Believing is Seeing: A proof-of-concept study on using mobile Virtual Reality to boost the effects of Interpretation Bias Modification for anxiety.

Abstract

textabstractBackground: Cognitive Bias Modification of Interpretations (CBM-I) is a computerized intervention designed to change \nnegatively biased interpretations of ambiguous information, which underlie and reinforce anxiety. The repetitive and monotonous \nfeatures of CBM-I can negatively impact training adherence and learning processes. \nObjective: This proof-of-concept study aimed to examine whether performing a CBM-I training using mobile virtual reality \ntechnology (virtual reality Cognitive Bias Modification of Interpretations [VR-CBM-I]) improves training experience and \neffectiveness. \nMethods: A total of 42 students high in trait anxiety completed 1 session of either VR-CBM-I or standard CBM-I training for \nperformance anxiety. Participants’ feelings of immersion and presence, emotional reactivity to a stressor, and changes in \ninterpretation bias and state anxiety, were assessed. \nResults: The VR-CBM-I resulted in greater feelings of presence (P<.001, d=1.47) and immersion (P<.001, ηp \n2 \n=0.74) in the \ntraining scenarios and outperformed the standard training in effects on state anxiety (P<.001, ηp \n2 \n=0.3) and emotional reactivity \nto a stressor (P=.03, ηp \n2 \n=0.12). Both training varieties successfully increased the endorsement of positive interpretations (P<.001, \ndrepeated measures [drm]=0.79) and decreased negative ones. (P<.001, drm=0.72). In addition, changes in the emotional outcomes were \ncorrelated with greater feelings of immersion and presence. \nConclusions: This study provided first evidence that (1) the putative working principles underlying CBM-I trainings can be \ntranslated into a virtual environment and (2) virtual reality holds promise as a tool to boost the effects of CMB-I training for \nhighly anxious individuals while increasing users’ experience with the training application.