A Gamified Virtual Reality Exposure Therapy for Individuals with Arachnophobia: A Pilot Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This study presents a promising exploration into the use of gamified Virtual Reality Exposure Therapy (VRET) for treating arachnophobia. The authors have employed a well-structured quasi-experimental design, incorporating various psychometric assessments and a thoughtful VR intervention. The paper effectively discusses the growing body of research on VRET and integrates the innovative element of gamification. Overall, the study provides valuable insights into the potential of VRET to treat specific phobias, particularly arachnophobia. Below are some suggestions for your consideration.

1. Participant Selection Criteria (Section 2.1): It is mentioned that participants were selected based on achieving a score exceeding 5 on the SPQ-15. To enhance the robustness of this criterion, it might be helpful to include references to relevant studies that support this cut-off score, as well as an explanation of why this specific threshold was selected.
2. Measurement Tools (Section 2.2): Several self-report measures are used to evaluate participants' fear and anxiety. If any of these scales have been modified for use in this study (e.g., through cultural or linguistic adaptations), it would be beneficial to include a detailed statement regarding the specific adaptations made.
3. Language and Clarity in Intervention Protocol (Section 2.3.1): I appreciate the detailed description of the intervention protocol in Section 2.3.1. However, I believe the language in this section could be improved in terms of clarity and flow.
4. Gamification and Virtual Reality Elements: The use of gamification elements in VRET is an important innovation. To better highlight the impact of these elements on treatment outcomes, I suggest providing more detailed descriptions of the gamification features, such as reward systems, difficulty levels, and how they engage participants. Furthermore, it would be helpful to include a more comprehensive explanation of the virtual reality scenes, particularly the design of the environments and how participants interact with them. These additional details will help readers better understand the intervention and its effectiveness.

Hope the suggestions will be helpful to your manuscript.

Comments on the Quality of English Language

Quality of English language can be improved.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Two major issues, which justify a rejection despite possible interesting observations

1. There is a concern on the adequate experimental practice

It is said "All participants previously completed an online pre-test questionnaire on the Microsoft Forms platform, with the following sections: (1) Sociodemographic data; (2) FSQ;
and (3) SPQ-15. Based on the answers obtained in the questionnaire, the participants who agreed to be contacted for the second phase of the study and who met the previously defined inclusion and exclusion criteria were selected." This basically says that data was acquired BEFORE inclusion to the study and BEFORE participants gave consent. This is a breach in ethical practice. The authors are welcome to explain better or justify, but this is definitely a cause for rejection.

2. there is a lack of clarity in the experimental protocol

After careful and repeated reading, it is still impossible for me to know the experimental setup used and the experimental conditions. All is said is that "Participants navigated the virtual environment with a joystick". Even line 166 "The field of vision was limited to prevent participants from looking away from the terrarium. Interactions could only be started 10 seconds after the previous one, to avoid quick clicks to avoid the spider. " make things more confusing by evoking 'clicks' (mouse clics? so it is on a desktop computer ?). Fig 1 is not helping.

 

 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Very interesting, but questions arise. Please pay attention to:
1. It must be very clear what exactly your pilot study contributes to what is already known about the same topic. This would be perfect in the discussion.
2. In the introduction you must clearly state the most recent findings on the topic and present the articles that are actually antecedents of your pilot study.
3. Explain the recruitment of the population sample. How was it done? Where and why? When?
4. Record the approval and its reference code by the bioethics committee. Where, which and when?
5. Why have you not made a control group? justify.
6. And explain the mental health and biomedical controls during exposure to virtual reality and phobia. Was there a risk? Did you have a protocol for action?
7. Explain more clearly the relationship between the sociodemographic data and the results of the instruments used. 8. Outline a future research agenda in relation to differences in gender, age, education, origin, ethnicity...

Comments on the Quality of English Language

That's fine, but a review by a native speaker would be nice.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

Ha mejorado con la revisión. Les animo a profundizar con una investigación con grupo de control.

Author Response

Thank you very much for the positive feedback and for the sugestion.