ClinicalTrials.gg
Not yet recruitingNCT07813364FobiAppUpdated Sep 10, 2026

Facing Fears From Home: Development, Feasibility and Maximization of FobiApp

An interventional study of FobiApp AR Exposure therapy, Self-administered augmented reality exposure for cockroach phobia and FobiApp AR Exposure therapy + ABM, Self- administered augmented reality exposure combined with attentional bias modification training for cockroach phobia. in Specific Phobia, sponsored by Universitat Jaume I. Not yet recruiting at 1 site in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-10.

Sponsored by Universitat Jaume I · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The aim of this study is to evaluate the feasibility (including usability, acceptance and satisfaction) and preliminary effectiveness of a smartphone App for self-administered exposure therapy using Augmented reality for cockroach phobia (FobiApp), compared to the same self-administered exposure therapy combined with training in attentional bias modification (ABM).

Read the detailed description

Specific phobia (SP) is an intense and disproportionate fear or anxiety response toward a specific object or situation, which is actively avoided or confronted with significant distress. The prevalence of specific phobias is high, with annual prevalence estimates ranging from 3% to 15%. Despite this, only a small proportion of affected individuals seek or receive psychological treatment.

Currently, the treatment of choice for specific phobias is exposure to the feared stimulus, which involves systematic and gradual confrontation to reduce fear responses. In vivo exposure therapy, which consists of direct confrontation with the feared stimulus in real-life situations, has the strongest empirical support, although it has certain limitations. Although exposure therapy is the gold-standard treatment, barriers such as patient reluctance and logistical constraints limit its dissemination. Technological advances, including augmented reality-based exposure and attentional bias modification, have emerged as promising approaches to increase accessibility and effectiveness of interventions.

This study will be conducted following the extension of the Consolidated Standards of Reporting Trials (CONSORT) statement for pilot and feasibility studies, the Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and online

TeleHealth guidelines, and the Standard Protocol Items:

Recommendations for Interventional Trials (SPIRIT) guidelines.

Specific objectives of the study include: (1) To analyse the feasibility of different recruitment and data collection methods (e.g., how broad or restrictive are the eligibility criteria, how willing are patients to participate, time needed to collect data), (2) To explore reasons for non-participation and drop-outs from treatment, (3) To assess patient satisfaction and acceptance of treatment (both quantitatively and qualitatively), (4) In addition, as a secondary objective to explore the potential effectiveness of the treatment at post-treatment and treatment at post-treatment and follow- up. A total of 40 participants will be included in the feasibility trial, with 20 participants per group.

Data will be analyzed using descriptive statistics to summarize sociodemographic and clinical characteristics, as well as feasibility outcomes including recruitment, adherence, and dropout rates. Normality assumptions will be assessed prior to analysis. Feasibility indicators will be expressed as percentages with confidence intervals. Preliminary efficacy outcomes will be explored using within-group (pre-post and follow-up) and between-group comparisons, and effect sizes will be calculated. Quantitative analyses will be performed using IBM SPSS Statistics. Qualitative data will be analyzed using thematic analysis to identify themes related to acceptability and user experience.

02

Conditions studied

  • Specific Phobia

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Keywords

  • Attention Bias Modification
  • Augmented Reality
  • Cockroach Phobia
  • Cognitive Bias Modification
  • Exposure Therapy
  • Mobile Application
  • Animal Phobia
03

In context

Phobia, Specific

85 studies on the registry are indexed under Phobia, Specific; 13 are open to participants now.

This study's planned enrollment of 40 is below the median of 74 across 81 interventional studies indexed under Phobia, Specific.

Browse Phobia, Specific studies →

Lead sponsor

Universitat Jaume I is the lead sponsor of 80 studies on the registry; 19 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥ 18 years
  • Meeting diagnostic criteria for Specific Phobia (animal subtype: cockroaches) based on diagnostic criteria.
  • Have had the phobia for at least one year.
  • Having a score of at least 4 on the fear and avoidance scales of the administered diagnostic interview.
  • Sign an .
  • Having a smartphone and access to the Internet.
  • Having an e-mail address.

