BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn Rd, Clayton, Victoria, Australia; The Melbourne Clinic Professorial Unit, Salisbury Street, Richmond, Victoria, Australia.
BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn Rd, Clayton, Victoria, Australia; The Melbourne Clinic Professorial Unit, Salisbury Street, Richmond, Victoria, Australia.
J Anxiety Disord. 2021 May;80:102404. doi: 10.1016/j.janxdis.2021.102404. Epub 2021 Apr 16.
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.
暴露和反应预防（ERP）是目前治疗强迫症（OCD）的一线心理治疗方法。然而，在治疗效果方面存在着显著的个体间差异，包括症状改善不充分，以及明显的拒绝和退出率。这在一定程度上是由于在临床环境中模拟侵入性思维的不切实际性。虚拟现实（VR）提供了一种克服这些限制的潜力，允许在支持性临床环境中创建精细控制的引起焦虑的场景。为了验证 VR 在治疗基于污染的 OCD 方面的潜力，22 名患者接受了 VR ERP 治疗和当前金标准的现场 ERP 治疗。在 VR 中，患者沉浸在污染环境中，可以灵活地进行可定制、分级的暴露任务。该 VR 环境使用 HTC Vive 硬件，允许患者与环境互动并在其中实际移动。记录了包括心率和呼吸率在内的主观和客观的苦恼指标。这些指标表明，虚拟和现场 ERP 治疗在暴露等级中引起一致的焦虑模式。虚拟暴露有利于参与和完成任务，并且治疗联盟得以维持。VR 是治疗污染 OCD 的一种有前途的 ERP 机制。
