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AzTrials

Social AnxietyABMTNCT03601377

Attention Bias Modification Treatment in Social Anxiety

A study testing Training away from threat and Training towards threat in people with Social Anxiety, run by University of Cyprus at 1 site in Cyprus.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study evaluates attention modification in social anxiety and It is comprised by 2 experiments. At experiment 1 socially anxious participants will receive either training away from threatening faces or placebo intervention and at experiment 2 they will receive either one of these 2 groups or training towards… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Social Anxiety
What is being tested?
Training away from threat and Training towards threat
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
140 participants
Where
1 siteCyprus
Study dates
3 Oct 2016to 30 Sep 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1) highly socially anxious students (based on self-report questionnaire)

Who cannot join

  • suicidal intent,
  • substance abuse,
  • primary diagnosis of post-traumatic stress disorder, obsessive-compulsive disorder,
  • or past schizophrenia, bipolar disorder, organic mental disorder,
  • any concurrent psychotherapy,
  • changes in medication during the 12 weeks prior to study and
  • CBT therapy 6 months before the beginning of treatment.

Trial locations and contacts

1 site in 1 country.

Cyprus1 site
  • Department of Psychology, University of Cyprus

    Nicosia, 1678

Other trials in Cyprus

About this study

Official title: Attention Bias Modification Treatment in Social Anxiety: Avoidance or Exposure to Threatening Faces? The Role of Pre-existing Attentional Biases and State Anxiety

This study evaluates attention modification in social anxiety and It is comprised by 2 experiments. At experiment 1 socially anxious participants will receive either training away from threatening faces or placebo intervention and at experiment 2 they will receive either one of these 2 groups or training towards threatening faces. At experiment 2 training will be done under state anxiety levels (video-recording of a speech). Anxiety levels (self-reports, physiological and behavioral measures) as well as attentional biases changes will be examined at pre and post - intervention levels plus 6 months follow-up only for experiment 1.

Read the detailed description

Social anxiety is a highly prevalent disorder in the population. Even though there are effective interventions that can help people who suffer from it, many of them do not seek or receive an evidence-based, face to face treatment. According to cognitive models, attention to social threat is one of the principles that maintain social anxiety. In fact, individuals with social anxiety present attention bias to threat stimuli. However, there is inconsistency in the literature with regards to attentional biases that individuals with anxiety present. A recent model is the vigilance-avoidance hypothesis, in which socially anxious initially focus on the threat and then they avoid it. Therefore, better understanding and then aiming to modify these attentional biases in a computerized manner, with minimal therapist interaction can be a novel and promising way to treat social anxiety, even among patients who avoid presenting for therapy.

Two experiments are aiming to shed some light with regards to the effect of attention bias modification treatment in individuals with social anxiety, taking into consideration the previous mixed results. The first experiment compares training attention to be directed away from threat with a placebo treatment. Approximately 60 socially anxious individuals are randomly allocated in the 2 groups. A structured interview and self-report assessment are done pre-treatment, post-treatment and 6 months follow-up.

The second experiment adds a third group of training towards threat (i.e. exposure), investigating if changing attentional avoidance can also affect anxiety levels. Moreover, the second experiment attempts to improve the typical attention modification paradigm by targeting treatment to participants' identified pre-experimental attentional biases. In addition, predictors of treatment effectiveness will be studied and particularly pre-intervention attentional biases as well as state anxiety. Participants are approximately 90 adults with social phobia who are randomly allocated in treatment and placebo groups. In experiment 2 participants will also be assessed behaviourally as well as physiologically to better demonstrate that anxiety reactions to anxiogenic situations have been reduced between pre and post treatment and that they are smaller than those of a placebo control group.

It is expected that participants in the intervention groups will show reduced attentional bias and social anxiety symptoms in comparison with the placebo group in both studies. In addition, the kind of pre-intervention bias as well as state anxiety will moderate anxiety changes. This study will enrich existing research on attention bias modification treatment by shedding light into potential mechanisms of change and will examine ways to improve the efficacy of this intervention.

