TY - JOUR
T1 - Exposure therapy in a virtual environment
T2 - Validation in obsessive compulsive disorder
AU - Cullen, Alison J.
AU - Dowling, Nathan L.
AU - Segrave, Rebecca
AU - Carter, Adrian
AU - Yücel, Murat
N1 - Funding Information:
Murat Yucel has received funding from Monash University, and Australian Government funding bodies such as the National Health and Medical Research Council, the Australian Research Council, Australian Defence Science and Technology, and the Department of Industry, Innovation and Science. He (and this project) received philanthropic donations from the David Winston Turner Endowment Fund, Wilson Foundation. The funding sources had no role in the design, management, data analysis, presentation, or interpretation and write-up of the data.
Funding Information:
Murat Yücel has received funding from Monash University , and Australian Government funding bodies such as the National Health and Medical Research Council , the Australian Research Council , Australian Defence Science and Technology , and the Department of Industry, Innovation and Science . He (and this project) received philanthropic donations from the David Winston Turner Endowment Fund, Wilson Foundation. The funding sources had no role in the design, management, data analysis, presentation, or interpretation and write-up of the data.
Publisher Copyright:
© 2021 Elsevier Ltd
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/5
Y1 - 2021/5
N2 - Exposure and response prevention (ERP) is the current first-line psychological treatment for Obsessive-compulsive disorder (OCD). However, substantial inter-individual variability exists in treatment outcomes, including inadequate symptom improvements, and notable refusal and attrition rates. These are driven, in part, by impracticalities in simulating intrusive thoughts within clinical settings. Virtual reality (VR) offers the potential of overcoming these limitations in a manner that allows for finely controlled anxiety-provoking scenarios to be created within supportive clinical settings. To validate the potential of VR for treating contamination-based OCD, 22 patients undertook a VR ERP session and a matched session of the current gold-standard of in vivo ERP. In VR, patients were immersed within a contamination environment that permitted flexible delivery of customisable, graded exposure tasks. The VR environment utilised HTC Vive hardware, to allow for patients to both interact with, and physically move through the environment. Subjective and objective measures of distress were recorded, including heart and respiration rates. These measures indicate virtual and in vivo ERP sessions provoke consistent anxiety profiles across an exposure hierarchy. Virtual exposure was advantageous for engagement and adherence to tasks, and the therapeutic alliance was upheld. VR is a promising mechanism for ERP in contamination OCD.
AB - Exposure and response prevention (ERP) is the current first-line psychological treatment for Obsessive-compulsive disorder (OCD). However, substantial inter-individual variability exists in treatment outcomes, including inadequate symptom improvements, and notable refusal and attrition rates. These are driven, in part, by impracticalities in simulating intrusive thoughts within clinical settings. Virtual reality (VR) offers the potential of overcoming these limitations in a manner that allows for finely controlled anxiety-provoking scenarios to be created within supportive clinical settings. To validate the potential of VR for treating contamination-based OCD, 22 patients undertook a VR ERP session and a matched session of the current gold-standard of in vivo ERP. In VR, patients were immersed within a contamination environment that permitted flexible delivery of customisable, graded exposure tasks. The VR environment utilised HTC Vive hardware, to allow for patients to both interact with, and physically move through the environment. Subjective and objective measures of distress were recorded, including heart and respiration rates. These measures indicate virtual and in vivo ERP sessions provoke consistent anxiety profiles across an exposure hierarchy. Virtual exposure was advantageous for engagement and adherence to tasks, and the therapeutic alliance was upheld. VR is a promising mechanism for ERP in contamination OCD.
KW - Anxiety
KW - Exposure therapy
KW - Obsessive compulsive disorder
KW - Psychophysiology
KW - Therapeutic alliance
KW - Virtual reality
UR - http://www.scopus.com/inward/record.url?scp=85104413472&partnerID=8YFLogxK
U2 - 10.1016/j.janxdis.2021.102404
DO - 10.1016/j.janxdis.2021.102404
M3 - Article
C2 - 33894550
AN - SCOPUS:85104413472
SN - 0887-6185
VL - 80
JO - Journal of Anxiety Disorders
JF - Journal of Anxiety Disorders
M1 - 102404
ER -