Social AnxietyNCT06977087
The Efficacy of Prospective Mental Imagery in Enhancing Approach Motivation Among Socially Anxious Individuals
A study testing Psychoeducation, Prospective Mental Imagery and Verbal Reasoning in people with Social Anxiety and Social Phobia, run by Philipps University Marburg at 1 site in Germany.
Trial summary
The efficacy of an online intervention aimed at enhancing approach motivation and behavioral engagement in confronting anxiety-inducing social situations is examined among individuals with elevated social anxiety. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Social Anxiety, Social Phobia
- What is being tested?
- Psychoeducation, Prospective Mental Imagery and Verbal Reasoning
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 129 participants
- Where
- 1 siteGermany
- Study dates
- 4 Mar 2025to 1 Jul 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 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Elevated score on Mini-Social Phobia Inventory (Mini-SPIN) > 6
- Moderate fear and avoidance of two specified social situations (i.e., giving a stranger a compliment and asking for a restaurant recommendation), each rated above 5 on a Likert scale ranging from 0 (not at all) to 10 (extremely), respectively
- Avoidance of the two specified social situations (i.e., giving a stranger a compliment and asking for a restaurant recommendation), indicated by not having engaged in either behaviors in the past 7 days
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: The Efficacy of Prospective Mental Imagery in Enhancing Approach Motivation Among Socially Anxious Individuals: A Randomized Controlled Trial
The efficacy of an online intervention aimed at enhancing approach motivation and behavioral engagement in confronting anxiety-inducing social situations is examined among individuals with elevated social anxiety. Participants will receive psychoeducation, followed by either a prospective mental-imagery task or a verbal reasoning task. Efficacy of the intervention is measured by ratings of experienced and anticipated pleasure, approach motivation and self-reported engagement with feared situations one week later.
Read the detailed description
With numerous studies demonstrating its long-term effectiveness, exposure therapy is currently considered the leading evidence-based treatment for anxiety disorders. However, a major limitation in its application is that patients often discontinue treatment due to their unwillingness to confront themselves with the feared situation. Considering that targeting avoidance behaviors and maladaptive fear responses are at the core of exposure therapy, strategies are needed to enhance both approach motivation as well as behavioral engagement with the feared situation. Among individuals with depression, prospective mental imagery has been demonstrated to increase motivation and behavioral engagement in pleasurable activities by elevating anticipated reward as well as anticipatory and anticipated pleasure ('motivational amplifier' hypothesis). Given alterations in motivational and reward processes in individuals with social anxiety, prospective mental imagery may enhance reward anticipation and facilitate approach motivation and engagement in exposure to socially feared situations. The current online study will compare the use of a prospective mental-imagery task to an active control group (verbal reasoning) in improving approach motivation and behavioral engagement with feared situations in individuals with heightened social anxiety. Participants in both conditions will receive psychoeducation. Participants in the experimental group will vividly imagine themselves successfully mastering the feared social situation. Participants in the control condition are asked to reflect on the pros and cons of confronting themselves with the feared social situation. Approach motivation as well as reward anticipation, anticipated and anticipatory pleasure will be assessed before and after the imagery or verbal reasoning task. Engagement with the feared social situation will be assessed one week later. Aim of the randomized controlled trial is to investigate whether prospective mental imagery is effective in enhancing self-reported motivation and engagement with feared situations compared to an active control group. In an exploratory analysis, we will examine whether the efficacy of the prospective imagery training is modulated by individuals' levels of reward sensitivity and anhedonia.
- Conditions
- Social Anxiety, Social Phobia
- Being tested
- Psychoeducation, Prospective Mental Imagery, Verbal Reasoning
- Medical subject headings
- Phobia, Social
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PsychoeducationBehavioural
Providing information about social anxiety, role of safety and avoidance behaviors in maintaining social anxiety, rationale for exposure to feared social situations
Prospective Mental ImageryBehavioural
A standard imagination script is recounted in which participants have successfully mastered the socially feared situation
Verbal ReasoningBehavioural
Participants are asked to reflect on the pros and cons of facing the socially feared situation
| Study group | Role | What they receive |
|---|---|---|
| Psychoeducation + Prospective Mental-Imagery Task | Experimental | Prospective mental imagery of post-exposure experience Receives: Behavioral: Psychoeducation; Behavioral: Prospective Mental Imagery |
| Psychoeducation + Verbal Reasoning Task | Active comparator | Verbal reasoning of pro and cons of exposure Receives: Behavioral: Psychoeducation; Behavioral: Verbal Reasoning |
What is being measured
The primary outcome is the main question the study is designed to answer.
