Virtual reality for acrophobia
Evaluating the usability of a commercial VRBox
Abstract
Introduction: The virtual reality (VR) has already been shown to be effective for phobias such as flying, agoraphobia, driving, insects, and rodents, etc., but it requires creating the virtual worlds adapted to the individual. Objectives: The aim was to access the usability, satisfaction and difficulties encountered by consultants with an affordable VR system (VRBox and a quality mobile phone) with 360º images freely available on the Internet for acrophobia. Method: 47 people aged 18-69 years, 21 of whom were female (45%), participated in this study. Users were exposed to 10 of 360-degree videos, in a VRBox headset that included a mobile phone. Questionnaires on anxiety, specific height phobia, usability, and satisfaction with the experience and equipment were administered. Results: Usability scores were high (M = 73.51 out of 100 points) and anxiety levels were low (M = 2.50 out of 10 points). No significant differences were found between men and women; those with previous VR experience rated it better; and those with vertigo or dizziness rate it lower and with more anxiety. Conclusion: The VR system for acrophobia is accepted and well appreciated by most users, although the technological system should be adapted to the individual, especially if discomfort arises when using it.
Downloads
References
Altemus, M., Sarvaiya, N., & Epperson, C. N. (2018). Sex differences in anxiety and depression clinical perspectives. Frontiers in Neuroendocrinology, 35(3), 320-330. https://doi.org/10.1016/j.yfrne.2014.05.004
American Psychiatric Association (2018). DSM-5: Manual de diagnóstico y estadístico de los trastornos mentales. Editorial Médica Panamericana.
Anderson, P., Rothbaum, B. O., & Hodges, L. (2003). Virtual reality exposure in the treatment of social anxiety. Cognitive and Behavioral Practice, 10, 240-247. https://doi.org/10.1016/S1077-7229(03)80036-6
Armayones, M., Boixadós, M., Gómez, B., Guillamón, N., Hernández, E., Nieto, R., Pausada, M., & Sara, B. (2015). Psicología 2.0: Oportunidades y retos para el profesional de la psicología en el ámbito de la esalud. Papeles del Psicólogo, 36(2), 153-160. https://www.redalyc.org/pdf/778/77839628009.pdf
Arroll, B., Wallace, H. B., Mount, V., Humm, S. P., & Kingsford, D. W. (2017). A systematic review and meta-analysis of treatment for acrophobia. The Medical Journal of Australia, 206(6), 263-267. https://doi.org/10.5694/mja16.00540
Bados, A., y García, E. (2011). Técnicas de exposición. Universidad de Barcelona. https://diposit.ub.edu/dspace/bitstream/2445/18403/1/Técnicas de Exposición 2011.pdf
Baños, R. M., Botella, C., Perpiñá, C., & Quero, S. (2001). Tratamiento mediante realidad virtual para la fobia a volar: Un estudio de caso. Clínica y Salud, 12(3), 391-404. https://journals.copmadrid.org/clysa/art/6c9882bbac1c7093bd5041881277658
Boeldt, D., McMahon, E., McFaul, M., & Greenleaf, W. (2019). Using virtual reality exposure therapy to enhance treatment of anxiety disorders: Identifying areas of clinical adoption and potential obstacles. Frontiers in Psychiatry, 10, https://doi.org/10.3389/fp-syt.2019.00773
