Phobic Disorders Clinical Trial
Official title:
Neurophysiological Correlates of Exposition Therapy in Spider Phobia
This study aims to investigate the neurophysiological correlates of spider phobia and its
treatment with CBT based Exposure Therapy. This is the first study to investigate the
neurophysiological correlates of Exposure Therapy in situ by means of functional
Near-Infrared Spectroscopy (fNIRS).
30 spider phobic patients will be assessed and randomly allocated to 5 sessions of exposure
therapy or waiting-list. Further, 30 non-phobic control subjects will be assessed (primary
assessment only).
During Exposure Therapy, changes in blood oxygenation will be measured with fNIRS in areas of
the Cognitive Control Network. Regions of interest are the bilateral dorsolateral prefrontal
cortex (DLPFC), bilateral inferior frontal gyrus (IFG) and somatosensory association cortex
(SAC). Before the treatment, subjects will have one session of psychoeducation in which the
rationale for the treatment is explained. In each therapy session subjects are exposed to 20
trials (each lasting 40s) of guided exposure by a psychotherapist. Further, 20 control trials
of equal length are assessed in which subjects work with an earthworm. During the therapy
additional anxiety coping strategies (e.g., controlled breathing, attention refocusing,
cognitive reappraisal) are trained. After the treatment or waiting-list phase, treatment
conditions are switched: The waiting list will be treated and the treated subject will wait
for approximately 6 weeks.
Before treatment (primary assessment), after treatment (secondary assessment) and after study
completion (final assessment), additional combined NIRS EEG measurements are done. On a
peripheral physiological level heart rate and EMG of the facial corrugator supercilii are
measured. During these measurements subjects are asked to watch 10s lasting video clips
showing spiders (experimental condition) or pets (dogs and cats). On a psychometric level,
spider phobia will be assessed by questionnaires (SPQ, FSQ, SBQ) and behavioral assessments.
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