Self-efficacy refers to the perceived belief to cope effectively, by personal efforts, with challenging situations and problems (Bandura, 1977). Basic research has shown that increases in perceived self-efficacy can enhance the extinction of fear (Zlomuzica et al., 2015). This study is aimed at translating these findings into a useful clinical application to augment exposure-based treatment outcome.
In this study, the effects of self-efficacy enhancement on treatment outcome in patients with height phobia will be investigated. Participants will be randomly assigned to one of the following conditions: i) virtual reality exposure + self-efficacy enhancement; ii) virtual reality exposure + control intervention; iii) virtual reality exposure only. The amount of exposure is identical across groups (i.e. maximum of 1 hour of exposure). The self-efficacy and the control intervention involve the retrieval of the exposure session with or without a focus on personal mastery experiences/achievements, respectively. Treatment-induced changes as well as the effects of self-efficacy enhancement will be measured on the subjective level (i.e. in-vivo Behavioral Approach Tests, BATs; church tower), physiological level (heart rate during the BATs), and subjective level (subjective fear during the BATs as well as height-phobia related questionnaires) at each of the three assessments (i.e. pretreatment, after which the exposure will conducted on the same day, i.e. day 1; posttreatment, which is scheduled approximately 2-3 days after exposure, and follow-up assessment, which will take place 1-month after exposure).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
71
specific instructions regarding the retrieval of mastery experiences during exposure will be given (e.g., pointing out discrepancies between expected negative consequences and actual outcome during exposure; focus on achievements)
specific instructions regarding the retrieval of the exposure session will be given without an emphasis on personal mastery experience (e.g., description of details regarding the virtual reality environment)
Mental Health Research and Treatment Center
Bochum, North Rhine-Westphalia, Germany
Change in the Behavioral Approach Test (BAT)
Time frame: from pretreatment through follow-up (i.e. baseline, approx. 2-3 days after treatment, 1 month after)
Change in subjective fear during the BAT
Subjective fear during the BATs will be measured using the Subjective Units of Distress Scale (SUDS)
Time frame: from pretreatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after)
Change in heart rate reactivity during the BAT
Time frame: from pretreatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after)
Change in Acrophobia Questionnaire (AQ)
Time frame: assessed from pre-treatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after
Change in Attitude Towards Heights Questionnaire (ATHQ)
Time frame: assessed from pre-treatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after
Change in Danger Expectancy Scale (DES)
Time frame: assessed from pre-treatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after
Change in Anxiety Expectancy Scale (AES)
Time frame: assessed from pre-treatment through follow-up (i.e. baseline, approx. 2-3 days after, 1 month after
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