeks)

• Change in fear extinction generalization as measured by skin conductance.

  Pre-treatment to post-treatment (9 weeks)

• Change in fear extinction generalization as measured by heart rate.

  Pre-treatment to post-treatment (10 weeks)

• Implicit Fear Association Test

  Pre-treatment to post-treatment (10 weeks)

• Behavioral Avoidance Test (BAT)

  Pre-treatment to post-treatment (10 weeks)

Study Arms (2)

Inhibitory Learning-Based Exposure

EXPERIMENTAL

Participants will receive exposure therapy aimed at increasing inhibitory learning.

Behavioral: Inhibitory Learning-Based Exposure

Habituation-Based Exposure

ACTIVE COMPARATOR

Participants will receive exposure therapy aimed at reducing fear responding.

Behavioral: Habituation-Based Exposure

Interventions

Inhibitory Learning-Based Exposure BEHAVIORAL

9 weekly treatment sessions conducted individually with a therapist. Exposure is focused on maximizing the mismatch between participant's feared outcome and what actually occurred (i.e., expectancy violation). This condition includes techniques that incorporate associative learning principles such as exposure to multiple feared stimuli (i.e., deepened extinction), exposure variability in contexts and stimuli, occasional reinforcement, and mental reinstatement of inhibitory learning.

Inhibitory Learning-Based Exposure

Habituation-Based Exposure BEHAVIORAL

9 weekly treatment sessions conducted individually with a therapist. Exposure is focused on fear reduction from initial fear ratings. This condition includes theoretically-consistent techniques such as staying in the situation until fear declines, repetition of exposures until fear has declined, and a gradual approach to feared stimuli using an exposure hierarchy.

Habituation-Based Exposure

Eligibility Criteria

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

You may qualify if:

• Seeking treatment for social anxiety or panic disorder and demonstration of elevated scores using standardized self-report measures and diagnostic interview
• Age 18 to 65
• Either stabilized on psychotropic medications or medication-free
• English-speaking
• Access to telehealth resources (for Zoom treatment sessions after March 2020 due to COVID-19)

You may not qualify if:

• Patient report of serious medical conditions - such as respiratory (e.g., chronic obstructive pulmonary disease), cardiovascular, pulmonary, neurological, muscular-skeletal diseases - or pregnancy
• Active suicidal ideation or self-harm in the past year; history of suicide attempts in the last 10 years
• History of bipolar disorder, psychosis, mental retardation or organic brain damage
• Substance abuse/dependence within last 6 months
• Concurrent therapy focused on anxiety. Participants are allowed to be in other forms of therapy, provided the therapy does not focus on anxiety (e.g., supportive counseling) and they have been stabilized on this alternative therapy for at least 6 months

Sponsors & Collaborators

• University of California, Los Angeles: lead

Study Sites (1)

University of California, Los Angeles

Los Angeles, California, 90095, United States

Location

MeSH Terms

Conditions

Phobia, Social; Panic Disorder; Anxiety Disorders; Substance-Related Disorders

Condition Hierarchy (Ancestors)

Phobic Disorders; Mental Disorders; Chemically-Induced Disorders

Study Officials

• Michelle G Craske, PhD

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: November 26, 2018
• First Posted: August 7, 2019
• Study Start: August 14, 2015
• Primary Completion: January 1, 2025
• Study Completion: January 1, 2025
• Last Updated: April 6, 2025

Record last verified: 2025-04

Locations

US (1)