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Social anxiety (SA) is a highly prevalent mental health concern, thought to disproportionately affect youth with recent international estimates of more than 30% of individuals reporting clinically elevated symptoms. Despite the prevalence of SA, as few as one in five individuals receive care, due to limited access to evidence-based treatments. Additionally there has been a notable increase in social anxiety since the start of the COVID-19 pandemic. This proposal will use iExposure to develop a personalized mechanism-focused approach to optimizing treatment response for individuals with social anxiety by testing standard iExposure against two augmentations that incorporate distinct attention mechanisms (attention guidance and attention control).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard iExposure | Active Comparator | iExposure. Participants will complete four intervention sessions within two weeks. The intervention will use an entirely self-guided protocol delivered via Qualtrics and Gorilla Experiment Builder:
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| iExposure + Attention Guidance Augmentation | Experimental | Attention Guidance Augmentation. The attention guidance condition consists of two unique components in addition to the standard iExposure intervention: (1) the intervention rationale will include information about the importance of visually attending to the faces of the audience; (2) participants will be given a target audience member to focus their gaze on during each impromptu response. They will be told that they should look at and focus on the target audience member for the whole response. In each progressive session the number of trials where the participant is directed to focus on an uninterested audience member will increase. |
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| iExposure + Attention Control Augmentation | Experimental | The attention control condition consists of two unique components in addition to the standard iExposure intervention (1) the intervention rationale will include information about the importance of developing attention control; (2) participants will be given a central region of the screen (non-audience member) to focus on. They will be told that they should look at and focus on the central region for the whole response. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| iExposure | Behavioral | There will be 4 treatment sessions, covering the iExposure intervention. The intervention and assessment process is entirely self-guided. Each session will last approximately 60 minutes. Participants will complete 10 mock-interaction trials for each session. |
| Measure | Description | Time Frame |
|---|---|---|
| Liebowitz Social Anxiety Scale Self Report Version | The Liebowitz Social Anxiety Scale Self Report Version is a 48-item self-report measure of fear and avoidance concerning social interactions and performance situations (e.g., telephoning in public, talking to people in authority). The range of scores is 0-144; higher scores are worse. | 0 days |
| Liebowitz Social Anxiety Scale Self Report Version | The Liebowitz Social Anxiety Scale Self Report Version is a 48-item self-report measure of fear and avoidance concerning social interactions and performance situations (e.g., telephoning in public, talking to people in authority). The range of scores is 0-144; higher scores are worse. | 15 days |
| Liebowitz Social Anxiety Scale Self Report Version | The Liebowitz Social Anxiety Scale Self Report Version is a 48-item self-report measure of fear and avoidance concerning social interactions and performance situations (e.g., telephoning in public, talking to people in authority). The range of scores is 0-144; higher scores are worse. | 45 days |
| Personal Report of Communication Apprehension (PRCA) | The Personal Report of Communication Apprehension is a 24-item that assesses anxiety related to speaking in a variety of situation. The range of scores is 24-120; higher scores are worse. | 0 days |
| Personal Report of Communication Apprehension | The Personal Report of Communication Apprehension is a 24-item that assesses anxiety related to speaking in a variety of situation. The range of scores is 24-120; higher scores are worse. | 15 days |
| Personal Report of Communication Apprehension |
| Measure | Description | Time Frame |
|---|---|---|
| Center for Epidemiologic Studies Depression Scale - Revised | The Center for Epidemiologic Studies Depression Scale - Revised is a 20-item measure of depression. The range of scores is 0-60; higher scores are worse. | 0 days |
| Center for Epidemiologic Studies Depression Scale - Revised |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Palo Alto University | Palo Alto | California | 94304 | United States |
IPD will be shared as part of the National Institute of Mental Health Data Archive
All publications will be posted to the PubMed database, consistent with the National Institutes of Health Public Access Policy and have an NDA study linking the analytical output to the underlying data collection, including a description of the analytic methodology, derived variables, and the statistical/analytical model outputs. Each of these studies is assigned a digital object identifier (DOI). This data DOI will be included in any resulting manuscripts to facilitate easy access to the data used for the publication. Data not previously shared through an NDA study will be made available at the end of the project period. Researchers will request data using standard NDA application processes, and the NDA committee will decide which requests are provided. The standard NDA access process allows access for one year and is renewable. Once the data are submitted to NDA, NDA will control the long-term persistence of the data.
Access will be controlled by the National Institute of Mental Health Data Archive Data Access Committee
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| iExposure plus attention guidance | Behavioral | The attention guidance condition consists of two unique components in addition to the standard iExposure intervention: (1) the intervention rationale will include information about the importance of visually attending to the faces of the audience; (2) participants will be given a target audience member to focus their gaze on during each impromptu response. They will be told that they should look at and focus on the target audience member for the whole response. In each progressive session the number of trials where the participant is directed to focus on an uninterested audience member will increase. |
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| iExposure plus attention control | Behavioral | The attention control condition consists of two unique components in addition to the standard iExposure intervention (1) the intervention rationale will include information about the importance of developing attention control; (2) participants will be given a central region of the screen (non-audience member) to focus on. They will be told that they should look at and focus on the central region for the whole response. |
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The Personal Report of Communication Apprehension is a 24-item that assesses anxiety related to speaking in a variety of situation. The range of scores is 24-120; higher scores are worse. |
| 45 days |
The Center for Epidemiologic Studies Depression Scale - Revised is a 20-item measure of depression. The range of scores is 0-60; higher scores are worse. |
| 15 days |
| Center for Epidemiologic Studies Depression Scale - Revised | The Center for Epidemiologic Studies Depression Scale - Revised is a 20-item measure of depression. The range of scores is 0-60; higher scores are worse. | 45 days |