Neural Mechanisms and Efficacy of Imagery Rescripting for Fear of Failure

NCT07196085 | Completed

• 1 other identifier: SONATA_BIS_JM2019b
• Study Type: interventional
• Target: 81
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial investigates the neural and psychophysiological mechanisms of Imagery Rescripting (ImRs) in individuals with high fear of failure. Participants (N=81, aged 21-34) were randomized to ImRs or an active control condition. The intervention targeted autobiographical memories of parental criticism across four sessions delivered within two weeks. Neuroimaging (fMRI), skin conductance, and self-report measures were assessed pre- and post-intervention (accordindly, TP1, TP5), with follow-ups at 3 and 6 months (accordingly, TP6, TP7). The primary aim was to examine whether ImRs reduces neural and subjective reactivity to autobiographical criticism memories and whether prediction error or memory reconsolidation disruption underlie therapeutic effects.

Conditions

Fear of Failure

Keywords

Fear of failure; Imagery Rescripting; Skin Conductance Level; fMRI

Outcome Measures

Primary Outcomes (7)

• BOLD fMRI activation to autobiographical criticism scenarios

  Blood-oxygen-level dependent (BOLD) signal in fear-related regions (amygdala, thalamus, insula, vmPFC) during listening to criticism vs. neutral autobiographical scenarios. Contrasts analyzed for anticipation (ANT), hotspot (HOT), and combined phases.

  Pre-treatment (TP1) and 2-weeks post-treatment (TP5).

• Performance Failure Appraisal Inventory (PFAI)

  The Performance Failure Appraisal Inventory was used to assess fear of failure. It is a 35-item questionnaire that measures the strength of subjective beliefs about the consequences of failure. The PFAI has five subscales: fear of experiencing shame and embarrassment; fear of devaluing one's self-esteem; fear of having an uncertain future; fear of important others losing interest, and fear of upsetting important others, with scores ranging 35-175. Higher scores indicate higher level of fear of failure.

  Screening, pre-treatment (TP1), 2-weeks post-treatment (TP5), 3- & 6-month follow-up (TP6, TP7)

• Functional connectivity (fMRI)

  Psychophysiological interaction (PPI) and ROI-to-ROI connectivity between vmPFC/dlPFC and fear-related subcortical regions (amygdala, insula, thalamus, hippocampus, PCC, ACC, precuneus) during criticism vs. neutral autobiographical scenarios.

  Pre-treatment (TP1) and 2-weeks post-treatment (TP5)

• Subjective ratings at the end of all sessions

  Subjective ratings at the end of all sessions - participants were asked to evaluate each fragment of the presented scenarios according to several measures: immersion, focus, emotions (happiness, sadness, guilt, fear, anger, disgust) on a 9-point Likert scale (very low-very high), and valence (very negative-very positive), scores ranging 1-9 for each factor.

  Pre-treatment (TP1), 2-weeks post-treatment (TP5), 3- & 6-month follow-up (TP6, TP7)

• Failure-related Schemas (FA-YSQ)

  Failure-related subscale of the Young Schema Questionnaire (YSQ). Higher scores indicate stronger maladaptive beliefs about failure. Scores ranges from 0 to 54.

  Pre-treatment (TP1), 2-weeks post-treatment (TP5), 3- & 6-month follow-up (TP6, TP7).

• Frost Multidimensional Perfectionism Scale (FROST)

  35-item questionnaire assessing perfectionism dimensions: Personal Standards, Organization, Concern Over Mistakes, Doubts About Actions, Parental Expectations, and Parental Criticism. Scores range 35-175. Higher scores indicate higher level of perfectionism.

  Pre-treatment (TP1), 2-weeks post-treatment (TP5), 3- & 6-month follow-up (TP6, TP7).

• SCL recordings

  Skin conductance level (SCL) was collected during the audio-guided scenarios' imagery at pre-treatment, treatment, post-treatment, and follow-up sessions. SCL was acquired using Biopack MP160 EDA-MRI system, with a sampling frequency of 2000Hz. The signal was resampled into 1000Hz, then smoothed with median (100 samples), and filtered with a high-passed 1Hz filter. We calculated normalized change in SCL with equation 100#(SCLStim-SCLbaseline/SCLbaseline), where SCLStim is the mean signal value during the stimulus and SCLbaseline is an SCL reaction during the baseline preceding the first part in each scenario (Sugimine et al., 2020). Our primary outcome was SCL during the imagery of different scenarios, separated for anticipation and hotspot parts.

  Screening, pre-treatment (TP1), 2-weeks post-treatment (TP5), 3- & 6-month follow-up (TP6, TP7)

Secondary Outcomes (10)

• Working Alliance Inventory (WAI, short form)

  6-month follow-up (TP7).

• Beck Depression Inventory

  Screening, 6-month follow-up

• Yale-Brown Obsessive-Compulsive

  Screening, 6-month follow-up

• M.I.N.I. Mini International Neuropsychiatric Interview

  Screening

• Social Anxiety Disorder Scale (DSM)

  Screening, 6-month follow-up

Study Arms (2)

Imagery Rescripting

EXPERIMENTAL

Four ImRs sessions over 2 weeks, targeting autobiographical criticism memory. Therapist-guided rescripting involved modifying the "hotspot" scene (critical interaction) with protective interventions addressing unmet needs.

