The proposed study will apply a one-session exposure treatment combined with CBM training modifying interpretational processing biases versus a sham training in acrophobic individuals. The main aim is to advance our understanding of the mechanisms underlying exposure treatment.
The present study will apply a one-session exposure treatment followed by a computerized interpretational training (CBM) or sham training in acrophobic individuals. By doing so, it aims to better understand the mechanisms underlying exposure, i.e., the role of cognitive change. Specifically, this study aims to enhance changes in disorder-relevant cognitive processing post-exposure, compared to a sham training. Further, we hope to improve both therapy outcomes and the generalization of therapeutic effects.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
81
One session exposure treatment during which patients will be confronted with a height-related situation.
Sham Cognitive Bias Modification training procedure matched in format to active training but adapted to not target height-related, interpretational processing biases.
Active Cognitive Bias Modification training targeting height-related, interpretational processing biases.
Mental Health and Research Center, Ruhr University of Bochum
Bochum, Germany
Acrophobia-related interpretational processing biases as measured using the Encoding Recognition Task
Acrophobia-related interpretational processing biases will be measured using a modified version of the Encoding Recognition Task (ERT, Salemink \& van den Hout, 2010). Bias scores of the Encoding Recognition Task can range from -4 to +4, with lower scores indicating a more negative interpretation bias. The primary outcome is change in bias score from baseline to post-training.
Time frame: baseline, post-training (~1 week post-baseline)
Acrophobia-related interpretational processing biases as measured using the Encoding Recognition Task
Acrophobia-related interpretational processing biases will be measured using a modified version of the Encoding Recognition Task (ERT, Salemink \& van den Hout, 2010). Bias scores of the Encoding Recognition Task can range from -4 to +4, with lower indicating a more negative interpretation bias.
Time frame: baseline, pre-training (~1 week post-baseline), follow-up (~5 weeks post-baseline)
Heights Interpretation Questionnaire (HIQ)
The Heights Interpretation Questionnaire (HIQ; Steinman \& Teachman, 2011) asks participants to rate the likelihood of eight negative interpretations for two height-related, ambiguous scenarios. Scores can range from 16 to 80, with higher scores indicating a worse outcome.
Time frame: baseline, post-training (~1 week post-baseline), follow-up (~5 weeks post-baseline)
Scrambled Sentences Task (SST)
Modified version of the Scrambled Sentences Task (Wenzlaff \& Bates, 1998), including 20 height-related items that can be unscrambled into positive or negative statements.
Time frame: post-training (~1 week post-baseline), follow-up (~5 weeks post-baseline)
Danger/ Anxiety Expectancy Scale (DES/AES)
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The Danger/ Anxiety Expectancy Scale (DES/AES; Gursky \& Reiss, 1987) asks participants to rate the likelihood of potential harmful events passing through their mind and the likelihood to experience anxiety symptoms if confronted with heights. Scores can range from 15 to 75, with higher scores indicating a worse outcome.
Time frame: baseline, post-training (~1 week post-baseline), follow-up (~5 weeks post-baseline)
Acrophobia Questionnaire (AQ)
The Acrophobia Questionnaire (AQ; Cohen, 1977) asks participants to rate their anxiety and avoidance behavior for 20 common height-related situations. Scores can range from 0 to 160, with higher scores indicating a worse outcome.
Time frame: baseline, pre-training (1 day after exposure; ~1 week post-baseline), follow-up (~5 weeks post-baseline)
Behavioral Approach Task (BAT)
With the Behavioral Approach Task (BAT), participants' behavioral approach tendencies to height-relevant situations will be assessed by instructing participants to go as high as possible at the emergency staircase at the therapy center and asking participants to rate their subjective fear with the Subjective Units of Distress Scale (SUDS; Wolpe 1973). Scores can range from 0 to 100, with higher scores indicating greater fear.
Time frame: baseline, post-training (~1 week post-baseline), follow-up (~5 weeks post-baseline)