Virtual Reality Behavioral Activation as an Intervention for Major Depressive Disorder: Case Report.

Margot Paul,Jeremy Bailenson,Kim Bullock

doi:10.2196/24331

Abstract

BackgroundMajor depressive disorder (MDD) is a global problem with an increasing incidence and prevalence. There has additionally been an increase in depression due to the COVID-19 pandemic. Behavioral activation is considered an evidence-based treatment for MDD. However, there are many barriers that could hinder one’s ability to engage in behavioral activation, with COVID-19 “shelter-in-place” and social distancing orders being current and large impediments. Virtual reality (VR) has been successfully used to help treat a variety of mental health conditions, but it has not yet been used as a method of administering behavioral activation to a clinical population. Using VR to engage in behavioral activation could eliminate barriers that pandemic precautions place and help decrease symptoms of depression that are especially exacerbated in these times.ObjectiveThe following case report examines the feasibility, acceptability, and tolerability of VR behavioral activation for an adult with MDD during a global pandemic. This participant was part of a larger pilot study, and the case serves as a description of the VR intervention.MethodsThe participant engaged in a weekly 50-minute psychotherapy Zoom session for 4 weeks, in which a modified behavioral activation protocol was administered using a VR headset to simulate activities. Data on mood ratings, homework compliance, and headset use were obtained from the headset. Acceptability, tolerability, and depression symptoms were obtained using self-report rating scales.ResultsThe intervention was feasible, acceptable, and tolerable, as reported by this participant. The participant’s depressive symptoms decreased by five-points on the Patient Health Questionnaire-9 over a month, with a beginning score of 10 (moderate depression) and a final score of 5 (mild depression).ConclusionsThe implications of these findings for future research are discussed.Trial RegistrationClinicalTrials.gov NCT04268316; http://clinicaltrials.gov/ct2/show/NCT04268316

Highlights

Depression, classified as major depressive disorder (MDD) by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), is a global problem with an increasing incidence and prevalence [1]
This case report used the information and data gathered from the first participant who completed the Virtual reality (VR) behavioral activation (BA) arm of the study
After the initial phone screen and intake session were complete, he was informed that he met criteria to participate in the study. He was randomized into the VR BA arm of the study

Summary

Introduction

Depression, classified as major depressive disorder (MDD) by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), is a global problem with an increasing incidence and prevalence [1]. COVID-19 has further led to an increased risk for people developing depression worldwide, due to containment measures such as confinement to one’s home with “shelter-in-place” and community shutdown orders lasting for months [3,4]. Major depressive disorder (MDD) is a global problem with an increasing incidence and prevalence. There are many barriers that could hinder one’s ability to engage in behavioral activation, with COVID-19 “shelter-in-place” and social distancing orders being current and large impediments. Using VR to engage in behavioral activation could eliminate barriers that pandemic precautions place and help decrease symptoms of depression that are especially exacerbated in these times

Methods

Results

Conclusion