Predictors of Exposure Success in Public Speaking Anxiety

University of California, San Diego24 enrolled

Overview

Anxiety disorders are common and impairing. Although exposure therapy is one of the most effective treatments for anxiety, some individuals do not fully respond to treatment, and these individual differences are not well understood. Exposure therapy involves repeated, deliberate, safe engagement with a feared stimulus without the feared outcome occurring. This treatment is thought to work through a type of emotional learning called fear extinction. This study aims to look at links between fear extinction learning and exposure success, with the overall goal of better understanding who is likely to respond best to exposure therapy and why.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Performance Anxiety

Interventions

Massed speech exposure sessionBEHAVIORAL

One session consisting of 4 speech exposures, each 5 minutes long.

Eligibility

Medical Language ↔ Plain English

Inclusion Criteria: * Score of at least 20 on the PRCS * Age 18-55 * English fluency Exclusion Criteria: * Psychotropic medication use in the past 4 weeks * Past experience with exposure based therapy * History of bipolar disorder, psychotic disorder, or substance dependence * Current major depressive disorder of greater than moderate severity (defined as a score on the 9 item Patient Health Questionnaire of greater than 14) * Clinically significant suicidal or homicidal ideation * Non-removable ferrous metal * Current significant neurological conditions * History of loss of consciousness greater than 5 minutes duration * Pregnant * Claustrophobic

Outcomes

Primary Outcomes

Change in peak Subjective Unit of Distress (SUDS) rating from first to fourth (last) exposure

Participants will complete 4 exposures during one 90 minute session. Change in the peak ratings on the final exposure relative to the first exposure will be the outcome measure.

Time frame: 90 minutes

Secondary Outcomes

Change from baseline on the Liebowitz Social Anxiety Scale (LSAS) at 2 weeks

Time frame: Baseline, week 2

Change from baseline on the Personal Report of Confidence as a Speaker (PRCS) at 2 weeks