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Open AccessArticle

Analysis of Usage Data from a Self-Guided App-Based Virtual Reality Cognitive Behavior Therapy for Acrophobia: A Randomized Controlled Trial

1
Department of Clinical, Neuro and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
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Amsterdam Public Health Research Institute Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Department of Psychology, Laboratory of Biological and Personality Psychology, Albert Ludwigs-University of Freiburg, Peter-Kaplan Meierstrasse 8, 79104 Freiburg im Breisgau, Germany
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Department of Education Sciences, Section Methods and Statistics and Amsterdam Center for Learning Analytics, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
5
Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
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Centre for Innovative Medical Technology, Odense University Hospital, Indgang 101, 5000 Odense, Denmark
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Institute of Education and Child Studies, Leiden University, Pieter de la Court building, 4th floor, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
8
Max Planck Institute for the Study of Crime, Security and Law, Department of Criminology, Günterstalstraße 73, 79100 Freiburg, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(6), 1614; https://doi.org/10.3390/jcm9061614
Received: 10 April 2020 / Revised: 14 May 2020 / Accepted: 22 May 2020 / Published: 26 May 2020
This study examined user engagement with ZeroPhobia, a self-guided app-based virtual reality (VR) Cognitive Behavior Therapy for acrophobia symptoms using cardboard VR viewers. Dutch acrophobic adults (n = 96) completed assessments at baseline and immediately following treatment. Primary outcome measures were the Acrophobia Questionnaire (AQ) and the Igroup Presence Questionnaire (IPQ). Usage data consisted of number of VR sessions practiced, practice time, and fear ratings directly after practicing. Results show that of the 66 participants who played at least one level, the majority continued to finish all levels, spending on average 24.4 min in VR. Self-reported fear consistently decreased between the start and finish of levels. Post-test AQ scores depended quadratically on time spent in VR. Higher pre-test AQ scores were significantly associated with subjective anxiety after the first level and a reduction of post-test AQ scores, but not with number of sessions, suggesting it might be more beneficial to play one level for a longer time period instead of practicing many VR levels. Results also show an optimum exposure level at which increasing practice time does not result in increased benefit. Self-guided VR acrophobia treatment is effective and leads to consistent reductions in self-reported anxiety both between levels and after treatment. Most participants progressed effectively to the highest self-exposure level, despite the absence of a therapist. View Full-Text
Keywords: acrophobia; cognitive behaviour therapy; mobile app; virtual reality; usage data acrophobia; cognitive behaviour therapy; mobile app; virtual reality; usage data
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Donker, T.; van Klaveren, C.; Cornelisz, I.; Kok, R.N.; van Gelder, J.-L. Analysis of Usage Data from a Self-Guided App-Based Virtual Reality Cognitive Behavior Therapy for Acrophobia: A Randomized Controlled Trial. J. Clin. Med. 2020, 9, 1614.

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