Fear of HeightsNCT05824884
Self-efficacy Enhancement in a Virtual Reality Training for Fear of Heights
A study testing Visual Feedback, Self-efficacy enhancement: and No visual feedback in people with Fear of Heights and Specific Phobia, Situational, run by Ruhr University of Bochum at 1 site in Germany.
Trial summary
Self-efficacy (SE) enhancement after virtual reality exposure (VRET) for heights can promote treatment-induced effects (Raeder et al. 2019). Raeder et al (2019) employed an intervention to enhance SE by introducing specific questions about autobiographical events of success and mastery experiences in the course of… Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Fear of Heights, Specific Phobia, Situational
- What is being tested?
- Visual Feedback, Self-efficacy enhancement: and No visual feedback
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 83 participants
- Where
- 1 siteGermany
- Study dates
- 22 Jun 2023to 30 Mar 2026
- 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
- age 18 to 65 years
- fear of heights
- normal or corrected vision
Who cannot join
- acute psychotherapy or psychotherapy in the past 2 years
- acute psychiatric drug intake
- acute schizophrenic or psychotic symptoms
- acute major depressive episode with severe symptoms
- acute substance use disorder
- neurological disorder or mental disability
- cardiac arrhythmias or pacemaker
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Self-efficacy Enhancement in a Virtual Reality Training for Fear of Heights: Promoting Mastery Experiences
Self-efficacy (SE) enhancement after virtual reality exposure (VRET) for heights can promote treatment-induced effects (Raeder et al. 2019). Raeder et al (2019) employed an intervention to enhance SE by introducing specific questions about autobiographical events of success and mastery experiences in the course of VRET. Building on these previous findings, the present study aims to examine whether SE-enhancement DURING and/or AFTER a brief VR-based exposure for fear of heights (in the following referred to as VR-height-exposure) is suitable to promote exposure-induced reductions in height-related fear and avoidance. To this end, repeated visual feedback DURING a brief VR-height-exposure will be used to selectively promote SE and mastery experiences. In a similar vein, SE-enhancement AFTER VR-height-exposure will be administered. The effects of these interventions will be assessed on different treatment outcome levels. It will be further examined whether the combined SE enhancement (DURING and AFTER exposure) is more effective that 1.) SE enhancement performed DURING VR-height-exposure only or 2.) SE enhancement performed AFTER VR-height-exposure only.
The investigators hypothesize that SE enhancement (either administered DURING or AFTER VR-height-exposure) will be more effective (as indicated by more pronounced reductions in height-related fear and avoidance) than VR-height-exposure alone. It is further expected that the combined SE enhancement DURING and AFTER VR-height-exposure will be more effective compared to SE enhancement DURING VR-height-exposure alone and/or SE enhancement DURING VR-height-exposure alone.
Read the detailed description
The aim of this study is to evaluate whether visual feedback DURING VR-height-exposure and SE-enhancement strategies that are designed to promote mastery experience AFTER exposure are suitable to benefit exposure-induced reductions in height-related fear and avoidance.
Participants will be randomly assigned to one of the following conditions: a) visual feedback DURING VR-height-exposure and SE-enhancement targeting mastery experience AFTER VR-height-exposure b) no visual feedback DURING VR-height-exposure but SE-enhancement targeting mastery experience AFTER VR-height-exposure, c) visual feedback DURING VR-height-exposure but a control intervention AFTER VR-height-exposure d) no visual feedback and control intervention after VR-height- exposure. The SE-enhancement as well as the control intervention involve memory reactivation either with or without emphasis on a mastery experience attained during the VR-height-exposure. The visual feedback is presented in form of a progress-update combined with positive affirmation.
The VR-height-exposure concludes different exercises in a virtual environment that simulate situations, that can be challenging to height-fearful individuals in real life, such as glass-elevators, a glass-bridge, a tall ladder and lattice stairs. During VR-height-exposure, self-reported fear is measured in Subjective Units of Distress (SUDS). The VR-environment is presented via head-mounted displays and the participants can use touch-controllers to navigate through the exercises guided by the experimenter.
As outcome measures, subjective fear and height-related avoidance will be assessed at three time points: pre-exposure, post-exposure and at 3 months-follow-up.
Subjective fear is measured using the Acrophobia Questionnaire (AQ; Cohen, 1977). To measure height-related avoidance behavior, a Behavioural Approach Test (BAT) will be performed in a nearby church tower, that includes 13 steps of varying difficulty and requires active behavioral approach towards height-situations.