Botella, C., Osma, J., García-Palacios, A., Quero, S., & Baños, R.M. (2004). Treatment of flying phobia using virtual reality: Data from a 1-year follow-up using a multiple baseline design. Clinical Psychology and Psychotherapy, 11, 311-323. https://doi.org/10.1002/cpp.404
Botella, C., Baños, R. M., Villa, H., Perpiñá, A., & García-Palacios, A. (2000). Virtual reality in the treatment of claustrophobic fear: A controlled, multiple-baseline design. Behavior Therapy, 31, 583-595. https://doi.org/10.1016/S0005-7894(00)80032-5
Botella, C., Fernández, J., Guillen, V., García-Palacios, A., & Baños, R. (2017). Recent progress in virtual reality exposure therapy for phobias: A systematic review. Current Psychiatry Reports, 19, 42. https://doi.org/10.1007/s11920-017-0788-4
Botella, C., García-Palacios, A., Baños, R. M., y Quero, S. (2007a). Realidad virtual y tratamientos psicológicos. Cuadernos de Medicina Psicosomática, 86, 17-31. https://www.academia.edu/download/50339241/Realidad_virtual_y_tratamientos_psicolgi20161115-6182-1cz20v4.pdf
Botella, C., Villa, H., García-Palacios, A., Baños, R. M., Quero, S., Alcañiz, M., & Riva, G. (2007b). Virtual reality exposure in the treatment of panic disorder and agoraphobia: a comparison with in vivo exposure. Clinical Psychology and Psychotherapy, 14(3), 1674-175. https://doi.org/10.1002/cpp.524
Brooke, J. (1995). SUS: A quick and dirty usability scale. In P.W. Jordan; B. Thomas, I. L., McClelland, & B. Weerdmeester (eds.) Usability Evaluation and Industry (pp. 189-195). CCR Press. https://doi.org/10.1201/9781498710411
Campo-Prieto, P., Rodríguez-Fuentes, G., & Cancela-Carral, J. (2022). Traducción y adaptación transcultural al español del Simulator Sickness Questionnaire. Retos, 43, 503-509. https://doi.org/10.47197/retos.v43i0.87605
Capafons, J. I. (2001). Tratamientos psicológicos eficaces para las fobias específicas. Psicothema, 13(3), 447-452. https://reunido.uniovi.es/index.php/PST/article/view/7898
Carl, E., Stein, A. T., Levihn-Coon, A. A, Pogue, J. R., Rothbaum, B., Emmelkamp, P., Asmundson, G. J. G., Carlbring, P., & Powers, M. B. (2019). Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of Anxiety Disorders, 61, 27-36. https://doi.org/10.1016/j.janxdis.2018.08.003
Choi, Y. H., Jang, D. P., Ku, J. H., Shin, M. B. y Kim, S. I. (2001). Short-term treatment of acrophobia with virtual reality therapy (VRT): A case report. CyberPsychology & Behavior, 4, 349-354. https://doi.org/10.1089/109493101300210240
Coelho, C. M., Santos, J. A., Silverio, J., & Silva, C. F. (2006). Virtual reality and acrophobia: One year follow-up and case study. Cyberpsychology & Behavior, 9(3), 336-341. https://doi.org/10.1089/cpb.2006.9.336
Cohen, D. C. (1977). Comparison of self-report and overt-behavioral procedures for assessing anxiety. Cognitive and Behavioral Practice, 10, 240-247. https://doi.org/10.1016/S1077-7229(03)80036-6
Donker, T., Cornelisz, I., Klaveren, C., Straten. A., Carlbring, P., Cuijpers, P., & Gelder, J. L. (2019) Effectiveness of self-guided app-based virtual reality cognitive behavior therapy for acrophobia: A randomized clinical trial. JAMA Psychiatry, 76(7), 682-690. https://doi.org/10.1001/jamapsychiatry.2019.0219
