Mor Sonia, Botella Cristina, Campos Daniel, Carlbring Per, Tur Cintia, Quero Soledad
Universitat Jaume I, Castellón, Spain.
CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.
Internet Interv. 2022 Feb 16;28:100510. doi: 10.1016/j.invent.2022.100510. eCollection 2022 Apr.
More research is needed in the field of Internet-delivered Cognitive Behavioral Treatments (ICBTs) for specific phobia in order to understand which characteristics are important in online exposure scenarios. The aim of the present work was to conduct a feasibility pilot study to explore participants' opinions, preferences, and acceptability ratings of two types of images (still images vs 360° navigable images) in an ICBT for Flying Phobia (FP). A secondary aim was to test the potential effectiveness of the two active treatment arms compared to a waiting list control group. An exploratory aim was to compare the role of navigable images vs. still images in the level of sense of presence and reality judgment and explore their possible mediation in treatment effectiveness.
Participants were randomly allocated to three conditions: NO-FEAR Airlines with still images ( = 26), NO-FEAR Airlines with still and navigable images (n = 26), and a waiting list group (n = 26). Primary outcome measures were participants' opinions, preferences, satisfaction, and acceptance regarding the images used in the exposure scenarios. Secondary outcome measures included FP symptomatology outcomes and measures of sense of presence and reality judgment.
Participants in the study preferred navigable images over still images before and after treatment (over 84%), and they considered them more effective and logical for the treatment of their problem. However, adherence in the experimental conditions was low (42.3% dropout rate), and more participants withdrew from the group that included navigable images compared to the group that only included still images (14 vs. 8), with no statistical differences in attrition between the two conditions. NO-FEAR Airlines proved to be effective in reducing FP symptomatology compared to the control group, with large between-group effect sizes on all FP measures (ranging from 0.76 to 2.79). No significant mediation effect was found for sense of presence or reality judgment in treatment effectiveness.
The results of the current study suggest that participants prefer more immersive images in exposure scenarios, providing data that can help to design useful exposure scenarios to treat specific phobias in the future. They also provide evidence supporting the effectiveness of an ICBT for FP.
Registered at Clinicaltrials.gov (NCT03900559) on April 9, 2019. Retrospectively registered.
在互联网提供的针对特定恐惧症的认知行为疗法（ICBT）领域，需要更多研究，以了解在在线暴露场景中哪些特征很重要。本研究的目的是进行一项可行性试点研究，以探索参与者对飞行恐惧症（FP）的ICBT中两种类型图像（静态图像与360°可导航图像）的意见、偏好和可接受性评分。次要目的是测试两个积极治疗组与等待列表对照组相比的潜在疗效。探索性目的是比较可导航图像与静态图像在临场感和现实判断水平中的作用，并探讨它们在治疗效果中的可能中介作用。
参与者被随机分配到三种条件下：使用静态图像的无畏航空公司组（n = 26）、使用静态和可导航图像的无畏航空公司组（n = 26）以及等待列表组（n = 26）。主要结局指标是参与者对暴露场景中使用的图像的意见、偏好、满意度和接受度。次要结局指标包括FP症状学结局以及临场感和现实判断的测量。
研究中的参与者在治疗前后都更喜欢可导航图像而非静态图像（超过84%），并且他们认为可导航图像在治疗其问题上更有效且更合理。然而，实验条件下的依从性较低（脱落率为42.3%），与仅包含静态图像的组相比，更多参与者退出了包含可导航图像的组（分别为14人和8人），两组之间的损耗没有统计学差异。与对照组相比，无畏航空公司被证明在减轻FP症状方面有效，在所有FP测量指标上组间效应量较大（范围从0.76到2.79）。在治疗效果方面，未发现临场感或现实判断有显著的中介作用。
当前研究结果表明，参与者在暴露场景中更喜欢更具沉浸感的图像，提供了有助于未来设计有效暴露场景以治疗特定恐惧症的数据。它们还提供了支持ICBT对FP有效性的证据。
于2019年4月9日在Clinicaltrials.gov（NCT03900559）注册。回顾性注册。
