Articlegold2018

Believing Is Seeing: A Proof-of-Concept Semiexperimental Study on Using Mobile Virtual Reality to Boost the Effects of Interpretation Bias Modification for Anxiety

Boris Otkhmezuri · Marilisa Boffo · Panote Siriaraya · Maria Matsangidou · Reinout W. H. J. Wiers · Bundy Mackintosh +2 more

37 citations0/0 files storedJMIR Mental Health

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Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Virtual Reality Applications and Impacts Digital Mental Health Interventions

Abstract

BACKGROUND Cognitive Bias Modification of Interpretations (CBM-I) is a computerized intervention designed to change negatively biased interpretations of ambiguous information, which underlie and reinforce anxiety. The repetitive and monotonous features of CBM-I can negatively impact training adherence and learning processes. OBJECTIVE This proof-of-concept study aimed to examine whether performing a CBM-I training using mobile virtual reality technology (virtual reality Cognitive Bias Modification of Interpretations [VR-CBM-I]) improves training experience and effectiveness. METHODS A total of 42 students high in trait anxiety completed 1 session of either VR-CBM-I or standard CBM-I training for performance anxiety. Participants’ feelings of immersion and presence, emotional reactivity to a stressor, and changes in interpretation bias and state anxiety, were assessed. RESULTS The VR-CBM-I resulted in greater feelings of presence (P<.001, d=1.47) and immersion (P<.001, ηp2=0.74) in the training scenarios and outperformed the standard training in effects on state anxiety (P<.001, ηp2=0.3) and emotional reactivity to a stressor (P=.03, ηp2=0.12). Both training varieties successfully increased the endorsement of positive interpretations (P<.001, drepeated measures [drm]=0.79) and decreased negative ones. (P<.001, drm=0.72). In addition, changes in the emotional outcomes were correlated with greater feelings of immersion and presence. CONCLUSIONS This study provided first evidence that (1) the putative working principles underlying CBM-I trainings can be translated into a virtual environment and (2) virtual reality holds promise as a tool to boost the effects of CMB-I training for highly anxious individuals while increasing users’ experience with the training application.

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References

2004Cognitive Vulnerability to Emotional Disorders 2008Measuring and defining the experience of immersion in games 2011Measures of anxiety: State‐Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale‐Anxiety (HADS‐A)2002Selective attention and emotional vulnerability: Assessing the causal basis of their association through the experimental manipulation of attentional bias.1997An information processing model of anxiety: Automatic and strategic processes 2010Mental imagery in emotion and emotional disorders 2011A meta-analysis of the effect of cognitive bias modification on anxiety and depression.2000Induced emotional interpretation bias and anxiety.

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