Anticipatory Pleasure
2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing current pleasure when imaging approaching and having approached the feared situations.
Measured: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
Anticipated Pleasure
2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing expected pleasure when approaching and having approached the feared situations.
Measured: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
Reward Anticipation
2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing expected reward related to approaching and having approached the feared situations.
Measured: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
Motivation
Self-reported motivation to approach the feared situations on a scale of 0 (not at all) to 100 (extremely).
Measured: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
Frequency of Exposure
Self-reported frequency of exposure to the feared situations.
Measured: Post-treatment (i.e., 7 days after baseline)
Secondary outcomes (9)
Social Phobia Inventory (SPIN)
17-item questionnaire on a 5-point Likert scale (0 = 'not at all'; 4 = 'extremely') assessing symptom severity related to social anxiety (i.e., fear, avoidance, physical symptoms). Total range score: 0 to 68. Higher scores indicating greater severity of social anxiety.
Measured: Change from baseline to post-treatment (i.e., 7 days)
Mood State Questionnaire
6-item assessment using a 7-point bipolar Likert scale to measure a person's current mood across three dimensions: energetic arousal, valence, and calmness. Higher scores indicating higher energetic arousal, more positive valence, and greater calmness.
Measured: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
Liebowitz Social Anxiety Scale (LSAS)
24-item questionnaire on a 4-point Likert scale (fear: 0 = 'none'; 3 = 'severe'; avoidance: 0 = 'never'; 3 = 'usually') assessing both fear/anxiety and avoidance of social situations, respectively. Total range score: 0 to 144. Higher scores indicating greater fear and avoidance as well as severity of social anxiety.
Measured: Change from baseline to post-treatment (i.e., 7 days)
Patient Health Questionnaire-9 (PHQ-9)
9-item questionnaire on a 4-point Likert scale (0 = 'not at all'; 3 = 'nearly every day') assessing the presence and severity of depressive symptoms. Total range score: 0 to 27. Higher scores indicating more severe depression.
Measured: Baseline
Positive and Negative Affect Schedule (PANAS)
20-item questionnaire on a 5-point Likert scale (0 = 'not at all'; 4 = 'extremely') assessing the presence and intensity of both positive and negative emotions. Total score range for positive affect (PA) and negative affect (NA), respectively: 0 to 50. Higher scores indicate on either scale indicate a higher level of that emotion.
Measured: Baseline
Snaith-Hamilton-Pleasure-Scale (SHAPS)
14-item questionnaire on a 4-point Likert scale (0 = 'strongly disagree'; 3 = 'strongly agree') measuring anhedonia. Total score range: 0 to 42. Higher total scores indicate greater levels of anhedonia.
Measured: Baseline
Positive Valence System Scale (PVSS-21)
21-item questionnaire on a 9-point Likert scale (1= 'extremely untrue of me'; 9 = 'extremely true of me') assessing an individual's response to various types of rewards in daily life. Total score range: 21 to 105. Higher scores indicating a greater tendency to experience pleasure and respond to rewards.
Measured: Baseline
Vividness of Mental Imagination
Vividness of imagination on a scale from 0 (not at all) to 100 (extremely vivid) assessed immediately after prospective mental-imagery and verbal reasoning task.
Measured: Immediately after assigned interventions (prospective mental imagery and verbal reasoning task) at baseline
Verbal Reasoning
Intensity of reflection on the pros and cons of seeking out the feared situation on a scale from (not intensive at all) to 100 (extremely intensive) assessed after prospective mental-imagery and verbal reasoning task.
Measured: Immediately after assigned interventions (prospective mental imagery and verbal reasoning task) at baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 May 2025
- Study start4 Mar 2025
- Primary completion1 Jul 2026
- Study completion1 Jul 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Social AnxietyStudies 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
- Single blind
- Who is masked
- Participant
- Enrolment
- 129 participants (actual)
Sponsor and investigators
- Lead sponsor
- Philipps University Marburg
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Christoph Benke, Philipps University Marburg
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06977087
- Sponsor's protocol ID
- Trau dich! 2.0
- Status last verified
- Jul 2026
- First submitted
- 30 Apr 2025
- Last updated
- 7 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Hallford DJ, Farrell H, Lynch E. Increasing anticipated and anticipatory pleasure through episodic thinking. Emotion. 2022 Jun;22(4):690-700. doi: 10.1037/emo0000765. Epub 2020 Jun 18.