Dönmez-Turan, A., & Kir, M. (2019). User anxiety as an external variable of technology acceptance model: A meta-analytic study. Procedia Computer Science, 158, 715-724. https://doi.org/10.1016/j.procs.2019.09.107
Emmelkamp, P. M. G., & Meyerbröker, K. (2021). Virtual reality therapy in mental health. Annual Review of Clinical Psychology, 17, 495-519. https://doi.org/10.1146/annurev-clinpsy-081219-115923
Emmelkamp, P. M. G., Krijin, M., Hulsbosh, A. M., De Vries, S., Schuemie, J. J., & Van der Mast, C. A. P. G (2002). Virtual reality treatment versus exposure in vivo: A comparative evaluation in acrophobia. Behaviour Research and Therapy, 40, 509-516. https://doi.org/10.1016/S0005-7967(01)00023-7
Esquerro, M., Ozamiz, I., Valverde, J., & Gómez-Varela, J. (2010). Adaptación y validación del Acrophobia Questionnaire de Cohen (AQ) a la población española. VII Congreso de la AIESP. https://altorendimiento.com/adaptacion-y-validacion-del-acrophobia-quetionaire-de-cohen-aq-a-la-poblacion-espanola/
Freeman, D., Haselton, P., Feeman, J., Spanlang, B., Kishore, S., Alberty, E., Denne, M., Brown, P., Slater, M., & Nickless, A. (2018). Automated psychological therapy using immersive virtual reality for treatment of fear of heights: A single-blind, parallel-group, randomised controled trial. The Lancet Psychiatry, 5(8), 625-632. https://doi.org/10.1016/S2215-0366(18)30226-8
Freitas, J. R. S., Velosa, V. H. S., Abreu, L. T. N., Jardim, R. L., Santos, J. A. V., Pérez, B., & Campos, P. F. (2021). Virtual reality exposure treatment in phobias: A systematic review. Psychiatric Quarterly, 92, 1685-1710. https://doi.org/10.1007/s11126-021-09935-6
Gambini, R. (2020). Sistema de RV Google Cardboard para mejorar el nivel de acrofobia de los pacientes de Psicosalud Equilibrio. Tesis doctoral no publicada. Universidad César Vallejo de Perú. https://repositorio.ucv.edu.pe/bitstream/handle/20.500.12692/42552/Rique_GJA.pdf?sequence=1&isAllowed=y
Hoppe, J. M., Holmes, E. A., & Agren, T. (2022). Imaginal extinction and vividness of mental imagery: Exploring the reduction of fear within the mind’s eye. Behavioural Brain Research, 418, 113632. https:/doi.org/10.1016/j.bbr.20221.113632
Jalnapurkar, I., Allen, M., & Pigott, T. (2018). Sex differences in anxiety disorders: A review. HSOA Journal of Psychiatry, Depression & Anxiety, 4:012. https://doi.org/10.24966/PDA-0150/100012
Jerald, J. (2016). The VR Book: Human-centered design for virtual reality. ACM Books. Kennedy, R. S., Lane, N. E., Berbaum, K. S., & Liliemthal, M. G. (1993). Simulator sickness questionnaire: An enhanced method of quantifying simulator sickness. The International Journal of Aviation Psychology, 3, 203-220. https://doi.org/10.1207/s15327108ijap0303_3
Krijn, M., Emmelkamp, P. M. G., Biemond, R., de Wilde, C., Schuemie, M. J., & van der Mast, C. A. P. G. (2004). Treatment of acrophobia in virtual reality: The role of immersion and presence. Behaviour Research and Therapy, 42, 229-239. https://doi.org/10.1016/S0005-7894(05)80100-5
Lamson, R. (1994). Application: VR in psychotherapy virtual therapy of anxiety disorders. Cyberedge Journal, 4(2),6-8.
