Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial.
Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial.
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DOI：
10.1016/s2215-0366(18)30226-8
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发表时间：
2018-08
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影响因子：
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通讯作者：
Nickless A
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作者：
Freeman D;Haselton P;Freeman J;Spanlang B;Kishore S;Albery E;Denne M;Brown P;Slater M;Nickless A
参与式、交互式和自动化的虚拟现实(VR)治疗可能有助于解决精神健康障碍患者未得到满足的需求。我们测试了一种针对恐高症的自动化认知干预的有效性，该干预由虚拟现实中的化身虚拟教练(使用演员的动作和声音捕捉进行动画制作)指导，并配备最新的消费设备。我们对自动虚拟现实和常规护理进行了随机试验。我们通过英国牛津郡的广播广告招募了18岁以上有恐高症的成年人。如果参与者在高地解释问卷(HiQ)上的得分超过29分，我们就会诊断出恐高症。我们通过计算机按1：1的比例随机将参与者分配到两组，一组是在两周内每周大约两到三次进行大约六次30分钟的自动VR治疗(干预组)，另一组是常规护理(对照组)。根据恐高症的严重程度进行随机化。研究小组在不知道随机分配的情况下，进行了三次恐高症评估，分别是基线(0周)、治疗结束(2周)和随访(4周)。主要的结果测量是HiQ评分(范围16-80，分数越高表明病情越严重)。这项试验在ISRCTN注册中心注册，编号为ISRCTN11898283。在2017年11月25日至2018年2月27日期间，100名受试者接受了随机分组，其中49人被分配到VR治疗组，51人被分配给对照组。所有参与者都完成了为期4周的随访。VR组平均总治疗时间124·43min(SD 34·23)。与对照组相比，VR治疗组在治疗结束时恐高症明显减少(VR组平均变化评分−24·5[SD 13·1]，对照组−1·2[7·3]；调整差−24·0，95%CI−27·7至−20·3；Cohen‘s d=2·0；p<；0·0001)。随访时，VR组的平均变化评分−为25·1[SD 13·9]，对照组为−1·5[7·8]；调整后的差值−为24·3，95%CI−为27·9至−20·6；至少需要治疗才能将恐高症减半的人数为1/3。没有不良反应的报道。由VR教练自动提供的心理治疗可以产生巨大的临床好处。基于证据的VR治疗有可能极大地增加心理健康障碍的治疗供应。牛津虚拟现实研究所和国家健康研究所牛津健康生物医学研究中心。
Engaging, interactive, and automated virtual reality (VR) treatments might help solve the unmet needs of individuals with mental health disorders. We tested the efficacy of an automated cognitive intervention for fear of heights guided by an avatar virtual coach (animated using motion and voice capture of an actor) in VR and delivered with the latest consumer equipment. We did a randomised trial of automated VR versus usual care. We recruited adults aged older than 18 years with a fear of heights by radio advertisements in Oxfordshire, UK. We diagnosed fear of heights if participants scored more than 29 on the Heights Interpretation Questionnaire (HIQ). We randomly allocated participants by computer in a 1:1 ratio to either automated VR delivered in roughly six 30-min sessions administered about two to three times a week over a 2-week period (intervention group) or to usual care (control group). Randomisation was stratified by severity of fear of heights. The research team, who were unaware of the random allocation, administered three fear-of-height assessments, at baseline (0 weeks), at the end of treatment (2 weeks), and at follow-up (4 weeks). The primary outcome measure was HIQ score (range 16–80, with higher scores indicating greater severity). This trial is registered with the ISRCTN registry, number ISRCTN11898283. Between Nov 25, 2017, and Feb 27, 2018, 100 individuals were enrolled and underwent randomisation, of whom 49 were assigned to the VR treatment group and 51 to the control group. All participants completed the 4-week follow-up. The mean total treatment time in VR was 124·43 min (SD 34·23). Compared with participants in the control group, the VR treatment reduced fear of heights at the end of treatment (mean change score −24·5 [SD 13·1] in the VR group vs −1·2 [7·3] in the control group; adjusted difference −24·0, 95% CI −27·7 to −20·3; Cohen's d=2·0; p<0·0001). The benefit was maintained at follow-up (mean change score −25·1 [SD 13·9] in the VR group vs −1·5 [7·8] in the control group; adjusted difference −24·3, 95% CI −27·9 to −20·6; Cohen's d=2·0; p<0·0001). The number needed to treat to at least halve the fear of heights was 1·3. No adverse events were reported. Psychological therapy delivered automatically by a VR coach can produce large clinical benefits. Evidence-based VR treatments have the potential to greatly increase treatment provision for mental health disorders. Oxford VR, and the National Institute of Health Research Oxford Health Biomedical Research Centre.