Automated virtual reality exposure therapy for spider phobia vs. in-vivo one-session treatment: A randomized non-inferiority trial

Alexander Miloff*, Philip Lindner, Peter Dafgård, Stefan Deak, Maria Garke, William Hamilton, Julia Heinsoo, Glenn Kristoffersson, Jonas Rafi, Kerstin Sindemark, Jessica Sjölund, Maria Zenger, Lena Reuterskiöld, Gerhard Andersson, Per Carlbring

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Objective: This study compared the efficacy of a technician-assisted single-session virtual reality exposure therapy (VRET)for the treatment of spider phobia featuring low-cost consumer-available hardware and novel automated software to gold-standard in-vivo one-session treatment (OST), using a parallel group randomized non-inferiority design. Method Participants (N = 100)were randomized to VRET and OST arms. Assessors blinded to treatment allocation evaluated participants at pre- and post-treatment as well follow-up (3 and 12 months)using a behavioral approach test (BAT)and self-rated fear of spider, anxiety, depression and quality-of-life scales. A maximum post-treatment difference of 2-points on the BAT qualified as non-inferiority margin. Results Linear mixed models noted large, significant reductions in behavioral avoidance and self-reported fear in both groups at post-treatment, with VRET approaching the strong treatment benefits of OST over time. Non-inferiority was identified at 3- and 12- months follow-up but was significantly worse until 12-months. There was no significant difference on a questionnaire measuring negative effects. Conclusions Automated VRET efficaciously reduced spider phobia symptoms in the short-term and was non-inferior to in-vivo exposure therapy in the long-term. VRET effectiveness trials are warranted to evaluate real-world benefits and non-specific therapeutic factors accruing from the presence of a technician during treatment. ClinicalTrials.gov (NCT02533310).

OriginalsprogEngelsk
TidsskriftBehaviour Research and Therapy
Vol/bind118
Sider (fra-til)130-140
ISSN0005-7967
DOI
StatusUdgivet - 1. jul. 2019

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Citationsformater

Miloff, A., Lindner, P., Dafgård, P., Deak, S., Garke, M., Hamilton, W., Heinsoo, J., Kristoffersson, G., Rafi, J., Sindemark, K., Sjölund, J., Zenger, M., Reuterskiöld, L., Andersson, G., & Carlbring, P. (2019). Automated virtual reality exposure therapy for spider phobia vs. in-vivo one-session treatment: A randomized non-inferiority trial. Behaviour Research and Therapy, 118, 130-140. https://doi.org/10.1016/j.brat.2019.04.004