BackgroundPersecutory delusions may be unfounded threat beliefs maintained by
safety-seeking behaviours that prevent disconfirmatory evidence being
successfully processed. Use of virtual reality could facilitate new
learning.AimsTo test the hypothesis that enabling patients to test the threat
predictions of persecutory delusions in virtual reality social
environments with the dropping of safety-seeking behaviours (virtual
reality cognitive therapy) would lead to greater delusion reduction than
exposure alone (virtual reality exposure).MethodConviction in delusions and distress in a real-world situation were
assessed in 30 patients with persecutory delusions. Patients were then
randomised to virtual reality cognitive therapy or virtual reality
exposure, both with 30 min in graded virtual reality social environments.
Delusion conviction and real-world distress were then reassessed.ResultsIn comparison with exposure, virtual reality cognitive therapy led to
large reductions in delusional conviction (reduction 22.0%,
P = 0.024, Cohen's d = 1.3) and
real-world distress (reduction 19.6%, P = 0.020, Cohen's
d = 0.8).ConclusionCognitive therapy using virtual reality could prove highly effective in
treating delusions.
Virtual reality in the treatment of persecutory delusions:
Randomised controlled experimental study testing how to reduce delusional
conviction
