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Completed

NCT Number: NCT03969160

Neural Activations During Imaginal Exposure in Individuals Fearful of Spiders

This study explores the brain basis of imaginal exposure, a widely used psychological treatment technique. Specifically, this study uses functional magnetic resonance imaging to examine brain areas activated during imaginal exposure, in individuals fearful of spiders. Physiological responses and subjective fear experienced during imaginal exposure are also assessed.

The primary aim of this study is to explore differences in neural activity during exposure to phobic, compared to neutral, mental imagery. The study will focus primarily on exploratory whole brain analyses, but will also include regions of interest analyses on brain areas previously associated with imaginal exposure. The experimental procedure consists of repeated exposure to mental imagery, i.e. imagery of short durations, including either highly emotion-provoking or neutral content, prompted by verbal instructions. A secondary aim is to explore the effects of repeated exposure to mental imagery, used during the experimental procedure, on subjective fear and physiological responses.

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Key information

Conditions

Individuals With Fear of Spiders

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Uppsala University Hospital - Akademiska sjukhuset, Uppsala, Sweden

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About this study

Results will elucidate if neural activity to phobic imagery differs from activity associated with the production of mental imagery per se. Findings will also increase our general understanding of the neural basis of imaginal exposure treatments.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Significant fear of spiders

Exclusion criteria

  • Current psychiatric disorder other than spider phobia
  • Substance abuse
  • Neurological disease
  • Psychological treatment or psychotropic medication within six months
  • Magnetic resonance imaging contradiction

Treatment and study plan

Imaginal exposure

Behavioral

Imaginal exposure to mental imagery of phobic and neutral stimuli

Primary outcomes

  1. Blood oxygen level dependent contrast (BOLD-signal)

    Time frame: Day 1

    BOLD-signal is assessed using functional magnetic resonance imaging.

  2. Physiological response during exposure to mental imagery

    Time frame: Day 1

    Skin-conductance responses are used as a measure of physiological response.

Secondary outcomes

  1. Physiological response during exposure to mental imagery

    Time frame: Follow-up (one week after day 1)

    Skin-conductance responses are used as a measure of physiological response.

  2. Differences in physiological response during exposure to mental imagery, during day 1 compared to the follow-up session.

    Time frame: Difference between day 1 and the follow-up session (one week after day 1)

    Skin-conductance responses are used as a measure of physiological response.

  3. Ratings of subjective fear participants' expect to experience during exposure to mental imagery

    Time frame: Day 1

    Scale: 0-100; no fear at all - extreme fear.

  4. Ratings of subjective fear experienced during exposure to mental imagery

    Time frame: Day 1

    Scale: 0-100; no fear at all - extreme fear. Fear ratings are completed immediately after the imaginal exposure experimental procedure

  5. Spielberger State-Trait Anxiety Inventory (STAI-S)

    Time frame: Day 1

    STAI-S is a self-rated questionnaire included to assess state-anxiety experienced during exposure. High scores indicate high levels of state anxiety (range, total score: 20 - 80).

  6. Differences in ratings of subjective fear during exposure to mental imagery, during day 1 compared to the follow-up session.

    Time frame: Difference between day 1 and the follow-up session (one week after day 1)

    Scale: 0-100; no fear at all - extreme fear.

  7. Vividness of mental imagery

    Time frame: Day 1

    Vividness of mental imagery of phobic stimuli (scale: 1-5; no image at all - image as clear and vivid as real life).

  8. Vividness of mental imagery

    Time frame: Follow-up (one week after day 1)

    Vividness of imagery of phobic stimuli (scale: 1-5; no image at all - image as clear and vivid as real life).

  9. Differences in vividness of mental imagery, during day 1 compared to the follow-up session.

    Time frame: Difference between day 1 and the follow-up session (one week after day 1)

    Vividness of imagery of phobic stimuli (scale: 1-5; no image at all - image as clear and vivid as real life).

  10. Difficulties in emotion regulation scale (DERS)

    Time frame: Day 1

    DERS is a self-rated questionnaire, included to explore potential relations between imaginal exposure and difficulties in emotion regulation. High scores indicate more difficulties in emotion regulation (range, total score: 36 - 180)

Other outcomes

  1. Spider Phobia Questionnaire (SPQ)

    Time frame: Recruitment

    SPQ is a self-rated questionnaire assessing fear of spiders. A high score in SPQ (>19) is required for inclusion in the study.

  2. Spielberger State-Trait Anxiety Inventory (STAI-T)

    Time frame: Day 1

    STAI-T is a self-rated questionnaire assessing trait anxiety and is included to describe the sample in terms of anxiety proneness. High scores indicate higher levels of trait anxiety (range, total score: 20 - 80)

  3. Number of intrusive mental imagery of phobic stimuli

    Time frame: 7 days, starting on day 1.

    Number of intrusive mental images of phobic stimuli recorded by participants in a diary, daily (morning, afternoon, evening and night) for 7 days. This measure is included as a manipulation check.

  4. Demand questions

    Time frame: Day 1

    Two questions asking participants' to appreciate the emotional impact of producing mental imagery versus focusing on the verbal aspects of phobic situations used in the experimental procedure. This measure is included as a manipulation check.

  5. The Plymouth Sensory Imagery Questionnaire (Psi-Q)

    Time frame: Day 1

    The Psi-Q is a self-rated measure of vividness of imagery across different sensory modalities. Higher scores indicate higher levels of vividness (range, total score 0 - 70).

Sponsors and collaborators

Lead sponsor

Uppsala University

Other

Registry information

Important dates

Study start
2017
Primary completion
2018
Study completion
2018
First posted
May 31, 2019
Registry last updated
May 31, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.