In Vivo Versus Augmented Reality Exposure for Small Animal Phobia

NCT ID: NCT01361074

Last Updated: 2015-12-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-01-31

Study Completion Date

2013-01-31

Brief Summary

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The aim of this study is to explore the differential efficacy of in vivo exposure versus augmented reality exposure in the treatment of specific phobia (small animals).

The hypothesis is: There will not be significant statistical differences in the efficacy of in vivo exposure therapy versus augmented reality exposure in the treatment of specific phobia (small animals).

Detailed Description

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Among anxiety disorders, specific phobias are highly prevalent (around 7.2% and 11.3% in the general population). Cockroach or spider phobia is a type of specific phobia, animal type. The gold standard for the treatment of specific phobia (included small animal phobia) is in vivo exposure. Most phobia sufferers (60-80%) never seek treatment. Besides, not all patients benefit from in vivo exposure, given that an important amount of them do not accept the intervention or drop out (around 25%) when they are informed about the intervention procedure.

Information and Communication Technologies (ICT) like Virtual Reality (VR) and Augmented Reality (AR) are pioneer applications that can improve treatment adherence and acceptance. There exist some studies offering preliminary evidence of the efficacy of AR for the treatment of small animal phobia. However, there are not any controlled study exploring the differential efficacy of ICT-based exposure interventions versus in vivo exposure. In the present study the differential efficacy of AR exposure versus in vivo exposure for the treatment of small animal phobia is explored with a between subject randomized controlled trial. A pre-treatment assessment will be conducted in order to establish the diagnosis and evaluate the main outcome measures. All participants will receive an intensive exposure session following Öst guidelines, (in vivo exposure in one experimental condition and AR exposure in the other experimental condition). After the treatment a post-treatment assessment will be carried out as well as follow-up assessments at 3- and 12-month after treatment completion.

Conditions

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Phobic Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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In Vivo Exposure

Group Type EXPERIMENTAL

In Vivo Exposure for Animal Phobia following Öst´s guidelines

Intervention Type BEHAVIORAL

In vivo exposure is applied using "one-session treatment" guidelines (Öst, Salkovskis and Hellström, 1991). Exposure is conducted in a single extended session lasting up to 3 hours and implemented individually. The treatment includes participant modelling, in vivo exposure, reinforced practice and cognitive challenge. Treatment in a single session is just a starting point; it is recommended that the participants continue to be exposed to the phobic situations after therapy in their daily lives in order to fully surmount their problems. Participants are informed that the treatment required close collaboration between themselves and the therapist. The exposure session is completed in a gradual and planned way.

Augmented Reality Exposure

Group Type EXPERIMENTAL

Augmented Reality Exposure for Animal Phobia following Öst´s guidelines

Intervention Type BEHAVIORAL

Augmented Reality (AR) is a variation of Virtual Reality in which the user sees the real world augmented by various virtual elements; it complements reality rather than replacing it completely (Azuma et al., 2001). The most significant aspect of AR is that the virtual elements add relevant and helpful information to the physical information available in the real world. The system includes the options of changing the number, movement and size of small animals. Preliminary data show the utility of the system for the treatment of insect phobia (Botella et al., 2005). AR exposure is applied in the same way than in vivo exposure, that is, in a gradual, planned and controlled way using "one-session treatment" guidelines (Öst, Salkovskis and Hellström, 1991). The therapist can see what the participant sees in AR on a monitor and observe the same stimuli.

Interventions

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In Vivo Exposure for Animal Phobia following Öst´s guidelines

In vivo exposure is applied using "one-session treatment" guidelines (Öst, Salkovskis and Hellström, 1991). Exposure is conducted in a single extended session lasting up to 3 hours and implemented individually. The treatment includes participant modelling, in vivo exposure, reinforced practice and cognitive challenge. Treatment in a single session is just a starting point; it is recommended that the participants continue to be exposed to the phobic situations after therapy in their daily lives in order to fully surmount their problems. Participants are informed that the treatment required close collaboration between themselves and the therapist. The exposure session is completed in a gradual and planned way.

Intervention Type BEHAVIORAL

Augmented Reality Exposure for Animal Phobia following Öst´s guidelines

Augmented Reality (AR) is a variation of Virtual Reality in which the user sees the real world augmented by various virtual elements; it complements reality rather than replacing it completely (Azuma et al., 2001). The most significant aspect of AR is that the virtual elements add relevant and helpful information to the physical information available in the real world. The system includes the options of changing the number, movement and size of small animals. Preliminary data show the utility of the system for the treatment of insect phobia (Botella et al., 2005). AR exposure is applied in the same way than in vivo exposure, that is, in a gradual, planned and controlled way using "one-session treatment" guidelines (Öst, Salkovskis and Hellström, 1991). The therapist can see what the participant sees in AR on a monitor and observe the same stimuli.