Behavioral: Imagery Rescripting

Sham Neutral Imagery

ACTIVE COMPARATOR

Four neutral imagery sessions over 2 weeks. Participants imagined neutral interpersonal interactions matched in structure and duration to ImRs but with rescription of neutral instead of criticism memories.

Behavioral: Sham Neutral Imagery

Interventions

Imagery Rescripting BEHAVIORAL

Four ImRs sessions over 2 weeks, targeting autobiographical criticism memory. Therapist-guided rescripting involved modifying the "hotspot" scene (critical interaction) with protective interventions addressing unmet needs.

Imagery Rescripting

Sham Neutral Imagery BEHAVIORAL

Four neutral imagery sessions over 2 weeks. Participants imagined neutral interpersonal interactions matched in structure and duration to ImRs but with rescription of neutral instead of criticism memories.

Sham Neutral Imagery

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• adults aged 18-35
• high fear of failure
• not currently undergoing psychotherapy or psychopharmacotherapy
• no severe punitive experiences in the past

You may not qualify if:

• current severe affective disorders
• current severe anxiety
• current severe personality disorders
• active suicidality
• psychosis
• substance abuse

Sponsors & Collaborators

• University of Social Sciences and Humanities, Warsaw: lead

Study Sites (1)

Poznań Laboratory of Affective Neuroscience, Institute of Psychology, SWPS University, Warsaw, Poland

Poznan, Wielkopolska, 61-719, Poland

Location

Related Publications (8)

• Conroy, D. E., Willow, J. P., & Metzler, J. N. (2002). Multidimensional fear of failure measurement: The performance failure appraisal inventory. Journal of applied sport psychology, 14(2), 76-90.

  BACKGROUND

• Agren T, Engman J, Frick A, Bjorkstrand J, Larsson EM, Furmark T, Fredrikson M. Disruption of reconsolidation erases a fear memory trace in the human amygdala. Science. 2012 Sep 21;337(6101):1550-2. doi: 10.1126/science.1223006.

  PMID: 22997340 BACKGROUND

• Arntz A, Weertman A. Treatment of childhood memories: theory and practice. Behav Res Ther. 1999 Aug;37(8):715-40. doi: 10.1016/s0005-7967(98)00173-9.

  PMID: 10452174 BACKGROUND

• Morina N, Lancee J, Arntz A. Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis. J Behav Ther Exp Psychiatry. 2017 Jun;55:6-15. doi: 10.1016/j.jbtep.2016.11.003. Epub 2016 Nov 9.

  PMID: 27855298 BACKGROUND

• Schiller D, Kanen JW, LeDoux JE, Monfils MH, Phelps EA. Extinction during reconsolidation of threat memory diminishes prefrontal cortex involvement. Proc Natl Acad Sci U S A. 2013 Dec 10;110(50):20040-5. doi: 10.1073/pnas.1320322110. Epub 2013 Nov 25.

  PMID: 24277809 BACKGROUND

• Siegesleitner M, Strohm M, Wittekind CE, Ehring T, Kunze AE. Improving imagery rescripting treatments: Comparing an active versus passive approach. J Behav Ther Exp Psychiatry. 2020 Dec;69:101578. doi: 10.1016/j.jbtep.2020.101578. Epub 2020 Jun 9.

  PMID: 32569854 BACKGROUND

• Sugimine S, Saito S, Takazawa T. Normalized skin conductance level could differentiate physical pain stimuli from other sympathetic stimuli. Sci Rep. 2020 Jul 2;10(1):10950. doi: 10.1038/s41598-020-67936-0.

  PMID: 32616939 BACKGROUND

• Craske MG, Kircanski K, Epstein A, Wittchen HU, Pine DS, Lewis-Fernandez R, Hinton D; DSM V Anxiety; OC Spectrum; Posttraumatic and Dissociative Disorder Work Group. Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V. Depress Anxiety. 2010 Feb;27(2):93-112. doi: 10.1002/da.20654.

  PMID: 20099270 BACKGROUND

Study Officials

• Jarosław M. Michałowski, PHD

  Poznań Laboratory of Affective Neuroscience, Institute of Psychology, SWPS

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: September 18, 2025
• First Posted: September 29, 2025
• Study Start: June 1, 2022
• Primary Completion: November 30, 2022
• Study Completion: May 30, 2023
• Last Updated: October 2, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ANALYTIC CODE
• Time Frame: The de-identified dataset was made publicly available 22 September 2025 and will remain accessible indefinitely.
• Access Criteria: The data used for analysis (in the form of questionnaires, psychophysiological, and neuroimaging measures) are openly available in the SWPS University repository under a Creative Commons license (CC BY-SA). Access to some raw data (e.g., unprocessed MRI files or full physiological recordings) may be granted upon reasonable request and with permission of the study's principal investigator.

Locations

PL (1)