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Excessive WorryNCT03654625

Development of a Scientifically Informed Written Exposure Procedure (The SCRIPTS Study)

A study testing Standard Written Exposure and Enhanced Written Exposure in people with Excessive Worry, run by Toronto Metropolitan University at 1 site in Canada.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry and anxiety. When people with GAD worry, they tend to think about problems and feared situations in a vague way. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Excessive Worry
What is being tested?
Standard Written Exposure and Enhanced Written Exposure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
108 participants
Where
1 siteCanada
Study dates
7 Sep 2018to 31 Dec 2020
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 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Score of 56 or higher on the Penn State Worry Questionnaire.
  • Endorsement of Generalized Anxiety Disorder as per the DSM-5 description (American Psychiatric Association, 2013).

Who cannot join

  • Clinically significant suicidal ideation, intent, or plan
  • Past or current history of psychosis or mania, or substance use disorder over the past 12 months
  • Current psychological treatment or counseling unless this treatment is infrequent (once monthly or less) or the participant has been receiving consistent weekly treatment for at least 12 weeks and still meets all other eligibility criteria
  • Psychotropic medication with a change in dose in the past 12 weeks. If they have recently discontinued a psychotropic medication, they will be included if it has been at least 1 month since discontinuation, or 3 months if they had been taking fluoxetine.

Trial locations and contacts

1 site in 1 country.

Canada1 site, 1 recruiting
  • Ryerson University

    Toronto, Ontario, M5B 2K3

    Naomi Koerner, PhD, 416-979-5000 ext. 2151, naomi.koerner@psych.ryerson.ca

    Recruiting

Other trials in Canada

About this study

Official title: Development of a Scientifically-Informed Written Exposure Procedure (The SCRIPTS Study)

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry and anxiety. When people with GAD worry, they tend to think about problems and feared situations in a vague way. Preliminary research suggests that writing about feared situations in a structured and detailed fashion may help with worry. In this experiment, the investigators are looking to improve the writing intervention. The investigators are testing the immediate and short-term effects of a new writing intervention.

Read the detailed description

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry and anxiety about bad things that may happen in the future. When people with GAD worry, they tend to think about the situations they fear in a vague way. Preliminary research suggests that writing repeatedly about one's fears in a structured and detailed way may help worry. In the present experiment, the investigators are comparing three structured writing interventions and testing their immediate and short-term effects on worry, and worry-related features.

Potential participants will be asked to complete a telephone screen. Those who meet eligibility criteria will be invited to the laboratory at Ryerson University. After completing pre-intervention outcome measures, participants will be randomly assigned to one of three writing interventions: (1) standard written exposure, (2) enhanced written exposure, or (3) neutral writing. All participants will write for 30 minutes on each of 4 days. The 4 sessions of writing will be spaced and will take place within a period of 2 weeks. Excessive worry will be assessed at pre-intervention, mid-intervention, post-intervention, 1-week follow-up and 1 month follow-up. With the exception of the Modified Behavioural Avoidance Test, which will only be assessed at pre-intervention and 1 month follow-up, all other outcomes will be assessed at pre-intervention, and at post-intervention, 1-week follow-up and 1 month follow-up. Additional assessments of Perceived Probability, Cost and Coping Questions will occur at each writing session.

During the 2-week intervention period and the three days following the intervention period, all participants will also track their worry and mood twice per day.

The present experiment will provide answers to important questions about the therapeutic potential of writing interventions for excessive worry.

Conditions
Excessive Worry
Being tested
Standard Written Exposure, Enhanced Written Exposure, Control Condition
Keywords
Worry, Anxiety, Generalized Anxiety Disorder, Written Exposure
Medical subject headings
Anxiety Disorders, Generalized Anxiety Disorder

What participants receive

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

  • Standard Written ExposureBehavioural

    Four spaced, 30-minute sessions occurring within a period of 2 weeks. Participants write a narrative about their worst worry.

  • Enhanced Written ExposureBehavioural

    Four spaced, 30-minute sessions occurring within a period of 2 weeks. Participants write a narrative about their worst worry and rescript it.

  • Control ConditionBehavioural

    Four spaced, 30-minute sessions occurring within a period of 2 weeks. At each session, participants write a narrative about a neutral topic.

