Social Anxiety, Social Phobia
Conditions
Brief summary
Efficacy of an online intervention aimed at enhancing both approach motivation and behavioral engagement in facing anxiety-provoking social situations among individuals with heightened social anxiety is investigated. Upon receiving psychoeducation, participants will either undergo a prospective mental-imagery task or no additional task. The intervention's efficacy will be assessed by ratings of experienced and expected pleasure, approach motivation as well as self-reported engagement with feared situation one week later.
Detailed description
Although exposure therapy is widely considered the gold standard for treating anxiety disorders, its effectiveness is often hindered by treatment discontinuation. Many individuals avoid facing feared situations, yet exposure is crucial for successful extinction learning. Therefore, there is a need for strategies to enhance both approach motivation and behavioral engagement in anxiety-provoking situations. Within the depression literature, imagery-based interventions have already gained some support in increasing motivation and behavioral engagement in pleasurable activities through enhancement of reward anticipation as well as anticipatory and anticipated pleasure ('motivational amplifier' hypothesis). Considering that social anxiety is characterized by disruptions in motivational and reward processes, prospective mental imagery may strengthen approach motivation and behavioral engagement in exposure to socially feared situations. Thus, the present online study will investigate the effect of a prospective mental-imagery task on approach motivation and behavioral engagement in socially anxious individuals. Following psychoeducation, participants in the experimental group will vividly imagine having successfully mastered the fear-provoking situation. The control group will receive only psychoeducation. Approach motivation as well as reward anticipation, anticipated and anticipatory pleasure will be assessed before and after the psychoeducation and imagery task. Engagement with the feared social situation will be assessed one week later. The aim of this randomized controlled trial in healthy individuals with heightened social anxiety is to investigate whether prospective mental imagery is effective in enhancing self-reported motivation and engagement with feared situation compared to a psychoeducation-only control group. In an exploratory analysis, we will investigate whether individuals' levels of reward sensitivity and anhedonia influence the effectiveness of prospective imagery training.
Interventions
BEHAVIORALPsychoeducation
Providing information about social anxiety, role of safety and avoidance behaviors in maintaining social anxiety, rationale for exposure to feared social situations
BEHAVIORALProspective Mental Imagery
A standard imagination script is recounted in which participants have successfully mastered the socially feared situation
Sponsors
Philipps University Marburg
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Elevated score on Mini-Social Phobia Inventory (Mini-SPIN) \> 6
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Anticipatory Pleasure | Baseline (prior to the assigned intervention) and immediately post-intervention (following prospective mental imagery or psychoeducation) | 2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing current pleasure when imaging approaching and having approached the feared situation. |
| Anticipated Pleasure | Baseline (prior to the assigned intervention) and immediately post-intervention (following prospective mental imagery or psychoeducation) | 2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing expected pleasure when approaching and having approached the feared situation. |
| Reward Anticipation | Baseline (prior to the assigned intervention) and immediately post-intervention (following prospective mental imagery or psychoeducation) | 2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing expected reward related to approaching and having approached the feared situation. |
| Motivation | Baseline (prior to the assigned intervention) and immediately post-intervention (following prospective mental imagery or psychoeducation) | Self-reported motivation to approach the feared situation on a scale of 0 (not at all) to 100 (extremely). |
| Frequency of Exposure | Post-treatment (i.e., 7 days after baseline) | Self-reported frequency of exposure to the feared situation. Scale: 0 to 10, indicating the frequency of exposure to the feared situation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Temporal Experience of Pleasure Scale (TEPS) | Baseline | 18-item questionnaire on a 6-point Likert scale (1 = 'strongly disagree'; 6 = 'strongly agree') assessing anticipatory and consummatory pleasure. Total score range: 18 to 108. Higher total scores indicating a greater capacity for pleasure. |
| Social Phobia Inventory (SPIN) | Change from baseline to post-treatment (i.e., 7 days) | 17-item questionnaire on a 5-point Likert scale (0 = 'not at all'; 4 = 'extremely') assessing symptom severity related to social anxiety (i.e., fear, avoidance, physical symptoms). Total range score: 0 to 68. Higher scores indicating greater severity of social anxiety. |
| Vividness of Mental Imagination | Immediately after prospective mental imagery at baseline | Vividness of imagination on a scale from 0 (not at all) to 100 (extremely vivid) assessed immediately after imagination exercise. |
| Liebowitz Social Anxiety Scale (LSAS) | Change from baseline to post-treatment (i.e., 7 days) | 24-item questionnaire on a 4-point Likert scale (fear: 0 = 'none'; 3 = 'severe'; avoidance: 0 = 'never'; 3 = 'usually') assessing both fear/anxiety and avoidance of social situations, respectively. Total range score: 0 to 144. Higher scores indicating greater fear and avoidance as well as severity of social anxiety. |
| Patient Health Questionnaire-9 (PHQ-9) | Change from baseline to post-treatment (i.e., 7 days) | 9-item questionnaire on a 4-point Likert scale (0 = 'not at all'; 3 = 'nearly every day') assessing the presence and severity of depressive symptoms. Total range score: 0 to 27. Higher scores indicating more severe depression. |
| Positive and Negative Affect Schedule (PANAS) | Change from baseline to post-treatment (i.e., 7 days) | 20-item questionnaire on a 5-point Likert scale (0 = 'not at all'; 4 = 'extremely') assessing the presence and intensity of both positive and negative emotions. Total score range for positive affect (PA) and negative affect (NA), respectively: 0 to 50. Higher scores indicate on either scale indicate a higher level of that emotion. |
| BIS/BAS Scales | Baseline | 24-item questionnaire on a 4-point Likert scale (1 = 'strongly disagree'; 4 = 'strongly agree') assessing an individual's tendency toward reward-seeking and punishment-avoidance behavior. Total score range BIS: 7 to 25. Higher scores indicating an increased sensitivity to threats or punishment (BIS). Total score range BAS: 13 to 52. Higher scores indicating a greater propensity to seek rewards and engage in approach behavior. |
Countries
Germany
Outcome results
None listed