About this trial
After screening (including parts of the Mini-DIPS), participants will receive a pre-assessment with a baseline heartrate measurement, self-report measures and two BATs (with the treated spider and the non-treated spider). All participants receive a brief psychoeducation \& video demonstration of exposure steps. Participants are randomly assigned to the three study arms and are then set to receive a single session of either in vivo exposure (IVET), videochat based vicarious exposure (VicET) or neither (Waiting List Control, WLC). Approximately 24 hours later, the two BATs with both spiders, a slightly reduced set of self-report measures and an interview will conduct the post-assessment. The order of all BATs, the spider individuals (treated vs. non-treated spider) and assignment to study arms will be randomized using a list that will be worked through in a sequence determined using "www.random.org". At a six-week follow-up, another long-term assessment will be conducted. Here, participants will receive a brief online questionnaire related to their experiences with spiders and self-report measures that were previously administered. Participants previously assigned to the waiting list control (WLC) will be invited to participate in an in-vivo exposure session. A set of questionnaires including demographic information, VAS scales on the current psychological state and wellbeing (administered at the start and end of the first and second assessment day), the BDI-II, the STAI-T and STAI-S, FEE, SPQ, SBQ, FSQ, GSE, SEQ-SP, TC/E for treatment credibility and the "positive attitudes towards technology subscale" of the MTUA will be used. BDI-II, STAI and MTUA are only administered at pre-assessment. The SAS is used for initial screening.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Presence of fear of spiders (Potential diagnosis of arachnophobia)
Disqualifiers
Reaching level 10 or higher in initial BATs
Any acute or chronic mental disease more debilitating than fear of spiders
Any debilitating acute or chronic somatic disease that prevents or counteracts exposure treatment effects (such as cardiovascular diseases)
Heart Diseases (Pace makers, Bradycardia, Arterial Hypertonia, Heart Arrhythmia)
Trial design
Parallel
Treatments tested in this trial
In Vivo Exposure Training (IVET)
BehavioralOne session of graded in-vivo exposure with the treated spider. Prior to the exposure, participants receive psychoeducation on spiders, exposure therapy and specific phobia.
Vicarious Exposure Training (VicET)
BehavioralOne session of graded video-based vicarious exposure with the treated spider. The steps are modeled by the experimenter. Prior to the exposure, participants receive psychoeducation on spiders, exposure therapy and specific phobia.
Treatment groups
Trial outcomes
Primary outcomes
Behavioral Approach Test (BAT)
Change in the Behavioral Approach Tests (BAT) from pre- to post-assessment. BATs are conducted with both the treated spider and the non-treated spider. In the Behavioral Approach Test (BAT) the closest distance that a participant approached the spider is measured (final approach distance).
Subjective fear
Change in subjective fear from pre- to post-assessment is measured regarding the treated spider and the non-treated spider (SUDS scale during pre-assessment and post-assessment BATs). A comparison of the SUDS at the final approach distance at pre-assessment with the SUDS at the same distance at post-assessment (so called "initial approach") allows for an estimate of subjective fear reduction. Additionally, the change in subjective fear at the final approach distance from pre- to post-assessment can be observed. SUDS are measured on a scale from 0 (no fear) to 100 (highest possible fear).
Subjective disgust
Change in subjective disgust from pre- to post-assessment is measured regarding the treated spider and the non-treated spider (SUDS scale during Pre-assessment and Post-assessment BAT). A comparison of the SUDS at the final approach distance at pre-assessment with the SUDS at the same distance at post-assessment (so called "initial approach") allows for an estimate of subjective disgust reduction. Additionally, the change in subjective disgust at the final approach distance from pre- to post-assessment can be observed. SUDS are measured on a scale from 0 (no disgust) to 100 (highest possible disgust).
Heart Rate
Change in mean heart rate from pre- to post-assessment BAT with treated spider and non-treated spider.
Secondary outcomes
Fear of Spiders Questionnaire (FSQ; german: FAS)
Scores of spider fear ranging from 0 to 108 (sum), with higher scores indicative of greater fear.
Spider Beliefs Questionnaire (SBQ)
The questionnaire consists of 48 statements of phobia related beliefs. Subjects are asked to rate how much they agree to the statements. Higher scores are indicative of greater fear.
Other outcomes
Specific Phobia Questionnaire (SPQ)
A modified version of the SPQ. The SPQ consists of two dimensions (fear \& interference with life). 45 items are rated ("none", "mild", "moderate", "severe", "extreme") on both dimensions. For the present study, we employed the fear subscale and dropped the interference scale. The fear scale was split up into fear and avoidance. This questionnaire allows for an estimate the overall fear and avoidance of 43 potentially phobic situations (+2 "other" options) and a composite score of each of the five phobia subtypes.
General Self-Efficacy (GSE) Scale
The GSE is employed to measure changes in self-efficacy. It consists of ten items that evaluate the participants' confidence in their ability to overcome difficult situations based on their self-reported competence. A sum score of all items is calculated (ranging from 10 to 40). Higher scores are indicative of a higher general self-efficacy.
Self-Efficacy Questionnaire for Phobic Situations (SEQ-SP)
The SEQ-SP is a 13 item questionnaire on specific animal-related phobic situations, assessing self-efficacy expectations on a five-point scale ranging from one (really sure I couldn't) to 5 (really sure I could).
Questionnaire for the Assessment of Disgust Sensitivity (German: Fragebogen zur Erfassung der Ekelempfindlichkeit (FEE))
The FEE is a 37-item questionnaire. It comprises of different situations that might elicit disgust, rated from "not disgusting" to "very disgusting" on a 5-point scale. The FEE is included as a measure of disgust sensitivity, as research points towards relevance of disgust sensitivity in the acquisition and maintenance of anxiety disorders (Schienle et al., 2002).
Sponsors and contacts
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