Furthermore, danger expectancies and fear expectancies (DES, AES) will be measured at pre- and post-exposure as well as at 3-months-follow-up. During all BATs and the VR-height-exposure, heart-rate variability (HRV) will be assessed as a psychophysiological indicator for fear response.
Moreover, participants are asked to rate their general self-efficacy via Questionnaire (GSE) and their perceived self-efficacy via Visual Analogue Scales (VAS) at pre- and post-exposure as well as 3-months follow-up. Furthermore, the VAS measures mood, excitement, and distraction.
Additionally, several control variables are assessed pre-exposure, including Beck's Depression Inventory II (BDI-II), The State-and-Trait-Anxiety Inventory (STAI-T; STAI-S), the Self-Efficacy Scale (SES) and the CSSES.
Implicit Approach-Avoidance biases towards height-related stimuli will also be assessed pre- and post VR-height-training utilizing the Approach-Avoidance-Task (AAT). The participants are instructed to push away (simulating avoidance) vs. pull towards (simulating approach) neutral vs. height-related pictures according to the way they are tilted (tilted-right vs. tilted left) using the computer mouse. Reaction time delays in the pull towards height-related pictures condition can be an indicator for implicit avoidance tendencies.
- Conditions
- Fear of Heights, Specific Phobia, Situational
- Being tested
- Visual Feedback, Self-efficacy enhancement:, placebo intervention, No visual feedback
- Keywords
- Specific phobia, fear of heights, Self-efficacy, virtual reality, exposure
- Medical subject headings
- Acrophobia, Phobia, Specific
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Visual FeedbackBehavioural
Visual progress feedback and words of positive affirmation will be presented triggered by checkpoints set in the VR-height-exposure.
Self-efficacy enhancement:Behavioural
specific instructions regarding the retrieval of mastery experiences during exposure will be given (modified version of the procedure used in Raeder et al. 2019).
placebo interventionBehavioural
specific instructions regarding the retrieval of the exposure session will be given without an emphasis on personal mastery experience (modified version of the procedure used in Raeder et al. 2019).
No visual feedbackBehavioural
Participants can not trigger any checkpoints during VR and therefore not receive any progress feedback or positive affirmation.
| Study group | Role | What they receive |
|---|---|---|
| Experimental 1 | Experimental | positive visual feedback during VR-height-exposure combined with SE-enhancement after exposure. Receives: Behavioral: Visual Feedback; Behavioral: Self-efficacy enhancement: |
| Active Comparator 1 | Active comparator | positive visual feedback during VR-height-exposure, and a placebo intervention after exposure. Receives: Behavioral: Visual Feedback; Behavioral: placebo intervention |
| Active Comparator 2 | Active comparator | no visual feedback during exposure but SE-enhancement after exposure. Receives: Behavioral: Self-efficacy enhancement:; Behavioral: No visual feedback |
| Placebo Comparator | Placebo comparator | no visual feedback during exposure and placebo intervention after exposure. Receives: Behavioral: placebo intervention; Behavioral: No visual feedback |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in the Behavioural Approach Test (BAT)
Measured: from baseline to 24 hours after exposure and 3-months-follow-up
Change in Acrophobia Questionnaire (AQ)
Measured: from baseline to 24 hours after exposure and 3-months-follow-up
Change in subjective fear during the BAT
Subjective fear during the BATs will be measured using the Subjective Units of Distress Scale (SUDS)
Measured: from baseline to 24 hours after exposure and 3-months-follow-up
Changes in Heart Rate Variability (HRV) during the BAT
Measured: at baseline, 24 hours after exposure and at 3-months-follow-up
Secondary outcomes (4)
Change in Danger Expectancy Scale (DES)
Measured: from baseline to 24 hours after exposure and 3-months-follow-up
Change in Anxiety Expectancy Scale (AES)
Measured: from baseline to 24 hours after exposure and 3-months-follow-up
Differences in GSE between the respective groups
ANOVA with mean GSE-scores
Measured: at pre-exposure, immediately after exposure and 3-months-follow-up
Differences in AQ between the respective groups
ANOVA with mean AQ-scores
Measured: at baseline, 24 hours after exposure and 3-months-follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Apr 2023
- Study start22 Jun 2023
- Primary completion30 Mar 2026
- Study completion30 Mar 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Fear of HeightsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Masking
- None (open label)
- Enrolment
- 83 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ruhr University of Bochum
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Armin Zlomuzica, Ruhr University of Bochum
