At a glance
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Reward Processes and Rehearsal in Exposure Therapy
In Brief
A clinical study evaluating Exposure and Rehearsal for Anxiety Disorders and Public Speaking Fear. Completed, enrolled 88 participants across 1 site.
Detailed Summary
The purpose of this study is to 1) examine the importance of self-reported relief following exposure and 2) test whether positive-focused rehearsal following exposure can improve treatment outcomes for participants who endorse fear of public speaking. Exposure therapy is an extinction-based behavioral technique, often employed in the context of cognitive behavioral therapy. It involves strategically exposing an individual to a feared stimulus in an effort to generate new non-fear associations with that stimulus. Relief refers to the positive, rewarding emotions associated with the absence of an expected aversive outcome following exposure to a feared stimulus. In the current study, participants will engage in a series of short public speaking exposures that take place over two sessions. After every two exposures, participants will be asked to complete either a positive or neutral rehearsal exercise, consisting of recalling either positive or neutral aspects of the speech exposures. At multiple points throughout the study, participants will complete ratings of reward sensitivity, positive affect, relief, and expectancy of the aversive outcome. The investigators will test the following: 1) the relationship of reward sensitivity and positive affect with relief following exposures, 2) the relationship between relief after exposure and learning rate (i.e., learning that the feared stimulus does not predict an aversive outcome), 3) potential differences in exposure outcomes between the positive and neutral rehearsal groups.
Study Details
Timeline
Interventions
All participants complete two study visits, each consisting of 8 exposure trials for durations of 1 minute each, resulting in a total of 16 exposures. For each exposure, participants are assigned a speech topic and given 1 minute to give an unprepared speech to two study confederates.
After every two exposures, participants will complete a rehearsal task where the participant is asked to use a positive or neutral approach to remember and recount the exposures they have just completed.