EMDR in Spider Phobia: Work Mechanisms and Treatment Outcome

The goal of this study is to increase the efficiency of exposure in virtual reality (VR).

Based on the EMDR research the investigators would like to show that the implementation of eye movements during the VR exposure results in a faster physiological relaxation response among probands with spider phobia, which has a positive effect on the subjective and behavioral efficacy of the VR exposure.

Study Overview

• Status: Completed
• Conditions: Spider Phobia
• Intervention / Treatment: Behavioral: Eye Movement Desensitization and Reprocessing Therapy; Behavioral: Virtual Reality Exposure Therapy

Detailed Description

The VR paradigm consists of one room with a spider in it. The proband is supposed to look at it for a few minutes. This exposure is repeated several times.

In the experimental group a ball appears during the exposure, that moves horizontally across the room. The probands are supposed to follow this movement with their eyes.

EDA, EKG and respiration are being recorded. Furthermore the subjective and behavioral spider phobia is measured before, during and after the exposure to determine occurring changes.

• Study Type: Interventional
• Enrollment (Actual): 53
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 55 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• the Structured Clinical Interview for DSM-IV (SCID, First et al., 2002; applied German translation: Strukturiertes Klinisches Interview für DSM-IV, Achse I, SKID I, Wittchen et al., 1997), in order to get a reliable diagnosis of spider phobia

Exclusion Criteria:

• pregnancy
• current psychopharmacological medication
• current involvement in psychiatric- or psychotherapeutic treatment
• cardiovascular or neurological diseases
• color blindness
• hearing disorders

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Eye movements; Eye Movement Desensitization and Reprocessing Therapy + virtual reality exposure therapy	Behavioral: Eye Movement Desensitization and Reprocessing Therapy; In 1989, Shapiro discovered that while talking about negative life events or thoughts, rhythmic eye movements on a horizontal axis can alleviate the associated vividness and burden (Shapiro, 1989). She established the psychodynamic-behavioral Eye Movement Desensitization and Reprocessing (EMDR) Therapy, which includes the induction of rhythmic eye movements as a central feature. EMDR is regarded as an efficient treatment tool. Several times it has also been successfully applied in the field of specific phobias (de Jongh, ten Broeke, & Renssen, 1999; de Jongh, Holmshaw, Carswell, & van Wijk, 2011; Lapsekili & Yelboga, 2014; Muris, Merckelbach, van Haaften, & Mayer, 1997) and there is a standard protocol for using EMDR on specific fears and phobias (de Jongh, 2015).; Behavioral: Virtual Reality Exposure Therapy; Exposure to fear-evoking stimuli is conducted more often in virtual environments using simulators or similar computer-technologies (Virtual Reality Exposure Therapy, VRET). One great advantage of using VR-technologies is that it is possible to create an environment which is highly controllable by its creators. Feared stimuli or scenarios can be varied on individual purposes and presented several times. This facili- tates the practice of exposure-based treatments especially for situations or places diffi- cult to access or requiring a considerable amount of time and/or money (e.g. being in war zones or a passenger on a flight), where in vivo exposures have often not been con- ducted or only in a limited manner (Mühlberger & Pauli, 2011).
ACTIVE_COMPARATOR: Control; virtual reality exposure therapy	Behavioral: Virtual Reality Exposure Therapy; Exposure to fear-evoking stimuli is conducted more often in virtual environments using simulators or similar computer-technologies (Virtual Reality Exposure Therapy, VRET). One great advantage of using VR-technologies is that it is possible to create an environment which is highly controllable by its creators. Feared stimuli or scenarios can be varied on individual purposes and presented several times. This facili- tates the practice of exposure-based treatments especially for situations or places diffi- cult to access or requiring a considerable amount of time and/or money (e.g. being in war zones or a passenger on a flight), where in vivo exposures have often not been con- ducted or only in a limited manner (Mühlberger & Pauli, 2011).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Behavioral Assessment Test (BAT) in vivo	expected fear just before getting started and actually present fear just before finishing	5 minutes before, 5 minutes after intervention and during folow up (2 weeks post Intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Skin Conductance Reactivity (SCR)		during the VR-session
Electrocardiogram (ECG)	providing the Heart Rate (HR)	during the VR-session
manipulation check electrode below the right eye (M. orbicularis oculi)	for registering eye movements	during the VR- exposure sessions (5 min x 4 sessions)
Change in Subjective Fear Ratings	Subjective Units of Disturbance Scale	1 min before and during ( each minute) exposure in Virtual Reality

Collaborators and Investigators

• Sponsor: University of Regensburg

Study record dates

Study Major Dates

• Study Start: July 1, 2015
• Primary Completion (ACTUAL): December 1, 2015
• Study Completion (ACTUAL): September 1, 2016

Study Registration Dates

• First Submitted: November 14, 2016
• First Submitted That Met QC Criteria: November 21, 2016
• First Posted (ESTIMATE): November 28, 2016

Study Record Updates

• Last Update Posted (ESTIMATE): November 28, 2016
• Last Update Submitted That Met QC Criteria: November 21, 2016
• Last Verified: November 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders; Phobic Disorders
• Other Study ID Numbers: URegensburg

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO