Trial record 2 of 11 for:    acrophobia

Anti-phobic and Safety Behaviors in the Treatment of Acrophobia

This study is currently recruiting participants. (see Contacts and Locations)
Verified February 2015 by University of Texas at Austin
Sponsor:
Information provided by (Responsible Party):
Michael J. Telch, University of Texas at Austin
ClinicalTrials.gov Identifier:
NCT02085343
First received: January 22, 2014
Last updated: February 18, 2015
Last verified: February 2015
  Purpose

This study tests whether a single session of exposure therapy may be enhanced by the addition of anti-phobic actions beyond the mere fading of safety behaviors. A total of 100 acrophobic participants will be randomly assigned to receive standard exposure therapy, exposure therapy with safety behavior fading, exposure with safety behavior fading and anti-phobic actions, or to a wait-list control group.


Condition Intervention
Specific Phobia
Behavioral: EXP
Behavioral: EXP + SBF
Behavioral: EXP + SBF + AA

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Factorial Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Anti-phobic and Safety Behaviors in the Treatment of Acrophobia

Further study details as provided by University of Texas at Austin:

Primary Outcome Measures:
  • Peak subjective fear (0 - 100) upon exposure to heights in the generalization context. [ Time Frame: Pre-treatment (1 week before treatment), treatment (1 week after pre-treatment), post-treatment (immediately following treatment), and follow-up (1 month after treatment). ] [ Designated as safety issue: No ]
    Peak subjective fear ratings (0 - 100).


Secondary Outcome Measures:
  • Acrophobia Questionnaire - Modified (Cohen, 1977; Wolitzky & Telch, 2009) [ Time Frame: Pre-treatment (1 week before treatment), treatment (1 week after pre-treatment), post-treatment (immediately following treatment), and follow-up (1 month after treatment). ] [ Designated as safety issue: No ]
    20-item Likert-type scale assessing acrophobic symptoms

  • Height estimation task [ Time Frame: Pre-treatment (1 week before treatment), treatment (1 week after pre-treatment), post-treatment (immediately following treatment), and follow-up (1 month after treatment). ] [ Designated as safety issue: No ]
    Perceptual task requiring estimation of height from the top of a flight of stairs

  • Heart rate [ Time Frame: Pre-treatment (1 week before treatment), treatment (1 week after pre-treatment), post-treatment (immediately following treatment), and follow-up (1 month after treatment). ] [ Designated as safety issue: No ]
    Heart rate reactivity assessed using a Polar Heart Rate Monitor.

  • Treatment Process Questionnaire [ Time Frame: Treatment (1 week following pre-treatment assessment) ] [ Designated as safety issue: No ]
    Self-efficacy, anticipated anxiety, anticipated danger, and utilization of safety behaviors assessed via self-report.


Estimated Enrollment: 100
Study Start Date: February 2013
Estimated Study Completion Date: May 2018
Estimated Primary Completion Date: August 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: EXP + SBF + AA
Exposure therapy (EXP) with safety behavior fading (SBF) and anti-phobic action (AA)
Behavioral: EXP
Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement throughout supporting efforts at exposure. An instructional set will be provided prior to treatment presenting the rationale for exposure as an effective means of reducing pathological fear.
Other Name: Standard Therapist-Guided In Vivo Exposure Therapy (EXP)
Behavioral: EXP + SBF
Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement supporting efforts at exposure. An instructional set will be provided prior to treatment explaining how safety behaviors serve to maintain fear, and how their elimination may enhance fear reduction. Additionally, the therapist will identify safety behaviors and prompt participants to reduce their utilization of them during treatment.
Other Name: Exposure Therapy with Safety Behavior Fading (EXP + SBF)
Behavioral: EXP + SBF + AA
Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement supporting efforts at exposure. An instructional set will be provided explaining the rationale for eliminating safety behaviors, and how engagement in anti-phobic actions may enhance fear reduction. Additionally, the therapist will identify safety behaviors and prompt participants to reduce their utilization of them during treatment, and will instruct participants to enact a series of progressively challenging anti-phobic actions which oppose the prototypical fear response.
Other Name: Exposure with Safety Behavior Fading and Anti-Phobic Actions
Active Comparator: EXP + SBF
Exposure therapy (EXP) with safety behavior fading (SBF)
Behavioral: EXP
Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement throughout supporting efforts at exposure. An instructional set will be provided prior to treatment presenting the rationale for exposure as an effective means of reducing pathological fear.
Other Name: Standard Therapist-Guided In Vivo Exposure Therapy (EXP)
Behavioral: EXP + SBF
Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement supporting efforts at exposure. An instructional set will be provided prior to treatment explaining how safety behaviors serve to maintain fear, and how their elimination may enhance fear reduction. Additionally, the therapist will identify safety behaviors and prompt participants to reduce their utilization of them during treatment.
Other Name: Exposure Therapy with Safety Behavior Fading (EXP + SBF)
Active Comparator: EXP
Standard therapist-guided in vivo exposure therapy (EXP)
Behavioral: EXP
Participants will receive one-session exposure therapy consisting of six-6 minute trials of exposure to heights, involving ascending a 9-landing flight of outdoor stairs. Participants will be asked to ascend, accompanied by the therapist who will provide verbal encouragement throughout supporting efforts at exposure. An instructional set will be provided prior to treatment presenting the rationale for exposure as an effective means of reducing pathological fear.
Other Name: Standard Therapist-Guided In Vivo Exposure Therapy (EXP)
No Intervention: Wait-list control
Wait-list control

