scholarly journals Effectiveness of Self-Guided Virtual Reality-based Cognitive Behavioral Therapy for Panic Disorder (Preprint)

10.2196/30590 ◽  
2021 ◽  
Author(s):  
Bokyoung Shin ◽  
Jooyoung Oh ◽  
Byung-Hoon Kim ◽  
Hesun Erin Kim ◽  
Hyunji Kim ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

Effectiveness of Self-Guided Virtual Reality-based Cognitive Behavioral Therapy for Panic Disorder (Preprint)

2021 ◽  
Author(s):  
Bokyoung Shin ◽  
Jooyoung Oh ◽  
Byung-Hoon Kim ◽  
Hesun Erin Kim ◽  
Hyunji Kim ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Panic Disorder ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Mobile App ◽  
Cognitive Behavioral ◽  
Sensitivity Index ◽  
Time Interaction ◽  
Panic Symptoms ◽  
Distress Scale

BACKGROUND Virtual reality (VR) is an effective technique as a traditional cognitive behavioral therapy (CBT) and a promising tool for treating panic disorder (PD) symptoms because VR exposure can be safer, with higher acceptability, than in vivo exposure; it is more immersive than exposure through imagination. CBT techniques can be delivered more effectively using VR. Thus far, VR has required high quality devices; however, the development of mobile VR technology has improved users' availability. Meanwhile, a well-structured form of VR can be reproduced and used anywhere, which means that VR is appropriate for self–guided treatment to address the high-treatment costs of evidence–based therapy and the lack of professional therapists. This study investigates the potential of self-guided VR as an alternative to high-cost treatment. OBJECTIVE The study’s main goal is to offer data about the efficacy of the mobile app–based self-led VR CBT in the treatment of PD. METHODS 54 subjects with PD were enrolled and randomly assigned to either the VR treatment group or waitlist group. The VR treatment was designed for a total of 12 sessions in 4 weeks. The VR comprises 4 steps in which patients are gradually exposed to phobic stimuli while learning to cope with panic symptoms. The effectiveness of the treatment was assessed through the PD Severity Scale (PDSS), the Hamilton Rating Scale for Depression (HRSD), the body sensation questionnaire (BSQ), the Albany Panic and Phobia Questionnaire (APPQ), the Anxiety Sensitivity Index (ASI), the state-trait anxiety inventory (STAI), the hospital anxiety and depression scale (HADS), the social avoidance and distress scale (K-SAD), the inventory for depressive symptomatology self-report (KIDS-SR), and the perceived stress scale, (PSS). Additionally, physiological changes using heart rate variability (HRV) were evaluated. RESULTS In total, 40 subjects (20 VR treatment and 20 waitlist patients) were included in the final analysis. For the PDSS scores, the main time (F_1,39 = 20.76, P < 0.01, η_p^2 = 0.09) and group-by-time interaction (F_1,39 = 10.59, P < 0.01, η_p^2 = 0.04) effects were significant. The post-hoc tests showed that the PDSS scores decreased significantly in the VR group (t_37 = 2.68; P = 0.01), but not in the waitlist group. The group-by-time interaction effect on the HADS total scores (F_1,39 = 5.51, P = 0.02, η_p^2 = 0.01) was significant, as was the main time effect on the STAI_total (F_1,39 = 4.32; P = 0.04) and STAI_S (F_1,39 = 6.00; P = 0.01) scores; however, there were no statistically significant between-group differences on the other scales. CONCLUSIONS The self-guided, mobile app–based VR was effective in treating panic symptoms and helped restore the autonomic nervous system, demonstrating the validity of VR for self-guided treatment and its cost-effective therapeutic approach.

scholarly journals Appropriate Number of Treatment Sessions in Virtual Reality-Based Individual Cognitive Behavioral Therapy for Social Anxiety Disorder

2021 ◽  
Vol 10 (5) ◽  
pp. 915
Author(s):  
Hyu Seok Jeong ◽  
Jee Hyun Lee ◽  
Hesun Erin Kim ◽  
Jae-Jin Kim
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioral Therapy ◽  
Social Anxiety Disorder ◽  
Behavioral Therapy ◽  
Early Termination ◽  
Cognitive Behavioral ◽  
Significant Group ◽  
Extension Group

Virtual reality (VR) was introduced to maximize the effect of cognitive behavioral therapy (CBT) by efficiently performing exposure therapy. The purpose of this study was to find out whether VR-based individual CBT with relatively few treatment sessions is effective in improving social anxiety disorder (SAD). This therapy was applied to 115 patients with SAD who were retrospectively classified into 43 patients who completed the nine or 10 sessions normally (normal termination group), 52 patients who finished the sessions early (early termination group), and 20 patients who had extended the sessions (session extension group). The Brief Fear of Negative Evaluation Scale (BFNE) scores tended to decrease in all groups as the session progressed, and the slope of decrease was the steepest in the early termination group and the least steep in the session extension group. Severity of social anxiety in the last session and symptom reduction rate showed no significant group difference. Our findings suggest that short-term VR-based individual CBT of nine to 10 sessions may be effective. When the therapeutic effect is insufficient during this period, the additional benefit may be minimal if the session is simply extended. The improvement in the early termination group suggests that even shorter sessions of five or six can also be effective.

scholarly journals One-year randomized trial comparing virtual reality-assisted therapy to cognitive–behavioral therapy for patients with treatment-resistant schizophrenia

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Laura Dellazizzo ◽  
Stéphane Potvin ◽  
Kingsada Phraxayavong ◽  
Alexandre Dumais
Keyword(s):  
Virtual Reality ◽  
Cognitive Behavioral Therapy ◽  
Psychiatric Symptoms ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Comparative Trial ◽  
Cognitive Behavioral ◽  
Treatment Resistant ◽  
Auditory Verbal Hallucinations

AbstractThe gold-standard cognitive–behavioral therapy (CBT) for psychosis offers at best modest effects. With advances in technology, virtual reality (VR) therapies for auditory verbal hallucinations (AVH), such as AVATAR therapy (AT) and VR-assisted therapy (VRT), are amid a new wave of relational approaches that may heighten effects. Prior trials have shown greater effects of these therapies on AVH up to a 24-week follow-up. However, no trial has compared them to a recommended active treatment with a 1-year follow-up. We performed a pilot randomized comparative trial evaluating the short- and long-term efficacy of VRT over CBT for patients with treatment-resistant schizophrenia. Patients were randomized to VRT (n = 37) or CBT (n = 37). Clinical assessments were administered before and after each intervention and at follow-up periods up to 12 months. Between and within-group changes in psychiatric symptoms were assessed using linear mixed-effects models. Short-term findings showed that both interventions produced significant improvements in AVH severity and depressive symptoms. Although results did not show a statistically significant superiority of VRT over CBT for AVH, VRT did achieve larger effects particularly on overall AVH (d = 1.080 for VRT and d = 0.555 for CBT). Furthermore, results suggested a superiority of VRT over CBT on affective symptoms. VRT also showed significant results on persecutory beliefs and quality of life. Effects were maintained up to the 1-year follow-up. VRT highlights the future of patient-tailored approaches that may show benefits over generic CBT for voices. A fully powered single-blind randomized controlled trial comparing VRT to CBT is underway.

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