Use of Safety Behaviors in Exposure Therapy for Arachnophobia

NCT04470882 | Completed

• 1 other identifier: 1330971-1
• Study Type: interventional
• Target: 59
• Locations: 1 country
• Sites: 1

Brief Summary

This study examines the impact of safety behaviors (i.e., unnecessary protective actions) on outcomes of exposure therapy for spider phobia. Researchers will compare exposure therapy with (a) no safety behaviors, (b) safety behaviors faded toward the end of treatment, and (c) unfaded safety behaviors.

Conditions

Specific Phobia; Arachnophobia; Spider Phobia

Keywords

Exposure therapy; Safety behaviors; Arachnophobia; Spider phobia; Specific phobia

Outcome Measures

Primary Outcomes (10)

• Behavioral approach test (treatment context) - behavioral outcome

  Participants will approach a live, non-poisonous tarantula, placed on the floor, at the opposite end of the room. The participant will walk toward the spider during this test. The test is over when the participant has reached the hardest step that they can complete at that time. During this BAT, investigators will assess fear response behaviorally by recording the most challenging step completed (range, steps 0 -12).

  Change from baseline up to 4 weeks later (through follow up assessment)

• Behavioral approach test (treatment context) - subjective outcome

  Participants will approach a live, non-poisonous tarantula, placed on the floor, at the opposite end of the room. The participant will walk toward the spider during this test. The test is over when the participant has reached the hardest step that they can complete at that time. During this BAT, investigators will assess fear response subjectively by having participants self report their peak fear level (on a 0 to 100 scale).

  Change from baseline up to 4 weeks later (through follow up assessment)

• Behavioral approach test (treatment context) - physiological outcome

  Participants will approach a live, non-poisonous tarantula, placed on the floor, at the opposite end of the room. The participant will walk toward the spider during this test. The test is over when the participant has reached the hardest step that they can complete at that time. During this BAT, investigators will assess fear response physiologically by assessing heart rate variability.

  Change from baseline up to 4 weeks later (through follow up assessment)

• Behavioral approach test (generalization context) - behavioral outcome

  Participants will approach a live, non-poisonous tarantula, placed in a clear tank on a table, at the opposite end of the room. The test is over when the participant has reached the hardest step that they can complete at that time. Steps include walking toward the spider and lowering one hand into the tank. During this BAT, investigators will assess fear response behaviorally by recording the most challenging step completed (range, steps 0-21).

  Change from baseline up to 4 weeks later (through follow up assessment)

• Behavioral approach test (generalization context) - subjective outcome

  Participants will approach a live, non-poisonous tarantula, placed in a clear tank on a table, at the opposite end of the room. The test is over when the participant has reached the hardest step that they can complete at that time. Steps include walking toward the spider and lowering one hand into the tank. During this BAT, investigators will assess fear response subjectively by having participants self report their peak fear level (on a 0 to 100 scale).

  Change from baseline up to 4 weeks later (through follow up assessment)

• Behavioral approach test (generalization context) - physiological outcome

  Participants will approach a live, non-poisonous tarantula, placed in a clear tank on a table, at the opposite end of the room. The test is over when the participant has reached the hardest step that they can complete at that time. Steps include walking toward the spider and lowering one hand into the tank. During this BAT, investigators will assess fear response physiologically by assessing heart rate variability.

  Change from baseline up to 4 weeks later (through follow up assessment)

• Fear of Spiders Questionnaire (FSQ)

  Self-report rating scale in which participants rate the extent that they agree with a number of statements that are representative of having a fear of spiders. Sum total scores will be calculated (range 0-108). Higher scores indicate more severe symptom levels.

  Change from baseline up to 4 weeks later (through follow up assessment)

• Spider Phobia Beliefs Questionnaire (SBQ)

  Self-report rating scale assessing the level to which the participant believes a number of cognitions/thoughts commonly associated with spider phobia. An overall average rating will be calculated (range 0-100). Higher average scores indicate greater belief in spider phobic cognitions.

