Self-efficacy Enhancement in a Virtual Reality Training for Fear of Heights
NCT ID: NCT05824884
Last Updated: 2026-01-29
Study Results
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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RECRUITING
NA
60 participants
INTERVENTIONAL
2023-06-22
2026-03-03
Brief Summary
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The investigators hypothesize that SE enhancement (either administered DURING or AFTER VR-height-exposure) will be more effective (as indicated by more pronounced reductions in height-related fear and avoidance) than VR-height-exposure alone. It is further expected that the combined SE enhancement DURING and AFTER VR-height-exposure will be more effective compared to SE enhancement DURING VR-height-exposure alone and/or SE enhancement DURING VR-height-exposure alone.
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Detailed Description
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Participants will be randomly assigned to one of the following conditions: a) visual feedback DURING VR-height-exposure and SE-enhancement targeting mastery experience AFTER VR-height-exposure b) no visual feedback DURING VR-height-exposure but SE-enhancement targeting mastery experience AFTER VR-height-exposure, c) visual feedback DURING VR-height-exposure but a control intervention AFTER VR-height-exposure d) no visual feedback and control intervention after VR-height- exposure. The SE-enhancement as well as the control intervention involve memory reactivation either with or without emphasis on a mastery experience attained during the VR-height-exposure. The visual feedback is presented in form of a progress-update combined with positive affirmation.
The VR-height-exposure concludes different exercises in a virtual environment that simulate situations, that can be challenging to height-fearful individuals in real life, such as glass-elevators, a glass-bridge, a tall ladder and lattice stairs. During VR-height-exposure, self-reported fear is measured in Subjective Units of Distress (SUDS). The VR-environment is presented via head-mounted displays and the participants can use touch-controllers to navigate through the exercises guided by the experimenter.
As outcome measures, subjective fear and height-related avoidance will be assessed at three time points: pre-exposure, post-exposure and at 3 months-follow-up.
Subjective fear is measured using the Acrophobia Questionnaire (AQ; Cohen, 1977). To measure height-related avoidance behavior, a Behavioural Approach Test (BAT) will be performed in a nearby church tower, that includes 13 steps of varying difficulty and requires active behavioral approach towards height-situations.
Furthermore, danger expectancies and fear expectancies (DES, AES) will be measured at pre- and post-exposure as well as at 3-months-follow-up. During all BATs and the VR-height-exposure, heart-rate variability (HRV) will be assessed as a psychophysiological indicator for fear response.
Moreover, participants are asked to rate their general self-efficacy via Questionnaire (GSE) and their perceived self-efficacy via Visual Analogue Scales (VAS) at pre- and post-exposure as well as 3-months follow-up. Furthermore, the VAS measures mood, excitement, and distraction.
Additionally, several control variables are assessed pre-exposure, including Beck's Depression Inventory II (BDI-II), The State-and-Trait-Anxiety Inventory (STAI-T; STAI-S), the Self-Efficacy Scale (SES) and the CSSES.
Implicit Approach-Avoidance biases towards height-related stimuli will also be assessed pre- and post VR-height-training utilizing the Approach-Avoidance-Task (AAT). The participants are instructed to push away (simulating avoidance) vs. pull towards (simulating approach) neutral vs. height-related pictures according to the way they are tilted (tilted-right vs. tilted left) using the computer mouse. Reaction time delays in the pull towards height-related pictures condition can be an indicator for implicit avoidance tendencies.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Experimental 1
positive visual feedback during VR-height-exposure combined with SE-enhancement after exposure.
Visual Feedback
Visual progress feedback and words of positive affirmation will be presented triggered by checkpoints set in the VR-height-exposure.
Self-efficacy enhancement:
specific instructions regarding the retrieval of mastery experiences during exposure will be given (modified version of the procedure used in Raeder et al. 2019).
Active Comparator 1
positive visual feedback during VR-height-exposure, and a placebo intervention after exposure.
Visual Feedback
Visual progress feedback and words of positive affirmation will be presented triggered by checkpoints set in the VR-height-exposure.
placebo intervention
specific instructions regarding the retrieval of the exposure session will be given without an emphasis on personal mastery experience (modified version of the procedure used in Raeder et al. 2019).
Active Comparator 2
no visual feedback during exposure but SE-enhancement after exposure.
Self-efficacy enhancement:
specific instructions regarding the retrieval of mastery experiences during exposure will be given (modified version of the procedure used in Raeder et al. 2019).
No visual feedback
Participants can not trigger any checkpoints during VR and therefore not receive any progress feedback or positive affirmation.
Placebo Comparator
no visual feedback during exposure and placebo intervention after exposure.
placebo intervention
specific instructions regarding the retrieval of the exposure session will be given without an emphasis on personal mastery experience (modified version of the procedure used in Raeder et al. 2019).
No visual feedback
Participants can not trigger any checkpoints during VR and therefore not receive any progress feedback or positive affirmation.
Interventions
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Visual Feedback
Visual progress feedback and words of positive affirmation will be presented triggered by checkpoints set in the VR-height-exposure.
Self-efficacy enhancement:
specific instructions regarding the retrieval of mastery experiences during exposure will be given (modified version of the procedure used in Raeder et al. 2019).
placebo intervention
specific instructions regarding the retrieval of the exposure session will be given without an emphasis on personal mastery experience (modified version of the procedure used in Raeder et al. 2019).
No visual feedback
Participants can not trigger any checkpoints during VR and therefore not receive any progress feedback or positive affirmation.
Eligibility Criteria
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Inclusion Criteria
* fear of heights
* normal or corrected vision
Exclusion Criteria
* acute psychiatric drug intake
* acute schizophrenic or psychotic symptoms
* acute major depressive episode with severe symptoms
* acute substance use disorder
* neurological disorder or mental disability
* cardiac arrhythmias or pacemaker
18 Years
65 Years
ALL
No
Sponsors
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Ruhr University of Bochum
OTHER
Responsible Party
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Armin Zlomuzica
Principal Investigator
Locations
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Mental Health Research and Treatment Center
Bochum, , Germany
Countries
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Facility Contacts
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Other Identifiers
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AZ 794
Identifier Type: -
Identifier Source: org_study_id
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