Virtual reality in the treatment of persecutory delusions: randomised controlled experimental study testing how to reduce delusional conviction.
Virtual reality in the treatment of persecutory delusions: randomised controlled experimental study testing how to reduce delusional conviction.
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DOI：
10.1192/bjp.bp.115.176438
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发表时间：
2016-07
期刊：
影响因子：
--
通讯作者：
Clark DM
中科院分区：
文献类型：
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作者：
Freeman D;Bradley J;Antley A;Bourke E;DeWeever N;Evans N;Černis E;Sheaves B;Waite F;Dunn G;Slater M;Clark DM
背景 被害妄想可能是由于寻求安全的行为而维持的毫无根据的威胁信念，这些行为阻止了否定性证据被成功处理。虚拟现实的使用可以促进新的学习。目的 检验以下假设：使患者能够在虚拟现实社会环境中测试被害妄想的威胁预测，同时减少寻求安全的行为（虚拟现实认知疗法），与单独暴露（虚拟现实暴露）相比，可以更大程度地减少妄想。方法 对 30 名被害妄想患者的妄想信念和现实情况中的痛苦进行了评估。然后，患者被随机分配接受虚拟现实认知治疗或虚拟现实暴露治疗，均在分级虚拟现实社交环境中进行 30 分钟。然后重新评估妄想信念和现实世界的痛苦。结果与暴露相比，虚拟现实认知疗法导致妄想信念（减少 22.0%，P = 0.024，科恩 d = 1.3）和现实世界痛苦（减少 19.6%，P = 0.020，科恩 d = 0.8）大幅减少。结论 使用虚拟现实的认知疗法对于治疗妄想症非常有效。
Background Persecutory delusions may be unfounded threat beliefs maintained by safety-seeking behaviours that prevent disconfirmatory evidence being successfully processed. Use of virtual reality could facilitate new learning. Aims To test the hypothesis that enabling patients to test the threat predictions of persecutory delusions in virtual reality social environments with the dropping of safety-seeking behaviours (virtual reality cognitive therapy) would lead to greater delusion reduction than exposure alone (virtual reality exposure). Method Conviction in delusions and distress in a real-world situation were assessed in 30 patients with persecutory delusions. Patients were then randomised to virtual reality cognitive therapy or virtual reality exposure, both with 30 min in graded virtual reality social environments. Delusion conviction and real-world distress were then reassessed. Results In comparison with exposure, virtual reality cognitive therapy led to large reductions in delusional conviction (reduction 22.0%, P = 0.024, Cohen's d = 1.3) and real-world distress (reduction 19.6%, P = 0.020, Cohen's d = 0.8). Conclusion Cognitive therapy using virtual reality could prove highly effective in treating delusions.