Virtual Reality Exposure Therapy for Acrophobia

NCT04975854 | Completed

• 1 other identifier: TL03000223-01
• Study Type: interventional
• Target: 43
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to examine the efficacy of virtual reality exposure therapy (VRET) as a treatment for specific phobia (acrophobia). The study will randomly assign 42 participants with acrophobia to one of two conditions: a) the experimental condition (consisting of 3 sessions of virtual reality exposure) or b) a control condition. Both groups will receive short information session about general principles of exposure therapy before the start of the study. After the end of the study, the waitlist group will be invited to attend the short version (one or two-sessions) of the VRET. Both groups will receive a final follow-up questionnaires 2 months after the last session.

Conditions

Specific Phobia; Acrophobia; Fear of Heights; Anxiety Disorders

Keywords

virtual reality exposure therapy; specific phobia; acrophobia

Outcome Measures

Primary Outcomes (7)

• Visual Height Intolerance Severity Scale (vHISS)

  The vHISS is a 8-item scale assessing the severity of visual height intolerance with additional questions for diagnosing acrophobia. Raw score range from 0 to 13, where 0 = least severely affected and 13 = most severely affected.

  Immediately Post-Treatment (Controlling for Baseline Score)

• Visual Height Intolerance Severity Scale (vHISS)

  The vHISS is a 8-item scale assessing the severity of visual height intolerance with additional questions for acrophobia.Raw score range from 0 to 13, where 0 = least severely affected and 13 = most severely affected.

  2-months Post-Treatment (Controlling for Immediate Post-Treatment Score)

• Severity Measure for Specific Phobia-Adult (SMSP-A)

  SMSP-A is a 10-item scale that assesses the severity of specific phobias in individuals aged 18 and older over the past 7 days. Items are scored on a 5-point Likert scale with item scores of 1-4 respectively indicating mild, moderate, severe and extreme severity of specific phobia related distress.

  Immediately Post-Treatment (Controlling for Baseline Score)

• Severity Measure for Specific Phobia-Adult (SMSP-A)

  SMSP-A is a 10-item scale that assesses the severity of specific phobias in individuals aged 18 and older over the past 7 days. Items are scored on a 5-point Likert scale with item scores of 1-4 respectively indicating mild, moderate, severe and extreme severity of specific phobia related distress.

  2-months Post-Treatment (Controlling for Immediate Post-Treatment Score)

• The IAPT phobia scale-avoidance

  The IAPT phobia scale-avoidance is a single item from the outcome measures administered by the UK National Health Service's IAPT programme (Improving Access to Psychological Therapies). The patient is asked to rate his/her avoidance of heights in daily situations on a scale from 0 (would not avoid it) to 8 (always avoid it).

  2-Weeks In-Treatment (Controlling for Baseline Score)

• The IAPT phobia scale-avoidance

  The IAPT phobia scale-avoidance is a single item from the outcome measures administered by the UK National Health Service's IAPT programme (Improving Access to Psychological Therapies). The patient is asked to rate his/her avoidance of heights in daily situations on a scale from 0 (would not avoid it) to 8 (always avoid it).

  Immediately Post-Treatment (Controlling for Baseline Score)

• The IAPT phobia scale-avoidance

  The IAPT phobia scale-avoidance is a single item from the outcome measures administered by the UK National Health Service's IAPT programme (Improving Access to Psychological Therapies). The patient is asked to rate his/her avoidance of heights in daily situations on a scale from 0 (would not avoid it) to 8 (always avoid it).

  2-months Post-Treatment (Controlling for Immediate Post-Treatment Score)

Secondary Outcomes (3)

• Six-item State-Trait Anxiety Inventory (STAI-6)

  Immediately Post-Sessions

• Subjective Units of Distress Scale (SUDS)

  Through study completion, an average of 1 months. During In-Sessions: week 1-3 (reported repeatedly during each session in response to presented exposure situations).

• Anxiety Hierarchy

  Immediately Post-Treatment (Controlling for Baseline Score)

Other Outcomes (2)

• The Igroup Presence Questionnaire (IPQ)

  Immediately Post-First Session

• Simulator Sickness Questionnaire (SSQ)

  Immediately Post-First Session

Study Arms (2)

Virtual Reality Exposure

EXPERIMENTAL

Participants complete three 30-40-minute sessions of exposure administered via a virtual reality headset. The exposure involve exposure to various heights and height cues in the virtual city environment. Experimental group also attends 20-minute online information session (prerecorded video).

Behavioral: Exposure Therapy (Virtual Reality); Other: Information Session

Control

OTHER

Control group attends a single 20-minute information session (prerecorded video) about general principles of exposure therapy and anxiety before the start of the study, but receives no exposure-based intervention.

Other: Information Session

Interventions

Exposure Therapy (Virtual Reality) BEHAVIORAL

Virtual reality scenarios consists of increasingly intense exposures to phobic stimuli (e.g., looking over railings from various floor levels) with the support of the therapist. The goal of VRET is sufficient reduction in anxiety to allow the patients to expose themselves to heights in everyday situations.

Virtual Reality Exposure

Information Session OTHER

This includes 20-minute information session about general principles of exposure therapy before the start of the study.

Control; Virtual Reality Exposure

Eligibility Criteria

• Age: 18 Years - 64 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• individual meeting ICD-10 criteria for diagnosis of specific phobia
• fluent in Czech

You may not qualify if:

• currently receiving psychological treatment for acrophobia
• psychotropic medication (unless on stable dosage for the previous 1 month and stabilized for the duration of the study)
• another severe mental disorder, such as bipolar disorder or psychotic disorder
• contradictions to using a virtual reality (e.g., epilepsy, balance problems)

Sponsors & Collaborators

• National Institute of Mental Health, Czech Republic: lead

Study Sites (1)

National Institute of Mental Health

Klecany, Czechia

Location

Related Publications (1)

• Francova A, Jablonska MK, Lhotska L, Husak J, Fajnerova I. Efficacy of exposure scenario in virtual reality for the treatment of acrophobia: A randomized controlled trial. J Behav Ther Exp Psychiatry. 2025 Sep;88:102035. doi: 10.1016/j.jbtep.2025.102035. Epub 2025 Mar 30.

  PMID: 40186999 DERIVED

MeSH Terms

Conditions

Phobia, Specific; Acrophobia; Anxiety Disorders

Interventions

Virtual Reality Exposure Therapy

Condition Hierarchy (Ancestors)

Mental Disorders

Intervention Hierarchy (Ancestors)

Desensitization, Psychologic; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: senior researcher

Study Record Dates

• First Submitted: July 12, 2021
• First Posted: July 26, 2021
• Study Start: July 13, 2021
• Primary Completion: June 17, 2022
• Study Completion: June 17, 2022
• Last Updated: May 16, 2024

Record last verified: 2024-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: IPD will be shared starting 6 month after the publication.
• Access Criteria: Data access requests will be reviewed using an online form. Requestors will be required to sign a data access agreement.

Locations

CZ (1)