Feasibility of an Online Modeled Exposure in Spider Fearful Individuals (OMEX)

Philipps University Marburg

Status: Completed

Conditions: Spider Fear; Arachnophobia

Treatments: Behavioral: mental retrieval cue; Behavioral: live psychoeducation video + modeled exposure; Behavioral: group exposure; Behavioral: online psychoeducation video + modeled exposure

Study type: Interventional

Funder types: Other

Identifiers

NCT06182709

OMEX_SPIDER

Details and patient eligibility

About

The effectiveness of an optimized group exposure treatment is investigated in spider-fearful individuals. Participants will undergo an optimized standardized exposure treatment. After receiving information about the treatment and the phobic stimulus (spider) through a psychoeducation video, participants will observe an exposure treatment of another fearful person, either live or by watching a movie of an exposure treatment online. Subsequently, participants will undergo a live in vivo exposure treatment conducted in a group setting. The effectiveness of the treatment is measured by symptom improvement according to online behavioral avoidance tests and subjective ratings immediately after training and one week later.

Full description

The treatment of various anxiety disorders often involves exposure therapy. However, a considerable number of patients do not benefit or experience a resurgence of anxiety following successful treatment. Vicarious safety learning (i.e., modeled exposure) presents a promising avenue to improve therapeutic outcome. Previous evidence indicates that vicarious safety learning can diminish previously acquired fear associations, thereby reducing behavioral avoidance. While single-session interventions have implemented modeled exposure, specific mechanisms of observational learning have not been extensively investigated. Due to high dropout rates in specific phobias, modeled exposure could be utilized as an additional treatment method, potentially yielding better outcomes trough additional learning experience.

This study aims to investigate the applicability of observational learning and its sustainability through mental retrieval cues. Specifically, the study is going to assess the feasibility of modeled exposure conveyed either live or online via video, offering a practical approach within a stepped-care framework. The modeled exposure treatment will be followed by a group exposure treatment to assess the influence of modeled exposure in spider-fearful individuals.

Physically healthy spider-fearful individuals will be either treated with an online or live modeled standardized exposure followed by a group exposure treatment. Half of the participants will receive a mental retrieval cue before the group exposure treatment one day after the modeled exposure treatment. The research aims to determine if long-term reduction of spider fear is achievable through online modeled exposure via video compared to in-person modeled exposure.

Enrollment: 78 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

- Elevated score on Spider Phobia Questionnaire (SPQ) >= 17

Exclusion criteria

• Severe allergies to bees/spiders/insects
• Current psychiatric/psychotherapeutic treatment
• Past psychotherapeutic/psychiatric treatment due to anxiety problems
• Current or past psychotic symptoms
• Current suicidal intent
• Experience with exposure-based treatment
• Current psychopharmacological medication
• Severe respiratory, neurological or cardiovascular diseases

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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78 participants in 4 patient groups

online modeled exposure + mental retrieval cue group exposure

Experimental group

Description:

online modeled exposure training followed by group exposure training, including mental retrieval cue with five standardized exposure steps

Treatment:

Behavioral: online psychoeducation video + modeled exposure

Behavioral: group exposure

Behavioral: mental retrieval cue

live modeled exposure + mental retrieval cue group exposure

Active Comparator group

Description:

live modeled exposure training followed by group exposure training, including mental retrieval cue with five standardized exposure steps

Treatment:

Behavioral: group exposure

Behavioral: mental retrieval cue

Behavioral: live psychoeducation video + modeled exposure

online modeled exposure + standardized group exposure

Active Comparator group

Description:

online modeled exposure training followed by group exposure training with five standardized exposure steps

Treatment:

Behavioral: online psychoeducation video + modeled exposure

Behavioral: group exposure

live modeled exposure + standardized group exposure

Active Comparator group

Description:

live modeled exposure training followed by group exposure training with five standardized exposure steps

Treatment:

Behavioral: group exposure

Behavioral: live psychoeducation video + modeled exposure