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The current study aims at comparing the efficacy of exposure in vivo and exposure via virtual reality for social anxiety disorder. 70 patients with social anxiety disorder will be randomized to either one of the active conditions or to a waiting-list condition. Participants on the waiting-list will be offered either exposure in vivo of in virtual reality after a waiting period of five weeks. Levels of psychopathology will be assessed at pre- and post-treatment as well as three and 12 months after treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exposure in vivo | Experimental | This treatment will consist of 10 sessions (twice a week) of exposure therapy based on the protocol used previously in exposure therapy for social anxiety disorder by Scholing & Emmelkamp (1993). |
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| Virtual Reality Exposure Therapy | Experimental | This treatment consists of 10 sessions (twice a week) of exposure therapy by using virtual environments. The difference between the exposure in vivo and virtual reality exposure therapy is the exposure component, which will be delivered in vivo in one condition and through the Head Mounted Display (HMD) in the other condition. |
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| Wait-list | No Intervention | Participants on the wait-list will be offered either exposure in vivo or in virtual reality after a waiting period of five weeks. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exposure in vivo | Behavioral |
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| Virtual Reality Exposure Therapy |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline: Liebowitz Social Anxiety Scale-Self report | Change from pre-treatment to post-treatment (5 weeks), 3 months follow-up and 12 months follow-up. | Pre-treatment to post-treatment (5 weeks), three months follow-up, and 12 months follow-up. |
| Change from baseline: Fear of Negative Evaluation Scale | Change from pre-treatment to post-treatment (5 weeks), 3 months follow-up and 12 months follow-up. | Pre-treatment to post-treatment (5 weeks), three months follow-up, and 12 months follow-up. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline: Behavioral Assessment Task (BAT), Public Speaking Performance Scale | The BAT consists of a videotaped 5 minute impromptu speech in front of two confederates. The Public Speaking Performance Scale will be used to evaluate the performance during the speech, both by patients and indipendent raters. Change from pre-treatment to post-treatment (5 weeks) will be examined. | Pre-treatment to post-treatment (5 weeks) |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline and in-treatment change: Focus of Attention Questionnaire | Focus of Attention will be assessed during the course of four weeks of exposure therapy that will take place twice a week (session 3 until 9). Change from pre-treatment to post-treatment (5 weeks) as well as change during treatment (four weeks) will be assessed. | Pre-treatment to post-treatment (5 weeks), change during the course of four weeks of exposure therapy (session 3 until 9) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Paul GM Emmelkamp, PhD | University of Amsterdam | Principal Investigator |
| Nexhmedin Morina, PhD | University of Amsterdam | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Amsterdam, Department of Clinical Psychology | Amsterdam | 1018 XA | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30795749 | Derived | Kampmann IL, Emmelkamp PMG, Morina N. Cognitive predictors of treatment outcome for exposure therapy: do changes in self-efficacy, self-focused attention, and estimated social costs predict symptom improvement in social anxiety disorder? BMC Psychiatry. 2019 Feb 22;19(1):80. doi: 10.1186/s12888-019-2054-2. |
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| ID | Term |
|---|---|
| D000072861 | Phobia, Social |
| ID | Term |
|---|---|
| D010698 | Phobic Disorders |
| D001008 | Anxiety Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D063367 | Virtual Reality Exposure Therapy |
| ID | Term |
|---|---|
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D003887 | Desensitization, Psychologic |
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| Behavioral |
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| Change from baseline: Structured Clinical Interview for DSM-IV (Social Phobia Module) | Change in diagnosis of Social Phobia from pre-treatment to three months follow-up. | Pre-treatment to three months follow-up. |
| Change from baseline: Depression Anxiety Stress Scale | Change from pre-treatment to post-treatment (5 weeks), 3 months follow-up and 12 months follow-up. | Pre-treatment to post-treatment (5 weeks), three months follow-up, 12 months follow-up. |
| Change from baseline: Personality Disorder Belief Questionnaire | Change from pre-treatment to post-treatment (5 weeks), 3 months follow-up and 12 months follow-up. | Pre-treatment to post-treatment (5 weeks), three months follow-up, 12 months follow-up. |
| Change from baseline: Eurohis Quality of Life Scale | Change from pre-treatment to post-treatment (5 weeks), 3 months follow-up and 12 months follow-up. | Pre-treatment to post-treatment (5 weeks), three months follow-up, 12 months follow-up. |
| In-treatment change: Social Phobia Weekly Summary Scale | The Social Phobia Weekly Summary Scale will be used in each session during the course of the treatment that will take place twice a week (session 1 until 10). Change during treatment will be assessed. | Change from session to session during the course of five weeks (i.e., session 1 until 10) |
| Change from baseline:Social Cost Questionnaire | Change from pre-treatment to sessino 7 (3,5 weeks) and to post-treatment (5 weeks). | Pre-treatment to session 7 (3,5 weeks) and post-treatment (5 weeks) |
| Experiences in Close Relationships Questionnaire | Pre-treatment |
| In treatment change: Self-efficacy for Social Situations | Self-efficacy will be used in each session during the course the treatment that will take place twice a week (session 1 until 10). Change during treatment will be assessed (5 weeks). | Change from session to session during the course of five weeks (i.e., session 1 until 10) |
| In-treatment change: Working Alliance Inventory -Short Revised | Change during treatment (with an expected average of two weeks) will be assessed. | Session 3 to session 6 (two weeks) |
| Simulator Sickness Questionnaire | This scale will be used in the Virtual Reality condition only | Session 2 (first week of treatment) |
| Credibility and Expectancy Questionnaire | Session 3 (second week of treatment) |
| In-treatment change: Ingroup Presence Questionnaire | This scale will be used in the Virtual Reality condition only to measure change in the sense of presence from session 2 to session 3 (one week) and session 6 (three weeks). | Session 2 to session 3 (one week) and session and 6 (three weeks). |
| Change from baseline: Dot-Probe Task | An implicit measure to assess attentional bias in social phobia. Change from pre-treatment to post-treatment (5 weeks), 3 months follow-up and 12 months follow-up. | Pre-treatment to post-treatment (5 weeks), three months follow-up, and 12 months follow-up. |
| Change from baseline: Approach Avoidance Task | A computer task to assess automatic approach and avoidance tendencies by measuring reaction times for pushing away or pulling closer faces with a joystick. Change from pre-treatment to post-treatment (5 weeks), 3 months follow-up and 12 months follow-up. | Pre-treatment to post-treatment (5 weeks), three months follow-up, and 12 months follow-up. |