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.

Study Overview

• Status: Completed
• Conditions: Individuals With Fear of Spiders
• Intervention / Treatment: Behavioral: Imaginal exposure

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Uppsala, Sweden
    • Uppsala University Hospital - Akademiska sjukhuset
  • Uppsala, Sweden
    • Uppsala University, Departement of Psychology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Imaginal exposure; The experimental procedure consists of imaginal exposure to mental imagery of phobic and neutral stimuli, prompted through recorded verbal instructions. Participants' repeat the experimental procedure one week later in a follow-up session. Brain imaging data is only collected during day 1	Behavioral: Imaginal exposure; Imaginal exposure to mental imagery of phobic and neutral stimuli

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Blood oxygen level dependent contrast (BOLD-signal)	BOLD-signal is assessed using functional magnetic resonance imaging.	Day 1
Physiological response during exposure to mental imagery	Skin-conductance responses are used as a measure of physiological response.	Day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physiological response during exposure to mental imagery	Skin-conductance responses are used as a measure of physiological response.	Follow-up (one week after day 1)
Differences in physiological response during exposure to mental imagery, during day 1 compared to the follow-up session.	Skin-conductance responses are used as a measure of physiological response.	Difference between day 1 and the follow-up session (one week after day 1)
Ratings of subjective fear participants' expect to experience during exposure to mental imagery	Scale: 0-100; no fear at all - extreme fear.	Day 1
Ratings of subjective fear experienced during exposure to mental imagery	Scale: 0-100; no fear at all - extreme fear. Fear ratings are completed immediately after the imaginal exposure experimental procedure	Day 1
Spielberger State-Trait Anxiety Inventory (STAI-S)	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).	Day 1
Differences in ratings of subjective fear during exposure to mental imagery, during day 1 compared to the follow-up session.	Scale: 0-100; no fear at all - extreme fear.	Difference between day 1 and the follow-up session (one week after day 1)
Vividness of mental imagery	Vividness of mental imagery of phobic stimuli (scale: 1-5; no image at all - image as clear and vivid as real life).	Day 1
Vividness of mental imagery	Vividness of imagery of phobic stimuli (scale: 1-5; no image at all - image as clear and vivid as real life).	Follow-up (one week after day 1)
Differences in vividness of mental imagery, during day 1 compared to the follow-up session.	Vividness of imagery of phobic stimuli (scale: 1-5; no image at all - image as clear and vivid as real life).	Difference between day 1 and the follow-up session (one week after day 1)
Difficulties in emotion regulation scale (DERS)	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)	Day 1

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Spider Phobia Questionnaire (SPQ)	SPQ is a self-rated questionnaire assessing fear of spiders. A high score in SPQ (>19) is required for inclusion in the study.	Recruitment
Spielberger State-Trait Anxiety Inventory (STAI-T)	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)	Day 1
Number of intrusive mental imagery of phobic stimuli	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.	7 days, starting on day 1.
Demand questions	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.	Day 1
The Plymouth Sensory Imagery Questionnaire (Psi-Q)	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).	Day 1

Collaborators and Investigators

• Sponsor: Uppsala University

Study record dates

Study Major Dates

• Study Start (Actual): November 11, 2017
• Primary Completion (Actual): February 14, 2018
• Study Completion (Actual): February 22, 2018

Study Registration Dates

• First Submitted: May 24, 2019
• First Submitted That Met QC Criteria: May 29, 2019
• First Posted (Actual): May 31, 2019

Study Record Updates

• Last Update Posted (Actual): May 31, 2019
• Last Update Submitted That Met QC Criteria: May 29, 2019
• Last Verified: May 1, 2019

More Information

Terms related to this study

• Keywords: brain imaging; mental imagery; Imaginal exposure
• Other Study ID Numbers: 2017/419

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No