Effects of Verbal Instructions on Fear Extinction and Extinction Retrieval

Ruhr University of Bochum

Status: Completed

Conditions: Anxiety Disorder

Treatments: Other: Explicit instructions before extinction; Other: Explicit instructions after extinction

Study type: Interventional

Funder types: Other

Identifiers

NCT05718271

673

Details and patient eligibility

About

The goal of this study is to examine if verbal instructions can improve fear extinction learning and extinction retrieval in patients with anxiety disorders (AD) and healthy controls.

Full description

Patients with anxiety disorders (AD) and highly anxious individuals show accelerated fear conditioning and diminished fear extinction learning (Duits et al., 2015). The aim of the current study is to investigate how verbal instructions impact fear extinction learning and extinction retrieval in AD patients and healthy controls. Using a 3-day fear conditioning paradigm, fear acquisition will take place on the first, extinction training on the second, and extinction retrieval and reinstatement on the third day (i.e., all phases are on consecutive days). Part of the participants will receive explicit instructions such that the unconditioned stimulus (UCS) won't be presented anymore, either before and/or after extinction training. Participants will be randomly assigned to four conditions: (1) no explicit instructions at all, (2) explicit instructions before extinction, (3) explicit instructions after extinction or (4) explicit instructions before and after extinction.

Enrollment: 240 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• For the patient group: DSM-5 anxiety disorder diagnosis via a structured clinical interview for diagnosing mental disorders (DIPS)
• For the healthy controls: no psychological disorder according to the Mini-DIPS

Exclusion criteria

• smoking
• alcohol abuse
• drug consumption
• current and chronic physical and neurological diseases
• for the patient group: anxiety not the primary diagnosis, psychological comorbidities e.g. schizophrenia, bipolar disorder, mental retardation, acute drug or alcohol addiction, personality disorder, currently in psychotherapy
• for the healthy controls: a diagnosis of psychological disorder at any point in life, ever been in psychotherapy, current and/or regular intake of medicine (incl. psychopharmaceutic medicine), current or past cognitive or neurological disorder
• for women: pregnancy, nursing period
• previous experience with fear conditioning paradigm

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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240 participants in 4 patient groups

Explicit instructions before + after extinction

Experimental group

Treatment:

Other: Explicit instructions after extinction

Other: Explicit instructions before extinction

Explicit instructions before extinction

Experimental group

Treatment:

Other: Explicit instructions before extinction

Explicit instructions after extinction

Experimental group

Treatment:

Other: Explicit instructions after extinction

No explicit instructions

No Intervention group