Reward Processing and Exposure Therapy for Social Anxiety Disorder

Launched by UNIVERSITY OF CALIFORNIA, LOS ANGELES · Jan 8, 2025

Keywords

ClinConnect Summary

This clinical trial is studying how different treatments can help people with social anxiety disorder, particularly those who struggle with public speaking. Participants in the study will first be assigned to one of two treatments: a positive mood treatment, which aims to boost how good they feel, or a relaxation treatment, which helps them feel calmer. After this initial treatment, everyone will go through exposure therapy, where they will gradually face their fear of public speaking. The goal is to find out if starting with a positive mood or relaxation helps make the exposure therapy more effective.

To be eligible for this trial, participants should be between 18 and 60 years old, diagnosed with social anxiety disorder, and have significant fear of public speaking. They should also have low levels of feeling rewarded or enjoying things, and they need to be off certain medications for a specified period. Participants can expect to engage in therapy sessions designed to help them manage their anxiety in a supportive environment. It's important to note that individuals with a history of severe mental health issues or certain medical conditions may not qualify for this study.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Diagnosis of social anxiety disorder from the Structural Clinical Interview for DSM 5.
• • Elevated fear of public speaking, defined as a score of \>= 66 (+1SD from the mean of population norms on a scale of 17-85) on the Public Speaking Anxiety Scale (PSAS; Bartholomay, E. M., \& Houlihan, D. D. (2016). Public Speaking Anxiety Scale: Preliminary psychometric data and scale validation. Personality and individual differences, 94, 211-215), which is a self-report scale measuring anxiety of public speaking.
• • Low reward processing, defined as a score of \<56 (less than the population mean) on the Dimensional Anhedonia Rating Scale (DARS) (Rizvi, S. J., Quilty, L. C., Sproule, B. A., Cyriac, A., Bagby, R. M., \& Kennedy, S. H. (2015). Dimensional Anhedonia Rating Scale (DARS) \[Database record\]. APA PsycTests).
• • Medication-free or stabilized on psychotropic medications for a minimum standard length of time (1 month for benzodiazepines and beta blockers, 3 months for SRIs/SNRIs and heterocyclics).
• • Psychotherapy-free or stabilized on alternative psychotherapies other than cognitive or behavioral therapies that were not focused on their anxiety disorder for at least 6 months prior to study entry.
• • Age 18-60. Fluent in English. To conduct MRI version of fear conditioning task, must have no MRI contraindications.
• Exclusion Criteria (none of the following):
• • Recent suicidal ideation with intent or plan - defined as suicidal ideation with intent or plan in the past year.
• • Lifetime history of suicide attempts. History of bipolar disorder, psychosis, intellectual disability, or organic brain damage.
• • Substance use disorder within the last 6 months. Major respiratory, cardiovascular, pulmonary, neurological, or muscular-skeletal diseases.
• • Pregnant or planning to become pregnant for next 6 months.