Fear of FailureJM2019aNCT07048756
Psychotherapeutic Imagery Techniques
A study testing Imagery Rescripting, Imagery Exposure and Imagery Rescripting with Disruption of Reconsolidation in people with Fear of Failure, run by University of Social Sciences and Humanities, Warsaw at 1 site in Poland.
Trial summary
This randomized controlled trial (RCT) examines the efficacy of Imagery Exposure (IE), Imagery Rescripting (ImRs), and Compassion-Focused Therapy (CFT) in individuals with a high fear of failure. Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Fear of Failure
- What is being tested?
- Imagery Rescripting, Imagery Exposure and Imagery Rescripting with Disruption of Reconsolidation
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 220 participants
- Where
- 1 sitePoland
- Study dates
- 1 Jun 2020to 1 Jun 2022
- 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 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- adults aged 18-35
- high fear of failure
- not currently undergoing psychotherapy or psychopharmacotherapy
- no severe punitive experiences in the past
Who cannot join
- current severe affective disorders
- current severe anxiety
- current severe personality disorders
- active suicidality
- psychosis
- substance abuse
Trial locations and contacts
1 site in 1 country.
Poland1 site
Poznań Laboratory of Affective Neuroscience, Institute of Psychology, SWPS University, Warsaw, Poland
Poznan, Wielkopolska, 61-719
About this study
Official title: Enhancing the Efficacy of Psychotherapeutic Imagery Techniques: A Randomized Controlled Trial
This randomized controlled trial (RCT) examines the efficacy of Imagery Exposure (IE), Imagery Rescripting (ImRs), and Compassion-Focused Therapy (CFT) in individuals with a high fear of failure. Participants (N=220) were randomly assigned to IE, ImRs, ImRs with a 10-minute break (ImRs-DSR), or CFT-based Imagery Rescripting (CFT_ImRs). Due to funding constraints, the CFT_ImRs group included a reduced sample (N=40, targeting 30 completers).
The two-week intervention consists of four structured imagery sessions. IE involves exposure to criticism-related memories without modification. In the ImRs group memory reactivation to criticism-related memories is followed by positive reappraisal. ImRs-DSR introduces a 10-minute delay before reappraisal to enhance memory updating. CFT_ImRs incorporates Compassion-Focused Therapy (CFT) principles into reappraisal, emphasizing self-compassion.
Read more
Primary outcomes include skin conductance level (SCL) and subjective emotional responses to criticism-related (and control) memories, changes in fear of failure and dysfunctional beliefs. All these variables are assessed pre-treatment, post-treatment, and at 3- and 6-month follow-ups. Results will be analyzed separately for:
IE vs. ImRs (rescripting vs. exposure and physiological predictors), ImRs vs. ImRs-DSR (memory reconsolidation effects), IE vs. CFT_ImRs (CFT vs. exposure efficacy).
Read the detailed description
This study aims to investigate the efficacy and underlying psychological mechanisms of Imagery Rescripting (ImRs), Imagery Exposure (IE), and Compassion-Focused Therapy (CFT) in individuals with high fear of failure. The project is designed as a randomized controlled trial (RCT) comparing four intervention conditions: Imagery Exposure (IE), standard Imagery Rescripting (ImRs), Imagery Rescripting with a 10-minute break (ImRs-DSR), and CFT-based Imagery Rescripting (CFT_ImRs). The addition of the CFT_ImRs condition was based on the decision to explore whether compassion-focused elements provide additional benefits in reducing criticism-related subjective and autonomic responses.
The study enrolled 220 participants, randomly assigned to one of the four groups (IE, ImRs, ImRs-DSR, CFT_ImRs) in a 3:3:3:2 allocation ratio. Due to funding limitations for CFT_ImRs, recruitment for this group has been capped at 40 participants, with the goal of obtaining a final sample of 30 subjects for the study phase. The treatment phase takes two weeks starting just after pre-treatment assessments and consisting of four treatment sessions. Each of them involves exposure to autobiographical memories of childhood criticism, presented in an audio format. The IE condition involves prolonged exposure to the criticism scene without modifications. In the ImRs condition, the reactivation of memory is followed by a positive reappraisal, where an imagined caregiver acknowledges the participant's needs. In ImRs-DSR, a 10-minute break separates the memory reactivation from the positive reappraisal, aiming to enhance memory updating by increasing memory trace destabilization. In the CFT_ImRs condition, the part aiming at positive reappraisal differs from the one used in ImRs condition by incorporating some principles of Compassion-Focused Imagery Rescripting.
Primary outcome measures include physiological arousal (skin conductance level, SCL), subjective ratings, and changes in self-reported fear of failure and dysfunctional beliefs. Treatment effects will be evaluated at pre-treatment, post-treatment, and at 3- and 6-month follow-ups. The efficacy and stability of each intervention will be assessed using renewal, reacquisition, and reinstatement paradigms, as they are known from behavioral studies.