Maramba, I., Chatterjee, A., & Newman, C. (2019). Methods of usability testing in the development of eHealth applications: A scoping review. International Journal of Medical Informatics, 16, 95-104. https://doi.org/10.1016/j.jijmedinf.2019.03.018
Mor, S., Botella, C., Campos. D., Carlbring, P, Tur, C., & Quero, S. (2022). An internet-based treatment for flying phobia using 360º images: A feasibility pilot study. Internet Intervention, 28, 100510. https://doi.org/10.1016/j.invent.2022.100510
North, M. M., North, S. M., & Coble, J. R. (1996). Virtual reality therapy in the treatment of psychological disorders. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 40(24), 1291–1291. https://doi.org/10.1177/154193129604002479
Oing, T., & Prescott, J. (2018). Implementations of virtual reality for anxiety-related disorders: Systematic review. JMIR Serious Games, 6(4):e10965. https://doi.org/10.2196/10965
Onyeaka, H. K., Wisniewski, H., Henson, P., & Torous, J. (2020). Understanding the evolving preferences for use of health information technology among adults with self reported anxiety and depression in the U.S. Journal of Behavioral and Cognitive Therapy, 30(1), 49-56. https://doi.org/10.1016/j.jbct.2020.03.017
Pérez-López, D.C. (2009). Desarrollo de sistemas de realidad virtual y aumentada para la visualización de entornos acrofóbicos: Estudios comparativos entre ellos. Tesis doctoral no publicada. Universidad Politécnica de Valencia. https://www.educacion.gob.es/teseo/imprimirFicheroTesis.do?idFichero=24sATZcO7h4%3D
Ramírez, A., Benítez, S. J., & Gómez, M. A. (2016). La acrofobia y su tratamiento a través de realidad virtual. Revista de Ingeniería, Matemáticas y Ciencias de la Información, 4(7), 77-82. http://ojs.urepublicana.edu.co/index.php/ingenieria/article/view/346/313
Rimer, E., Husby, L. V., & Solem, S. (2021). Virtual reality exposure therapy for fear of heights: Clinicians’ attitudes become more positive after trying VRET. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.671871
Rothbaum, B. O., Hodges, S. F., Kooper, R., Opdyke, D., Williford, J. S. & North, M. (1995). Virtual reality graded exposure in the treatment of acrophobia: A case report. Behavior Therapy, 26, 547-554. https://doi.org/10.1016/S0005-7894(05)80100-S
Ruiz, A., y Valero, L. (2021a). Progressive multimedia exposure for specific phobias: A clinical case of claustrophobia and acrophobia. Clinical Case Studies, https://doi.org/10.1177/15346501211007208
Ruiz, A., y Valero, L. (2021b). Protocolo multimedia para fobias específicas: Evaluación, intervención y casos clínicos. Pirámide.
Saredakis, D., Szpak, A., Birckhead, B., Keage, H. A. D., Rizzo, A., & Loetscher, T. (2020). Factors associated with virtual reality sickness in head-mounted display: A systematic review and meta-analysis. Frontiers in Human Neuroscience, 14, https://doi.org/10.3389/fn-hum.2020.00096
Serrano, B., Botella, C., Wiederhold, B. K., & Baños, R. M. (2019). Virtual reality and anxiety disorders treatment: Evolution and future perspectives. In Rizzo, A., Bouchard, S. (eds.) Virtual reality technologies for psychological and neurocognitive interventions. Virtual reality technologies for health and clinical applications (pp. 47-84). Springer.
Soto, J. & Gómez, C. (2018). Avances en realidad virtual e intervenciones en psicología clínica. Revista Tesis Psicológica, 13(1), 1-15. https://www.redalyc.org/journal/1390/139059076005/139059076005.pdf
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1982). Manual STAI: Cuestionario de Ansiedad Estado Rasgo. (Versión Buela-Casal et al., 2011). TEA Ediciones.
Wechsler, T. F., Kümpers, F., & Mühlberger, A. (2019). Inferiority or even superiority of virtual reality exposure therapy in phobias? A systematic review and quantitative meta-analysis on randomized controlled trials specifically comparing the efficacy of virtual reality exposure to gold standard in vivo exposure in agoraphobia, specific phobia, and social phobia. Frontiers in Psychology, 10. https://doi.org/10.3389/fp-syg.2019.0175
All articles published in this journal –unless otherwise stated- are distributed under the terms of the Creative Commons Attribution-NoDerives (CC-BY-ND 3.0 ES) Spain 3.0 License, which allows others to copy, distribute and transmit in a public way as long as they credit the author(s), journal and institution that publish these articles, and provided that they are not altered or modified. The complete license can be consulted in: https://creativecommons.org/licenses/by/3.0/es/deed/.es
The copyright belongs to the manuscript’s author just on the basis of creating this work:
- Moral rights are undeniable and inalienable.
- Economic or exploitation rights can be transferred to third parties, as it occurs when articles are published and authors partially or totally transfer their exploitation rights to publishers
Authors can archive their own articles in an institutional repository as long as their publications are cited in this journal.