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Principal Investigator: Mikael Rubin
Organization: PALO ALTO UNIVERSITY
Fiscal Year: 2024
Award: $335,000
Funding agency: National Institute of Mental Health
Project Summary (Abstract)
Social anxiety is a prevalent mental health concern that impacts approximately 12% of the US population. Yet,
the majority of individuals with social anxiety do not receive treatment in large part because it is difficult to access
mental health resources. There is a need for targeted mechanism-focused interventions for social anxiety that
are also highly scalable. The PI developed a naturalistic paradigm to study social anxiety using simulated
teleconferencing interactions and demonstrated their utility for both eliciting social evaluative threat and testing
attention and audio vocal mechanisms. The PI then used these simulated teleconferencing interactions as the
basis of a new brief exposure-focused self-guided internet-based intervention called iExposure. The intervention
only required four sessions, completed over two weeks. The pilot study also tested two potential attention
mechanisms thought to maintain social anxiety, avoidance and attention control. Results were promising, with
the majority of participants completing the entire intervention and reporting medium-large decreases in
symptoms of social anxiety. Additionally, the attention augmentations appeared to enhance the efficacy of the
intervention. However, a larger study is needed to validate these results and to test potential mechanisms in
social anxiety. The overarching goal of this proposal is to test several mechanisms implicated in social anxiety
using the newly developed self-guided internet-based intervention called iExposure. Aim 1 will directly test two
different attention mechanisms implicated in social anxiety by augmenting iExposure with attention guidance or
attention control. Aim 2 will test the causal role of attentional processes in the intervention’s efficacy for reducing
social anxiety symptoms through mediation and moderation models. Aim 3 will test the role of engagement
(proportion of time spent speaking) as a causal factor in treatment outcomes and other audio vocal features
(pitch or amplitude) as potential predictors of treatment response. This project will provide graduate student
mentees experience with mechanism-focused research in the context of a clinical trial. Additionally, mentees will
learn a highly adaptable framework for conducting internet-based interventions for their own future mentored
research. Mentees will also gain advanced theoretical, technical, and statistical knowledge critical for conducting
eye movement (i.e., visual attention) and audio-vocal based research. This proposal will also offer mentees
opportunities to connect with the scientific community through conference presentations and journal publications,
as well as provide them with training opportunities in other labs. Findings will test potential targetable and
modifiable mechanisms maintaining social anxiety, in the context of a highly adaptable and scalable internet
intervention framework. Results may inform tailored treatments for individuals with social anxiety addressing
person-specific maintaining factors. Taken together, this project offers important advances in the training of
future clinical scientists and the development of targeted digital therapeutics for social anxiety.
Terms: <18 year old><18 years of age><21+ years old><Access to Care><Address><Adult><Adult Human><Attention><Behavior><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Caring><Clinical><Clinical Sciences><Clinical Trials><Cognition Therapy><Cognitive Psychotherapy><Cognitive Therapy><Cognitive treatment><Communities><Computer software><Data><Development><Elements><Evidence based treatment><Experimental Therapies><Exposure to><Eye Movements><Fear><Fostering><Fright><Future><Goals><Health Resources><Health Services Accessibility><Heterogeneity><Home><Individual><International><Internet><Intervention><Intervention Strategies><Investigational Therapies><Investigational Treatments><Investigators><Journals><Knowledge><Learning><Loudness><Magazine><Mediating><Mediation><Mediator><Mental Health><Mental Hygiene><Mentors><Modeling><Negotiating><Negotiation><Outcome><Participant><Persons><Pilot Projects><Population><Prediction of Response to Therapy><Prevalence><Process><Protocol><Protocols documentation><Psychological Health><Publications><Randomized Controlled Clinical Trials><Reporting><Research><Research Methodology><Research Methods><Research Personnel><Researchers><Role><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Sampling><Scientific Publication><Scientist><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Software><Symptoms><Teleconferences><Testing><Therapeutic Intervention><Time><Training><Treatment Efficacy><Treatment outcome><Visual attention><WWW><access to health services><access to services><access to treatment><accessibility to health services><adulthood><age 18 years><anxiety symptoms><anxious symptom><arm><attentional control><availability of services><care access><clinical significance><clinically significant><cognitive behavior intervention><cognitive behavior modification><cognitive behavior therapy><cognitive behavioral intervention><cognitive behavioral modification><cognitive behavioral therapy><cognitive behavioral treatment><conference><convention><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><customized therapy><customized treatment><developmental><digital therapeutics><digital therapy><digital treatment><efficacious therapy><efficacious treatment><efficacy testing><eighteen year old><eighteen years of age><experience><experimental therapeutic agents><experimental therapeutics><eye tracking><gaze><graduate student><health service access><health services availability><homes><improved><individual response><individualized medicine><individualized patient treatment><individualized response><individualized therapeutic strategy><individualized therapy><individualized treatment><insight><internet-based intervention><intervention efficacy><intervention therapy><interventional strategy><member><new technology><next generation><novel technologies><participant engagement><patient engagement><patient specific therapies><patient specific treatment><personalization of treatment><personalized medicine><personalized therapy><personalized treatment><pilot study><predict therapeutic response><predict therapy response><randomized control clinical trial><research and methods><response to therapy><response to treatment><screening><screenings><service availability><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><social><social anxiety><social factors><social interventions><social role><social situation><socially anxious><summit><symposia><symposium><tailored medical treatment><tailored therapy><tailored treatment><therapeutic efficacy><therapeutic response><therapy efficacy><therapy optimization><therapy prediction><therapy response><training opportunity><treatment access><treatment optimization><treatment prediction><treatment response><treatment response prediction><treatment responsiveness><treatment strategy><undergrad><undergraduate><undergraduate student><unique treatment><virtual reality><virtual reality exposure><visual tracking><web><web-based intervention><world wide web>