  Change from baseline up to 4 weeks later (through follow up assessment)

• Armfield and Mattiske Disgust Questionnaire (AMDQ)

  Self-report questionnaire assessing feelings of disgust associated with spiders. Sum total scores will be calculated (range 0-48). Higher scores indicate more severe spider-related disgust.

  Change from baseline up to 4 weeks later (through follow up assessment)

• Anxiety Disorders Interview Schedule for DSM-5 (ADIS-5)

  Participants will be given a structured interview to identify whether they meet diagnostic criteria for specific phobia. Responses will be coded dichotomously (yes = has diagnosis; no = no diagnosis).

  Change from baseline up to 4 weeks later (through follow up assessment)

Secondary Outcomes (2)

• Treatment Acceptability/Adherence Scale (Modified version)

  Measured just prior to beginning a one-session treatment

• Treatment Acceptability/Adherence Scale (Modified version)

  Measured immediately after completing a one-session treatment

Study Arms (3)

Exposure with faded safety behaviors

EXPERIMENTAL

Exposure therapy will involve three, 10-minute trials in which participants encounter a spider. Participants in this group will wear protective gear during the first two trials, and will remove the protective gear during the last trial.

Behavioral: Exposure with faded safety behaviors

Exposure without safety behaviors

ACTIVE COMPARATOR

Exposure therapy will involve three, 10-minute trials in which participants encounter a spider. Participants in this group will not wear protective gear during any of the exposure therapy trials.

Behavioral: Exposure without safety behaviors

Exposure with unfaded safety behaviors

EXPERIMENTAL

Exposure therapy will involve three, 10-minute trials in which participants encounter a spider. Participants in this group will wear protective gear during all three exposure therapy trials.

Behavioral: Exposure with unfaded safety behaviors

Interventions

Exposure with faded safety behaviors BEHAVIORAL

Exposure therapy will involve three, 10-minute trials in which participants encounter a spider. Participants in this group will wear protective gear during the first two trials, and will remove the protective gear during the last trial.

Exposure with faded safety behaviors

Exposure without safety behaviors BEHAVIORAL

Exposure therapy will involve three, 10-minute trials in which participants encounter a spider. Participants in this group will not wear protective gear during any of the exposure therapy trials.

Exposure without safety behaviors

Exposure with unfaded safety behaviors BEHAVIORAL

Exposure therapy will involve three, 10-minute trials in which participants encounter a spider. Participants in this group will wear protective gear during all three exposure therapy trials.

Exposure with unfaded safety behaviors

Eligibility Criteria

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

You may qualify if:

• Fluent in English
• Displays sufficiently high fear of spiders, as indicated by responses on (a) a self report questionnaire (the Fear of Spiders Questionnaire) at prescreening, and (b) Behavioral Avoidance Tests at baseline

You may not qualify if:

• younger than 18 years old

Sponsors & Collaborators

• University of Nevada, Reno: lead

Study Sites (1)

University of Nevada, Reno

Reno, Nevada, 89557, United States

Location

Related Publications (2)

• Powers MB, Smits JA, Telch MJ. Disentangling the effects of safety-behavior utilization and safety-behavior availability during exposure-based treatment: a placebo-controlled trial. J Consult Clin Psychol. 2004 Jun;72(3):448-54. doi: 10.1037/0022-006X.72.3.448.

  PMID: 15279528 BACKGROUND

• Deacon BJ, Sy JT, Lickel JJ, Nelson EA. Does the judicious use of safety behaviors improve the efficacy and acceptability of exposure therapy for claustrophobic fear? J Behav Ther Exp Psychiatry. 2010 Mar;41(1):71-80. doi: 10.1016/j.jbtep.2009.10.004. Epub 2009 Oct 24.

  PMID: 19892318 BACKGROUND

MeSH Terms

Conditions

Phobia, Specific; Arachnophobia

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: Assistant Professor, Clinical Psychology

Study Record Dates

• First Submitted: April 11, 2019
• First Posted: July 14, 2020
• Study Start: February 28, 2019
• Primary Completion: April 6, 2020
• Study Completion: April 6, 2020
• Last Updated: October 18, 2021

Record last verified: 2021-10

Locations

US (1)