Augmentation of Exposure Using Positive Mental Rehearsal in Individuals With Increased Social Anxiety

NCT06564402 | Recruiting

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

Brief Summary

Efficacy of an optimized exposure therapy training is investigated in individuals with heightened social anxiety. Participants will undergo a one-session standardized exposure training, followed by either standard or positive mental rehearsal of the exposure experience. The efficacy is measured by symptom improvement according to subjective ratings one week later.

Conditions

Social Anxiety; Social Phobia

Outcome Measures

Primary Outcomes (3)

• Social Interaction Anxiety Scale (SIAS)

  20-item questionnaire on a 5-point Likert scale (0 = 'not at all'; 4 = 'very strongly') assessing severity of anxiety experienced in social interactions and situations. Total score range: 0 to 80. Higher scores indicate higher severity of social anxiety.

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

• Liebowitz Social Anxiety Scale (LSAS)

  2-items from the Liebowitz Social Anxiety Scale (LSAS) on a 4-point Likert scale (fear: 0 = 'none'; 3 = 'high'; avoidance: 0 = 'never'; 3 = 'usually') assessing fear and avoidance of the in the intervention exposed situations. Higher scores indicating greater level of fear and avoidance.

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

• Communication Anxiety Inventory (CAI) - Trait Version

  21-item questionnaire on a 4-point Likert scale (0 = 'almost never'; 3 = 'almost always') assessing an individual's general level of anxiety in communication situations. Total range score: 0 to 84. Higher scores indicate greater level of communication anxiety.

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

Secondary Outcomes (6)

• Communication Anxiety Inventory (CAI) - State Version

  Baseline

• Positive and Negative Affect Schedule (PANAS)

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

• Post-Event Processing Inventory (PEPI) - Trait Version

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

• Post-Event Processing Inventory (PEPI) - State Version

  Post-treatment

• Plymouth Sensory Imagery Questionnaire (PSI-Q)

  Baseline

Study Arms (2)

Exposure + Positive Mental Rehearsal

EXPERIMENTAL

Mental rehearsal of the positive aspects of exposure experience

Behavioral: Positive Mental Rehearsal; Behavioral: Exposure

Exposure + Mental rehearsal

ACTIVE COMPARATOR

Mental rehearsal of the exposure experience

Behavioral: Mental Rehearsal; Behavioral: Exposure

Interventions

Positive Mental Rehearsal BEHAVIORAL

After exposure trial, participants are asked about the positive aspects of their exposure experience (e.g., thoughts, feelings), based on which an imagination script is formulated and recounted

Exposure + Positive Mental Rehearsal

Mental Rehearsal BEHAVIORAL

After exposure, participants are asked about what happened during the exposure experience and whether their central concerns/expected outcome actually occurred during exposure

Exposure + Mental rehearsal

Exposure BEHAVIORAL

All participants complete exposure exercises (i.e., talking on the phone and talking with a stranger) before positive mental rehearsal is executed

Exposure + Mental rehearsal; Exposure + Positive Mental Rehearsal

Eligibility Criteria

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

You may qualify if:

• Elevated score on Social Interactions Anxiety Scale (SIAS) \> 26

You may not qualify if:

• Current psychotherapeutic/psychiatric treatment
• Plans to start psychotherapeutic/psychiatric treatment in upcoming weeks
• Current suicidal intent
• Severe cardiovascular, respiratory or neurological diseases

Sponsors & Collaborators

• Philipps University Marburg: lead

Study Sites (1)

Germany Philipps University

Marburg, 35037, Germany

RECRUITING

Related Publications (4)

• Rosenberg BM, Barnes-Horowitz NM, Zbozinek TD, Craske MG. Reward processes in extinction learning and applications to exposure therapy. J Anxiety Disord. 2024 Aug;106:102911. doi: 10.1016/j.janxdis.2024.102911. Epub 2024 Jul 29.

  PMID: 39128178 BACKGROUND

• McGlade AL, Craske MG. Optimizing exposure: Between-session mental rehearsal as an augmentation strategy. Behav Res Ther. 2021 Apr;139:103827. doi: 10.1016/j.brat.2021.103827. Epub 2021 Feb 11.

  PMID: 33607459 BACKGROUND

• Craske MG, Meuret AE, Echiverri-Cohen A, Rosenfield D, Ritz T. Positive affect treatment targets reward sensitivity: A randomized controlled trial. J Consult Clin Psychol. 2023 Jun;91(6):350-366. doi: 10.1037/ccp0000805. Epub 2023 Mar 9.

  PMID: 36892884 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

MeSH Terms

Conditions

Phobia, Social

Condition Hierarchy (Ancestors)

Phobic Disorders; Anxiety Disorders; Mental Disorders

Central Study Contacts

Andrea Stoliarov, M.Sc.

CONTACT

+4964212826991; andrea.stoliarov@uni-marburg.de

Christoph Benke, PhD

CONTACT

+4964212824091; christoph.benke@uni-marburg.de

Study Design

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

Study Record Dates

• First Submitted: August 19, 2024
• First Posted: August 21, 2024
• Study Start: May 28, 2024
• Primary Completion: February 1, 2026
• Study Completion: March 1, 2026
• Last Updated: January 9, 2026

Record last verified: 2026-01

Locations

DE (1)