Intervention Type BEHAVIORAL

Other Intervention Names

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In vivo exposure in phobic disorders In vivo exposure for small animal phobia Augmented Reality Exposure in phobic disorders Augmented Reality Exposure for small animal phobia

Eligibility Criteria

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Inclusion Criteria

* Be between 18-65 years of age.
* To meet current DSM-IV-TR criteria for specific phobia (animal type)
* Have as the major presenting complaint anxiety in, and avoidance of, a large range of situations involving spiders or cockroaches.
* A minimum of 1 year duration of the phobia.
* To have scores over 4 in phobic avoidance (on a scale of 0 to 8).
* Express a willingness to participate in the study.

Exclusion Criteria

* To be able to put a hand inside the container with a spider or cockroach during the behavioral test.
* Have other psychiatric problem in immediate need of treatment.
* Have psychotic or organic symptoms.
* Have heart or lung disease.
* Current alcohol or drug dependence or medication.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Valencia

OTHER

Sponsor Role collaborator

Universitat Jaume I

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Cristina Botella, Full Professor

Role: STUDY_DIRECTOR

University Jaume I, Castellon, Spain.

Cristina Botella, Full Professor

Role: STUDY_DIRECTOR

University Jaume I, Castellon, Spain

Locations

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University Jaume I

Castellon, Castellon, Spain

Site Status

University Jaume I

Castellon, Castellón, Spain

Site Status

Countries

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Spain

References

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Botella C, Breton-Lopez J, Quero S, Banos R, Garcia-Palacios A. Treating cockroach phobia with augmented reality. Behav Ther. 2010 Sep;41(3):401-13. doi: 10.1016/j.beth.2009.07.002. Epub 2010 Mar 20.

Reference Type BACKGROUND
PMID: 20569788 (View on PubMed)

Essau CA, Conradt J, Petermann F. Frequency, comorbidity, and psychosocial impairment of specific phobia in adolescents. J Clin Child Psychol. 2000 Jun;29(2):221-31. doi: 10.1207/S15374424jccp2902_8.

Reference Type BACKGROUND
PMID: 10802831 (View on PubMed)

Magee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC. Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Arch Gen Psychiatry. 1996 Feb;53(2):159-68. doi: 10.1001/archpsyc.1996.01830020077009.

Reference Type BACKGROUND
PMID: 8629891 (View on PubMed)

Garcia-Palacios A, Botella C, Hoffman H, Fabregat S. Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias. Cyberpsychol Behav. 2007 Oct;10(5):722-4. doi: 10.1089/cpb.2007.9962.

Reference Type BACKGROUND
PMID: 17927544 (View on PubMed)

Garcia-Palacios A, Hoffman HG, See SK, Tsai A, Botella C. Redefining therapeutic success with virtual reality exposure therapy. Cyberpsychol Behav. 2001 Jun;4(3):341-8. doi: 10.1089/109493101300210231.

Reference Type BACKGROUND
PMID: 11710258 (View on PubMed)

Marks IM, Mathews AM. Brief standard self-rating for phobic patients. Behav Res Ther. 1979;17(3):263-7. doi: 10.1016/0005-7967(79)90041-x. No abstract available.

Reference Type BACKGROUND
PMID: 526242 (View on PubMed)

Botella CM, Juan MC, Banos RM, Alcaniz M, Guillen V, Rey B. Mixing realities? An application of augmented reality for the treatment of cockroach phobia. Cyberpsychol Behav. 2005 Apr;8(2):162-71. doi: 10.1089/cpb.2005.8.162.

Reference Type BACKGROUND
PMID: 15938656 (View on PubMed)

Juan MC, Alcaniz M, Monserrat C, Botella C, Banos RM, Guerrero B. Using augmented reality to treat phobias. IEEE Comput Graph Appl. 2005 Nov-Dec;25(6):31-7. doi: 10.1109/mcg.2005.143. No abstract available.

Reference Type BACKGROUND
PMID: 16315475 (View on PubMed)

Ost LG. One-session treatment for specific phobias. Behav Res Ther. 1989;27(1):1-7. doi: 10.1016/0005-7967(89)90113-7.

Reference Type BACKGROUND
PMID: 2914000 (View on PubMed)

Ost LG. [One-session treatment of specific phobias--a rapid and effective method]. Lakartidningen. 1988 Mar 30;85(13):1139-42. No abstract available. Swedish.

Reference Type BACKGROUND
PMID: 3352391 (View on PubMed)

Related Links

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http://www.labpsitec.uji.es/esp/index.php

Information about our research group

http://www.hitl.washington.edu/projects/magnet/

International research group that focuses on virtual reality and analgesic effects

Other Identifiers

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UJaumeI01

Identifier Type: -

Identifier Source: org_study_id