In Vivo Exposure vs. Videochat-Based Vicarious Exposure

NCT07432945 | Recruiting

• 1 other identifier: 1026
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

After screening (including parts of the Mini-DIPS), participants will receive a pre-assessment with a baseline heartrate measurement, self-report measures and two BATs (with the treated spider and the non-treated spider). All participants receive a brief psychoeducation \& video demonstration of exposure steps. Participants are randomly assigned to the three study arms and are then set to receive a single session of either in vivo exposure (IVET), videochat based vicarious exposure (VicET) or neither (Waiting List Control, WLC). Approximately 24 hours later, the two BATs with both spiders, a slightly reduced set of self-report measures and an interview will conduct the post-assessment. The order of all BATs, the spider individuals (treated vs. non-treated spider) and assignment to study arms will be randomized using a list that will be worked through in a sequence determined using "www.random.org". At a six-week follow-up, another long-term assessment will be conducted. Here, participants will receive a brief online questionnaire related to their experiences with spiders and self-report measures that were previously administered. Participants previously assigned to the waiting list control (WLC) will be invited to participate in an in-vivo exposure session. A set of questionnaires including demographic information, VAS scales on the current psychological state and wellbeing (administered at the start and end of the first and second assessment day), the BDI-II, the STAI-T and STAI-S, FEE, SPQ, SBQ, FSQ, GSE, SEQ-SP, TC/E for treatment credibility and the "positive attitudes towards technology subscale" of the MTUA will be used. BDI-II, STAI and MTUA are only administered at pre-assessment. The SAS is used for initial screening.

Conditions

Anxiety; Anxiety Disorders

Keywords

Exposure Therapy; Vicarious Exposure Therapy; Generalization of Exposure Effects; Disgust; Fear of Spiders; Anxiety Disorders; Specific Phobia

Outcome Measures

Primary Outcomes (4)

• Behavioral Approach Test (BAT)

  Change in the Behavioral Approach Tests (BAT) from pre- to post-assessment. BATs are conducted with both the treated spider and the non-treated spider. In the Behavioral Approach Test (BAT) the closest distance that a participant approached the spider is measured (final approach distance).

  Pre-Assessment (immediately prior to exposure for the IVET & VicET groups, which corresponds to the end of first assessment day for the WLC group as they receive exposure at the end of the study), Post-Assessment (the next day).

• Subjective fear

  Change in subjective fear from pre- to post-assessment is measured regarding the treated spider and the non-treated spider (SUDS scale during pre-assessment and post-assessment BATs). A comparison of the SUDS at the final approach distance at pre-assessment with the SUDS at the same distance at post-assessment (so called "initial approach") allows for an estimate of subjective fear reduction. Additionally, the change in subjective fear at the final approach distance from pre- to post-assessment can be observed. SUDS are measured on a scale from 0 (no fear) to 100 (highest possible fear).

  At Pre-Assessment (during BATs, Day 1 & treatments), At Post-Assessment (during BATs, Day 2)

• Subjective disgust

  Change in subjective disgust from pre- to post-assessment is measured regarding the treated spider and the non-treated spider (SUDS scale during Pre-assessment and Post-assessment BAT). A comparison of the SUDS at the final approach distance at pre-assessment with the SUDS at the same distance at post-assessment (so called "initial approach") allows for an estimate of subjective disgust reduction. Additionally, the change in subjective disgust at the final approach distance from pre- to post-assessment can be observed. SUDS are measured on a scale from 0 (no disgust) to 100 (highest possible disgust).

  Pre-Assessment (during BATs & treatments), Post-Assessment (during BATs)

• Heart Rate

  Change in mean heart rate from pre- to post-assessment BAT with treated spider and non-treated spider.

  Pre-Assessment (during BATs) & Post-Assessment (during BATs). Measured throughout all of Pre-Assessment (including 5-minute resting heartrate measurement), all of Post-Assessment (including 5-minute resting heartrate measurement) & Treatment.

Secondary Outcomes (2)

• Fear of Spiders Questionnaire (FSQ; german: FAS)

  Prior to the Pre-Assessment BATs (Day 1), after Post-Assessment BATs (Day 2, 24 hours later) and at Follow-Up (approx. 6 weeks after Day 2).

• Spider Beliefs Questionnaire (SBQ)

  Prior to the Pre-Assessment BATs (Day 1), after Post-Assessment BATs (Day 2, 24 hours later) and at Follow-Up (approx. 6 weeks after Day 2).