Conditions
Social Anxiety
Being tested
Training away from threat, Training towards threat, Placebo
Keywords
attention bias, treatment predictors

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Training away from threatBehavioural

    Dot-probe task: Pairs of stimuli, angry - neutral face or neutral - neutral faces of the same actor (20 different individuals;10 male, 10 female) are presented horizontally in the centre of the screen (160 trials; 120 angry-neutral and 40 neutral-neutral). Each trial begins with a fixation cross (500 ms), on which the participants are instructed to focus their gaze. After that a pair of faces follows which is presented on the screen for 500ms. After the faces presentation a small visual probe (< or >) appears at the same place of one of the two faces. Participants have to determine which symbol appeared by clicking right or left on the mouse as quickly as possible. The target probe remains on the screen until there is a response, which starts a new trial.

  • Training towards threatBehavioural

    Dot-probe task: Pairs of stimuli, angry - neutral face or neutral - neutral faces of the same actor (20 different individuals;10 male, 10 female) are presented horizontally in the centre of the screen (160 trials; 120 angry-neutral and 40 neutral-neutral). Each trial begins with a fixation cross (500 ms), on which the participants are instructed to focus their gaze. After that a pair of faces follows which is presented on the screen for 500ms. After the faces presentation a small visual probe (< or >) appears at the same place of one of the two faces. Participants have to determine which symbol appeared by clicking right or left on the mouse as quickly as possible. The target probe remains on the screen until there is a response, which starts a new trial.

  • PlaceboBehavioural

    Dot-probe task: Pairs of stimuli, angry - neutral face or neutral - neutral faces of the same actor (20 different individuals;10 male, 10 female) are presented horizontally in the centre of the screen (160 trials; 120 angry-neutral and 40 neutral-neutral). Each trial begins with a fixation cross (500 ms), on which the participants are instructed to focus their gaze. After that a pair of faces follows which is presented on the screen for 500ms. After the faces presentation a small visual probe (< or >) appears at the same place of one of the two faces. Participants have to determine which symbol appeared by clicking right or left on the mouse as quickly as possible. The target probe remains on the screen until there is a response, which starts a new trial.

Study groups in NCT03601377
Study groupRoleWhat they receive
Training away from threatExperimentalExperiment 1 and 2: In the intervention group -training away from threat-, in all angry-neutral faces presentation the probe is presented only after neutral face. Probe type (< or >) is not factorially counterbalanced but there is equal possibility of presentation for each of the following: angry-face location, probe location, or actor. Experiment 1: received 8 times (2 times per week for 4 weeks) Experiment 2: received 4 times (2 times for 2 weeks)
Receives: Behavioral: Training away from threat
Training towards threatExperimentalOnly for Experiment 2: The second ABMT condition -training towards threat- is identical to the first one with the exception that in all angry-neutral face presentations the symbol is presented only after threat face. In addition, at the beginning of every session participants will be informed that a random number of participants will have to repeat their speech. They will also be informed that this instruction will be given right after the dot probe task completion. This will be done in order for the participants to maintain their state anxiety but repetition of the speech task will not actually happen at this stage. Experiment 2: received 4 times (2 times for 2 weeks)
Receives: Behavioral: Training towards threat
PlaceboPlacebo comparatorExperiment 1 and 2: In the placebo group, angry-face location, probe location and actor are fully counterbalanced with regards to their presentation. Experiment 1: received 8 times (2 times per week for 4 weeks) Experiment 2: received 4 times (2 times for 2 weeks)
Receives: Behavioral: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Social Anxiety levels

    Experiment 1 \& 2: self-reported questionnaires, with the primary one to be Social Phobia and Anxiety Inventory-23.

    Measured: Pre-treatment (day 1)

  2. Social Anxiety changes

    Experiment 1 \& 2: Measured in self-reported questionnaires with the primary one to be Social Phobia and Anxiety Inventory-23.

    Measured: Experiment 1: 4 weeks after the day 1, Experiment 2: 3 weeks after the day 1 (Post-treatment)

  3. Social Anxiety changes

    Only for experiment 1: Measured in self-reported questionnaires with the primary one to be Social Phobia and Anxiety Inventory-23.

