Optimizing Exposure Using Occasional Aversive Imagery in Spider Fearful Individuals

NCT05424250 | Completed

• 1 other identifier: OPEX_SPIDER
• Study Type: interventional
• Target: 67
• Locations: 1 country
• Sites: 1

Brief Summary

The effectiveness of an optimized extinction training is investigated in spider-fearful individuals. Participants will undergo a one-session standardized extinction training, either with or without occasional metal imagination of most feared apprehension towards spiders. The effectiveness of the training is measured by symptom improvement according to subjective ratings and behavioural avoidance tests one week later.

Conditions

Spider Fear; Arachnophobia

Outcome Measures

Primary Outcomes (3)

• Spider Phobia Questionnaire (SPQ)

  31-item true/false questionnaire assessing symptoms of arachnophobia. Scores range from 0 to 31, with greater scores representing greater fear of spiders. Spider phobic individuals have obtained mean scores of 23.20 (SD = 2.90) and 23.76 (SD = 3.80) on the SPQ.

  Change from baseline to post-treatment (i.e., 7-9 days)

• Behavioral Approach Test (BAT)

  Number of test steps fully completed (0-14 steps)

  Change from baseline to post-treatment (i.e., 7-9 days)

• Fear rating

  Maximum fear rating on a scale from 0 (no fear) to 100 (severe fear) recorded once during BAT

  Change from baseline to post-treatment (i.e., 7-9 days)

Secondary Outcomes (4)

• Fear of Spider Questionnaire (FSQ)

  Change from baseline to post-treatment (i.e., 7-9 days)

• Change in anxiety sensitivity (ASI-3)

  change from baseline to post-treatment (i.e. 7-9 days)

• PROMIS Emotional Distress-Anxiety-Short Form

  change from baseline to post-treatment (i.e. 7-9 days)

• US expectancy and fear ratings

  Baseline

Study Arms (2)

Exposure + occasional aversive imagination

EXPERIMENTAL

repeated imaginations of the participants' most feared apprehension during extinction training with seven standardized exposure steps

Behavioral: occasional aversive imagination; Behavioral: Exposure

Exposure

ACTIVE COMPARATOR

Standard extinction training with seven standardized exposure steps

Behavioral: Exposure

Interventions

occasional aversive imagination BEHAVIORAL

During six of the 27 exposure trials, participants in the experimental group are asked to imagine their most feared outcome towards spiders as vividly as possible while completing the specific trial.

Exposure + occasional aversive imagination

Exposure BEHAVIORAL

• All participants complete an exposure training session (approx. 75 min) with seven exposure steps, which are repeated between one and five times (e.g. Step 4: directing the spider with a pen by touching its legs at least five times per repetition; this step must be repeated five times before continuing to the next step). One repetition per step is considered one trial, therefore each participant aims to complete 27 exposure trials.

Exposure; Exposure + occasional aversive imagination

Eligibility Criteria

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

You may qualify if:

• Elevated score on Spider Phobia Questionnaire (SPQ) \> 17

You may not qualify if:

• Severe allergies to bees/spiders/insects
• current psychotherapeutic/psychiatric treatment
• past psychotherapeutic/psychiatric treatment due to anxiety problems
• current or past psychotic symptoms
• current suicidal intent
• experience with exposure-based treatment
• current psychopharmacological medication
• severe cardiovascular, respiratory or neurological diseases

Sponsors & Collaborators

• Philipps University Marburg: lead

Study Sites (1)

Philipps-University Marburg

Marburg, Hesse, 35037, Germany

Location

Related Publications (5)

• Craske MG, Treanor M, Conway CC, Zbozinek T, Vervliet B. Maximizing exposure therapy: an inhibitory learning approach. Behav Res Ther. 2014 Jul;58:10-23. doi: 10.1016/j.brat.2014.04.006. Epub 2014 May 9.

  PMID: 24864005 BACKGROUND

• Culver NC, Stevens S, Fanselow MS, Craske MG. Building physiological toughness: Some aversive events during extinction may attenuate return of fear. J Behav Ther Exp Psychiatry. 2018 Mar;58:18-28. doi: 10.1016/j.jbtep.2017.07.003. Epub 2017 Jul 25.

  PMID: 28777975 BACKGROUND

• Lipp OV, Ryan KM, Luck CC, Craske MG, Waters AM. Presentation of unpaired unconditional stimuli during extinction reduces renewal of conditional fear and slows re-acquisition. Psychophysiology. 2021 Oct;58(10):e13899. doi: 10.1111/psyp.13899. Epub 2021 Jul 6.

  PMID: 34231228 BACKGROUND

• Shiban Y, Wittmann J, Weissinger M, Muhlberger A. Gradual extinction reduces reinstatement. Front Behav Neurosci. 2015 Sep 15;9:254. doi: 10.3389/fnbeh.2015.00254. eCollection 2015.

  PMID: 26441581 BACKGROUND

• Thompson A, McEvoy PM, Lipp OV. Enhancing extinction learning: Occasional presentations of the unconditioned stimulus during extinction eliminate spontaneous recovery, but not necessarily reacquisition of fear. Behav Res Ther. 2018 Sep;108:29-39. doi: 10.1016/j.brat.2018.07.001. Epub 2018 Jul 3.

  PMID: 29981936 BACKGROUND

MeSH Terms

Conditions

Arachnophobia

Study Officials

• Christoph Benke, PhD

  Philipps University Marburg

  PRINCIPAL INVESTIGATOR

• Christiane Pané-Farré, PhD

  Philipps University Marburg

  PRINCIPAL INVESTIGATOR

• Dorothee Scheuermann, M.Sc.

  Philipps University Marburg

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: June 14, 2022
• First Posted: June 21, 2022
• Study Start: June 15, 2022
• Primary Completion: July 31, 2023
• Study Completion: September 30, 2023
• Last Updated: January 9, 2026

Record last verified: 2026-01

Locations

DE (1)