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虚拟现实暴露疗法治疗牙科恐惧症的疗效:一项随机对照试验。

Efficacy of virtual reality exposure therapy for treatment of dental phobia: a randomized control trial.

作者信息

Raghav Kumar, Van Wijk A J, Abdullah Fawzia, Islam Md Nurul, Bernatchez Marc, De Jongh Ad

机构信息

Department of Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 LA, Amsterdam, The Netherlands.

Faculty of Dentistry, SEGi University, No:9 Jalan Teknologi, Kotadamansara, PJU-5, Petalingjaya-47810, Selangor, Malaysia.

出版信息

BMC Oral Health. 2016 Feb 27;16:25. doi: 10.1186/s12903-016-0186-z.

Abstract

BACKGROUND

Virtual Reality Exposure Therapy (VRET) is found to be a promising and a viable alternative for in vivo exposure in the treatment of specific phobias. However, its usefulness for treating dental phobia is unexplored. The aims of the present study are to determine: (a) the efficacy of VRET versus informational pamphlet (IP) control group in terms of dental trait and state anxiety reductions at 1 week, 3 months and 6 months follow-up (b) the real-time physiological arousal [heart rate (HR)] of VRET group participants during and following therapy (c) the relation between subjective (presence) and objective (HR) measures during VRET.

METHODS

This study is a single blind, randomized controlled trial with two parallel arms in which participants will be allocated to VRET or IP with a ratio of 1:1. Thirty participants (18-50 years) meeting the Phobia Checklist criteria of dental phobia will undergo block randomization with allocation concealment. The primary outcome measures include participants' dental trait anxiety (Modified Dental Anxiety Scale and Dental Fear Survey) and state anxiety (Visual Analogue Scale) measured at baseline (T0), at intervention (T1), 1-week (T2), 3 months (T3) and 6 months (T4) follow-up. A behavior test will be conducted before and after the intervention. The secondary outcome measures are real-time evaluation of HR and VR (Virtual Reality) experience (presence, realism, nausea) during and following the VRET intervention respectively. The data will be analyzed using intention-to-treat and per-protocol analysis.

DISCUSSION

This study uses novel non-invasive VRET, which may provide a possible alternative treatment for dental anxiety and phobia.

TRIAL REGISTRATION NUMBER

ISRCTN25824611 , Date of registration: 26 October 2015.

摘要

背景

虚拟现实暴露疗法(VRET)被认为是治疗特定恐惧症时一种有前景且可行的体内暴露替代疗法。然而,其对治疗牙科恐惧症的有效性尚未得到探索。本研究的目的是确定:(a)在1周、3个月和6个月随访时,VRET与信息手册(IP)对照组相比在降低牙科特质焦虑和状态焦虑方面的疗效;(b)VRET组参与者在治疗期间及治疗后的实时生理唤醒[心率(HR)];(c)VRET期间主观(临场感)和客观(HR)测量之间的关系。

方法

本研究是一项单盲、随机对照试验,有两个平行组,参与者将按1:1的比例分配到VRET组或IP组。30名符合牙科恐惧症恐惧症检查表标准的参与者(18 - 50岁)将进行区组随机化并实施分配隐藏。主要结局指标包括在基线(T0)、干预时(T1)、1周(T2)、3个月(T3)和6个月(T4)随访时测量的参与者牙科特质焦虑(改良牙科焦虑量表和牙科恐惧调查)和状态焦虑(视觉模拟量表)。在干预前后将进行行为测试。次要结局指标分别是VRET干预期间及干预后的HR实时评估和VR(虚拟现实)体验(临场感、真实感、恶心感)。数据将使用意向性分析和符合方案分析进行分析。

讨论

本研究使用了新型非侵入性VRET,这可能为牙科焦虑和恐惧症提供一种可能的替代治疗方法。

试验注册号

ISRCTN25824611,注册日期:2015年10月26日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f27/4769551/08671e24eabb/12903_2016_186_Fig1_HTML.jpg

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