Study groups in NCT03654625
Study groupRoleWhat they receive
Standard Written ExposureExperimentalFour writing sessions at the laboratory
Receives: Behavioral: Standard Written Exposure
Enhanced Written ExposureExperimentalFour writing sessions at the laboratory
Receives: Behavioral: Enhanced Written Exposure
Control ConditionPlacebo comparatorFour writing sessions at the laboratory
Receives: Behavioral: Control Condition

What is being measured

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

  1. Change in self-reported past-week worry as measured by the Penn State Worry Questionnaire-Past Week Version

    Self-report measure assessing the degree of excessive worry experienced over the past week. Fifteen items are summed to create a total score. Scores range from 0 to 90, with greater scores indicating a greater degree of worry.

    Measured: Administered before the intervention on day 1 (pre-intervention), within week 2 of the intervention (at writing session 3), post-intervention (3 days after writing session 4), 1-week follow-up and 1-month follow-up.

Secondary outcomes (12)
  1. Self-reported generalized anxiety disorder symptoms as measured by the Generalized Anxiety Disorder Questionnaire for the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV.

    Self-report measure of GAD symptoms. Fourteen items are summed to create a total score. Total scores range from 0 to 12, with greater scores indicating greater GAD symptom severity.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  2. Self-reported cognitive avoidance as measured by the Cognitive Avoidance Questionnaire

    Self-report measure of the tendency to engage in various cognitive avoidance strategies. Twenty-five items are summed to create a total score. Total scores range from 25 to 125, with higher scores indicating greater cognitive avoidance.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  3. Self-reported attitudes towards problems as measured by the Negative Problem Orientation Questionnaire

    Self-report measure of attitudes towards problems. Twelve items are summed to create a total score. Total scores range from 12 to 60, with higher scores indicating greater negative attitudes towards problems.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  4. Self-reported fear of emotions as measured by the Affective Control Scale

    Self-report measure of fear of emotions and attempts to control emotional experience. The scale contains 42 items divided into four subscales for distinct emotions: anxiety; depression; anger; positive emotion. Total scores range from 42 to 294; subscale scores range from 13 to 91, with higher scores indicating a greater fear of emotions.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  5. Self-reported perceptions of shame as measured by the Shame-Aversive Reactions Questionnaire

    Self-report measure of perception of shame as an undesirable and painful emotion. Fourteen items are summed to create a total score. Total scores range from 14 to 98, with higher scores indicating higher levels of shame aversion.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  6. Self-reported maladaptive beliefs as measured by the Early Maladaptive Schema Questionnaire - Research version

    Self-report measure of stable maladaptive beliefs. The scale contains 75 items divided into fifteen subscales for distinct maladaptive beliefs. Subscale scores range from 0 to 15, with higher scores indicating greater maladaptive beliefs.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  7. Self-reported worry-related behaviours as measured by the Worry Behaviours Inventory

    Self-report measure of worry-related behaviours. Ten items are summed to create a total score. Total scores range from 0 to 40, with higher scores indicating greater engagement in avoidant behaviors that are associated with worry.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  8. Self-reported mastery as measured by the Self-Mastery scale

    Self-report measure that assesses the extent to which an individual perceives a sense of personal control or mastery over life outcomes. Seven items are summed to create a total score. Total scores range from 7 to 49, with higher scores indicating greater personal control or mastery.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  9. Self-reported Perceived probability, cost and coping as measured by Perceived Probability, Cost and Coping questions

    Self-report measure of perceptions of probability and costliness of, and ability to cope with one's feared scenario. Three distinct questions assess each of the following perceptions related to feared scenarios: 1) Probability, 2) Cost and 3) Coping. Perceived probability scores range from 0 to 6 with higher scores indicating greater perceived likelihood of worst fears coming true. Perceived costliness scores range from 0 to 6, with higher scores indicating greater perceived costliness of worst fears. Perceived coping scores range from 0 to 6, with greater scores indicating greater ability to cope.

    Measured: Administered before the intervention on day 1, within week 1 of the intervention (at writing session 2), within week 2 of the intervention (writing sessions 3 and 4), post-intervention (3 days after writing session 4), and 1-week and 1-month follow-up.