Due to the broad scope of this study, the results will be reported separately for different comparisons, as each addresses distinct research questions:
IE vs. ImRs: Examines whether rescripting differs from exposure and how the dynamics of physiological arousal influences treatment outcomes.
ImRs vs. ImRs-DSR: Investigates whether adding a mechanism for interrupting memory reconsolidation improves the efficacy of ImRs.
IE vs. CFT_ImRs: Evaluates the efficacy of Compassion-Focused Therapy in comparison to exposure-based treatment.
This study seeks to determine whether standard ImRs is better than IE and whether ImRs-DSR or CFT_ImRs provide additional benefits in reducing criticism-related subjective and autonomic responses, and whether the dynamics of physiological arousal during imagery predicts treatment responses. The findings may contribute to optimizing imagery-based therapeutic techniques for individuals with pathological fear of failure.
Due to human error in study planning, the retrospective registration for the ImRs vs. ImRs-DSR condition has already been registered in another repository under the following code: NCT06537284.
- Conditions
- Fear of Failure
- Being tested
- Imagery Rescripting, Imagery Exposure, Imagery Rescripting with Disruption of Reconsolidation, Compassion-Focused Therapy Imagery Rescripting
- Keywords
- Imagery Rescripting, Imagery Exposure, Schema Therapy, Compassion Focused Therapy, Fear of Failure, Disruption of Reconsolidation, Skin Conductance Level
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Imagery RescriptingBehavioural
Also called ImRs
Imagery Rescripting (Regular)
Imagery ExposureBehavioural
Also called IE
Imagery Exposure
Imagery Rescripting with Disruption of ReconsolidationBehavioural
Also called ImRs-DSR
Imagery Rescripting with Disruption of Reconsolidation
Compassion-Focused Therapy Imagery RescriptingBehavioural
Also called CFT_ImRs
Imagery Rescripting in Compassion-Focused Therapy
| Study group | Role | What they receive |
|---|---|---|
| Imagery Rescripting (ImRs) | Experimental | Before treatment each participant took part in 2 imagery sessions during which a cognitive-behavioral therapist (CBT) asked him/her to recall 3 events of being criticized for failures (2 past and 1 future events). Information from these sessions was used to create 1 criticism scenario related to the future and 2 related to the past, one of the latter was processed into a treatment scenario. Each of the 3 scenarios consisted of a memory anticipation part that required recalling 3 images one after another: the image of self, the surroundings, and the person of the critic involved in the scene. In the treatment scenario immediately after the imagery of the critic the rescripting part was presented, in which: 1. therapist enters the scene and prevents the criticism 2. therapist addresses a critic and points out the child's needs 3. therapist addresses the child and acknowledges its needs 4. therapist suggests to the child to perform an activity that would meet its needs. Receives: Behavioral: Imagery Rescripting |
| Imagery Rescripting with memory reconsolidation disruption (ImRs-DSR) | Experimental | Before treatment each participant took part in 2 imagery sessions during which a cognitive-behavioral therapist (CBT) asked him/her to recall 3 events of being criticized for failures (2 past and 1 future events). Information from these sessions was used to create 1 criticism scenario related to the future and 2 related to the past, one of the latter was processed into a treatment scenario. Each of the 3 scenarios consisted of a memory anticipation part that required recalling 3 images one after another: the image of self, the surroundings, and the person of the critic involved in the scene. In the treatment scenario 10 minutes after the imagery of the critic the rescripting part was presented, in which: 1) the therapist enters the scene and prevents the criticism 2) the therapist addresses a critic and points out the child's needs 3) the therapist addresses the child and acknowledges its needs 4) the therapist suggests to the child to perform an activity that would meet its needs. Receives: Behavioral: Imagery Rescripting with Disruption of Reconsolidation |
| Imagery Exposure (IE) | Experimental | Before treatment each participant took part in 2 imagery sessions during which a cognitive-behavioral therapist (CBT) asked him/her to recall 3 event of being criticized for failures. Information from these sessions was used to create 1 criticism scenario related to the future and 2 related to the past, one of the latter was processed into a treatment scenario. Each of the 3 scenarios consisted of a memory anticipation part that required recalling 3 images one after another: the image of self, the surroundings, and the person of the critic involved in the scene. In the treatment scenario the imagery of the critic was followed by the prolonged exposure to the criticism situation. Receives: Behavioral: Imagery Exposure |
| Compassion-Focused Therapy Imagery Rescripting (CFT_ImRs) | Experimental | Before treatment each participant took part in 2 imagery sessions during which a cognitive-behavioral therapist (CBT) asked him/her to recall 3 event of being criticized for failures. Information from these sessions was used to create 1 criticism scenario related to the future and 2 related to the past, one of the latter was processed into a treatment scenario. Each of the 3 scenarios consisted of a memory anticipation part that required recalling 3 images one after another: the image of self, the surroundings, and the person of the critic involved in the scene. In the treatment scenario immediately after the imagery of the critic the rescripting part was presented, in which: 1) therapist expressed intention to protect the child 2) desire to reduce the child's suffering 3) explained that suffering is part of the human experience 4) provided sense of community and understanding. Receives: Behavioral: Compassion-Focused Therapy Imagery Rescripting |
What is being measured
The primary outcome is the main question the study is designed to answer.