Other Outcomes (4)

• Specific Phobia Questionnaire (SPQ)

  Prior to the Pre-Assessment BATs (Day 1), after Post-Assessment BATs (Day 2, 24 hours later) and at Follow-Up (approx. 6 weeks after Day 2).

• General Self-Efficacy (GSE) Scale

  Prior to the Pre-Assessment BATs (Day 1), after Post-Assessment BATs (Day 2, 24 hours later) and at Follow-Up (approx. 6 weeks after Day 2).

• Self-Efficacy Questionnaire for Phobic Situations (SEQ-SP)

  Prior to the Pre-Assessment BATs (Day 1), after Post-Assessment BATs (Day 2, 24 hours later) and at Follow-Up (approx. 6 weeks after Day 2).

Study Arms (3)

In Vivo Exposure (IVET)

EXPERIMENTAL

Participants are subjected to a pre-assessment (questionnaires and BATs with treated spider and non-treated spider) and an in-vivo exposure, exposing them to the treated spider by approaching it in a predetermined sequence of steps. For further analyses, subjective fear, subjective disgust \& heart rate are measured during treatment. Post assessment consists of two BATs (treated spider and non-treated spider) and questionnaires. An online follow-up consists of brief questionnaires.

Behavioral: In Vivo Exposure Training (IVET)

Vicarious Exposure (VicET)

EXPERIMENTAL

Participants are set to receive a pre-assessment (questionnaires and BATs with treated spider and non-treated spider) and a vicarious exposure, exposing them to the treated spider by watching the experimenter approach it in a predetermined sequence of step (same as IVET) via two cameras. For further analyses, subjective fear, subjective disgust \& heart rate are measured during treatment. Post assessment consists of two BATs (treated spider and non-treated spider) and questionnaires. An online follow-up consists of brief questionnaires.

Behavioral: Vicarious Exposure Training (VicET)

Waitinglist Control (WLC)

NO INTERVENTION

Participants are set to receive a pre-assessment (questionnaires and BATs with treated spider and non-treated spider). Subsequent post-assessment consists of two BATs (treated spider and non-treated spider) and questionnaires. An online follow-up consists of brief questionnaires. Participants receive a session of IVET after assessment is completed.

Interventions

In Vivo Exposure Training (IVET) BEHAVIORAL

One session of graded in-vivo exposure with the treated spider. Prior to the exposure, participants receive psychoeducation on spiders, exposure therapy and specific phobia.

Also known as: Exposure, Exposure Training

In Vivo Exposure (IVET)

Vicarious Exposure Training (VicET) BEHAVIORAL

One session of graded video-based vicarious exposure with the treated spider. The steps are modeled by the experimenter. Prior to the exposure, participants receive psychoeducation on spiders, exposure therapy and specific phobia.

Also known as: Exposure, Exposure Training

Vicarious Exposure (VicET)

Eligibility Criteria

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

You may qualify if:

• Presence of fear of spiders (Potential diagnosis of arachnophobia)

You may not qualify if:

• Reaching level 10 or higher in initial BATs
• Any acute or chronic mental disease more debilitating than fear of spiders
• Any debilitating acute or chronic somatic disease that prevents or counteracts exposure treatment effects (such as cardiovascular diseases)
• Heart Diseases (Pace makers, Bradycardia, Arterial Hypertonia, Heart Arrhythmia)
• Psychological, psychiatric, neurological or pharmacological treatment
• Drug or alcohol abuse
• Pregnancy
• Insect Sting Allergy

Sponsors & Collaborators

• Ruhr University of Bochum: lead

Study Sites (1)

Behavioral and Clinical Neuroscience

Bochum, Germany

RECRUITING

Related Publications (14)

• Zlomuzica, A., Raeder, F., Reher, S., Lange, M., & Dere, E. (2025). Context-dependency of vicarious extinction learning. Behavioural Brain Research, 482, 115461. https://doi.org/10.1016/j.bbr.2025.115461

  BACKGROUND

• Gilroy, L. J., Kirkby, K. C., Daniels, B. A., Menzies, R. G., & Montgomery, I. M. (2000). Controlled comparison of computer-aided vicarious exposure versus live exposure in the treatment of spider phobia. Behavior Therapy, 31(4), 733-744. https://doi.org/10.1016/S0005-7894(00)80041-6

