Imagery Rescripting for Traumatic Panic Attack Memories

NCT07769996 | Completed

• 3 other identifiers: 224K50826.12.2023 10/1223.05.2024 2024/09
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

The current project consists of two studies investigating the phenomenological characteristics, centrality levels, and traumatic symptoms of panic attack memories, while testing the effectiveness of the Imagery Rescripting (ImRs) intervention in the treatment of panic disorder. The first study investigates whether panic attack memories share similar phenomenological features, centrality levels, and physiological responses with classic traumatic memories and general negative life event memories in a sample of 152 participants. The second study is a randomized controlled trial (RCT) involving 32 participants diagnosed with panic disorder based on DSM-5 criteria. Participants are randomly assigned to either an Imagery Rescripting (ImRs) intervention group or a control group. The primary objective is to evaluate the clinical effectiveness of a 6-session ImRs protocol in reducing panic disorder symptoms and physiological arousal associated with panic attack memories.

Conditions

Panic Disorder

Keywords

panic disorder; panic attack; trauma; autobiographical memory; imagery rescripting

Outcome Measures

Primary Outcomes (3)

• Change from Baseline in DSM-5 Panic Disorder Symptom Severity at Post-Intervention and 1-Month Follow-Up

  The DSM-5 Panic Disorder Scale (American Psychiatric Association, 2013; Turkish validation by Balıkçı et al., 2017) was used to measure the severity of panic disorder symptoms over the past 7 days. The scale is a 10-item, single-factor measure. The internal consistency coefficient (Cronbach's alpha) for the Turkish version was reported as .96. Higher scores reflect greater severity of panic disorder symptoms.

  Baseline, 6 weeks (post-treatment, following six weekly 50-minute sessions), and 1-month post-treatment follow-up

• Change from Baseline in Physiological Reactivity (Heart Rate) During Panic Attack Memory Recall at Post-Intervention and 1-Month Follow-Up

  Assessed by recording Heart Rate (beats per minute, BpM) an indicator of autonomic nervous system arousal during the panic attack memory writing/recall task. Data are recorded using NeuLog Heart Rate \& Pulse Logger Sensor (NUL-208) attached to the ring finger of the non-dominant hand. Higher values of heart rate reflect greater autonomic arousal and physiological reactivity during traumatic memory recall.

  Baseline, 6 weeks (post-treatment, following six weekly 50-minute sessions), and 1-month post-treatment follow-up

• Change from Baseline in Physiological Reactivity (Skin Conductance Level) During Panic Attack Memory Recall at Post-Intervention and 1-Month Follow-Up

  Assessed by recording Skin Conductance (microSiemens) as indicators of autonomic nervous system arousal during the panic attack memory writing/recall task. Data are recorded using NeuLog NeuLog GSR Logger Sensor (NUL-217) attached to the index finger of the non-dominant hand. Higher values of the skin conductance reflect greater autonomic arousal and physiological reactivity during traumatic memory recall.

  Baseline, 6 weeks (post-treatment, following six weekly 50-minute sessions), and 1-month post-treatment follow-up

Secondary Outcomes (5)

• Change from Baseline in Phenomenological Characteristics of Autobiographical Memory at Post-Intervention and 1-Month Follow-Up

  Baseline, 6 weeks (post-treatment, following six weekly 50-minute sessions), and 1-month post-treatment follow-up

• Change from Baseline in Event Centrality Score at Post-Intervention and 1-Month Follow-Up

  Baseline, 6 weeks (post-treatment, following six weekly 50-minute sessions), and 1-month post-treatment follow-up

• Change from Baseline in Traumatic Stress Symptom Severity at Post-Intervention and 1-Month Follow-Up

  Baseline, 6 weeks (post-treatment, following six weekly 50-minute sessions), and 1-month post-treatment follow-up

• Change from Baseline in General Self-Efficacy Score at Post-Intervention and 1-Month Follow-Up