The Performance Failure Appraisal Inventory
The Performance Failure Appraisal Inventory was used to assess fear of failure. It is a 35-item questionnaire that measures the strength of subjective beliefs about the consequences of failure. The PFAI has five subscales: fear of experiencing shame and embarrassment; fear of devaluing one's self-esteem; fear of having an uncertain future; fear of important others losing interest, and fear of upsetting important others, with scores ranging 35-175.
Measured: Screening, 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Subjective ratings at the end of all sessions
Subjective ratings at the end of all sessions - participants were asked to evaluate each fragment of the presented scenarios according to several measures: immersion, focus, emotions (happiness, sadness, guilt, fear, anger, disgust) on a 9-point Likert scale (very low-very high), and valence (very negative-very positive), scores ranging 1-9 for each factor.
Measured: Pre-Treatment (TP1), during 2-weeks treatment (TP2-TP5), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
SCL recordings
Skin conductance level (SCL) was collected during the audio-guided scenarios' imagery at pre-treatment, treatment, post-treatment, and follow-up sessions. SCL was acquired using Biopack MP160 EDA-MRI system, with a sampling frequency of 2000Hz. The signal was resampled into 1000Hz, then smoothed with median (100 samples), and filtered with a high-passed 1Hz filter. We calculated normalized change in SCL with equation 100✕(SCLStim-SCLbaseline/SCLbaseline), where SCLStim is the mean signal value during the stimulus and SCLbaseline is an SCL reaction during the baseline preceding the first part in each scenario (Sugimine et al., 2020). Our primary outcome was SCL during the imagery of different scenarios, separated for anticipation and hotspot parts.
Measured: Pre-Treatment (TP1), during 2-weeks treatment (TP2-TP5), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Saliva sampling sAA
Saliva samples were collected on pre- and post-treatment with cotton rolls. Samples were collected using cotton rolls that were chewed for 1 min and were later secured in sterile V-bottom tubes and stored at 4°C temperature upon analysis. Samples were coded and sent to the Institute of Human Genetics Polish Academy of Science where the level of alpha amylase was measured.
Measured: Pre-Treatment (TP1), 2-weeks post-treatment (TP6)
Secondary outcomes (14)
Beck Depression Inventory
Beck Depression Inventory second edition (BDI-II) is a self-report scale using 21 items regarding the presence and strength of depression symptoms, with scores ranging 0-63.
Measured: Pre-Treatment (TP1), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Yale-Brown Obsessive-Compulsive
Yale-Brown Obsessive-Compulsive self-report severity scale Y-BOCS-SR a 10-item, self-report questionnaire created to evaluate OCD severity, scores ranging 0-40.
Measured: Screening, 6-month Follow-up (TP8)
The Alcohol Use Disorders Identification Test
The Alcohol Use Disorders Identification Test AUDIT is a self-reported tool containing 10 items used to assess recent alcohol consumption, alcohol dependence symptoms, and problems related to alcohol consumption, with scores ranging 0-40.
Measured: Screening, 6-month Follow-up (TP8)
Drug Abuse Screen Test
Drug Abuse Screen Test DAST 10 is a self-reported questionnaire to detect drug use disorders, scores ranging 0-10.
Measured: Screening, 6-month Follow-up (TP8)
Structured Clinical Interview for DSM-5 (SCID-5-PD)
Structured Clinical Interview for DSM-5 SCID-5-PD is a semistructured clinical interview that evaluates DSM-5 personality disorders under three clusters of A, B, and C, and other specific personality disorders. Based on positive answers to questions clinician diagnose adequate personality disorders.
Measured: Screening
M.I.N.I. Mini International Neuropsychiatric Interview
M.I.N.I. Mini International Neuropsychiatric Interview is a short structured interview for DSM IV and ICD 10 disorders, used to assess mental disorders: major depressive disorder, dysthymic disorder, suicidality, mania, panic disorder, agoraphobia, social phobia, specific phobia, obsessive-compulsive disorder, post-traumatic stress disorder, alcohol dependence/abuse, drug dependence/abuse, antisocial personality disorder. Based on positive answers to questions clinician diagnose adequate disorders.
Measured: Screening
Liebowitz Social Anxiety Scale
Liebowitz Social Anxiety Scale (LSAS) is a 24-item scale to evaluate fear and avoidance in social situations such as social interaction, public speaking, being observed by others, eating and drinking in public, with scores ranging from 0 to 144.
Measured: Pre-Treatment (TP1), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Pure Procrastination Scale
Pure Procrastination Scale (PPS) is composed of 12 items, which measures three components of procrastination: decisional delay, implemental delay and delays in lateness/timeliness, with scores ranging 12-60.
Measured: Pre-Treatment (TP1), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Frost Multidimensional Perfectionism Scale
Frost Multidimensional Perfectionism Scale was used to assess overall perfectionism and its dimensions: Personal Standards, Organization, Concern Over Mistakes, Doubts About Actions, Parental Expectations, and Parental Criticism, with scores ranging 35-175.
Measured: Pre-Treatment (TP1), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Social Anxiety Disorder Scale (DSM)
Self-report dimensional scale for Social Anxiety Disorder based on DSM-5 criteria. The scale consists of 10 items measuring frequency of symptoms experienced in the last 7 days. Each item is rated on a 4-point Likert scale (0 = never, 4 = all the time). Scores range 0-40, with higher scores indicating greater symptom severity.
Measured: Screening, 6-month Follow-up (TP8)
Agoraphobia Scale (DSM)
Self-report dimensional scale for Agoraphobia based on DSM-5 criteria. The scale includes 10 items evaluating thoughts, feelings, and behaviors associated with agoraphobic avoidance in the past 7 days. Each item is scored on a 0-4 scale. Total score range: 0-40.
Measured: Screening, 6-month Follow-up (TP8)
Panic Disorder Scale (DSM)
10-item self-rating questionnaire based on DSM-5 criteria for Panic Disorder. The scale assesses symptom frequency over the past 7 days using a 4-point Likert scale (0-4), with total scores ranging from 0 to 40.
Measured: Screening, 6-month Follow-up (TP8)
Generalized Anxiety Disorder Scale (DSM)
A dimensional measure for Generalized Anxiety Disorder based on DSM-5, comprising 10 items. Participants indicate how frequently they experienced each symptom during the past 7 days. Scoring is on a 4-point Likert scale from 0 (never) to 4 (all the time), with total scores ranging 0-40.
Measured: Screening, 6-month Follow-up (TP8)
Post-Traumatic Stress Symptoms Scale (DSM)
Self-report scale assessing PTSD symptoms as defined by DSM-5 criteria. The instrument includes 10 items evaluating symptom frequency over the previous 7 days on a 0-4 Likert scale. Total scores range from 0 to 40.
Measured: Screening, 6-month Follow-up (TP8)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jul 2025
- Study start1 Jun 2020
- Primary completion1 Jun 2022
- Study completion1 Jun 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Fear of FailureStudies 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
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 220 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Social Sciences and Humanities, Warsaw
- Sponsor type
- University, hospital or other
- Collaborators
- National Science Centre, Poland
- Responsible party
- Principal investigator, Jaroslaw Michalowski, University SWPS
- Investigators
- Jarosław M. Michałowski, PhD, Principal investigator, SWPS University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07048756
- Sponsor's protocol ID
- SONATA_BIS_JM2019a
- Acronym
- JM2019a
- Status last verified
- Aug 2025
- First submitted
- 24 Jun 2025
- Last updated
- 20 Aug 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Craske MG, Kircanski K, Epstein A, Wittchen HU, Pine DS, Lewis-Fernandez R, Hinton D; DSM V Anxiety; OC Spectrum; Posttraumatic and Dissociative Disorder Work Group. Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V. Depress Anxiety. 2010 Feb;27(2):93-112. doi: 10.1002/da.20654.
PubMed 20099270Sugimine S, Saito S, Takazawa T. Normalized skin conductance level could differentiate physical pain stimuli from other sympathetic stimuli. Sci Rep. 2020 Jul 2;10(1):10950. doi: 10.1038/s41598-020-67936-0.
PubMed 32616939Wild J, Clark DM. Imagery Rescripting of Early Traumatic Memories in Social Phobia. Cogn Behav Pract. 2011 Nov;18(4):433-443. doi: 10.1016/j.cbpra.2011.03.002.
PubMed 22298942Siegesleitner M, Strohm M, Wittekind CE, Ehring T, Kunze AE. Improving imagery rescripting treatments: Comparing an active versus passive approach. J Behav Ther Exp Psychiatry. 2020 Dec;69:101578. doi: 10.1016/j.jbtep.2020.101578. Epub 2020 Jun 9.
PubMed 32569854Schiller D, Kanen JW, LeDoux JE, Monfils MH, Phelps EA. Extinction during reconsolidation of threat memory diminishes prefrontal cortex involvement. Proc Natl Acad Sci U S A. 2013 Dec 10;110(50):20040-5. doi: 10.1073/pnas.1320322110. Epub 2013 Nov 25.