PubMed 32551746Renner F, Werthmann J, Paetsch A, Bar HE, Heise M, Bruijniks SJE. Prospective Mental Imagery in Depression: Impact on Reward Processing and Reward-Motivated Behaviour. Clin Psychol Eur. 2021 Jun 18;3(2):e3013. doi: 10.32872/cpe.3013. eCollection 2021 Jun.
PubMed 36397959Renner F, Murphy FC, Ji JL, Manly T, Holmes EA. Mental imagery as a "motivational amplifier" to promote activities. Behav Res Ther. 2019 Mar;114:51-59. doi: 10.1016/j.brat.2019.02.002. Epub 2019 Feb 5.
PubMed 30797989Ji JL, Geiles D, Saulsman LM. Mental imagery-based episodic simulation amplifies motivation and behavioural engagement in planned reward activities. Behav Res Ther. 2021 Oct;145:103947. doi: 10.1016/j.brat.2021.103947. Epub 2021 Aug 15.
PubMed 34433114
Study at a glance
From the registry record, last updated by the sponsor on 7 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Efficacy of Prospective Mental Imagery in Enhancing Approach Motivation Among Socially Anxious Individuals: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06977087
- Acronym / sponsor ID
- Trau dich! 2.0
- Conditions
- Social Anxiety, Social Phobia
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 129 participants (actual)
- Lead sponsor
- Philipps University MarburgUniversity, hospital or other
- Study start
- 4 Mar 2025 (actual)
- Primary completion
- 1 Jul 2026 (actual)
- Study completion
- 1 Jul 2026 (actual)
- First posted
- 18 May 2025 (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.
The efficacy of an online intervention aimed at enhancing approach motivation and behavioral engagement in confronting anxiety-inducing social situations is examined among individuals with elevated social anxiety. Participants will receive psychoeducation, followed by either a prospective mental-imagery task or a verbal reasoning task. Efficacy of the intervention is measured by ratings of experienced and anticipated pleasure, approach motivation and self-reported engagement with feared situations one week later.
Detailed description
With numerous studies demonstrating its long-term effectiveness, exposure therapy is currently considered the leading evidence-based treatment for anxiety disorders. However, a major limitation in its application is that patients often discontinue treatment due to their unwillingness to confront themselves with the feared situation. Considering that targeting avoidance behaviors and maladaptive fear responses are at the core of exposure therapy, strategies are needed to enhance both approach motivation as well as behavioral engagement with the feared situation. Among individuals with depression, prospective mental imagery has been demonstrated to increase motivation and behavioral engagement in pleasurable activities by elevating anticipated reward as well as anticipatory and anticipated pleasure ('motivational amplifier' hypothesis). Given alterations in motivational and reward processes in individuals with social anxiety, prospective mental imagery may enhance reward anticipation and facilitate approach motivation and engagement in exposure to socially feared situations. The current online study will compare the use of a prospective mental-imagery task to an active control group (verbal reasoning) in improving approach motivation and behavioral engagement with feared situations in individuals with heightened social anxiety. Participants in both conditions will receive psychoeducation. Participants in the experimental group will vividly imagine themselves successfully mastering the feared social situation. Participants in the control condition are asked to reflect on the pros and cons of confronting themselves with the feared social situation. Approach motivation as well as reward anticipation, anticipated and anticipatory pleasure will be assessed before and after the imagery or verbal reasoning task. Engagement with the feared social situation will be assessed one week later. Aim of the randomized controlled trial is to investigate whether prospective mental imagery is effective in enhancing self-reported motivation and engagement with feared situations compared to an active control group. In an exploratory analysis, we will examine whether the efficacy of the prospective imagery training is modulated by individuals' levels of reward sensitivity and anhedonia.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Psychoeducation + Prospective Mental-Imagery Task | Experimental | Behavioral: Psychoeducation, Behavioral: Prospective Mental ImageryProspective mental imagery of post-exposure experience |
| Psychoeducation + Verbal Reasoning Task | Active comparator | Behavioral: Psychoeducation, Behavioral: Verbal ReasoningVerbal reasoning of pro and cons of exposure |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Elevated score on Mini-Social Phobia Inventory (Mini-SPIN) > 6
- Moderate fear and avoidance of two specified social situations (i.e., giving a stranger a compliment and asking for a restaurant recommendation), each rated above 5 on a Likert scale ranging from 0 (not at all) to 10 (extremely), respectively
- Avoidance of the two specified social situations (i.e., giving a stranger a compliment and asking for a restaurant recommendation), indicated by not having engaged in either behaviors in the past 7 days
Key exclusion criteria (0 listed)
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 |
|---|---|---|
| PsychoeducationProviding information about social anxiety, role of safety and avoidance behaviors in maintaining social anxiety, rationale for exposure to feared social situations | Behavioural | Psychoeducation + Prospective Mental-Imagery Task, Psychoeducation + Verbal Reasoning Task |
| Prospective Mental ImageryA standard imagination script is recounted in which participants have successfully mastered the socially feared situation | Behavioural | Psychoeducation + Prospective Mental-Imagery Task |
| Verbal ReasoningParticipants are asked to reflect on the pros and cons of facing the socially feared situation | Behavioural | Psychoeducation + Verbal Reasoning Task |
Primary outcome
Anticipatory Pleasure
Time frame: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing current pleasure when imaging approaching and having approached the feared situations.