Exclusion criteria

Exclusion Criteria:

  • Presence of another psychological problem that requires immediate attention
  • Having current dependence or abuse of alcohol or drugs, psychosis or serious organic disease.
  • Being currently treated in a similar treatment program.
  • Being able to put his/her hands into a plastic container with a cockroach (during the behavioral test).
  • Taking anxiolytics during the study (or if taking them, changing the drug or dose during the study).
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Active comparator
    FobiApp with self-administered AR exposure therapy alone.

    Participants receive the standard intervention consisting solely of the self-administered AR exposure therapy module via FobiaApp. Compliance requires utilizing the app for 30 minutes per session, 3 times per week for 2 weeks period.

    Behavioral: FobiApp AR Exposure therapy, Self-administered augmented reality exposure for cockroach phobia

  • Active comparator
    FobiApp with AR exposure therapy combined with ABM.

    Participants first complete the augmented reality exposure therapy module following the same protocol (30 minutes per session, 3 times per week for 2 weeks). Following this, for an additional two weeks, participants complete the ABM training module. This module requires participants to complete progressive levels of ABM that involve, on the one hand, changes aimed at reducing the initial rapid detection of cockroaches (hypervigilance bias) and, on the other hand, prolonged visual focus on cockroaches to produce changes aimed at reducing avoidance behavior (avoidance bias) and thus address and modify attentional biases related to the phobia (hypervigilance-avoidance attentional biases).

    Behavioral: FobiApp AR Exposure therapy + ABM, Self- administered augmented reality exposure combined with attentional bias modification training for cockroach phobia.

Interventions

  • BehavioralFobiApp AR Exposure therapy, Self-administered augmented reality exposure for cockroach phobia

    The intervention will be delivered through a mobile application (FobiApp) that offers AR self-exposure therapy and ABM training for cockroach phobia. The AR Exposure Module consists of progressively increasing levels of difficulty and intensity, controlled by predefined variables (number of cockroaches, location, and required behavior). These levels are interspersed with psychoeducation (addressing fear, anxiety, and the justification for exposure) and educational information to debunk catastrophic beliefs. Participants are instructed to use the AR module for two weeks, at least three times per week, for 30 minutes per session.

  • BehavioralFobiApp AR Exposure therapy + ABM, Self- administered augmented reality exposure combined with attentional bias modification training for cockroach phobia.

    The ABM Module (administered once participants in Arm 2 have completed the exposure module) presents different levels that require specific behaviors, such as directing initial attention to a positive stimulus instead of the cockroach and maintaining visual attention on the cockroaches for an extended period. This training aims to systematically modify hypervigilance and sustained attentional biases inherent in cockroach phobia.

06

What researchers measure

Primary outcomes

  1. Expectations and Satisfaction Questionnaire adapted from Borkovec and Nau (1972).

    Participants' expectations and Satisfaction about the intervention will be assessed before the start of the treatment using the Expectations and Satisfaction Scales adapted from Borkovec and Nau (1972). This questionnaire consists of two different scales. Both include 6 items rated from 1 ("Not at all") to 10 ("Highly"), and provide information on the degree to which: 1) the treatment is perceived as logical; 2) patients are satisfied 3) would recommend the treatment to a friend with the same problem; 4) the treatment would be useful for treating other psychological problems; 5) patients perceive the treatment as useful for their specific problem; and 6) the treatment is perceived as aversive.

    Time frame: Baseline (pre-treatment), immediately after the intervention (post-treatment) and follow-up 6 months after the intervention

  2. Quantitative and qualitative opinion measure

    Participants' satisfaction and opinions about the intervention A semi-structured opinion interview including both quantitative and qualitative questions will be administered, adapted from a previous feasibility study conducted by the research group (Mor et al., 2022).

