Believing is seeing: A proof-of-concept semiexperimental study on using mobile virtual reality to boost the effects of interpretation bias modification for anxiety

B. Otkhmezuri, M. Boffo, P. Siriaraya, M. Matsangidou, R.W. Wiers, B. Mackintosh, C.S. Ang, E. Salemink

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Cognitive Bias Modification of Interpretations (CBM-I) is a computerized intervention designed to change negatively biased interpretations of ambiguous information, which underlie and reinforce anxiety. The repetitive and monotonous features of CBM-I can negatively impact training adherence and learning processes. Objective: This proof-of-concept study aimed to examine whether performing a CBM-I training using mobile virtual reality technology (virtual reality Cognitive Bias Modification of Interpretations [VR-CBM-I]) improves training experience and effectiveness. Methods: A total of 42 students high in trait anxiety completed 1 session of either VR-CBM-I or standard CBM-I training for performance anxiety. Participants’ feelings of immersion and presence, emotional reactivity to a stressor, and changes in interpretation bias and state anxiety, were assessed. Results: The VR-CBM-I resulted in greater feelings of presence (P<.001, d=1.47) and immersion (P<.001, ηp 2=0.74) in the training scenarios and outperformed the standard training in effects on state anxiety (P<.001, ηp 2=0.3) and emotional reactivity to a stressor (P=.03, ηp 2=0.12). Both training varieties successfully increased the endorsement of positive interpretations (P<.001, drepeated measures [drm]=0.79) and decreased negative ones. (P<.001, drm=0.72). In addition, changes in the emotional outcomes were correlated with greater feelings of immersion and presence. Conclusions: This study provided first evidence that (1) the putative working principles underlying CBM-I trainings can be translated into a virtual environment and (2) virtual reality holds promise as a tool to boost the effects of CMB-I training for highly anxious individuals while increasing users’ experience with the training application.

Original languageEnglish
Article numbere11517
Number of pages13
JournalJournal of Medical Internet Research
Volume6
Issue number2
DOIs
Publication statusPublished - 2019

Funding

This study was supported by the Department of Engineering and Digital Arts of the University of Kent, Kent, United Kingdom.

Keywords

  • Anxiety
  • Cognitive bias modification
  • Emotional reactivity
  • Head mounted display
  • Immersion
  • Interpretation bias
  • Presence
  • Virtual reality

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