Anticipated Pleasure
Time frame: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing expected pleasure when approaching and having approached the feared situations.
Reward Anticipation
Time frame: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
2-item questionnaire on a scale 0 (not at all) to 100 (extremely) assessing expected reward related to approaching and having approached the feared situations.
Motivation
Time frame: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
Self-reported motivation to approach the feared situations on a scale of 0 (not at all) to 100 (extremely).
Frequency of Exposure
Time frame: Post-treatment (i.e., 7 days after baseline)
Self-reported frequency of exposure to the feared situations.
9 secondary outcomes
Social Phobia Inventory (SPIN)
Time frame: Change from baseline to post-treatment (i.e., 7 days)
Mood State Questionnaire
Time frame: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)
Liebowitz Social Anxiety Scale (LSAS)
Time frame: Change from baseline to post-treatment (i.e., 7 days)
Patient Health Questionnaire-9 (PHQ-9)
Time frame: Baseline
Positive and Negative Affect Schedule (PANAS)
Time frame: Baseline
Snaith-Hamilton-Pleasure-Scale (SHAPS)
Time frame: Baseline
Positive Valence System Scale (PVSS-21)
Time frame: Baseline
Vividness of Mental Imagination
Time frame: Immediately after assigned interventions (prospective mental imagery and verbal reasoning task) at baseline
Verbal Reasoning
Time frame: Immediately after assigned interventions (prospective mental imagery and verbal reasoning task) at baseline
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 Jul 2026.
- Background: PubMed 32551746Hallford DJ, Farrell H, Lynch E. Increasing anticipated and anticipatory pleasure through episodic thinking. Emotion. 2022 Jun;22(4):690-700. doi: 10.1037/emo0000765. Epub 2020 Jun 18.
- Background: PubMed 36397959Renner F, Werthmann J, Paetsch A, Bar HE, Heise M, Bruijniks SJE. Prospective Mental Imagery in Depression: Impact on Reward Processing and Reward-Motivated Behaviour. Clin Psychol Eur. 2021 Jun 18;3(2):e3013. doi: 10.32872/cpe.3013. eCollection 2021 Jun.
- Background: PubMed 30797989Renner F, Murphy FC, Ji JL, Manly T, Holmes EA. Mental imagery as a "motivational amplifier" to promote activities. Behav Res Ther. 2019 Mar;114:51-59. doi: 10.1016/j.brat.2019.02.002. Epub 2019 Feb 5.
- Background: PubMed 34433114Ji JL, Geiles D, Saulsman LM. Mental imagery-based episodic simulation amplifies motivation and behavioural engagement in planned reward activities. Behav Res Ther. 2021 Oct;145:103947. doi: 10.1016/j.brat.2021.103947. Epub 2021 Aug 15.
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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 Psychoeducation, Prospective Mental Imagery and Verbal Reasoning in people with Social Anxiety and Social Phobia, run by Philipps University Marburg 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 0 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 Jul 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. 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?
Anticipatory Pleasure (time frame: Baseline (prior to the assigned intervention) and immediately post-intervention (following the prospective mental imagery or verbal reasoning task)). The study lists 5 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 NCT06977087, which also lists 4 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 7 Jul 2026.