This study will recruit 100 participants who self-report high symptoms of social anxiety (Social phobia inventory \>30). Participants will be randomly assigned to receive either one analog intervention of Imagery Rescripting (IR) or Imaginal Exposure. We will test the efficacy and mechanisms behind each interventions.
After being informed about the study potential risks, all patients giving written informed consent will undergo screening to determine eligibility for study entry. They will be randomly assigned to two conditions (Imagery rescripting Vs. Imaginal exposure) at a 1:1 ratio. Participants will attend three \~1 hour online ZOOM sessions (pre-assessment and measurement, intervention, and post assessment and measurement). Assessors will be blind to the treatment condition.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
Participants in this arm will be asked to decide alongside with the intervention provider (a clinical PhD student or M.A student under the supervision of the principal investigator) to imagine a script based on a future distressing anxiety provoking scenarios multiple times while honing in on the most negative aspects.
Participants in this arm will be asked to decide alongside with the intervention provider (a clinical PhD student or M.A student under the supervision of the principal investigator) o imagine a script based on a future distressing anxiety provoking scenarios one time while honing in on the most negative aspects. Afterwards they will insert changes into the script that try to help them cope in the imagery.
Hebrew University of Jerusalem
Jerusalem, Israel
RECRUITINGChange from baseline in the Social phobia inventory (SPIN) at the follow-up session
The SPIN is a validated self-report instrument assessing average social phobia symptom intensity over the past week. possible scores range from 0 (not at all) to 4 (Extremly). change = (follow-up score - Baseline Score)
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention), Post-intervention (immediately after the intervention) and Follow-up ( 7 days after the intervention)
Change from Baseline in the Thought fusion inventory (TFI) at the follow-up session
The TFI is a validated 14 item self-reported instrument assessing average belief in statement that describe the effects of thoughts on reality, objects and actions. Possible scores range from 0 (Do not believe at all) to 100 (completely convinced it is true) in intervals of 10. change = Follow-up - Baseline Score.
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention), Post-intervention (immediately after the intervention) and Follow-up ( 7 days after the intervention)
Change from Baseline in the White Bear Suppresion inventory (WBSI) at the follow-up session
The WBSI is a validated 15 item self-reported instrument assessing average tendency to suppress mental thoughts. Possible scores range from 0 (Do not agree) to 5 (very much agree). change = Follow-up - Baseline Score.
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention), Post-intervention (immediately after the intervention) and Follow-up ( 7 days after the intervention)
Change from Baseline in the Positive and Negative Affect Scale (PANAS) international version short form (10 items from the negative subscale only) at the follow-up session
The PANAS International short form is a validated 10 item self-reported instrument assessing emotions after at a certain point in time. Possible scores range from 0 (Not at all) to 5 (Extremely). It will be assessed right after the participant describes the script. change = Follow-up - Baseline Score.
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Time frame: Will be measured at Baseline (6,9, or 12 days before intervention) and Follow-up ( 7 days after the intervention)
Change from Baseline to follow-up in the amount of negative and positive/neutral content details the participant provides while describing the negative imagery. The imagery will be probed using the Waterloo Image and Memories Interview (WIMI).
The WIMI is a validated 10 item interview for assessing content of imagery. valence of the details will be scored using a trained coder. change = Follow-up - Baseline Score.
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention) and Follow-up ( 7 days after the intervention)
Change from Baseline to follow-up in negativity of the core-beliefs that the participant link to the negative imagery provided in the WIMI.
The WIMI is a validated 10 item interview for assessing content of imagery and core-beliefs. Core beliefs are related to the participant perception of himself, others and the world. valence of the beliefs will be scored using a trained coder. change = Follow-up - Baseline Score.
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention) and Follow-up ( 7 days after the intervention)
imaginal Behavioral Approach Test (iBAT) that measures the participant's willingness to interact with pre-scripted distressing scenarios in imagination
The iBAT is currently being developed in our lab. The more levels the participants passes (listen to imaginal scenario in full without pressing "skip") the higher the score (from 0 to 10) Recruitment is under way and pre-registration is available at the open science frame work website: https://osf.io/bp42h/?view\_only=5211617cedf94f71a4daa746e98d924a
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention) and Follow-up ( 7 days after the intervention)
Sentence Completion Task (SCT). Measures participants automatic interpretation bias while being presented with 10 ambiguous social scenarios.
The SCT has been found to correlate with social anxiety symptoms and differentiate between clinical and non clinical population. participants enters words that complete scenario described in a sentence. Participant's answers are coded to negative, positive and neutral valence. Then, the participant ratio negative bias is calculated from 0 (complete positive bias) to 1 (complete negative bias)
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention) and Follow-up ( 7 days after the intervention)
The Patient's Experience of Attunement and Responsiveness Scale (PEAR) measures participants' feelings of acceptance by the intervention and interview providers
the PEAR is a well validated self-report instrument. It has 20 items total. Each item is scored from 0 (not at all) to 3 (very much)
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention), Post-intervention (immediately after the intervention) and Follow-up ( 7 days after the intervention)
The Brief core schema scale (BCSS) measures participants' self beliefs about themselves and others.
the BCSS is a well validated self-report instrument. It has 24 items total. Each item is scored from 1 (believe it slightly) to 3 (believe it totally)
Time frame: Will be measured at Baseline (6,9, or 12 days before intervention), Post-intervention (immediately after the intervention) and Follow-up ( 7 days after the intervention)
Change across time in the Mini Social phobia inventory - revised (mini SPIN-R) from baseline to pre-treatment and from pre-treatment to follow-up.
The Mini SPIN-R is a validated self-report instrument assessing average social phobia symptom intensity over the past day. possible scores range from 0 (not at all) to 4 (Extremly). measured once at the end of each day.
Time frame: Daily, from Baseline to follow-up (a total of 14, 17, or 20 days)
Daily questionnaire about negative intrusive imagery in general and specific to the imagery provided in the interview.
Participants are asked alongside the MINI-SPIN-R (see above) whether they had negative imagery during that day (In general) or the specific image they provided (specific). If the report they did experience images they rate two items from the TFI and two items from WBSI adapted for daily measurment. One item about feelings of mastery on the image. 4 items from the BCSS (2 related to the self, one negative and one positive and 2 related to others, one negative and one positive belief). With regards to the specific image they also report on a 0-100 analog scale how vivid, intrusive, distressing that image was for them.
Time frame: Daily, from Baseline to follow-up (a total of 14, 17, or 20 days)