Mixed Response Patterns to a Virtual Reality Intervention targeting Trauma-related Shame in Adolescents after Sexual Abuse: A Single-Case Experimental Design

Child Psychiatry & Human Development

Abstract

Although trauma-related shame is increasingly recognized as an impactful phenomenon following inter-personal trauma, it appears to be under-addressed in evidence-based trauma treatments in youth. Virtual Reality (VR) technology has potential to act as an adjunct to existing treatments by targeting trauma-related shame. Using a multiple baseline single-case experimental design (SCED), this study aims to test the effectiveness of a novel VR intervention (SHINE-VR) addressing trauma-related shame in adolescents with a history of sexual abuse. The intervention consists of three consecutive modules which include psychoeducation, virtual social sharing and self-compassion tasks. Each module lasts between 15 and 20 min and is followed by a discussion with the administering clinician. Six adolescents (ages 14-17 years) were included. They received SHINE-VR additional to their regular trauma treatment. Direct and indirect shame, self-compassion and post-traumatic stress disorder (PTSD) symptoms were measured daily. Individual-level analyses indicated decreases in direct shame for most, and decreases in indirect shame as well as increases in self-compassion for some adolescents, though magnitude varied. The PTSD symptoms stagnated above a clinically relevant cut-off. Across cases, effects suggested small to modest improvements in direct shame but no consistent changes in indirect shame and self-compassion. Given the small sample and the heterogeneity in treatment responses, findings should be interpreted descriptively. The results suggest that SHINE-VR may be a promising addition to existing trauma treatments to decrease direct shame. Future studies should examine, in larger samples and over the full treatment course, whether more in-depth sessions and longer time periods would increase effectiveness.

Authors 5

1. Nina Krupljanin Aachen

   Leiden University

   Affiliation as printed

   Leiden University Institute of Education and Child Studies, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands

2. Anja van der Voort Aachen

   Leiden University

   Affiliation as printed

   Leiden University Institute of Education and Child Studies, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands

3. Lenneke R. A. Alink Aachen

   Leiden University

   Affiliation as printed

   Leiden University Institute of Education and Child Studies, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands

4. Ramón Lindauer

   Amsterdam University Medical Centers · Levvel · University of Amsterdam

   Affiliation as printed

   Dept. Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

   Levvel Centrum voor Trauma en Gezin, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands

5. Catharina E. Bergwerff corresponding Aachen

   Leiden University

   Affiliation as printed

   Leiden University Institute of Education and Child Studies, Wassenaarseweg 52, Leiden, 2333 AK, The Netherlands. c.e.bergwerff@fsw.leidenuniv.nl