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Trial registered on ANZCTR
Registration number
ACTRN12616001346460
Ethics application status
Approved
Date submitted
5/09/2016
Date registered
27/09/2016
Date last updated
13/08/2019
Date data sharing statement initially provided
13/08/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomized controlled trial of the rapid symptom shifting therapy for anxiety
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Scientific title
A randomized controlled trial of the Rapid symptom shifting technique (a form on imaginal therapy) for people with significant anxiety versus a control imaginal therapy using an anxiety inventory score (STAI) as an outcome..
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Secondary ID [1]
290061
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Nil
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Universal Trial Number (UTN)
U1111-1179-1166
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Trial acronym
RASST (Rapid Symptom Shift Technique)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anxiety
300192
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Condition category
Condition code
Mental Health
300075
300075
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0
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Anxiety
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention group will receive the Rapid Symptom Shift. The interviewer (a GP with 30 years experience, a masters student with research training and a alternative therapy practitioner with 20 years experience) asks the patient if they can describe where their anxiety is in space. While this may seem an unusual request, patients often have no difficulty in explaining where it is located. They are asked to describe their anxiety in terms of colour and shape. In almost all cases they say it is close but has no shape and a variety of colours. Then they are asked to change the shape to a circle and put it in front of them. They are then asked what a “safe” colour for them is and to make the circle that colour. That image is then moved away visually and pushed to the horizon where it is stood up like a 50 cent piece. They are asked to then make it a 10 cent piece and put it face down so it is not visible. At this point they are asked how they feel about their “anxiety or stress’ and this visualisation from experience in the clinic almost always provides a positive response. We plan to measure this response with changes in the STAI questionnaire and the participant’s heart rate variability. The moving of the image to the horizon we think is the essential difference between the intervention and the control intervention. The mode of the interview delivery will be face to face on a one to one basis. It is done once only and lasts about 3 minutes. The interview will be conducted in University consulting rooms or private clinics.
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Intervention code [1]
295844
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Treatment: Other
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Comparator / control treatment
The control condition will be a visualisation of washing a car. This will not involve any attempt to move the visual object (the car) to the horizon. The sessions last about 3 minutes and they are done once only.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome of the trial is to measure any statistically significant change to the participants anxiety scores on the state trait anxiety scale immediately after the intervention, and at 8 weeks after the intervention.
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Assessment method [1]
299545
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Timepoint [1]
299545
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Immediately after the intervention
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Primary outcome [2]
299546
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Heart rate variability as measured by a chest lead sending a signal to a Polar watch.
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Assessment method [2]
299546
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Timepoint [2]
299546
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Immediately after the intervention
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Secondary outcome [1]
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STAI questionnaire
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Assessment method [1]
327489
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Timepoint [1]
327489
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8 weeks after the intervention
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Secondary outcome [2]
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HAD-s Hospital anxiety and depression scale
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Assessment method [2]
327490
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Timepoint [2]
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8 weeks after the intervention.
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Eligibility
Key inclusion criteria
Otherwise healthy volunteers with significant anxiety
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Minimum age
16
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Inability to understand the information sheet.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Via remote server www.caseweaver.co.nz)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Patients are randomised to the control group or treatment arm by way of the standard built-in random number generator on the server. This produces a random number between zero (assignment to the control group) and the treatment arm (assignment to one of the treatment arm or control). Each time the application launches, the random number generator is initialized with a random value, which is obtained from the system clock
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
There will be a validation certificate asking participants to state that the interviewers have not implied that the intervention they got was better than the one they did not and that there was no influence on how they answered the questionnaire.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The analysis will done by intention to treat analysis. Categorical outcomes were expressed using counts (percentages) and compared between treatment groups using the Chi squared test. Continuous variables were expressed using mean (standard deviation) and compared between groups using an analysis of variance. The secondary outcome of GAD is expressed in medians and compared between groups using the Mann-Whitney U test. The multivariate models for the dichotomous outcomes will be evaluated using logistic regression to calculate odds ratios (which will be converted to risk ratios using the formula of Zhang), with confidence intervals. The continuous outcomes will be analysed using multiple linear regression. All multivariate models controlled for age and gender (and the baseline level of STAI for the primary outcome of STAI). Missing data at 8 weeks will be imputed. A two-tailed p value< 0.05 was considered to be significant. Statistical analysis was performed using SAS V.9.3 (SAS Institute Inc., Cary, North Carolina, USA).