  Baseline, 6 weeks (post-treatment, following six weekly 50-minute sessions), and 1-month post-treatment follow-up

• Change from Baseline in Perceived Panic Self-Efficacy Score at Post-Intervention and 1-Month Follow-Up

  Baseline, 6 weeks (post-treatment, following six weekly 50-minute sessions), and 1-month post-treatment follow-up

Study Arms (2)

Imagery Rescripting Group

EXPERIMENTAL

Participants in this arm receive a structured 6-session Imagery Rescripting (ImRs) protocol targeting traumatic panic attack memories. The intervention incorporates psychoeducation regarding panic symptoms and autobiographical memory, breathing exercises, and imagery rescripting techniques aimed at modifying the traumatic components of panic memories and developing a healthy adult perspective.

Behavioral: Imagery Rescripting

Control Group

NO INTERVENTION

Participants in this arm are assigned to the control group and do not receive the Imagery Rescripting intervention during the active study phase. Assessment data (physiological measurements and psychological scales) are collected at parallel time points corresponding to the baseline, post-intervention, and 1-month follow-up of the intervention group.

Interventions

Imagery Rescripting BEHAVIORAL

The protocol consists of a 6-session Imagery Rescripting (ImRs) intervention followed by a 1-month follow-up assessment. Session 1 involves introduction, study orientation and baseline assessments (physiological recordings during memory writing and psychological scales). Session 2 covers psychoeducation on panic disorder, breathing exercises, and the Safe Place exercise. Session 3 introduces Healthy Adult Imagery to foster adaptive coping mechanisms. Sessions 4 and 5 consist of core ImRs applications targeting traumatic panic attack memories and related early memories, utilizing therapist- or client-led adult interventions to fulfill unmet emotional needs. Session 6 evaluates the intervention outcomes, future concerns and collects post-intervention measurements. Session 7 serves as a 1-month follow-up evaluation with no active intervention.

Imagery Rescripting Group

Eligibility Criteria

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

You may qualify if:

• Being aged between 18 and 65 years. Voluntarily agreeing to participate in the study and providing informed consent.
• Being fluent in written and spoken Turkish. Having a current diagnosis of Panic Disorder according to DSM-5 criteria, confirmed by a psychiatrist.
• Answering "No" to the traumatic event screening question regarding the index panic memory (i.e., the panic memory does not involve exposure to actual or threatened death, serious injury, or physical threat).

You may not qualify if:

• Being under 18 or over 65 years of age. Inability or unwillingness to provide informed consent. Insufficient Turkish literacy. Absence of a current psychiatric diagnosis of Panic Disorder according to DSM-5 criteria.
• Having a lifetime diagnosis of Post-Traumatic Stress Disorder (PTSD) according to DSM-5 criteria.
• Answering "Yes" to the traumatic event screening question (i.e., presence of an explicit Criterion A traumatic event/physical threat in the index memory).

Sponsors & Collaborators

• İmge eylem yılmaz namlı: lead
• Aydin Adnan Menderes University: collaborator
• The Scientific and Technological Research Council of Turkey: collaborator

Study Sites (1)

Bağcılar Eğitim ve Araştırma Hastanesi

Istanbul, Bağcılar, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Panic Disorder; Wounds and Injuries

Condition Hierarchy (Ancestors)

Anxiety Disorders; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor

Model Details: A stratified randomized controlled trial design is utilized for the intervention study (Study 2). Participants meeting DSM-5 criteria for Panic Disorder are stratified by gender and randomly assigned in a 1:1 ratio to either the Imagery Rescripting (ImRs) intervention group (n = 16) or the control group (n = 16).

Study Record Dates

• First Submitted: August 8, 2026
• First Posted: August 18, 2026
• Study Start: October 1, 2024
• Primary Completion: June 1, 2025
• Study Completion: June 1, 2025
• Last Updated: August 18, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)