PubMed 24277809Morina N, Lancee J, Arntz A. Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis. J Behav Ther Exp Psychiatry. 2017 Jun;55:6-15. doi: 10.1016/j.jbtep.2016.11.003. Epub 2016 Nov 9.
PubMed 27855298Conroy, D. E., Willow, J. P., & Metzler, J. N. (2002). Multidimensional fear of failure measurement: The performance failure appraisal inventory. Journal of applied sport psychology, 14(2), 76-90.
Arntz A, Weertman A. Treatment of childhood memories: theory and practice. Behav Res Ther. 1999 Aug;37(8):715-40. doi: 10.1016/s0005-7967(98)00173-9.
PubMed 10452174Agren T, Engman J, Frick A, Bjorkstrand J, Larsson EM, Furmark T, Fredrikson M. Disruption of reconsolidation erases a fear memory trace in the human amygdala. Science. 2012 Sep 21;337(6101):1550-2. doi: 10.1126/science.1223006.
PubMed 22997340Baczek J, Karkosz S, Pietruch M, Szymanski R, Michalowski JM. Imagine yourself as a little girl...-efficacy and psychophysiology of imagery techniques targeting adverse autobiographical childhood experiences- multi-arm randomised controlled trial. Front Psychol. 2026 Jan 16;16:1710963. doi: 10.3389/fpsyg.2025.1710963. eCollection 2025.
PubMed 41625469
Study at a glance
From the registry record, last updated by the sponsor on 20 Aug 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Enhancing the Efficacy of Psychotherapeutic Imagery Techniques: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07048756
- Acronym / sponsor ID
- JM2019a / SONATA_BIS_JM2019a
- Conditions
- Fear of Failure
- Keywords
- Imagery Rescripting, Imagery Exposure, Schema Therapy, Compassion Focused Therapy, Fear of Failure, Disruption of Reconsolidation, Skin Conductance Level
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 220 participants (actual)
- Lead sponsor
- University of Social Sciences and Humanities, WarsawUniversity, hospital or other
- Collaborators
- National Science Centre, Poland
- Study start
- 1 Jun 2020 (actual)
- Primary completion
- 1 Jun 2022 (actual)
- Study completion
- 1 Jun 2022 (actual)
- First posted
- 2 Jul 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.
This randomized controlled trial (RCT) examines the efficacy of Imagery Exposure (IE), Imagery Rescripting (ImRs), and Compassion-Focused Therapy (CFT) in individuals with a high fear of failure. Participants (N=220) were randomly assigned to IE, ImRs, ImRs with a 10-minute break (ImRs-DSR), or CFT-based Imagery Rescripting (CFT_ImRs). Due to funding constraints, the CFT_ImRs group included a reduced sample (N=40, targeting 30 completers).
The two-week intervention consists of four structured imagery sessions. IE involves exposure to criticism-related memories without modification. In the ImRs group memory reactivation to criticism-related memories is followed by positive reappraisal. ImRs-DSR introduces a 10-minute delay before reappraisal to enhance memory updating. CFT_ImRs incorporates Compassion-Focused Therapy (CFT) principles into reappraisal, emphasizing self-compassion.
Primary outcomes include skin conductance level (SCL) and subjective emotional responses to criticism-related (and control) memories, changes in fear of failure and dysfunctional beliefs. All these variables are assessed pre-treatment, post-treatment, and at 3- and 6-month follow-ups. Results will be analyzed separately for:
IE vs. ImRs (rescripting vs. exposure and physiological predictors), ImRs vs. ImRs-DSR (memory reconsolidation effects), IE vs. CFT_ImRs (CFT vs. exposure efficacy).
Detailed description
This study aims to investigate the efficacy and underlying psychological mechanisms of Imagery Rescripting (ImRs), Imagery Exposure (IE), and Compassion-Focused Therapy (CFT) in individuals with high fear of failure. The project is designed as a randomized controlled trial (RCT) comparing four intervention conditions: Imagery Exposure (IE), standard Imagery Rescripting (ImRs), Imagery Rescripting with a 10-minute break (ImRs-DSR), and CFT-based Imagery Rescripting (CFT_ImRs). The addition of the CFT_ImRs condition was based on the decision to explore whether compassion-focused elements provide additional benefits in reducing criticism-related subjective and autonomic responses.
