Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand.
Aust N Z J Psychiatry. 2023 May;57(5):736-744. doi: 10.1177/00048674221110779. Epub 2022 Jul 11.
Mobile health applications for mental health are widely accessible but most have had limited research evaluation. Virtual reality exposure therapy is an emerging treatment for specific phobias. Most virtual reality studies have investigated high-end virtual reality devices, typically only available in research and limited clinical settings for a single phobia. This study evaluated the effectiveness of oVRcome, a mobile health application combining self-guided virtual reality exposure and cognitive behaviour therapy, for five specific phobias.
This is a 2-arm 6-week randomised controlled trial, with a waitlist control group and follow-up at week 12. Participants were required to live in New Zealand; be aged 18-64 years; have a fear of flying, heights, spiders, dogs and needles; score above 4 on the Brief Standard Self-rating scale for phobic patients; and have access to a smartphone and Internet. oVRcome consists of six modules of psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through virtual reality and relapse prevention over 6 weeks. The primary outcome was the change from baseline to week 6 on the Severity Measures for Specific Phobia - Adults. All analyses were performed on intention-to-treat set.
A total of 126 participants were randomised, and 109 completed the follow-up at week 6, for a retention rate of 86.5%. The mean change in Severity Measures for Specific Phobia - Adults score from baseline to week 6 was greater in the active group compared with the waitlist group (active group -20.53 [standard deviation = 8.24]; waitlist group: - 12.31 [standard deviation = 10.66]; < 0.001). The effect size for this difference was 0.86.
Self-guided use of the oVRcome app was effective at reducing severity of specific phobia symptoms in a sample of people with a self-reported fear of flying, heights, spiders, dogs or needles.
移动心理健康应用程序使用广泛，但大多数应用程序的研究评估都很有限。虚拟现实暴露疗法是一种新兴的特定恐惧症治疗方法。大多数虚拟现实研究都调查了高端虚拟现实设备，这些设备通常仅在研究和有限的临床环境中用于单一恐惧症。本研究评估了 oVRcome 的有效性，oVRcome 是一种结合自我引导虚拟现实暴露和认知行为疗法的移动健康应用程序，用于治疗五种特定恐惧症。
这是一项为期 6 周的 2 臂随机对照试验，设等待对照组，随访时间为 12 周。参与者需居住在新西兰；年龄在 18-64 岁之间；患有飞行恐惧、恐高症、蜘蛛恐惧症、狗恐惧症和针恐惧症；恐惧症患者的简短标准自评量表得分高于 4 分；并能够使用智能手机和互联网。oVRcome 由六个模块组成，包括心理教育、放松、正念、认知技巧、虚拟现实暴露和 6 周的复发预防。主要结局指标是从基线到第 6 周的特定恐惧症严重程度量表的变化。所有分析均基于意向治疗集进行。
共有 126 名参与者被随机分组，109 名参与者在第 6 周完成了随访，保留率为 86.5%。与等待对照相比，活跃组从基线到第 6 周的特定恐惧症严重程度量表评分的平均变化更大（活跃组-20.53[标准差=8.24]；等待对照组：-12.31[标准差=10.66]；<0.001）。这种差异的效应大小为 0.86。
在一个自我报告有飞行恐惧、恐高症、蜘蛛恐惧症、狗恐惧症或针恐惧症的人群样本中，自我指导使用 oVRcome 应用程序可以有效降低特定恐惧症症状的严重程度。
