Assessing and training fear inhibition in spider phobia via eye-movements

ISRCTN ISRCTN12918583
DOI https://doi.org/10.1186/ISRCTN12918583
Submission date
23/02/2022
Registration date
28/02/2022
Last edited
02/09/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aim
Anxiety and fear can be characterized by a shift of attention in favor of threatening stimuli. According to the Attentional-Control-Theory, this bias is associated with a decreased inhibition of bottom-up perceptual processes. Inhibitory control can be investigated by means of the antisaccade task, in which participants are required to look into the opposite direction of a stimulus in the peripheral visual field. Higher antisaccade latencies and error rates thereby indicate inhibitory control deficits, which are considered a pathogenic factor in anxiety disorders. In line with this, previous studies have revealed an impaired antisaccade performance in participants with subclinical anxiety. However, studies investigating clinical populations are sparse.
This study has three main goals: First, we aim to compare the antisaccade performance of spider phobic patients with healthy control participants. Second, we aim to investigate associations between antisacccade performance and psychophysiological (heart rate, skin conductance level, startle response) as well as behavioral measures of fear (ratings, behavioral avoidance test) towards threatening stimuli. Third, this study aims to explore effects of an antisaccade training on inhibitory control (indexed by antisaccade performance), as well as psychophysiological and behavioral measures of fear.

Who can participate?
Patients with a specific phobia of the animal subtype (spiders) who fulfill the criteria for a specific phobia.
Healthy participants who do not fulfill the criteria for a specific phobia and do not exceed a value of 19 points in the spider phobia questionnaire (SPQ).

What does the study involve?
Participants take part in a brief screening and a diagnostic interview via telephone. If they meet the inclusion criteria, they will provide informed consent, fill in psychometric questionnaires and participate in laboratory assessments (2-3 hours for healthy controls and 3-4 hours for patients with spider phobia): First, a baseline assessment including a Behavioral Avoidance Test (BAT), a free viewing paradigm with physiological assessments (heart rate, skin conductance level, startle response), and the anti-saccade task with an eye-tracking assessment will be obtained. Second, participants are randomized into two intervention groups receiving an anti-saccade (experimental group) or a pro-saccade training (control group). Afterwards, the post-1-assessment of the antisaccade task and the BAT are conducted.
From this point on the assessment continues only for participants with specific phobia. These switch training conditions and then participate in the post-2-assessment composed of the antisaccade task, the free viewing physiological assessment, and the BAT.

What are the possible benefits and risks of participating?
Results of this study shed light to pathogenic mechanisms involved in pathological anxiety and their modulation. As such, it may inform future research and clinical approaches of anxiety treatment. The risks of participating in the study are a short increase of anxiety, due to the anxiety-inducing stimuli, loud startle noises, and fatigue of the eyes.

Where is the study run from?
University of Siegen (Germany) and University of Münster (Germany)

When is the study starting and how long is it expected to run for?
June 2021 to December 2023

Who is funding the study?
DGPs (German Society for Psychology: Biological Psychology and Neuropsychology)
Movisens (Germany)
Innovative Medizinische Forschung (IMF) of the medical faculty of Münster (Germany)

Who is the main contact?
Dr. Kati Roesmann (Kati.Roesmann@uni-siegen.de)
Fabian Breuer M.Sc. (breuerfa@uni-muenster.de)

Contact information

Dr Kati Roesmann
Principal Investigator

Obergraben 23
Siegen
57072
Germany

ORCiD logoORCID ID 0000-0001-6940-3551
Phone +49 271 740-5123
Email Kati.Roesmann@uni-siegen.de

Study information

Study designInterventional randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typeOther
Participant information sheet Not available in web format, please use contact information to request a participant information sheet
Scientific titleInhibitory control and its modification in specific phobia - An antisaccade study
Study acronymSPIN
Study objectivesH1: Phobics will show higher latencies and error rates, i.e. a poorer performance, than healthy controls in the antisaccade paradigm.
H1.1: Differences in antisaccade performance between phobics and healthy controls are higher when using phobia-related vs. neutral stimuli.
H2: Latencies and error-rates in the anti-saccade task are correlated with physiological (skin conductance response, heart rate, startle-response) and behavioral measures of fear.
H3: The anti-saccade training improves antisaccade performance (i.e., lower error rates, and shorter latencies)
H4: Changes in antisaccade performance are associated with changes in behavioral and physiological measures of fear.
Ethics approval(s)Approved 08/09/2021, Ethics Committee of the University of Siegen (Adolf-Reichwein-Str. 2a, NA, 57076, Germany; +49 0271 740-4819; ethikrat@uni-siegen.de), ref: ER_39/2021
Health condition(s) or problem(s) studiedInhibitory control in specific phobia of the animal typus (spider).
InterventionIntervention group: Antisaccade training
Control group: Prosaccade training
Participants will be randomised into the two groups by a randomisation sheet.

