Automated psychological therapy using immersive virtual reality for the treatment of the fear of heights: a single-blind parallel-group randomised controlled trial

<p>Background: Engaging, interactive, and automated virtual reality (VR) treatments might help solve the unmet needs of individuals with mental health disorders. We tested the efficacy of an automated cognitive intervention for fear of heights guided by an avatar virtual coach (animated using...

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Автори: Freeman, D, Haselton, P, Freeman, J, Spanlang, B, Kishore, S, Albery, E, Denne, M, Brown, P, Slater, M, Nickless, A
Формат: Journal article
Опубліковано: Elsevier 2018
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author Freeman, D
Haselton, P
Freeman, J
Spanlang, B
Kishore, S
Albery, E
Denne, M
Brown, P
Slater, M
Nickless, A
author_facet Freeman, D
Haselton, P
Freeman, J
Spanlang, B
Kishore, S
Albery, E
Denne, M
Brown, P
Slater, M
Nickless, A
author_sort Freeman, D
collection OXFORD
description <p>Background: Engaging, interactive, and automated virtual reality (VR) treatments might help solve the unmet needs of individuals with mental health disorders. We tested the efficacy of an automated cognitive intervention for fear of heights guided by an avatar virtual coach (animated using motion and voice capture of an actor) in VR and delivered with the latest consumer equipment.</p><p> Methods: We did a randomised trial of automated VR versus usual care. We recruited adults aged older than 18 years with a fear of heights by radio advertisements in Oxfordshire, UK. We diagnosed fear of heights if participants scored more than 29 on the Heights Interpretation Questionnaire (HIQ). We randomly allocated participants by computer in a 1:1 ratio to either automated VR delivered in roughly six 30-min sessions administered about two to three times a week over a 2-week period (intervention group) or to usual care (control group). Randomisation was stratified by severity of fear of heights. The research team, who were unaware of the random allocation, administered three fear-of-height assessments, at baseline (0 weeks), at the end of treatment (2 weeks), and at follow-up (4 weeks). The primary outcome measure was HIQ score (range 16–80, with higher scores indicating greater severity). This trial is registered with the ISRCTN registry, number ISRCTN11898283.</p><p> Findings: Between Nov 25, 2017, and Feb 27, 2018, 100 individuals were enrolled and underwent randomisation, of whom 49 were assigned to the VR treatment group and 51 to the control group. All participants completed the 4-week follow-up. The mean total treatment time in VR was 124·43 min (SD 34·23). Compared with participants in the control group, the VR treatment reduced fear of heights at the end of treatment (mean change score −24·5 [SD 13·1] in the VR group vs −1·2 [7·3] in the control group; adjusted difference −24·0, 95% CI −27·7 to −20·3; Cohen's d=2·0; p&lt;0·0001). The benefit was maintained at follow-up (mean change score −25·1 [SD 13·9] in the VR group vs −1·5 [7·8] in the control group; adjusted difference −24·3, 95% CI −27·9 to −20·6; Cohen's d=2·0; p&lt;0·0001). The number needed to treat to at least halve the fear of heights was 1·3. No adverse events were reported.</p><p> Interpretation: Psychological therapy delivered automatically by a VR coach can produce large clinical benefits. Evidence-based VR treatments have the potential to greatly increase treatment provision for mental health disorders.</p>
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spelling oxford-uuid:fd612c74-312e-4ed0-acdb-24c305b01bf92022-03-27T13:28:29ZAutomated psychological therapy using immersive virtual reality for the treatment of the fear of heights: a single-blind parallel-group randomised controlled trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fd612c74-312e-4ed0-acdb-24c305b01bf9Symplectic Elements at OxfordElsevier2018Freeman, DHaselton, PFreeman, JSpanlang, BKishore, SAlbery, EDenne, MBrown, PSlater, MNickless, A<p>Background: Engaging, interactive, and automated virtual reality (VR) treatments might help solve the unmet needs of individuals with mental health disorders. We tested the efficacy of an automated cognitive intervention for fear of heights guided by an avatar virtual coach (animated using motion and voice capture of an actor) in VR and delivered with the latest consumer equipment.</p><p> Methods: We did a randomised trial of automated VR versus usual care. We recruited adults aged older than 18 years with a fear of heights by radio advertisements in Oxfordshire, UK. We diagnosed fear of heights if participants scored more than 29 on the Heights Interpretation Questionnaire (HIQ). We randomly allocated participants by computer in a 1:1 ratio to either automated VR delivered in roughly six 30-min sessions administered about two to three times a week over a 2-week period (intervention group) or to usual care (control group). Randomisation was stratified by severity of fear of heights. The research team, who were unaware of the random allocation, administered three fear-of-height assessments, at baseline (0 weeks), at the end of treatment (2 weeks), and at follow-up (4 weeks). The primary outcome measure was HIQ score (range 16–80, with higher scores indicating greater severity). This trial is registered with the ISRCTN registry, number ISRCTN11898283.</p><p> Findings: Between Nov 25, 2017, and Feb 27, 2018, 100 individuals were enrolled and underwent randomisation, of whom 49 were assigned to the VR treatment group and 51 to the control group. All participants completed the 4-week follow-up. The mean total treatment time in VR was 124·43 min (SD 34·23). Compared with participants in the control group, the VR treatment reduced fear of heights at the end of treatment (mean change score −24·5 [SD 13·1] in the VR group vs −1·2 [7·3] in the control group; adjusted difference −24·0, 95% CI −27·7 to −20·3; Cohen's d=2·0; p&lt;0·0001). The benefit was maintained at follow-up (mean change score −25·1 [SD 13·9] in the VR group vs −1·5 [7·8] in the control group; adjusted difference −24·3, 95% CI −27·9 to −20·6; Cohen's d=2·0; p&lt;0·0001). The number needed to treat to at least halve the fear of heights was 1·3. No adverse events were reported.</p><p> Interpretation: Psychological therapy delivered automatically by a VR coach can produce large clinical benefits. Evidence-based VR treatments have the potential to greatly increase treatment provision for mental health disorders.</p>
spellingShingle Freeman, D
Haselton, P
Freeman, J
Spanlang, B
Kishore, S
Albery, E
Denne, M
Brown, P
Slater, M
Nickless, A
Automated psychological therapy using immersive virtual reality for the treatment of the fear of heights: a single-blind parallel-group randomised controlled trial
title Automated psychological therapy using immersive virtual reality for the treatment of the fear of heights: a single-blind parallel-group randomised controlled trial
title_full Automated psychological therapy using immersive virtual reality for the treatment of the fear of heights: a single-blind parallel-group randomised controlled trial
title_fullStr Automated psychological therapy using immersive virtual reality for the treatment of the fear of heights: a single-blind parallel-group randomised controlled trial
title_full_unstemmed Automated psychological therapy using immersive virtual reality for the treatment of the fear of heights: a single-blind parallel-group randomised controlled trial
title_short Automated psychological therapy using immersive virtual reality for the treatment of the fear of heights: a single-blind parallel-group randomised controlled trial
title_sort automated psychological therapy using immersive virtual reality for the treatment of the fear of heights a single blind parallel group randomised controlled trial
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