    Time frame: immediately after the intervention (post-treatment)

  3. Total score obtained in System Usability Scale (SUS)

    Users respond to 10 statements using a 5-point Likert scale (where 1 = strongly disagree and 5 = strongly agree, offering a final score from 0 to 100.

    Time frame: immediately after the intervention (post-treatment)

Secondary outcomes

  1. Change in Behavioral Avoidance Test (BAT; adapted from Öst, Salkovskis, & Hellström's, 1991).

    Behavioral avoidance will be assessed using a Behavioral Avoidance Test (BAT), adapted from Öst, Salkovskis, and Hellström (1991), which measures participants' ability to approach cockroach-related stimuli during a structured behavioral task.

    Time frame: Baseline (pre-treatment), immediately after the intervention (post-treatment) and follow-up 6 months after the intervention

  2. Change in Fear of Cockroaches Questionnaire (adapted from Fear of Spiders Questionnaire; FSQ, Szymanski &; O'Donohue, 1995).

    Fear of cockroaches will be assessed using the Fear of Spiders Questionnaire adapted for cockroach phobia (FSQ; adapted from Szymanski \& O\'Donohue, 1995). This self-report questionnaire measures the intensity of fear associated with cockroach-related situations.

    Time frame: Baseline (pre-treatment), immediately after the intervention (post-treatment) and follow-up 6 months after the intervention

  3. Change in attentional biases.

    Attentional bias will be measured using an eye-tracking task designed to assess visual attention patterns (hypervigilance and sustained attention) toward cockroach-related stimuli. Specifically, this task assessesthe attentional biases in terms of total time spent in looking at cockroaches, first fixation direction and the number and duration of fixations.

    Time frame: Baseline (pre-treatment), after the intervention (post- treatment), and 6 months after the intervention

  4. Change in Fear and Avoidance Scales (adapted from Marks & Mathews, 1979).

    Patient improvement will be assessed using The Clinician Severity Scale (adapted from Di Nardo, Brown \& Barlow, 1994). which rates overall clinical change following the intervention assessed by the clinician.

    Time frame: Baseline (pre-treatment), after the intervention (post-treatment), and follow-up 6 months after the intervention.

Other outcomes

  1. Diagnostic interview for SP in Anxiety Disorders Interview Schedule for DSM-IV-TR (ADIS-IV) - Specific Phobia.

    Assessed using the Phobia Section of the Anxiety Disorders Interview Schedule for DSM-IV-TR (ADIS-IV; Di Nardo, Brown \& Barlow, 1994).

    Time frame: Baseline (pre-treatment), after the intervention (post-treatment), and follow-up 6 months after the intervention

  2. Pretreatment levels of Depressive Symptoms

    Depressive symptoms will be measured using the Beck Depression Inventory-II (BDI-II; Beck, Steer, \& Brown, 1996), a widely used self-report measure assessing the severity of depressive symptoms.

    Time frame: Baseline (pre-treatment)

  3. Change in Disgust Propensity and Sensitivity Scale-Revised-12 (DPSS-R-12; Sandín et al., 2008)

    This questionnaire includes two subscales that measure propensity to disgust and sensitivity to disgust. It contains 12 items ranged from 1 (never) to 5 (always).

    Time frame: Baseline (pre-treatment), after the intervention (post-treatment), and follow-up 6 months after the intervention.

  4. Pretreatment levels of State-Trait Anxiety Inventory (adapted from Laux, Glanzmann, Schaffner & Spielberger, 1981)

    This instrument includes two scales designed to assess state and trait anxiety respectively. Each scale contains 20 items ranged from 0 (nothing/rarely) to 3 (very much/always).

    Time frame: Baseline (pre-treatment).

