Bell Imogen H, Li Cassandra, Thompson Andrew, Ellinghaus Carli, O'Sullivan Shaunagh, Reynolds Kate Alexandra, Wadley Greg, Liu Yang, Bendall Sarah, Gleeson John, Valmaggia Lucia, Alvarez-Jimenez Mario
Orygen, Parkville, Australia.
Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
JMIR Ment Health. 2025 Aug 7;12:e70160. doi: 10.2196/70160.
Third-wave psychological treatments such as acceptance and commitment therapy can be effective for improving depression and anxiety in youth. However, third-wave therapeutic techniques such as cognitive defusion can be abstract, challenging to learn, and difficult to apply in real-world settings. Translating these techniques into virtual reality (VR) may provide interactive, enjoyable, and concrete learning opportunities, potentially enhancing engagement and effectiveness. This study evaluated a novel VR application that translates the technique of cognitive defusion into a brief, gamified VR experience.
The objectives of this study were to evaluate the feasibility, acceptability, usability, and safety of the VR cognitive defusion application; examine whether it could improve negative thinking and mood states; and understand how it compared to a non-VR cognitive defusion exercise.
In a mixed methods experimental study, 20 young people completed both a VR and audio cognitive defusion exercise in a randomized order within a single session. Quantitative state-based measures were taken before and after each exercise, and a qualitative interview at the end focused on how the two experiences compared.
It was feasible to recruit participants, and all participants completed both exercises and assessments. Both the VR and audio exercises were acceptable to participants, with qualitative themes highlighting a preference for VR due to the novel and engaging format; however, there was a need for better guidance and more personalized environments. No severe adverse events were reported, although one participant experienced distress during the VR exercise. Pretest-posttest effects showed improvements in thought discomfort, cognitive defusion, and state anger for both the VR and audio conditions (P<.05), with the latter showing broader improvements, including thought negativity, rumination, tension, depression, distress, and confusion (P<.05).
The VR cognitive defusion application was feasible, safe, and acceptable for young people, with potential to enhance mental health treatment through an engaging and enjoyable approach to learning third-wave cognitive behavioral therapy techniques. While VR was preferred by participants, further refinements could improve effectiveness. Future research should focus on enhancing the VR application design based on user feedback, incorporating audio guidance, and conducting a larger trial in real-world settings to thoroughly evaluate the effectiveness and implementation of the VR application.
诸如接纳与承诺疗法等第三波心理治疗方法对改善青少年的抑郁和焦虑可能有效。然而，诸如认知解离等第三波治疗技术可能较为抽象，学习起来具有挑战性，且难以在现实环境中应用。将这些技术转化为虚拟现实（VR）可能会提供互动性、趣味性且具体的学习机会，从而有可能提高参与度和有效性。本研究评估了一种新颖的VR应用程序，该程序将认知解离技术转化为一种简短的、游戏化的VR体验。
本研究的目的是评估VR认知解离应用程序的可行性、可接受性、可用性和安全性；检查它是否能改善消极思维和情绪状态；并了解它与非VR认知解离练习相比如何。
在一项混合方法实验研究中，20名年轻人在单个疗程内以随机顺序完成了VR和音频认知解离练习。在每次练习前后进行基于状态的定量测量，并且在最后进行了定性访谈，重点是比较这两种体验。
招募参与者是可行的，所有参与者都完成了这两种练习和评估。VR和音频练习对参与者来说都是可以接受的，定性主题突出了由于新颖且引人入胜的形式而对VR的偏好；然而，需要更好的指导和更个性化的环境。尽管有一名参与者在VR练习期间经历了痛苦，但未报告严重不良事件。前测-后测结果显示，VR和音频条件下的思维不适、认知解离和状态愤怒均有改善（P<0.05），后者显示出更广泛的改善，包括思维消极性、沉思、紧张、抑郁、痛苦和困惑（P<0.05）。
VR认知解离应用程序对年轻人来说是可行、安全且可接受的，有可能通过一种引人入胜且有趣的方式来学习第三波认知行为治疗技术，从而增强心理健康治疗效果。虽然参与者更喜欢VR，但进一步改进可能会提高有效性。未来的研究应专注于根据用户反馈改进VR应用程序设计，纳入音频指导，并在现实环境中进行更大规模的试验，以全面评估VR应用程序的有效性和实施情况。
