Automated mobile virtual reality cognitive behavior therapy for aviophobia in a natural setting: a randomized controlled trial
Psychological Medicine, vol. 53, pp. 6232–6241
Abstract
Abstract Background Access to evidence-based psychological treatment is a challenge worldwide. We assessed the effectiveness of a fully automated aviophobia smartphone app treatment delivered in combination with a $5 virtual reality (VR) viewer. Methods In total, 153 participants from the Dutch general population with aviophobia symptoms and smartphone access were randomized in a single-blind randomized controlled trial to either an automated VR cognitive behavior therapy (VR-CBT) app treatment condition (n = 77) or a wait-list control condition (n = 76). The VR-CBT app was delivered over a 6-week period in the participants' natural environment. Online self-report assessments were completed at baseline, post-treatment, at 3-month and at 12-month follow-up. The primary outcome measure was the Flight Anxiety Situations Questionnaire (FAS). Analyses were based on intent-to-treat. Results A significant reduction of aviophobia symptoms at post-test for the VR-CBT app compared with the control condition [p < 0.001; d = 0. 98 (95% CI 0.65–1.32)] was demonstrated. The dropout rate was 21%. Results were maintained at 3-month follow-up [within-group d = 1.14 (95% CI 0.46–1.81)] and at 12-month follow-up [within-group d = 1.12 (95% CI 0.46–1.79)]. Six participants reported adverse effects of cyber sickness symptoms. Conclusions This study is the first to show that fully automated mobile VR-CBT therapy delivered in a natural setting can maintain long-term effectiveness in reducing aviophobia symptoms. In doing so, it offers an accessible and scalable evidence-based treatment solution that can be applied globally at a fraction of the cost of current treatment alternatives.
Authors 7
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Tara Donker corresponding
University of Freiburg · Amsterdam Public Health · Vrije Universiteit Amsterdam
Affiliation as printed
Department of Biological Psychology, Clinical Psychology and Psychotherapy, Albert Ludwigs-University of Freiburg, Freiburg im Breisgau, Baden-Württenberg, Germany
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute Amsterdam, Amsterdam, Noord-Holland, The Netherlands
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Amsterdam Public Health · Vrije Universiteit Amsterdam
Affiliation as printed
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute Amsterdam, Amsterdam, Noord-Holland, The Netherlands
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Affiliation as printed
Amsterdam Center for Learning Analytics (ACLA), Amsterdam, Noord-Holland, The Netherlands
Department of Education Sciences, Section Methods and Statistics, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
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Affiliation as printed
Amsterdam Center for Learning Analytics (ACLA), Amsterdam, Noord-Holland, The Netherlands
Department of Education Sciences, Section Methods and Statistics, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
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Amsterdam Public Health · Vrije Universiteit Amsterdam
Affiliation as printed
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute Amsterdam, Amsterdam, Noord-Holland, The Netherlands
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Amsterdam Public Health · Vrije Universiteit Amsterdam
Affiliation as printed
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute Amsterdam, Amsterdam, Noord-Holland, The Netherlands
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J.L. van Gelder Aachen Department of Clinical Neurodevelopmental Sciences Institute of Education and Child Studies
Leiden University · Max Planck Institute for the Study of Crime, Security and Law
Affiliation as printed
Department of Clinical Neurodevelopmental Sciences, Institute of Education and Child Studies, Leiden University, Leiden, Zuid-Holland, The Netherlands
Department of Criminology, Max Planck Institute for the Study of Crime, Security and Law, Freiburg im Breisgau, Baden-Württenberg, Germany
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