Antisaccade Training: Visual stimuli (pictures of spiders) will be presented on a screen in the left or right peripheral visual field. Participants are instructed to look at the mirrored position on the screen. The duration of this training is 15 minutes including short breaks.
Prosaccade Training: Visual stimuli (pictures of neutral objects) will be presented on a screen in the left or right peripheral visual field. Participants are instructed to look at the presented stimulus. The duration of this training is 15 minutes including short breaks.
Intervention typeBehavioural
Primary outcome measureAntisaccade latencies will be measured in the antisaccade task at baseline, post-1-, and - for spider phobics only - post-2-assessment. All assessments take place on one day.
Secondary outcome measuresAntisaccade error rates will be measured in the antisaccade task at baseline, post-1-, and - for spider phobics only - post-2-assessment. All assessments take place on one day
Overall study start date01/06/2021
Completion date31/12/2023

Eligibility

Participant type(s)Mixed
Age groupAdult
Lower age limit18 Years
Upper age limit65 Years
SexBoth
Target number of participants60 (30 patients with spider phobia, 30 healthy control participants)
Key inclusion criteria1. 18-65 years
2. Specific phobia (animal-subtype: spider) and healthy controls
3. Normal or corrected-to normal vision
4. Normal hearing
Key exclusion criteria1. Lifetime diagnosis of substance-related bipolar or psychotic disorder
2. Current psychiatric disorder or a psychiatric disorder in the past (exception for spider phobics: past mild to moderate depressive episode and/or current or past specific phobia of the animal typus)
3. Medication (Benzodiazepine, Barbiturate)
4. Neurological disorder (especially epilepsy)
5. Dementia
6. Injury of the central nervous system
7. Hearing disorder (also tinnitus anamnestic), subjective auditory hypersensitivity (like hyperacusis)
8. Regular nicotine consumption (>5 cigarettes/day)
9. Known allergy to bites of insects or arachnids
Date of first enrolment01/03/2022
Date of final enrolment31/12/2023

Locations

Countries of recruitment

  • Germany

Study participating centre

University of Siegen
Obergraben 23
Siegen
57072
Germany

Sponsor information

University of Siegen
University/education

Adolf-Reichwein-Straße 2
Siegen
57076
Germany

Phone +49 271 740-4106
Email tim.klucken@psychologie.uni-siegen.de
Website https://www.uni-siegen.de/start/
ROR logo "ROR" https://ror.org/02azyry73

Funders

Funder type

University/education

Medizinische Fakultät, Westfälische Wilhelms-Universität Münster
Government organisation / Local government
Alternative name(s)
Medical Faculty Münster, Medical Faculty, WWU Münster, Medizinische Fakultät Münster
Location
Germany
German Society for Psychology: Biological Psychology and Neuropsychology

No information available

Movisens

No information available

Results and Publications

Intention to publish date31/12/2024
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal
IPD sharing planData are available upon reasonable request.
Kati.Roesmann@uni-siegen.de, breuerfa@uni-muenster.de

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Statistical Analysis Plan A SAP on planned analyses of data obtained during the baseline assessment
version 1.0
30/11/2022 09/12/2022 No No
Statistical Analysis Plan A SAP on planned analyses of data obtained during the intervention assessment
version 1.0
12/04/2023 No No
Protocol article 19/12/2023 08/01/2024 Yes No
Statistical Analysis Plan 02/09/2024 No No

Additional files

ISRCTN12918583 SAP_Baseline v1.0 30Nov2022.pdf
A SAP on planned analyses of data obtained during the baseline assessment
ISRCTN12918583_SAP_Intervention_v1.0.pdf
A SAP on planned analyses of data obtained during the intervention assessment
ISRCTN12918583_SAP_Aim3.pdf

Editorial Notes

02/09/2024: Uploaded statistical analysis plan.
21/08/2024: Uploaded statistical analysis plan.
08/01/2024: Publication reference added.
12/04/2023: Uploaded statistical analysis plan.
09/12/2022: Uploaded statistical analysis plan.
25/02/2022: Trial's existence confirmed by University of Siegen