Abstract
Obsessive-compulsive disorder (OCD) is characterized by the presence of unwanted and repetitive thoughts triggering significant anxiety, as well as the presence of ritual behaviours or mental acts carried out in response to obsessions to reduce the associated distress. In the contamination subtype, individuals are scared of germs and bacteria, are excessively concerned with cleaning, fear contamination and the spread of disease, and may have a very strong aversion to bodily secretions. A few studies on virtual reality have been conducted with people suffering from OCD, but they all focus on the subtype characterized by checking rituals. The goal of this study is to confirm the potential of a “contaminated” virtual environment in inducing anxiety in 12 adults suffering from contamination-subtype OCD compared to 20 adults without OCD (N = 32) using a within-between protocol. Subjective (questionnaire) and objective (heart rate) measurements were compiled. Participants were immersed in a control virtual environment (empty and clean room) and a “contaminated” virtual environment (filthy public restroom) designed for the treatment of OCD. Immersions were conducted in a 6-wall CAVE-like system. As hypothesized, the results of repeated-measures ANCOVAs revealed the significant impact of immersion in a filthy public restroom for participants suffering from OCD on both measures. Presence was correlated with anxiety in OCD participants and no difference in presence was observed between groups. Unwanted negative side effects induced by immersions in virtual reality were higher in the OCD group. The clinical implications of the results and directions for further studies are discussed.
Highlights
The DSM-5 (American Psychiatric Association, 2013) defines obsessive–compulsive disorder (OCD) as characterized by the presence of thoughts, images, or urges perceived as unwanted and inappropriate and causing considerable distress, as well as behavioral or mental rituals used to cope with these obsessions and lessen the associated anxiety
Once we obtained the approval of the ethics committees of the universities involved in the project, participants were recruited through ads targeting the general population and others posted in hospitals and local community service centers to establish a representative sample of individuals with Obsessive–compulsive disorder (OCD)
The average Yale–Brown Obsessive–Compulsive Scale (YBOCS) for the OCD group was 25.04 (SD = 6.31), representing an average score that falls within the “severe” end of the scale
Summary
The DSM-5 (American Psychiatric Association, 2013) defines obsessive–compulsive disorder (OCD) as characterized by the presence of thoughts, images, or urges perceived as unwanted and inappropriate and causing considerable distress, as well as behavioral or mental rituals used to cope with these obsessions and lessen the associated anxiety. The contamination subtype is the most prevalent among people suffering from OCD, affecting 47.6% of these individuals (Ball et al, 1996). It is characterized by obsessions, such as fear of germs and filth, fear of disease, and fear of chemicals, as well as by compulsive cleaning, washing, and avoidance of situations where one can be contaminated (e.g., toilet seats). People who suffer from OCD often see their ability to function impaired by this disorder as a result of their obsessions and compulsions interfering in their interpersonal and professional lives (Moritz et al, 2005)
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