The sample size: based on a difference of 7 points from a baseline of 45 (SD 13.5) on the STAI states scale and will require -58 in the intervention and 58 in the control group (two sided alpha =0.05, beta = 0.2) Total n= 116. We will recruit 130 participants to allow for 14 dropouts.
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Recruitment
Recruitment status
Stopped early
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Data analysis
No data analysis planned
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Reason for early stopping/withdrawal
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
5/10/2016
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Actual
5/10/2016
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Date of last participant enrolment
Anticipated
29/12/2017
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Actual
29/12/2017
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Date of last data collection
Anticipated
23/02/2018
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Actual
23/02/2018
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Sample size
Target
130
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Accrual to date
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Final
10
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Recruitment outside Australia
Country [1]
8203
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New Zealand
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State/province [1]
8203
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Auckland
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Oakley Mental Health Research Foundation
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Address [1]
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PO Box 302499
North Harbour
Auckland 0751
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
University of Auckland
Private Bag 92019
Auckland 1142
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
293447
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Country [1]
293447
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Health and Disability Ethics Committees
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Ethics committee address [1]
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Ministry of Health Freyberg Building 20 Aitken Street PO Box 5013 Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
295975
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Approval date [1]
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20/09/2016
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Ethics approval number [1]
295975
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16/NTB/140
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Summary
Brief summary
Anxiety disorders are the most common mental disorder in the developed world. The prevalence of any anxiety disorder in general practice is approximately 13% (35.7% of patients in primary care have mental disorders). In the New Zealand (NZ) community the lifetime prevalence is 24.9% and the one month prevalence is 9.3%.Anxiety is associated with poorer mental, physical health, reduced role functioning and more physical pain. General practitioners are in a good position to treat anxiety but have limited access to psychological therapies and are not always keen (and patient resistance) on using medication. A brief and effective therapy would be very helpful. The rapid symptom shifting technique has worked well when used in clinical general practice. The aim of this research is to test the effectiveness of a rapid therapy for anxiety. The symptom shifting is an adaptation of Neurolingistic Programming (NLP) processes. We have recently completed the rapid phobia NLP cure (single visit) for fear of heights (funded by the Oakley Foundation) and we found a statistically significant result (as yet unpublished other than in a conference abstract).
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Bruce Arroll
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Address
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Elaine Gurr Chair of General Practice and Primary Health Care
Director of the Goodfellow Unit
Department of General Practice and Primary Health Care
University of Auckland
Private Bag 92019
Auckland 1142
Physical Address
Tamaki Campus
261 Morrin Road
Glen Innes 1072
New Zealand
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Country
68722
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New Zealand
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Phone
68722
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+64 9-9236978
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Fax
68722
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+64-3737624
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Email
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[email protected]
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Contact person for public queries
Name
68723
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Bruce Arroll
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Address
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Elaine Gurr Chair of General Practice and Primary Health Care
Director of the Goodfellow Unit
Department of General Practice and Primary Health Care
University of Auckland
Private Bag 92019
Auckland 1142
Physical Address
Tamaki Campus
261 Morrin Road
Glen Innes 1072
New Zealand
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Country
68723
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New Zealand
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Phone
68723
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+64 9-9236978
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Fax
68723
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+64-3737624
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Email
68723
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[email protected]
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Contact person for scientific queries
Name
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Bruce Arroll
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Address
68724
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Director of the Goodfellow Unit
Department of General Practice and Primary Health Care
University of Auckland
Private Bag 92019
Auckland 1142
Physical Address
Tamaki Campus
261 Morrin Road
Glen Innes 1072
New Zealand
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Country
68724
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New Zealand
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Phone
68724
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+64 9-9236978
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Fax
68724
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+64-3737624
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Email
68724
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
all data collected except patient names
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When will data be available (start and end dates)?
1/5/2019 to indefinite
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Available to whom?
to whomever makes the case
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Available for what types of analyses?
any analysis
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How or where can data be obtained?
email
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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