The study enrolled 220 participants, randomly assigned to one of the four groups (IE, ImRs, ImRs-DSR, CFT_ImRs) in a 3:3:3:2 allocation ratio. Due to funding limitations for CFT_ImRs, recruitment for this group has been capped at 40 participants, with the goal of obtaining a final sample of 30 subjects for the study phase. The treatment phase takes two weeks starting just after pre-treatment assessments and consisting of four treatment sessions. Each of them involves exposure to autobiographical memories of childhood criticism, presented in an audio format. The IE condition involves prolonged exposure to the criticism scene without modifications. In the ImRs condition, the reactivation of memory is followed by a positive reappraisal, where an imagined caregiver acknowledges the participant's needs. In ImRs-DSR, a 10-minute break separates the memory reactivation from the positive reappraisal, aiming to enhance memory updating by increasing memory trace destabilization. In the CFT_ImRs condition, the part aiming at positive reappraisal differs from the one used in ImRs condition by incorporating some principles of Compassion-Focused Imagery Rescripting.
Primary outcome measures include physiological arousal (skin conductance level, SCL), subjective ratings, and changes in self-reported fear of failure and dysfunctional beliefs. Treatment effects will be evaluated at pre-treatment, post-treatment, and at 3- and 6-month follow-ups. The efficacy and stability of each intervention will be assessed using renewal, reacquisition, and reinstatement paradigms, as they are known from behavioral studies.
Due to the broad scope of this study, the results will be reported separately for different comparisons, as each addresses distinct research questions:
IE vs. ImRs: Examines whether rescripting differs from exposure and how the dynamics of physiological arousal influences treatment outcomes.
ImRs vs. ImRs-DSR: Investigates whether adding a mechanism for interrupting memory reconsolidation improves the efficacy of ImRs.
IE vs. CFT_ImRs: Evaluates the efficacy of Compassion-Focused Therapy in comparison to exposure-based treatment.
This study seeks to determine whether standard ImRs is better than IE and whether ImRs-DSR or CFT_ImRs provide additional benefits in reducing criticism-related subjective and autonomic responses, and whether the dynamics of physiological arousal during imagery predicts treatment responses. The findings may contribute to optimizing imagery-based therapeutic techniques for individuals with pathological fear of failure.
Due to human error in study planning, the retrospective registration for the ImRs vs. ImRs-DSR condition has already been registered in another repository under the following code: NCT06537284.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Imagery Rescripting (ImRs) | Experimental | Behavioral: Imagery RescriptingBefore treatment each participant took part in 2 imagery sessions during which a cognitive-behavioral therapist (CBT) asked him/her to recall 3 events of being criticized for failures (2 past and 1 future events). Information from these sessions was used to create 1 criticism scenario related to the future and 2 related to the past, one of the latter was processed into a treatment scenario. Each of the 3 scenarios consisted of a memory anticipation part that required recalling 3 images one after another: the image of self, the surroundings, and the person of the critic involved in the scene. In the treatment scenario immediately after the imagery of the critic the rescripting part was presented, in which: 1. therapist enters the scene and prevents the criticism 2. therapist addresses a critic and points out the child's needs 3. therapist addresses the child and acknowledges its needs 4. therapist suggests to the child to perform an activity that would meet its needs. |
| Imagery Rescripting with memory reconsolidation disruption (ImRs-DSR) | Experimental | Behavioral: Imagery Rescripting with Disruption of ReconsolidationBefore treatment each participant took part in 2 imagery sessions during which a cognitive-behavioral therapist (CBT) asked him/her to recall 3 events of being criticized for failures (2 past and 1 future events). Information from these sessions was used to create 1 criticism scenario related to the future and 2 related to the past, one of the latter was processed into a treatment scenario. Each of the 3 scenarios consisted of a memory anticipation part that required recalling 3 images one after another: the image of self, the surroundings, and the person of the critic involved in the scene. In the treatment scenario 10 minutes after the imagery of the critic the rescripting part was presented, in which: 1) the therapist enters the scene and prevents the criticism 2) the therapist addresses a critic and points out the child's needs 3) the therapist addresses the child and acknowledges its needs 4) the therapist suggests to the child to perform an activity that would meet its needs. |
| Imagery Exposure (IE) | Experimental | Behavioral: Imagery ExposureBefore treatment each participant took part in 2 imagery sessions during which a cognitive-behavioral therapist (CBT) asked him/her to recall 3 event of being criticized for failures. Information from these sessions was used to create 1 criticism scenario related to the future and 2 related to the past, one of the latter was processed into a treatment scenario. Each of the 3 scenarios consisted of a memory anticipation part that required recalling 3 images one after another: the image of self, the surroundings, and the person of the critic involved in the scene. In the treatment scenario the imagery of the critic was followed by the prolonged exposure to the criticism situation. |
