Abstract
BackgroundAlthough there is solid evidence for the efficacy of in vivo and virtual reality (VR) exposure therapy for a specific phobia, there is a significant debate over whether techniques promoting distraction or relaxation have impairing or enhancing effects on treatment outcome. In the present pilot study, we investigated the effect of diaphragmatic breathing (DB) as a relaxation technique during VR exposure treatment.MethodTwenty-nine patients with aviophobia were randomly assigned to VR exposure treatment either with or without diaphragmatic breathing (six cycles per minute). Subjective fear ratings, heart rate and skin conductance were assessed as indicators of fear during both the exposure and the test session one week later.ResultsThe group that experienced VR exposure combined with diaphragmatic breathing showed a higher tendency to effectively overcome the fear of flying. Psychophysiological measures of fear decreased and self-efficacy increased in both groups with no significant difference between the groups.ConclusionsOur findings indicate that diaphragmatic breathing during VR exposure does not interfere with the treatment outcome and may even enhance treatment effects of VR exposure therapy for aviophobic patients.Trial registrationRetrospectively registered. ClinicalTrials.gov NCT02990208. Registered 07 December 2016.
Highlights
There is solid evidence for the efficacy of in vivo and virtual reality (VR) exposure therapy for a specific phobia, there is a significant debate over whether techniques promoting distraction or relaxation have impairing or enhancing effects on treatment outcome
The group that experienced VR exposure combined with diaphragmatic breathing showed a higher tendency to effectively overcome the fear of flying
Psychophysiological measures of fear decreased and self-efficacy increased in both groups with no significant difference between the groups
Summary
There is solid evidence for the efficacy of in vivo and virtual reality (VR) exposure therapy for a specific phobia, there is a significant debate over whether techniques promoting distraction or relaxation have impairing or enhancing effects on treatment outcome. In order to control their fear, many use coping strategies that include the avoidance of fear-related situations, self-medication or alcohol [3]. In clinical practice, various coping strategies based on distraction are commonly used in order to help patients deal with anxiety-inducing situations [4, 5]. The results by Oliver and Page [10] support the assumption that distraction is an appropriate coping style by showing a beneficial effect of distraction techniques during in vivo exposure treatment for participants with a fear of blood, injections, and/or injury. The participants displayed an additional increase of subjective control over their anxiety during the month following the exposure session
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