Efficacy of Virtual Reality Based Worry Exposure Therapy on the Anxiety Severity and Worry in Generalized Anxiety Disorder

Neda Keshavarz, Touraj Hashemi Nosrat Abad, Mansour Beyrami, Majid Mahmoud alilou, Abbas Bakhshipour Roudsari

Abstract


Background: Generalized anxiety disorder is one of the most common anxiety disorders observed in clinical centers and the general population. This study aimed to evaluate the efficacy of virtual reality-based worry exposure therapy on the Anxiety Severity and worry in patients with symptoms of generalized anxiety disorder. Materials and Methods: This study was conducted in the framework of a single-subject experimental design using Multiple baselines with a 6-week follow-up. Three women with GAD were selected through a structured clinical interview based on the criteria of Diagnostic and Statistical Manual of Mental Disorders 5 by Convenience Sampling among those who referred to the Counseling centers in Tabriz. The protocol of this study followed the manual by Becker and Margraf which describes imaginal exposure for GAD applied in 15 sessions. The only difference was that in this research exposure to virtual reality replaced with imagination. In this study, three 360-degree films were made by the researcher used for exposure. The content made in the form of 360-degree videos and displayed to patients through virtual reality tools. The scales to assess changes in Anxiety Severity and worry include The Penn State Worry Questionnaire and The Overall Anxiety Severity and Impairment Scale. Data analyzed with visuals inspection, improvement percentage, and reliable change index strategies. Results: Results showed that virtual reality-based worry exposure therapy has significant efficiency on the reduction of Anxiety Severity and worry clinically and statistically (p<0.05). Conclusion: Virtual reality-based worry exposure therapy has appropriate efficacy in reducing GAD symptom severity.

Keywords


Generalized Anxiety Disorder, Virtual Reality, Worry Exposure Therapy

Full Text:

PDF

References


Abdi R, Bakhshipour A, Alilou MM, Farnam A. Efficacy evaluation of unified transdiagnostic treatment on reduction of symptoms severity in women with generalized anxiety disorder.(2013). Journal of Research and Behavior Science. 11(5): 375- 90. [Persian].

Anderson PL, Price M, Edwards SM, Obasaju MA, Schmertz SK, Zimand E, Calamaras MR (2013) Virtual reality exposure therapy for social anxiety disorder: a randomized controlled trial. Journal of Consultant Clinical Psychology. ;81(5)751-60

Becker E, & Margraf J. Generalisierte Angststörung. Ein Therapie programm . Weinheim: Beltz. 2002.

Behar E, & Borkovec T. D. (2005). The nature and treatment of generalized anxiety disorder.In: B.O. Rothbaum (Ed.), The nature and treatment of pathological anxiety:essays in honor of Edna B. Foa (pp.181-196).New York:Guilford Press.

Borkovec T, Robinson E, Pruzinsky T, DePree J. (1983) Preliminary exploration of worry: Some characteristics and processes. Behaviour Research Therapy.; 21(1): 9–16.

Borkovec TD, Alcaine OM, Behar E. (2004) Avoidance theory of worry and generalized anxiety disorder. In: Heimberg RG, Turk CL, Mennin DS. Generalized Anxiety Disorder: Advances in Research and Practice. New York: Guilford Press;.77108. 18.

Brown T A, O Leary T A, & Barlow D H. (1993). Generalized anxiety disorder. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders (pp. 137–188). 2nd ed. New York: The Guilford Press.

Craske M G, Barlow D H, O, & Leary T A. (1992). Mastery of your anxiety and worry. Albany, NY: Graywind Publications

Cuijpers P, Sijbrandij M, Koole, S Huibers M, Berking M, Anderssone G. (2014) Psychological treatment of generalized anxiety disorder: A meta-analysis. Clinical Psychology Review34130–140.

Dehshiri, gholamreza. Golzari, Mahmoud. Borjali, Ahmad. Sohrabi, Faramarz. (2010) Psychometrics Particularity of Farsi Version of Pennsylvania State Worry Questionnaire for College Students. Journal of Clinical Psychology. Vol. 1, No. 4, 67-75

Giuseppe Riva, Monica Bacchetta, Margherita Baruffi, and Enrico Molinari.( 2002 ) Virtual-Reality-Based Multidimensional Therapy for the Treatment of Body Image Disturbances in Binge Eating Disorders: A Preliminary Controlled Study. IEEE Transactions on Information Technology. Sep;6(3):224-34.

