An internet-based treatment for flying phobia using 360° images: A feasibility pilot study

Mor, Sonia; Botella, Cristina; Campos, Daniel; Carlbring, Per; Tur, Cintia; Quero, Soledad

doi:10.1016/j.invent.2022.100510

Cited by 3 publications

(4 citation statements)

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“…Owing to time constraints, we did not use any statistical method to calculate the required sample size. The study by Mor et al [ 48 ] recommended a minimum of 20 participants in each study arm for feasibility pilot studies on treating flying phobia using 360° images. Certainly, a larger number of patients is needed in each arm for the primary assessments.…”

Section: Discussionmentioning

confidence: 99%

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A Smartphone-Gamified Virtual Reality Exposure Therapy Augmented With Biofeedback for Ailurophobia: Development and Evaluation Study

Khaleghi,

Narimani,

Aghaei

et al. 2024

JMIR Serious Games

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Background To the best of our knowledge, no specialized research has been conducted to address ailurophobia (fear of cats) in Iran or globally. This has driven our project, along with the prevalence of ailurophobia and the absence of a gamified virtual reality exposure therapy (VRET) that incorporates affordable and easily accessible biofeedback (BF) tools. We hypothesize that a gamified VRET augmented with BF will yield more positive effects than a similar device lacking BF. Objective This study primarily focuses on the development and preliminary evaluation of a smartphone-gamified VRET integrated with BF, targeting animal phobia, with a specific case study on ailurophobia. The secondary objectives are using affordable and readily available BF found in devices such as smart bands and smartwatches and creating a mobile virtual reality gamified app to improve patients’ adherence to treatments while simultaneously enhancing the app’s accessibility, scalability, and outreach. Methods Evaluations encompassed 3 methods. First, we identified the tool’s potential positive effects on phobia interventions, exploring 4 effects: intrinsic motivation, simulation of fearful situations, management of stressful circumstances without therapists’ presence and mitigation of catastrophic thoughts, and preliminary effects on ailurophobia treatment. Participants were divided into BF and non-BF groups. Second, we gathered user preferences and opinions about the treatment. Third, we conducted heuristic evaluations using 44 heuristics from existing system usability scales assessing user interfaces, virtual reality platforms, and video games’ playability. To interpret the data, mean scores; ANOVA, single factor; and ANOVA, 2-factor with replication were used. A total of 29 individuals were identified, of which 10 met the eligibility criteria or were accessible. Results The smartphone-gamified VRET augmented with BF exhibited better results on the identified effects compared with the non-BF version and contributed to normalizing encounters with cats. Moreover, 41 of the 44 heuristics achieved a percentage above 62%, indicating its potential as a therapeutic product and its ability to enhance patient adherence to treatments. Patient preferences on the treatment and its strengths and weaknesses were provided for further improvement. Conclusions The tool has the potential to evolve into a comprehensive solution by incorporating various types of cats and their behaviors, simulating environments in which they are commonly found, and enhancing its appeal through an increased sense of adventure without inducing unrealistic fears. By adapting fear elements, the game can be tailored to treat various animal phobias. Phobia-focused games should avoid action and combat scenarios to prevent reinforcement of fear responses. After rigorous evaluation, further exploration is required to provide remote use beyond clinical settings.

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Section: Discussionmentioning

confidence: 99%

“…To gather patients’ opinions on the implemented treatment, an adapted preference questionnaire [ 48 ] was used. This 6-item questionnaire focused on patients’ preferences regarding the types of cat models, their behaviors, sounds, and sizes.…”

Section: Methodsmentioning

confidence: 99%

A Smartphone-Gamified Virtual Reality Exposure Therapy Augmented With Biofeedback for Ailurophobia: Development and Evaluation Study

Khaleghi,

Narimani,

Aghaei

et al. 2024

JMIR Serious Games

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“…También, al ser un sistema accesible permitiría al clínico utilizar paisajes adaptados específicamente a cada individuo, partiendo de la gran cantidad de imágenes 360º ya disponibles gratuitamente por Internet, de forma que el tratamiento fuese totalmente personalizado. Al igual que otras experiencias con tecnologías de RV similares (Freeman et al, 2018;Gambini, 2020;Mor et al, 2022;Donker et al, 2019;Pérez-López, 2009), esta es fácil de utilizar y ha mostrado su aceptación y usabilidad.…”

Section: Discusión Y Conclusionesunclassified

“…Se han probado también otras tecnologías comerciales como el visor Google Cardboard por parte de otros quipos que han desarrollado paisajes virtuales para estas gafas y han tratado la acrofobia con buenos resultados y aceptación de los participantes (Donker et al, 2019;Gambini, 2020). El equipo de Botella (Mor et al, 2022) ha utilizado también imágenes de 360º en un programa a través de Internet, como forma de tratamiento de exposición on-line para el miedo a volar en avión; previamente también evaluaron la usabilidad, las opiniones y la aceptación de los usuarios sobre esas imágenes. Incluso se ha desarrollado un programa de RV totalmente inmersiva, con un terapeuta virtual preguntando y guiando al usuario en distintos escenarios con alturas, que obtuvo resultados superiores al grupo control (Freeman et al, 2018).…”

