Believing Is Seeing: A Proof-of-Concept Semiexperimental Study on Using Mobile Virtual Reality to Boost the Effects of Interpretation Bias Modification for Anxiety.

Boris Otkhmezuri,Bundy Mackintosh,Elske Salemink,Reinout W Wiers,Panote Siriaraya,Maria Matsangidou,Chee Siang Ang,Marilisa Boffo

doi:10.2196/11517

Abstract

BackgroundCognitive 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.ObjectiveThis 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.MethodsA 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.ResultsThe VR-CBM-I resulted in greater feelings of presence (P<.001, d=1.47) and immersion (P<.001, ηp2=0.74) in the training scenarios and outperformed the standard training in effects on state anxiety (P<.001, ηp2=0.3) and emotional reactivity to a stressor (P=.03, ηp2=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.ConclusionsThis 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.

Highlights

BackgroundNegative biases in information processing have been found to be a vulnerability factor and to play a causal role in the development and exacerbation of emotional disorders, anxiety [1,2,3]
An independent-samples t test was carried out to examine whether participants completing the virtual reality (VR)-Cognitive Bias Modification of Interpretations (CBM-I) experienced more intense feelings of presence during training than participants completing the standard Cognitive Bias Modification (CBM)-I training, as measured by the mean rating on the Slater-Usoh-Steed visual analogue scales (VAS) (SUS) items
Results showed that the VR-CBM-I group experienced significantly higher levels of presence than the standard CBM-I group

Summary

Introduction

Negative biases in information processing have been found to be a vulnerability factor and to play a causal role in the development and exacerbation of emotional disorders, anxiety [1,2,3]. Experimental research established that interpretation bias can be manipulated (or retrained) using a scenario-based procedure labeled Cognitive Bias Modification of Interpretations (CBM-I) [4]. In this training paradigm, participants repeatedly read short text scenarios describing ambiguous situations relevant to their type of anxiety, each one ending with a word fragment. 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

Results

Discussion

Conclusion