Goldman N, Dugas, M J, Sexton K A, & Gervais, NJ. (2007). The impact of written exposure on worry: A preliminary investigation. Behavior Modification, 31, 512-538.

Gorini A, Pallavincini F, Algeri D, Repetto C, Gaggioli A, Riva G. (2010) Virtual reality in the treatment of generalized anxiety disorders. Studies in health technology and informatics; 8:831–5

Guitard T, Bouchard S, Bélanger C, Berthiaume M. (2019) Exposure to a Standardized Catastrophic Scenario in Virtual Reality or a Personalized Scenario in Imagination for Generalized Anxiety Disorder. Journal of clinical Medicine., 8, 309

Hamidpour H, Akbari M ، Andooz Z, The psychometric properties of the scale of intolerance Negative orientation to the problem, (WWQ-II) why worry questionnaire - 2, (IUS) dilemmas. (PSWQ) and Penn State Worry Questionnaire (CAQ) Inventory cognitive avoidance. 2009. [Persian].

Hirsch CR, Hayes S, Mathews A, Perman G, Borkovec T(2012). The extent and nature of imagery during worry and positive thinking in generalized anxiety disorder. Journal of Abnormol Psychology.; 121(1): 238-243.

Hoyer, J., Beesdo, K., Gloster, A.T., Runge, J., Hofler, M. & Becker, ES. (2009). Worry Exposure versus Applied Relaxation in the Treatment of Generalized Anxiety Disorder. Psychother Psychosom: 78: 106-115.

Kim k, Kim CH,Cha KR et al(2008). Anxiety provocation and measurement using virtual reality in patients with obsessive compulsive disorder. CyberPsychology & Behavior; 11:637-41

M.R. Naeinian PhD *, M.R. Shaeiri Ph.D., M. Sharif B. A, M. Hadian B. A. (2011) Study Reliability and Validity for A Brief Measure for Assessing Generalized Anxiety Disorder (GAD-7). Clinical psychology& personality.2 ( 4 ).

Norman SB, Cissell SH, Means-Christensen AJ, Stein MB. Development and validation of an overall anxiety severity and impairment scale (OASIS). Depress Anxiety 2006; 23(4): 245–9

P.M.G Emmelkamp. M Krijn. A.MHulsbosch. Sde Vriesa. M.JSchuemie. C.A.P.G (2002) van der Mast .Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia. Behaviour Research and Therapy. ;40(5):509-16.

Rauch, S. A.M., Foa, E. B., Purr, J. M., & Filip, J. C. (2004). Imagery vividness and perceived anxious arousal in prolonged exposure treatment for PTSD. Journal of Traumatic Stress, 17,461-465. 96

Rizzo AA, Buckwalter JG, Bowerly T, Van Der Zaag C, Humphrey L, Neumann U, et al. (2000) The virtual classroom: a virtual reality environment for the assessment and rehabilitation of attention deficits. CyberPsychology & Behavior. 3:483–499

Rothbaum, B.O., Hodges, L., Ready, D., Graap, K. and Alarcon, R. (1999) Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. Journal of Traumatic Stress. 12(2):263-71

Sexton, K. A., & Dugas, M. J.(2009) An investigation of factors associated with cognitive avoidance in worry. Cognitive Therapy and Research . 33(2), 150–162.

Spitzer,R.L,Kroneke,Williams,J.B.,&Low,B,.(2006).A brief measure of assessing generalized anxiety disorder: The GAD-7. Archives of internal Medicine,166.

Vincelli F1, Anolli L, Bouchard S, Wiederhold BK, Zurloni V, Riva G. (2003) Experiential cognitive therapy in the treatment of panic disorders with agoraphobia: a controlled study. CyberPsychology & Behavior. ;6(3):321-8.




DOI: https://doi.org/10.7575/aiac.abcmed.v.9n.2p.21

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

2013-2023 (CC-BY) Australian International Academic Centre PTY.LTD.

Advances in Bioscience and Clinical Medicine