  BACKGROUND

• Rinck, M., Bundschuh, S., Engler, S., Müller, A., Wissmann, J., Ellwart, T., & Becker, E. S. (2002). Reliabilität und Validität dreier Instrumente zur Messung von Angst vor Spinnen. [Reliability and validity of German versions of three instruments measuring fear of spiders.]. Diagnostica, 48(3), 141-149. https://doi.org/10.1026//0012-1924.48.3.141

  BACKGROUND

• Szymanski, J., & O'Donohue, W. (1995). Fear of spiders questionnaire. Journal of behavior therapy and experimental psychiatry, 26(1), 31-34.

  BACKGROUND

• Schienle, A., Walter, B., Stark, R., & Vaitl, D. (2002). Ein Fragebogen zur Erfassung der Ekelempfindlichkeit (FEE). Zeitschrift für Klinische Psychologie und Psychotherapie, 31(2), 110-120. https://doi.org/10.1026/0084-5345.31.2.110

  BACKGROUND

• Rosen, L. D., Whaling, K., Carrier, L. M., Cheever, N. A., & Rokkum, J. (2013). The Media and Technology Usage and Attitudes Scale: An empirical investigation. Computers in Human Behavior, 29(6), 2501-2511. https://doi.org/10.1016/j.chb.2013.06.006

  BACKGROUND

• Pössel, P., & Hautzinger, M. (2003). Dysfunktionale Überzeugungen bei Spinnenangst. Zeitschrift für Klinische Psychologie und Psychotherapie, 32(1), 24-30. https://doi.org/10.1026/0084-5345.32.1.24

  BACKGROUND

• Ovanessian, M. M., Fairbrother, N., Vorstenbosch, V., McCabe, R. E., Rowa, K., & Antony, M. M. (2019). Psychometric Properties and Clinical Utility of the Specific Phobia Questionnaire in an Anxiety Disorders Sample. Journal of Psychopathology and Behavioral Assessment, 41(1), 36-52. https://doi.org/10.1007/s10862-018-9687-1

  BACKGROUND

• Laux, L., Glanzmann, P., Schaffner, P., & Spielberger, C. D. (1981). State-Trait-Angstinventar (STAI). Beltz.

  BACKGROUND

• Jerusalem, M., & Schwarzer, R. (1999). Skala zur Allgemeinen Selbstwirksamkeitserwartung (SWE). In Skalen zur Erfassung von Lehrer- und Schülermerkmalen: Dokumentation der psychometrischen Verfahren im Rahmen der wissenschaftlichen Begleitung des Modellversuchs Selbstwirksame Schulen.

  BACKGROUND

• Gilroy, L. J., Kirkby, K. C., Daniels, B. A., Menzies, R. G., & Montgomery, I. M. (2003). Long-term follow-up of computer-aided vicarious exposure versus live graded exposure in the treatment of spider phobia. Behavior Therapy, 34(1), 65-76. https://doi.org/10.1016/S0005-7894(03)80022-9

  BACKGROUND

• Flatt, N., & King, N. (2009). The Self-Efficacy Questionnaire for Phobic Situations (SEQ-SP): Development and Psychometric Evaluation. Behaviour Change, 26(2), 141-152. https://doi.org/10.1375/bech.26.2.141

  BACKGROUND

• Borkovec, T. D., & Nau, S. D. (1972). Credibility of analogue therapy rationales. Journal of Behavior Therapy and Experimental Psychiatry, 3(4), 257-260. https://doi.org/10.1016/0005-7916(72)90045-6

  BACKGROUND

• Beck, A. T., Keller, F., & Kühner, C. (2006). Beck Depressions-Inventar: BDI II.Revision [Testmaterial]. Harcourt Test Services.

  BACKGROUND

MeSH Terms

Conditions

Anxiety Disorders; Arachnophobia; Phobia, Specific

Condition Hierarchy (Ancestors)

Mental Disorders

Study Officials

• Armin Zlomuzica, Prof. Dr.

  Ruhr University of Bochum

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jan A Heistermann, M.Sc.

CONTACT

(+49)02343228469; Jan.Heistermann@ruhr-uni-bochum.de

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: Principal Investigator

Study Record Dates

• First Submitted: February 11, 2026
• First Posted: February 25, 2026
• Study Start: February 26, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: March 2, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

DE (1)