  10. Fear and avoidance related to worst case scenario as measured by the Modified Behavioural Avoidance Test

    Participants are asked to hold a mental image in mind of their hypothetical worst case scenario and rate their level of fear from 0 (no fear at all) to 10 (the most fear), and desire to avoid the mental image from 0 (no desire to avoid imagining) to 10 (the highest possible desire to avoid imagining).

    Measured: Administered before the intervention on day 1 (pre-intervention) and 1-month follow-up.

  11. Self-reported depression, anxiety and stress as measured by the Depression, Anxiety and Stress Scale

    Self-report measure that assesses depression, anxiety and stress symptoms over the past week. The scale contains 21 items, divided into three subscales: 1) Depression, 2) Anxiety and 3) Stress. Scores on the subscales range from 0 to 42, with higher scores indicating greater severity of depression, anxiety and stress.

    Measured: Administered before the intervention on day 1 (pre-intervention), post-intervention (3 days after writing session 4), 1-week follow-up, and 1-month follow-up.

  12. Daily Worry and Emotion Questions

    A daily self-report measure of (1) emotions, (2) worry controllability, (3) worry intensity and (4) worry duration.

    Scores for the first three items range from 0 to 8, with higher scores indicating greater degree of emotions, worry intensity, and difficulty controlling worry. Worry duration is reported in minutes, with greater numbers indicating longer time spent worrying.

    Measured: During the two-week intervention period and for three days following the intervention period, all participants are asked to respond to questions about their worry and emotions twice per day (morning and evening) using an online diary.

Timeline

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

  1. First posted31 Aug 2018
  2. Study start7 Sep 2018
  3. Primary completion30 Sep 2020 (estimated)
  4. Study completion31 Dec 2020 (estimated)

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
Baseline (pre-intervention) outcome measures will be completed at the first visit to the lab at Ryerson University. Participants will then be randomly assigned to one of the following conditions: (1) standard written exposure, (2) enhanced written exposure or (3) neutral writing. All participants will write at the lab for 30 minutes on each of 4 days. The 4 writing sessions will be spaced and take place within a 2-week period. During the 2-week intervention period and the three days following the intervention period, participants will track their worry and mood twice per day. With the exception of the Modified Behavioural Avoidance Test, which will only be assessed at pre-intervention and 1 month follow-up , all other outcomes will be reassessed at post-intervention, 1-week and 1-month follow-up. An additional assessment of excessive worry will occur at mid-intervention, and additional assessments of Perceived Probability, Cost and Coping Questions will occur at each writing session.
Masking
Single blind
Who is masked
Participant
Enrolment
108 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03654625
Sponsor's protocol ID
REB 2018-094
Status last verified
Mar 2020
First submitted
11 Aug 2018
Last updated
16 Mar 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Results of the study will be disseminated via conference presentations, journal publications, and through our lab website. Upon request, anonymized aggregate participant data may be made available to a publishing journal or individual research group. Individual research groups interested in accessing anonymized data will be required to submit a proposal detailing their intended use of the data. Their qualifications will be reviewed based on their proposal and curricula vitae (CVs). Individual research groups approved for access will be required to agree to not attempt to re-identify participants, not further distribute data, and not use the data for purposes other than specified in their original proposal. No individual data will be shared.

Publications

  • Fracalanza K, Koerner N, Antony MM. Testing a procedural variant of written imaginal exposure for generalized anxiety disorder. J Anxiety Disord. 2014 Aug;28(6):559-69. doi: 10.1016/j.janxdis.2014.05.011. Epub 2014 Jun 14.

    PubMed 24983797

Questions about this trial

What is this clinical trial studying?

A study testing Standard Written Exposure and Enhanced Written Exposure in people with Excessive Worry, run by Toronto Metropolitan University at 1 site in Canada.

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 2 inclusion and 4 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: status not confirmed, as of the sponsor's last update on 16 Mar 2020. 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 Canada. 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?

Results are not available in the source record.

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

Contact Naomi Koerner, PhD (416-979-5000 ext. 2151, naomi.koerner@psych.ryerson.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in self-reported past-week worry as measured by the Penn State Worry Questionnaire-Past Week Version (time frame: Administered before the intervention on day 1 (pre-intervention), within week 2 of the intervention (at writing session 3), post-intervention (3 days after writing session 4), 1-week follow-up and 1-month follow-up.). 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 NCT03654625, which also lists 1 linked publication.

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 16 Mar 2020.

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