    Measured: 6 months after day 1 (Follow-up)

  4. Attentional Biases

    For experiment 1: Assess kind of attentional biases using the dot-probe task (comparison of reaction time to threatening and a neutral stimulus).

    For experiment 2: Assess kind of attentional biases using the eye-tracking task (measuring eye gaze).

    Measured: Pre-treatment (day 1)

  5. Attentional Biases changes

    For experiment 1: Assess kind of attentional biases using the dot-probe task (comparison of reaction time to threatening and a neutral stimulus).

    For experiment 2: Assess kind of attentional biases using the eye-tracking task (measuring eye gaze).

    Measured: 4 weeks after the day 1 (Post-treatment)

  6. Attentional Biases changes

    Only for experiment 1: Assess kind of attentional biases using the dot-probe task (comparison of reaction time to threatening and a neutral stimulus).

    Measured: 6 months after day 1 (Follow-up)

  7. Physical social anxiety levels

    Only for experiment 2: measured through physiological measures, with the primary one to be heart rate.

    Measured: Pre-treatment (day 1)

  8. Physical social anxiety changes

    Only for experiment 2: measured through physiological measures, with the primary one to be heart rate.

    Measured: 3 weeks after the day 1 (Post-treatment)

Secondary outcomes (7)
  1. Social Anxiety levels (clinical interview)

    Experiment 1 \& 2: measured through clinical interview, Anxiety Disorders Interview Schedule (ADIS) adult version.

    Measured: Pre-treatment (day 1)

  2. Physical social anxiety levels 1

    Only for experiment 2: measured through skin conductance

    Measured: Pre-treatment (day 1)

  3. Physical social anxiety levels 2

    Only for experiment 2: measured through corrugator supercilii

    Measured: Pre-treatment (day 1)

  4. Social anxiety changes

    Experiment 1: measured through clinical interview, Anxiety Disorders Interview Schedule (ADIS) adult version.

    Measured: 4 weeks after the day 1 (Post-treatment)

  5. Physical social anxiety changes 1

    Only for experiment 2: measured through skin conductance

    Measured: 3 weeks after the day 1 (Post-treatment)

  6. Social anxiety changes

    Experiment 1: measured through clinical interview, Anxiety Disorders Interview Schedule (ADIS) adult version.

    Measured: 6 months after day 1 (follow-up)

  7. Physical social anxiety changes 2

    Only for experiment 2: measured through corrugator supercilii

    Measured: 3 weeks after the day 1 (Post-treatment)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jul 2018
  2. Study start3 Oct 2016
  3. Primary completion31 Jul 2018
  4. Study completion30 Sep 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Experiment 1: 2 groups (1 intervention and 1 placebo) receive treatment in parallel Experiment 2: 3 groups (2 types of intervention and 1 placebo) receive treatment in parallel
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
140 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03601377
Sponsor's protocol ID
ABMT University of Cyprus
Acronym
ABMT
Status last verified
Oct 2018
First submitted
6 Jun 2018
Last updated
30 Oct 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Amir N, Beard C, Taylor CT, Klumpp H, Elias J, Burns M, Chen X. Attention training in individuals with generalized social phobia: A randomized controlled trial. J Consult Clin Psychol. 2009 Oct;77(5):961-973. doi: 10.1037/a0016685.

    PubMed 19803575
  • Bar-Haim Y. Research review: Attention bias modification (ABM): a novel treatment for anxiety disorders. J Child Psychol Psychiatry. 2010 Aug;51(8):859-70. doi: 10.1111/j.1469-7610.2010.02251.x. Epub 2010 May 6.

    PubMed 20456540

Questions about this trial

What is this clinical trial studying?

A study testing Training away from threat and Training towards threat in people with Social Anxiety, run by University of Cyprus at 1 site in Cyprus.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Oct 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Cyprus. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Social Anxiety levels (time frame: Pre-treatment (day 1)). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03601377, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Oct 2018.

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