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05824884
- Sponsor's protocol ID
- AZ 794
- Status last verified
- Apr 2026
- First submitted
- 8 Apr 2023
- Last updated
- 7 May 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 7 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Self-efficacy Enhancement in a Virtual Reality Training for Fear of Heights: Promoting Mastery Experiences
- ClinicalTrials.gov ID
- NCT05824884
- Acronym / sponsor ID
- AZ 794
- Conditions
- Fear of Heights, Specific Phobia, Situational
- Keywords
- Specific phobia, fear of heights, Self-efficacy, virtual reality, exposure
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 83 participants (actual)
- Lead sponsor
- Ruhr University of BochumUniversity, hospital or other
- Study start
- 22 Jun 2023 (actual)
- Primary completion
- 30 Mar 2026 (actual)
- Study completion
- 30 Mar 2026 (actual)
- First posted
- 24 Apr 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Self-efficacy (SE) enhancement after virtual reality exposure (VRET) for heights can promote treatment-induced effects (Raeder et al. 2019). Raeder et al (2019) employed an intervention to enhance SE by introducing specific questions about autobiographical events of success and mastery experiences in the course of VRET. Building on these previous findings, the present study aims to examine whether SE-enhancement DURING and/or AFTER a brief VR-based exposure for fear of heights (in the following referred to as VR-height-exposure) is suitable to promote exposure-induced reductions in height-related fear and avoidance. To this end, repeated visual feedback DURING a brief VR-height-exposure will be used to selectively promote SE and mastery experiences. In a similar vein, SE-enhancement AFTER VR-height-exposure will be administered. The effects of these interventions will be assessed on different treatment outcome levels. It will be further examined whether the combined SE enhancement (DURING and AFTER exposure) is more effective that 1.) SE enhancement performed DURING VR-height-exposure only or 2.) SE enhancement performed AFTER VR-height-exposure only.
The investigators hypothesize that SE enhancement (either administered DURING or AFTER VR-height-exposure) will be more effective (as indicated by more pronounced reductions in height-related fear and avoidance) than VR-height-exposure alone. It is further expected that the combined SE enhancement DURING and AFTER VR-height-exposure will be more effective compared to SE enhancement DURING VR-height-exposure alone and/or SE enhancement DURING VR-height-exposure alone.
Detailed description
The aim of this study is to evaluate whether visual feedback DURING VR-height-exposure and SE-enhancement strategies that are designed to promote mastery experience AFTER exposure are suitable to benefit exposure-induced reductions in height-related fear and avoidance.
Participants will be randomly assigned to one of the following conditions: a) visual feedback DURING VR-height-exposure and SE-enhancement targeting mastery experience AFTER VR-height-exposure b) no visual feedback DURING VR-height-exposure but SE-enhancement targeting mastery experience AFTER VR-height-exposure, c) visual feedback DURING VR-height-exposure but a control intervention AFTER VR-height-exposure d) no visual feedback and control intervention after VR-height- exposure. The SE-enhancement as well as the control intervention involve memory reactivation either with or without emphasis on a mastery experience attained during the VR-height-exposure. The visual feedback is presented in form of a progress-update combined with positive affirmation.
The VR-height-exposure concludes different exercises in a virtual environment that simulate situations, that can be challenging to height-fearful individuals in real life, such as glass-elevators, a glass-bridge, a tall ladder and lattice stairs. During VR-height-exposure, self-reported fear is measured in Subjective Units of Distress (SUDS). The VR-environment is presented via head-mounted displays and the participants can use touch-controllers to navigate through the exercises guided by the experimenter.
As outcome measures, subjective fear and height-related avoidance will be assessed at three time points: pre-exposure, post-exposure and at 3 months-follow-up.
Subjective fear is measured using the Acrophobia Questionnaire (AQ; Cohen, 1977). To measure height-related avoidance behavior, a Behavioural Approach Test (BAT) will be performed in a nearby church tower, that includes 13 steps of varying difficulty and requires active behavioral approach towards height-situations.
Furthermore, danger expectancies and fear expectancies (DES, AES) will be measured at pre- and post-exposure as well as at 3-months-follow-up. During all BATs and the VR-height-exposure, heart-rate variability (HRV) will be assessed as a psychophysiological indicator for fear response.
