Phobia, Specific
Conditions
Keywords
Specific phobia, Exposure therapy, Virtual reality, Randomized controlled trial
Brief summary
The aim of this study is to examine the efficacy of virtual reality exposure therapy as a treatment for specific phobia (spiders). A gamified virtual reality simulation of one-session therapy (VR-OST) will be compared to the gold-standard treatment in the form of traditional one-session phobia treatment (OST) using in-vivo stimuli. This study was powered to detect a non-inferiority margin of a 2-point difference between groups.
Interventions
OTHEROST treatment with in-vivo spiders
Subjects are exposed to phobic stimuli with the aid of a trained psychotherapist during a session of maximum 3 hrs duration. The intensity of exposure is increased in four sequential steps, 1. learning to catch a spider with a glass and paper, 2. touching a spider, 3. letting a spider walk on your hand, 4. letting a spider walk on your body. These stages repeat with increasingly larger spiders. The goal of therapy is not absolute symptom reduction but sufficient reduction to allow the individual to expose themselves in everyday situations.
OTHERVR-OST treatment with virtual spiders
The VR-OST treatment introduces a virtual gamified version of OST treatment using a modern virtual reality headset. Individuals advance themselves through increasing levels of exposure intensity with the assistance of an automated virtual therapist.
Sponsors
Stockholm University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Score of 10 or less in Behavioral Approach Test * Individual meeting DSM-5 criteria according to interview for primary diagnosis of specific phobia, spider * Swedish residency * Fluent in Swedish
Exclusion criteria
* Ongoing psychotherapy * Ongoing psychotropic medication (unless stabilized for three months) * Indication of suicidal ideation, as assessed by item 9 of the PHQ-9 * Meets criteria for alcohol or substance use disorder * Meets criteria for serious mental disorder, such as bipolar disorder, schizophrenia or psychosis * Balance and/or eyesight problems (such as lack of stereoscopic vision) that could interfere with VR treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Behavioral Approach Test (BAT) | Change from baseline on BAT (1 week) | The BAT consists of 13 approach steps measuring intensity of phobia symptoms, from approaching a few metres from to holding a spider. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Spider Phobia Questionnaire 31 (SPQ-31) | Change from baseline on SPQ-31 (1 week) | SPQ-31 features 31 spider-focused scenarios which must be answered by a yes/no response, with ascending scores indicative of increased degree of arachnophobia. |
| Fear of Spiders Questionnaire 18 (FSQ-18) | Change from baseline in FSQ-18 (1 week) | FSQ-18 features 18 questions about fear and avoidance of spiders. |
| Brunnsviken Brief Quality of Life Scale (BBQ) | Change from baseline in BBQ (1 week) | BBQ features 12 items concerning 6 areas of life rated on importance and satisfaction. |
| Patient Health Questionnaire 9 (PHQ-9) | Change from baseline in PHQ-9 (1 week) | PHQ-9 features nine items for assessing depression in a clinical context and screening of depression in the general population. |
| Diagnostic criteria for specific phobia according to interview (DSM-5) | Change from baseline for specific phobia (DSM-5) (12 weeks) | — |
| Generalized Anxiety Disorder Assessment 7 (GAD-7) | Change from baseline in GAD-7 (1 week) | GAD-7 features seven items for assessing anxiety and screening for generalized anxiety disorder. |
Countries
Sweden
Outcome results
None listed