Optimizing Exposure Therapy Via Reward-focused Interventions in Individuals With Public Speaking Anxiety

NCT06258889 | Completed

• 1 other identifier: EXOPAT_SPEAKING_ANX
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The present study aims to examine whether the efficacy of an exposure treatment in individuals with public speaking anxiety can be enhanced by implementing interventions that target reward processes. Optimized exposure enriched with reward-focused interventions will be compared to exposure in combination with interventions targeting cognitive flexibility. The efficacy of the exposure training will be assessed by behavioural and self-report measures of public-speaking anxiety at baseline (before intervention), intermediate-assessment (7-9 days after baseline assessment) and post-assessment (at least 7-9 days after intermediate-assessment). The investigators expect that exposure optimized by implementing reward-focused interventions is more effective in reducing public speaking anxiety compared to exposure in combination with interventions targeting cognitive flexibility.

Conditions

Public Speaking Fear

Outcome Measures

Primary Outcomes (2)

• Personal Report of Public Speaking Anxiety (PRPSA)

  34-item scale for measuring fear of public speaking, each item is rated on a 5-item Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Cronbach's alpha has been shown to range from 0.84 to 0.97. High scores on the scale reflect higher fear of public speaking

  Change from baseline to intermediate-assessment (i.e., 7-9 days later) to post assessment (i.e., at least 7 days after intermediate-assessment)

• Behavioral Approach Test (BAT)

  Rated fear on a scale from 0 (no fear) to 100 (severe fear) during oral presentation.

  Change from baseline to intermediate-assessment (i.e., 7-9 days later) to post assessment (i.e., at least 7 days after intermediate-assessment)

Secondary Outcomes (4)

• Temporal Experience of Pleasure Scale (TEPS)

  Change from baseline to intermediate-assessment (i.e., 7-9 days later) to post assessment (i.e., at least 7 days after intermediate-assessment)

• Positive and Negative Affect Schedule (PANAS)

  Change from baseline to intermediate-assessment (i.e., 7-9 days later) to post assessment (i.e., at least 7 days after intermediate-assessment)

• Social Phobia Scale (SPS)

  Change from baseline to intermediate-assessment (i.e., 7-9 days later) to post assessment (i.e., at least 7 days after intermediate-assessment)

• Brief fear of negative evaluations (BFNE-R)

  Change from baseline to intermediate-assessment (i.e., 7-9 days later) to post assessment (i.e., at least 7 days after intermediate-assessment)

Study Arms (2)

reward-focused intervention + exposure

EXPERIMENTAL

Psychoeducation reward-focused interventions based on Positive Affect Treatment (Finding the silver lining, taking ownership, imagining the positive) Exposure \& reward-focused interventions before and after exposure trials

Behavioral: reward-focused intervention; Behavioral: exposure; Behavioral: Psychoeducation

Cognitive flexibility intervention + exposure

ACTIVE COMPARATOR

Psychoeducation Cognitive Flexibility based on Unified Protocol of emotional disorders Exposure \& cognitive flexibility interventions before and after exposure trials

Behavioral: cognitive flexibility intervention; Behavioral: exposure; Behavioral: Psychoeducation

Interventions

reward-focused intervention BEHAVIORAL

Participants complete three interventions based on the Positive Affect Treatment: * Finding the silver lining includes attending to and appreciating positive aspects of past events * Taking ownership includes identifying the personal behavioral contribution to rewarding past experiences * Imagining the positive includes training the prospective, positive imagination of future events Participants are asked to practice these interventions at least three times a week (approx. 15 mins each) until the next training session.

reward-focused intervention + exposure

exposure BEHAVIORAL

All participants undergo an exposure training session lasting approximately 90 minutes, which includes three exposure trial where participants give a speech, each lasting 5 minutes. Exposure exercises are enriched with interventions of the respective treatment group (either reward-focused or cognitive flexibility interventions).

Cognitive flexibility intervention + exposure; reward-focused intervention + exposure

cognitive flexibility intervention BEHAVIORAL

This training aims to promote cognitive flexibility in the context of public speaking situations. The intervention is based on the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Participants will be trained to identify and modify non-adaptive thoughts occurring in the context of public speaking situations.

Cognitive flexibility intervention + exposure

Psychoeducation BEHAVIORAL

All participants received information on anxiety, and the maintenance of anxiety as well as a rationale for the exposure session.

Cognitive flexibility intervention + exposure; reward-focused intervention + exposure

Eligibility Criteria

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

You may qualify if:

• Proficient in the German language.
• Elevated levels of anxiety and avoidance of public speaking situations as indicated by a score of \> 5 and \> 4, respectively, on a scale from 0 to 8 using the following items:
• How anxious would you feel giving a formal speech before a live audience? How likely would you be to avoid taking a class that required taking an oral presentation?

You may not qualify if:

• severe cardiovascular, respiratory or neurological diseases
• current psychotherapeutic/psychiatric treatment
• Intention to start psychotherapeutic/psychiatric treatment
• current suicidal ideations
• psychotic symptoms (lifetime)
• current psychopharmacological medication

Sponsors & Collaborators

• Philipps University Marburg: lead

Study Sites (1)

Philipps-University Marburg

Marburg, Hesse, 35032, Germany

Location

Related Publications (3)

• Craske MG, Meuret AE, Ritz T, Treanor M, Dour HJ. Treatment for Anhedonia: A Neuroscience Driven Approach. Depress Anxiety. 2016 Oct;33(10):927-938. doi: 10.1002/da.22490.

  PMID: 27699943 BACKGROUND

• Craske MG, Meuret AE, Ritz T, Treanor M, Dour H, Rosenfield D. Positive affect treatment for depression and anxiety: A randomized clinical trial for a core feature of anhedonia. J Consult Clin Psychol. 2019 May;87(5):457-471. doi: 10.1037/ccp0000396.

  PMID: 30998048 BACKGROUND

• Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Conklin LR, Boswell JF, Ametaj A, Carl JR, Boettcher HT, Cassiello-Robbins C. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Compared With Diagnosis-Specific Protocols for Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry. 2017 Sep 1;74(9):875-884. doi: 10.1001/jamapsychiatry.2017.2164.

  PMID: 28768327 BACKGROUND

MeSH Terms

Conditions

Glossophobia

Study Officials

• Christoph Benke, PhD

  Philipps University Marburg

  PRINCIPAL INVESTIGATOR

• Anton Regorius, PhD

  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: February 6, 2024
• First Posted: February 14, 2024
• Study Start: January 8, 2024
• Primary Completion: December 13, 2024
• Study Completion: December 13, 2024
• Last Updated: January 9, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

DE (1)