Moreover, participants are asked to rate their general self-efficacy via Questionnaire (GSE) and their perceived self-efficacy via Visual Analogue Scales (VAS) at pre- and post-exposure as well as 3-months follow-up. Furthermore, the VAS measures mood, excitement, and distraction.
Additionally, several control variables are assessed pre-exposure, including Beck's Depression Inventory II (BDI-II), The State-and-Trait-Anxiety Inventory (STAI-T; STAI-S), the Self-Efficacy Scale (SES) and the CSSES.
Implicit Approach-Avoidance biases towards height-related stimuli will also be assessed pre- and post VR-height-training utilizing the Approach-Avoidance-Task (AAT). The participants are instructed to push away (simulating avoidance) vs. pull towards (simulating approach) neutral vs. height-related pictures according to the way they are tilted (tilted-right vs. tilted left) using the computer mouse. Reaction time delays in the pull towards height-related pictures condition can be an indicator for implicit avoidance tendencies.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Experimental 1 | Experimental | Behavioral: Visual Feedback, Behavioral: Self-efficacy enhancement:positive visual feedback during VR-height-exposure combined with SE-enhancement after exposure. |
| Active Comparator 1 | Active comparator | Behavioral: Visual Feedback, Behavioral: placebo interventionpositive visual feedback during VR-height-exposure, and a placebo intervention after exposure. |
| Active Comparator 2 | Active comparator | Behavioral: Self-efficacy enhancement:, Behavioral: No visual feedbackno visual feedback during exposure but SE-enhancement after exposure. |
| Placebo Comparator | Placebo comparator | Behavioral: placebo intervention, Behavioral: No visual feedbackno visual feedback during exposure and placebo intervention after exposure. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- age 18 to 65 years
- fear of heights
- normal or corrected vision
Key exclusion criteria (7 listed)
- acute psychotherapy or psychotherapy in the past 2 years
- acute psychiatric drug intake
- acute schizophrenic or psychotic symptoms
- acute major depressive episode with severe symptoms
- acute substance use disorder
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Visual FeedbackVisual progress feedback and words of positive affirmation will be presented triggered by checkpoints set in the VR-height-exposure. | Behavioural | Active Comparator 1, Experimental 1 |
| Self-efficacy enhancement:specific instructions regarding the retrieval of mastery experiences during exposure will be given (modified version of the procedure used in Raeder et al. 2019). | Behavioural | Active Comparator 2, Experimental 1 |
| placebo interventionspecific instructions regarding the retrieval of the exposure session will be given without an emphasis on personal mastery experience (modified version of the procedure used in Raeder et al. 2019). | Behavioural | Active Comparator 1, Placebo Comparator |
| No visual feedbackParticipants can not trigger any checkpoints during VR and therefore not receive any progress feedback or positive affirmation. | Behavioural | Active Comparator 2, Placebo Comparator |
Primary outcome
Change in the Behavioural Approach Test (BAT)
Time frame: from baseline to 24 hours after exposure and 3-months-follow-up
Change in Acrophobia Questionnaire (AQ)
Time frame: from baseline to 24 hours after exposure and 3-months-follow-up
Change in subjective fear during the BAT
Time frame: from baseline to 24 hours after exposure and 3-months-follow-up
Subjective fear during the BATs will be measured using the Subjective Units of Distress Scale (SUDS)
Changes in Heart Rate Variability (HRV) during the BAT
Time frame: at baseline, 24 hours after exposure and at 3-months-follow-up
4 secondary outcomes
Change in Danger Expectancy Scale (DES)
Time frame: from baseline to 24 hours after exposure and 3-months-follow-up
Change in Anxiety Expectancy Scale (AES)
Time frame: from baseline to 24 hours after exposure and 3-months-follow-up
Differences in GSE between the respective groups
Time frame: at pre-exposure, immediately after exposure and 3-months-follow-up
Differences in AQ between the respective groups
Time frame: at baseline, 24 hours after exposure and 3-months-follow-up
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 May 2026.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Visual Feedback, Self-efficacy enhancement: and No visual feedback in people with Fear of Heights and Specific Phobia, Situational, run by Ruhr University of Bochum at 1 site in Germany.
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 3 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 7 May 2026. 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 Germany. 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?
Change in the Behavioural Approach Test (BAT) (time frame: from baseline to 24 hours after exposure and 3-months-follow-up). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 7 May 2026.