Donker Tara, Klaveren Chris van, Cornelisz Ilja, Kok Robin N, van Gelder Jean-Louis
Department of Clinical, Neuro and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
Amsterdam Public Health Research Institute Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
J Clin Med. 2020 May 26;9(6):1614. doi: 10.3390/jcm9061614.
This study examined user engagement with ZeroPhobia, a self-guided app-based virtual reality (VR) Cognitive Behavior Therapy for acrophobia symptoms using cardboard VR viewers. Dutch acrophobic adults ( = 96) completed assessments at baseline and immediately following treatment. Primary outcome measures were the Acrophobia Questionnaire (AQ) and the Igroup Presence Questionnaire (IPQ). Usage data consisted of number of VR sessions practiced, practice time, and fear ratings directly after practicing. Results show that of the 66 participants who played at least one level, the majority continued to finish all levels, spending on average 24.4 min in VR. Self-reported fear consistently decreased between the start and finish of levels. Post-test AQ scores depended quadratically on time spent in VR. Higher pre-test AQ scores were significantly associated with subjective anxiety after the first level and a reduction of post-test AQ scores, but not with number of sessions, suggesting it might be more beneficial to play one level for a longer time period instead of practicing many VR levels. Results also show an optimum exposure level at which increasing practice time does not result in increased benefit. Self-guided VR acrophobia treatment is effective and leads to consistent reductions in self-reported anxiety both between levels and after treatment. Most participants progressed effectively to the highest self-exposure level, despite the absence of a therapist.
本研究调查了使用纸板虚拟现实（VR）头戴设备的基于应用程序的自我引导式VR认知行为疗法ZeroPhobia对恐高症症状的用户参与度。荷兰成年恐高症患者（ = 96）在基线和治疗后立即完成评估。主要结局指标为恐高症问卷（AQ）和Igroup临场感问卷（IPQ）。使用数据包括练习的VR疗程数、练习时间以及练习后直接进行的恐惧评分。结果显示，在66名至少玩过一个关卡的参与者中，大多数人继续完成了所有关卡，平均在VR中花费24.4分钟。自我报告的恐惧在关卡开始和结束之间持续下降。测试后AQ分数与在VR中花费的时间呈二次关系。测试前AQ分数较高与第一关后的主观焦虑以及测试后AQ分数的降低显著相关，但与疗程数无关，这表明长时间玩一关而不是练习多个VR关卡可能更有益。结果还显示了一个最佳暴露水平，超过此水平增加练习时间并不会带来更多益处。自我引导式VR恐高症治疗是有效的，并且在关卡之间以及治疗后均能持续降低自我报告的焦虑。尽管没有治疗师在场，大多数参与者仍有效地进展到了最高的自我暴露水平。