| Compassion-Focused Therapy Imagery Rescripting (CFT_ImRs) | Experimental | Behavioral: Compassion-Focused Therapy Imagery RescriptingBefore treatment each participant took part in 2 imagery sessions during which a cognitive-behavioral therapist (CBT) asked him/her to recall 3 event of being criticized for failures. Information from these sessions was used to create 1 criticism scenario related to the future and 2 related to the past, one of the latter was processed into a treatment scenario. Each of the 3 scenarios consisted of a memory anticipation part that required recalling 3 images one after another: the image of self, the surroundings, and the person of the critic involved in the scene. In the treatment scenario immediately after the imagery of the critic the rescripting part was presented, in which: 1) therapist expressed intention to protect the child 2) desire to reduce the child's suffering 3) explained that suffering is part of the human experience 4) provided sense of community and understanding. |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- adults aged 18-35
- high fear of failure
- not currently undergoing psychotherapy or psychopharmacotherapy
- no severe punitive experiences in the past
Key exclusion criteria (6 listed)
- current severe affective disorders
- current severe anxiety
- current severe personality disorders
- active suicidality
- psychosis
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 |
|---|---|---|
| Imagery RescriptingAlso: ImRsImagery Rescripting (Regular) | Behavioural | Imagery Rescripting (ImRs) |
| Imagery ExposureAlso: IEImagery Exposure | Behavioural | Imagery Exposure (IE) |
| Imagery Rescripting with Disruption of ReconsolidationAlso: ImRs-DSRImagery Rescripting with Disruption of Reconsolidation | Behavioural | Imagery Rescripting with memory reconsolidation disruption (ImRs-DSR) |
| Compassion-Focused Therapy Imagery RescriptingAlso: CFT_ImRsImagery Rescripting in Compassion-Focused Therapy | Behavioural | Compassion-Focused Therapy Imagery Rescripting (CFT_ImRs) |
Primary outcome
The Performance Failure Appraisal Inventory
Time frame: Screening, 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
The Performance Failure Appraisal Inventory was used to assess fear of failure. It is a 35-item questionnaire that measures the strength of subjective beliefs about the consequences of failure. The PFAI has five subscales: fear of experiencing shame and embarrassment; fear of devaluing one's self-esteem; fear of having an uncertain future; fear of important others losing interest, and fear of upsetting important others, with scores ranging 35-175.
Subjective ratings at the end of all sessions
Time frame: Pre-Treatment (TP1), during 2-weeks treatment (TP2-TP5), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Subjective ratings at the end of all sessions - participants were asked to evaluate each fragment of the presented scenarios according to several measures: immersion, focus, emotions (happiness, sadness, guilt, fear, anger, disgust) on a 9-point Likert scale (very low-very high), and valence (very negative-very positive), scores ranging 1-9 for each factor.
SCL recordings
Time frame: Pre-Treatment (TP1), during 2-weeks treatment (TP2-TP5), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Skin conductance level (SCL) was collected during the audio-guided scenarios' imagery at pre-treatment, treatment, post-treatment, and follow-up sessions. SCL was acquired using Biopack MP160 EDA-MRI system, with a sampling frequency of 2000Hz. The signal was resampled into 1000Hz, then smoothed with median (100 samples), and filtered with a high-passed 1Hz filter. We calculated normalized change in SCL with equation 100✕(SCLStim-SCLbaseline/SCLbaseline), where SCLStim is the mean signal value during the stimulus and SCLbaseline is an SCL reaction during the baseline preceding the first part in each scenario (Sugimine et al., 2020). Our primary outcome was SCL during the imagery of different scenarios, separated for anticipation and hotspot parts.
Saliva sampling sAA
Time frame: Pre-Treatment (TP1), 2-weeks post-treatment (TP6)
Saliva samples were collected on pre- and post-treatment with cotton rolls. Samples were collected using cotton rolls that were chewed for 1 min and were later secured in sterile V-bottom tubes and stored at 4°C temperature upon analysis. Samples were coded and sent to the Institute of Human Genetics Polish Academy of Science where the level of alpha amylase was measured.
14 secondary outcomes
Beck Depression Inventory
Time frame: Pre-Treatment (TP1), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Yale-Brown Obsessive-Compulsive
Time frame: Screening, 6-month Follow-up (TP8)
The Alcohol Use Disorders Identification Test
Time frame: Screening, 6-month Follow-up (TP8)
Drug Abuse Screen Test
Time frame: Screening, 6-month Follow-up (TP8)
Structured Clinical Interview for DSM-5 (SCID-5-PD)
Time frame: Screening
M.I.N.I. Mini International Neuropsychiatric Interview
Time frame: Screening
Liebowitz Social Anxiety Scale
Time frame: Pre-Treatment (TP1), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Pure Procrastination Scale
Time frame: Pre-Treatment (TP1), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Frost Multidimensional Perfectionism Scale
Time frame: Pre-Treatment (TP1), 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)
Social Anxiety Disorder Scale (DSM)
Time frame: Screening, 6-month Follow-up (TP8)
Agoraphobia Scale (DSM)
Time frame: Screening, 6-month Follow-up (TP8)
Panic Disorder Scale (DSM)
Time frame: Screening, 6-month Follow-up (TP8)
Generalized Anxiety Disorder Scale (DSM)
Time frame: Screening, 6-month Follow-up (TP8)
Post-Traumatic Stress Symptoms Scale (DSM)
Time frame: Screening, 6-month Follow-up (TP8)
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 20 Aug 2025.