Detailed Description:

This study tests whether a single session of exposure therapy may be enhanced by the addition of one of two augmentation strategies, including engagement in anti-phobic actions and fading of safety behaviors. Because utilization of safety behaviors is functionally precluded by anti-phobic action, the present study design will both replicate and extend prior research by addressing whether anti-phobic actions enhance exposure therapy beyond the mere fading of safety behaviors. A total of 100 individuals between the ages of 18 and 65 meeting DSM-IV criteria for acrophobia (fear of heights) will be randomly assigned to one of four conditions including (1) standard exposure therapy, (2) exposure therapy with safety behavior fading, (3) exposure therapy with safety behavior fading and anti-phobic actions, and (4) a wait-list control condition. All participants will complete an online prescreen and face-to-face screening assessment to determine eligibility and pre-treatment symptom severity. Participants will also complete assessments at post-treatment and 1-month follow-up assessments. Subjective fear during two behavioral approach tests (in the treatment and generalization context, respectively) conducted at pre-treatment, post-treatment, and 1-month follow-up assessments will serve as the primary measure of treatment outcome. Additionally, a battery of self-report questionnaires will be completed at pre-treatment, during treatment, at post-treatment, and at a 1-month follow-up assessment.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Age 18 to 65.
  2. Fluent in English (written and spoken). This is required because assessment instruments are validated only in English.
  3. Meet DSM-IV criteria for specific phobia, natural environment type, with acrophobic concerns, based on the Composite International Diagnostic Interview (CIDI-Auto; World Health Organization, 1997).
  4. Report moderate fear or avoidance (i.e., a score of 30 or higher) on a modified version of the Acrophobia Questionnaire (AQ; Cohen, 1977).
  5. Exhibit at least moderate fear (i.e., a fear score of 50 or higher, where 0 = no fear and 100 = extreme fear) during two behavioral approach tests (BATs) consisting of ascending two moderately challenging flights of stairs.

Exclusion Criteria:

1. Medical condition(s) which may prevent safely climbing or descending stairs or walking for more than 15 minutes at a time (It will be necessary to walk to different sites for the behavioral approach tests).

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT02085343

Contacts
Contact: Adam R. Cobb, MA 325-201-4228 adamrcobb@utexas.edu
Contact: Michael J. Telch, PhD 512-471-3722 telch@austin.utexas.edu

Locations
United States, Texas
The University of Texas at Austin Recruiting
Austin, Texas, United States, 78712
Contact: Michael J. Telch, PhD    512-404-9188    telch@austin.utexas.edu   
Sponsors and Collaborators
University of Texas at Austin
Investigators
Study Director: Adam R. Cobb, MA The University of Texas at Austin
Principal Investigator: Michael J. Telch, PhD The University of Texas at Austin
  More Information

No publications provided

Responsible Party: Michael J. Telch, Professor, University of Texas at Austin
ClinicalTrials.gov Identifier: NCT02085343     History of Changes
Other Study ID Numbers: 2013-02-0023
Study First Received: January 22, 2014
Last Updated: February 18, 2015
Health Authority: United States: Institutional Review Board

Keywords provided by University of Texas at Austin:
Exposure therapy
Specific phobia
Fear of heights
Acrophobia
Safety behavior fading
Anti-phobic Actions

ClinicalTrials.gov processed this record on August 27, 2015