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La realidad virtual para la acrofobia

Aguayo

2023

Rev Esp Comun Salud

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Introducción: La realidad virtual (RV) ya ha mostrado su eficacia en fobias a volar, agorafobia, conducir, insectos, roedores, etc., pero requiere crear los mundos virtuales adaptados al individuo. Objetivos: Evaluar la usabilidad, la satisfacción y las dificultades que tienen los consultantes con un sistema de RV asequible (VRBox y un teléfono móvil de calidad) con imágenes de 360º disponibles libremente en Internet en problemas de acrofobia. Método: Participaron 47 personas (entre 18 y 69 años), de ellas 21 mujeres (45%). Los usuarios fueron expuestos a 10 vídeos de 360 grados, en una montura VRBox que incluía un teléfono móvil. Se aplicaron diversos cuestionarios de ansiedad, fobia específica a las alturas, usabilidad y satisfacción con la experiencia y el equipo. Resultados: Las puntuaciones de usabilidad fueron elevadas (M = 73.51 sobre 100 puntos) y el grado de ansiedad baja (M = 2.50 sobre 10 puntos). No aparecieron diferencias significativas entre hombres y mujeres; los que habían tenido experiencia previa con RV la valoraban mejor; y quienes padecían de vértigos o mareos la valoraban peor y con más ansiedad. Conclusión: El sistema de RV sobre acrofobia es aceptado y bien valorado por la mayoría de los usuarios, aunque habría que adaptar el sistema tecnológico a cada persona, sobre todo si aparecen molestias al utilizarlo.

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Evaluation and Future Challenges in a Self-Guided Web-Based Intervention With and Without Chat Support for Depression and Anxiety Symptoms During the COVID-19 Pandemic: Randomized Controlled Trial

Dominguez-Rodriguez,

Sanz-Gomez,

González Ramírez

et al. 2024

JMIR Form Res

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Background The COVID-19 pandemic has had an impact on mental health worldwide. Low- and middle-income countries were largely affected by it. Mexico was one of the most affected countries. Extended periods of lockdowns, isolation, and social distancing, among other factors, highlighted the need to introduce web-based psychological interventions to the Mexican population. In this context, Mental Health COVID-19 emerged as a self-guided web-based intervention (SGWI) aimed at adults to improve mental health during the COVID-19 pandemic. Objective This study aims to assess the efficacy of 2 modalities of a self-guided intervention (with and without chat support) in reducing depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation. In addition, it aimed to compare the moderating role of coping strategies, acceptance, and satisfaction in participants’ symptom reduction. We hypothesize that the self-guided, chat-supported modality will show higher efficacy than the modality without chat support in achieving clinical change and better performance as a moderator of depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation, as well as an increase in participants’ satisfaction and acceptability. Methods A randomized controlled trial was conducted. Data were collected from May 2020 to June 2022. We performed intrasubject measures at 4 evaluation periods: pretest, posttest, and follow-up measurements at 3 and 6 months. Differences between intervention groups were assessed through the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. Changes due to intervention were analyzed using Wilcoxon W test. Moderated regression analysis was performed to test the hypothesized moderating role of coping strategies, usability, and opinion about treatment on clinical change. Results A total of 36 participants completed the intervention; of these, 5 (14%) were part of the SGWI group, and 31 (86%) were on the SGWI plus chat support (SGWI+C) group, which included a chat service with therapists. The perceived high complexity of the system for the SGWI group had a moderating effect associated with a lack of efficacy of the intervention regarding depression, but not when controlled for sociodemographic variables. A perception of lower helpfulness of the intervention was associated with poorer outcomes. Coping strategies did not show moderating effects. Conclusions Enhancing the utility of web-based interventions for reducing clinical symptoms by incorporating a support chat to boost treatment adherence seemed to improve the perception of the intervention’s usefulness. Web-based interventions face several challenges, such as eliminating complexities in platform use and increasing the users’ perceived utility of the intervention, among other issues identified in the study. Trial Registration ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/study/NCT04468893?tab=results International Registered Report Identifier (IRRID) RR2-10.2196/23117

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An internet-based treatment for flying phobia using 360° images: A feasibility pilot study

Cited by 3 publications

References 65 publications

A Smartphone-Gamified Virtual Reality Exposure Therapy Augmented With Biofeedback for Ailurophobia: Development and Evaluation Study

A Smartphone-Gamified Virtual Reality Exposure Therapy Augmented With Biofeedback for Ailurophobia: Development and Evaluation Study

La realidad virtual para la acrofobia

Evaluation and Future Challenges in a Self-Guided Web-Based Intervention With and Without Chat Support for Depression and Anxiety Symptoms During the COVID-19 Pandemic: Randomized Controlled Trial

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