07

Study locations

1 site
08

References and documents

Publications

  • Wechsler TF, Kumpers F, Muhlberger A. Inferiority or Even Superiority of Virtual Reality Exposure Therapy in Phobias?-A Systematic Review and Quantitative Meta-Analysis on Randomized Controlled Trials Specifically Comparing the Efficacy of Virtual Reality Exposure to Gold Standard in vivo Exposure in Agoraphobia, Specific Phobia, and Social Phobia. Front Psychol. 2019 Sep 10;10:1758. doi: 10.3389/fpsyg.2019.01758. eCollection 2019. PubMed 31551840 ↗
  • Wardenaar KJ, Lim CCW, Al-Hamzawi AO, Alonso J, Andrade LH, Benjet C, Bunting B, de Girolamo G, Demyttenaere K, Florescu SE, Gureje O, Hisateru T, Hu C, Huang Y, Karam E, Kiejna A, Lepine JP, Navarro-Mateu F, Oakley Browne M, Piazza M, Posada-Villa J, Ten Have ML, Torres Y, Xavier M, Zarkov Z, Kessler RC, Scott KM, de Jonge P. The cross-national epidemiology of specific phobia in the World Mental Health Surveys. Psychol Med. 2017 Jul;47(10):1744-1760. doi: 10.1017/S0033291717000174. Epub 2017 Feb 22. PubMed 28222820 ↗
  • Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009). The Cruelest Cure? Ethical Issues in the Implementation of Exposure-Based Treatments. Cognitive and Behavioral Practice, 16(2), 172-180. https://doi.org/10.1016/j.cbpra.2008.07.003
  • Nathan, P., & Gorman, J. (2015). A guide to treatments that work (P. Nathan & J. Gorman (eds.)). Oxford University Press.
  • Mogoase C, David D, Koster EH. Clinical efficacy of attentional bias modification procedures: an updated meta-analysis. J Clin Psychol. 2014 Dec;70(12):1133-57. doi: 10.1002/jclp.22081. Epub 2014 Mar 20. PubMed 24652823 ↗
  • Kazdin, A. E., & Rabbitt, S. M. (2013). Novel Models for Delivering Mental Health Services and Reducing the Burdens of Mental Illness. Clinical Psychological Science, 1(2), 170-191. https://doi.org/10.1177/2167702612463566
  • Grimaldos, J., Duque, A., Bretón-López, J., Díaz-Sanahuja, L. y Quero, S. (2024). Is everyone afraid of them? Attentional biases in cockroach phobia: Evidence from eye-tracking. Submitted to Journal of Behavior Therapy and Experimental Psychiatry.
  • Garcia-Palacios A, Botella C, Hoffman H, Fabregat S. Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias. Cyberpsychol Behav. 2007 Oct;10(5):722-4. doi: 10.1089/cpb.2007.9962. PubMed 17927544 ↗
  • Fox E, Zougkou K, Ashwin C, Cahill S. Investigating the efficacy of attention bias modification in reducing high spider fear: The role of individual differences in initial bias. J Behav Ther Exp Psychiatry. 2015 Dec;49(Pt A):84-93. doi: 10.1016/j.jbtep.2015.05.001. Epub 2015 May 13. PubMed 26060177 ↗
  • Fodor LA, Georgescu R, Cuijpers P, Szamoskozi S, David D, Furukawa TA, Cristea IA. Efficacy of cognitive bias modification interventions in anxiety and depressive disorders: a systematic review and network meta-analysis. Lancet Psychiatry. 2020 Jun;7(6):506-514. doi: 10.1016/S2215-0366(20)30130-9. Epub 2020 May 20. PubMed 32445689 ↗
  • Eaton WW, Bienvenu OJ, Miloyan B. Specific phobias. Lancet Psychiatry. 2018 Aug;5(8):678-686. doi: 10.1016/S2215-0366(18)30169-X. PubMed 30060873 ↗
  • Craske, M. G., Antony, M. M., & Barlow, D. H. (2006). Mastering your fears and phobias. Oxford University Press.
  • Clauss K, Gorday JY, Bardeen JR. Eye tracking evidence of threat-related attentional bias in anxiety- and fear-related disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2022 Apr;93:102142. doi: 10.1016/j.cpr.2022.102142. Epub 2022 Mar 7. PubMed 35279537 ↗
  • Carl E, Stein AT, Levihn-Coon A, Pogue JR, Rothbaum B, Emmelkamp P, Asmundson GJG, Carlbring P, Powers MB. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. J Anxiety Disord. 2019 Jan;61:27-36. doi: 10.1016/j.janxdis.2018.08.003. Epub 2018 Aug 10. PubMed 30287083 ↗
  • Botella, C., Baños, R. M., García-Palacios, A., & Quero, S. (2017). Virtual Reality and Other Realities. In The Science of Cognitive Behavioral Therapy (pp. 551-590). Elsevier. https://doi.org/10.1016/B978-0-12-803457- 6.00022-2
  • Beard C. Cognitive bias modification for anxiety: current evidence and future directions. Expert Rev Neurother. 2011 Feb;11(2):299-311. doi: 10.1586/ern.10.194. PubMed 21306216 ↗
  • Bar-Haim Y, Lamy D, Pergamin L, Bakermans-Kranenburg MJ, van IJzendoorn MH. Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychol Bull. 2007 Jan;133(1):1-24. doi: 10.1037/0033-2909.133.1.1. PubMed 17201568 ↗
  • Baus O, Bouchard S. Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: a review. Front Hum Neurosci. 2014 Mar 4;8:112. doi: 10.3389/fnhum.2014.00112. eCollection 2014. PubMed 24624073 ↗
  • Armstrong T, Hemminger A, Olatunji BO. Attentional bias in injection phobia: overt components, time course, and relation to behavior. Behav Res Ther. 2013 Jun;51(6):266-73. doi: 10.1016/j.brat.2013.02.008. Epub 2013 Mar 4. PubMed 23523867 ↗
  • First MB. Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility. J Nerv Ment Dis. 2013 Sep;201(9):727-9. doi: 10.1097/NMD.0b013e3182a2168a. No abstract available. PubMed 23995026 ↗