- Background: PubMed 20099270Craske MG, Kircanski K, Epstein A, Wittchen HU, Pine DS, Lewis-Fernandez R, Hinton D; DSM V Anxiety; OC Spectrum; Posttraumatic and Dissociative Disorder Work Group. Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V. Depress Anxiety. 2010 Feb;27(2):93-112. doi: 10.1002/da.20654.
- Background: PubMed 32616939Sugimine S, Saito S, Takazawa T. Normalized skin conductance level could differentiate physical pain stimuli from other sympathetic stimuli. Sci Rep. 2020 Jul 2;10(1):10950. doi: 10.1038/s41598-020-67936-0.
- Background: PubMed 22298942Wild J, Clark DM. Imagery Rescripting of Early Traumatic Memories in Social Phobia. Cogn Behav Pract. 2011 Nov;18(4):433-443. doi: 10.1016/j.cbpra.2011.03.002.
- Background: PubMed 32569854Siegesleitner M, Strohm M, Wittekind CE, Ehring T, Kunze AE. Improving imagery rescripting treatments: Comparing an active versus passive approach. J Behav Ther Exp Psychiatry. 2020 Dec;69:101578. doi: 10.1016/j.jbtep.2020.101578. Epub 2020 Jun 9.
- Background: PubMed 24277809Schiller D, Kanen JW, LeDoux JE, Monfils MH, Phelps EA. Extinction during reconsolidation of threat memory diminishes prefrontal cortex involvement. Proc Natl Acad Sci U S A. 2013 Dec 10;110(50):20040-5. doi: 10.1073/pnas.1320322110. Epub 2013 Nov 25.
- Background: PubMed 27855298Morina N, Lancee J, Arntz A. Imagery rescripting as a clinical intervention for aversive memories: A meta-analysis. J Behav Ther Exp Psychiatry. 2017 Jun;55:6-15. doi: 10.1016/j.jbtep.2016.11.003. Epub 2016 Nov 9.
- BackgroundConroy, D. E., Willow, J. P., & Metzler, J. N. (2002). Multidimensional fear of failure measurement: The performance failure appraisal inventory. Journal of applied sport psychology, 14(2), 76-90.
- Background: PubMed 10452174Arntz A, Weertman A. Treatment of childhood memories: theory and practice. Behav Res Ther. 1999 Aug;37(8):715-40. doi: 10.1016/s0005-7967(98)00173-9.
- Background: PubMed 22997340Agren T, Engman J, Frick A, Bjorkstrand J, Larsson EM, Furmark T, Fredrikson M. Disruption of reconsolidation erases a fear memory trace in the human amygdala. Science. 2012 Sep 21;337(6101):1550-2. doi: 10.1126/science.1223006.
- Derived from this study: PubMed 41625469Baczek J, Karkosz S, Pietruch M, Szymanski R, Michalowski JM. Imagine yourself as a little girl...-efficacy and psychophysiology of imagery techniques targeting adverse autobiographical childhood experiences- multi-arm randomised controlled trial. Front Psychol. 2026 Jan 16;16:1710963. doi: 10.3389/fpsyg.2025.1710963. eCollection 2025.
- Individual participant dataSharing planned: Undecided
Related trials for Fear of Failure
Recruiting
Optimization of Late Imagery Rescripting Research Using Generative Artificial Intelligence
Generalized Anxiety, Fear of Failure
Not yet recruiting
The Effect of Using Distractor Cards and Thermochromic Cards on Pain, Fear, Anxiety and Procedure Time in Children Receiving Inhaler Therapy
Pediatric Acute Upper Respiratory Tract Infection, Pediatric
Recruiting
Optimization of Imagery Rescripting Research Using Generative Artificial Intelligence
Generalized Anxiety, Fear of Failure
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.
Jarosław M. Michałowski, PhD principal investigator
SWPS University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Imagery Rescripting, Imagery Exposure and Imagery Rescripting with Disruption of Reconsolidation in people with Fear of Failure, run by University of Social Sciences and Humanities, Warsaw at 1 site in Poland.
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 4 inclusion and 6 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 20 Aug 2025. 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 Poland. 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?
The Performance Failure Appraisal Inventory (time frame: Screening, 2-weeks post-treatment (TP6), 3- & 6-month follow-up (TP7, TP8)). 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?
On the ClinicalTrials.gov record for NCT07048756, which also lists 10 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 20 Aug 2025.