Specific Phobia
Conditions
Keywords
specific phobia, height phobia, exposure, virtual reality, extinction, self-efficacy
Brief summary
Self-efficacy refers to the perceived belief to cope effectively, by personal efforts, with challenging situations and problems (Bandura, 1977). Basic research has shown that increases in perceived self-efficacy can enhance the extinction of fear (Zlomuzica et al., 2015). This study is aimed at translating these findings into a useful clinical application to augment exposure-based treatment outcome.
Detailed description
In this study, the effects of self-efficacy enhancement on treatment outcome in patients with height phobia will be investigated. Participants will be randomly assigned to one of the following conditions: i) virtual reality exposure + self-efficacy enhancement; ii) virtual reality exposure + control intervention; iii) virtual reality exposure only. The amount of exposure is identical across groups (i.e. maximum of 1 hour of exposure). The self-efficacy and the control intervention involve the retrieval of the exposure session with or without a focus on personal mastery experiences/achievements, respectively. Treatment-induced changes as well as the effects of self-efficacy enhancement will be measured on the subjective level (i.e. in-vivo Behavioral Approach Tests, BATs; church tower), physiological level (heart rate during the BATs), and subjective level (subjective fear during the BATs as well as height-phobia related questionnaires) at each of the three assessments (i.e. pretreatment, after which the exposure will conducted on the same day, i.e. day 1; posttreatment, which is scheduled approximately 2-3 days after exposure, and follow-up assessment, which will take place 1-month after exposure).
Interventions
OTHERSelf-efficacy enhancement
specific instructions regarding the retrieval of mastery experiences during exposure will be given (e.g., pointing out discrepancies between expected negative consequences and actual outcome during exposure; focus on achievements)
OTHERControl intervention
specific instructions regarding the retrieval of the exposure session will be given without an emphasis on personal mastery experience (e.g., description of details regarding the virtual reality environment)
Sponsors
Ruhr University of Bochum
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 38 Years
Healthy volunteers
No
Inclusion criteria
* specific phobia (acrophobia) * normal or corrected vision
Exclusion criteria
* somatic or neurological disease * personality disorder * bipolar disorder * acute drug- or alcoholabuse * pharmacological treatment within the past 4 weeks * mental retardation * any schizophrenic disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in the Behavioral Approach Test (BAT) | from pretreatment through follow-up (i.e. baseline, approx. 2-3 days after treatment, 1 month after) | — |
| Change in subjective fear during the BAT | from pretreatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after) | Subjective fear during the BATs will be measured using the Subjective Units of Distress Scale (SUDS) |
| Change in heart rate reactivity during the BAT | from pretreatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after) | — |
Secondary
| Measure | Time frame |
|---|---|
| Change in Danger Expectancy Scale (DES) | assessed from pre-treatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after |
| Change in Anxiety Expectancy Scale (AES) | assessed from pre-treatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after |
| Change in Acrophobia Questionnaire (AQ) | assessed from pre-treatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after |
| Change in Attitude Towards Heights Questionnaire (ATHQ) | assessed from pre-treatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after |
Other
| Measure | Time frame | Description |
|---|---|---|
| Salivary cortisol | assessed twice at each of the three assessments, i.e. pretreatment, posttreatment, follow-up (windows: pretreatment on day 1; approx. 2-3 days after; 1 month after) | — |
| Change in perceived self-efficacy | assessed three times on day 1: before and after the exposure session as well as after the intervention; assessed once at posttreatment (window: 2-3 days after exposure treatment); assessed once at follow-up (window: 1 month after treatment) | Changes in perceived self-efficacy will be measures with visual analogue scales (VAS) |
| Changes in Test zum kognitiven Schätzen (TKS) | assessed twice on day 1: before and after exposure treatment | — |
| Becks Depression Inventory II (BDI II) | assessed at pre-treatment (day 1) | — |
| State-Trait Anxiety Inventory (STAI) | assessed at pre-treatment (day 1) | — |
| Emotion Regulation Questionnaire (ERQ) | assessed at pre-treatment (day 1) | — |
| General Self-efficacy Scale (GSE) | assessed at pre-treatment (day 1) | — |
| Self-efficacy Scale (SES) | assessed at pre-treatment (day 1) | — |
| Resilience Appraisal Scale (RAS) | assessed after the intervention on day 1 | — |
Countries
Germany
Outcome results
None listed