Individual participant data

Plan to share: Yes — Only aggregated data will be shared. If additional data are requested for scientific purposes or to support published findings, they will be provided in an anonymized form and in accordance with applicable ethical and data protection regulations.

Supporting information: Study protocol, Statistical analysis plan, Analytic code

Time frame: Data will be available upon reasonable request after publication of the main study results.

Access criteria: Access to de-identified data may be granted upon reasonable request for the purpose of verifying, reproducing, or further evaluating published findings.

Data sharing details ↗ · repositori.uji.es

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Oct 2026; primary completion for Feb 2028, 16 months later.

Of 48 non-industry interventional studies with no phase under Phobia, Specific, half reached primary completion within 24 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 42. This study's planned 16 months is below that.

Counting every sponsor, half of 49 studies reached it within 28 months; a quarter within 11 and three quarters within 42.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 23, 2026
First posted
Sep 10, 2026
StartEst.
Oct 2026
Primary completionEst.
Feb 28, 2028
CompletionEst.
Aug 31, 2028
Last update
Sep 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07813364
Lead sponsor
Universitat Jaume I
Collaborators
Generalitat Valenciana
Responsible party
Sponsor
First posted
Sep 10, 2026
Start date
Oct 2026 (estimated)
Primary completion
Feb 28, 2028 (estimated)
Completion
Aug 31, 2028 (estimated)
Last update
Sep 10, 2026

Study contacts

Soledad Quero, Ph.D
Contact
squero@uji.es
+34 964 38 76 41
Lucía V Gómez-Fernández, Master's degree
Contact
al404316@uji.es
+34 644329743
Soledad Quero, Ph.D
principal investigator · Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
Almudena Duque, Ph.D
study director · School of Psychology, Pontifical University of Salamanca, Spain.
Lucía V Gómez-Fernández, Master's degree
study chair · Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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