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Open AccessArticle

The Role of Sense of Voice Presence and Anxiety Reduction in AVATAR Therapy

1
Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, 44787 Bochum, Germany
2
Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AB, UK
3
Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AB, UK
4
South London & Maudsley NHS Foundation Trust, London SE5 8AZ, UK
*
Author to whom correspondence should be addressed.
These authors contributed equally as senior authors.
J. Clin. Med. 2020, 9(9), 2748; https://doi.org/10.3390/jcm9092748
Received: 30 July 2020 / Revised: 18 August 2020 / Accepted: 19 August 2020 / Published: 25 August 2020
AVATAR therapy offers a unique therapeutic context that uses virtual reality technology to create a virtual embodiment of the voice-hearing experience, enabling the person to visualize their persecutory voice and engage in real-time “face-to-face” dialogue. The present study explores, for the first time, the contribution of sense of voice presence, together with session-by-session reduction of anxiety and paranoid attributions about the avatar, to changes in primary outcomes following AVATAR therapy. Data from 39 participants, who completed AVATAR therapy and attended a 12-week follow-up assessment, were analysed. Mid- to high-levels of sense of voice presence were reported across the therapy sessions, along with significant reductions of anxiety levels and paranoid attributions about the avatar. The interaction of sense of voice presence and reduction of anxiety was associated with two of the significant therapy outcomes: PSYRATS total and frequency of voices. The findings suggest that improvements in voice severity and frequency at post AVATAR therapy may be influenced by the combination of feeling less anxious in the context of a realistic simulation of the voice, while voice-related distress may involve additional cognitive and relational processes. View Full-Text
Keywords: auditory hallucinations; voices; AVATAR therapy; anxiety; presence; exposure therapy auditory hallucinations; voices; AVATAR therapy; anxiety; presence; exposure therapy
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MDPI and ACS Style

Rus-Calafell, M.; Ward, T.; Zhang, X.C.; Edwards, C.J.; Garety, P.; Craig, T. The Role of Sense of Voice Presence and Anxiety Reduction in AVATAR Therapy. J. Clin. Med. 2020, 9, 2748. https://doi.org/10.3390/jcm9092748

AMA Style

Rus-Calafell M, Ward T, Zhang XC, Edwards CJ, Garety P, Craig T. The Role of Sense of Voice Presence and Anxiety Reduction in AVATAR Therapy. Journal of Clinical Medicine. 2020; 9(9):2748. https://doi.org/10.3390/jcm9092748

Chicago/Turabian Style

Rus-Calafell, Mar; Ward, Thomas; Zhang, Xiao C.; Edwards, Clementine J.; Garety, Philippa; Craig, Tom. 2020. "The Role of Sense of Voice Presence and Anxiety Reduction in AVATAR Therapy" J. Clin. Med. 9, no. 9: 2748. https://doi.org/10.3390/jcm9092748

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