Virtual reality self-help treatment for aviophobia: A protocol for a randomized-controlled trial (Preprint)

BACKGROUND Aviophobia (fear of flying) can greatly impact daily life functioning in those afflicted. Traditional exposure-based treatment is hampered by limited availability to practice with airplane situations due to economical and practical reasons. Low-cost and easily accessible virtual reality exposure therapy may address these challenges. OBJECTIVE The purpose of this study is to investigate the effectiveness of ZeroPhobia: Aviophobia in reducing flight anxiety symptoms as well as depressive and anxiety symptoms. We will also investigate the effect of usage intensity, sense of immersion, inherent absorption ability, and perceived user-friendliness on the treatment effect. METHODS Participants (n = 113, age 18 - 64 reporting at least mild symptoms of aviophobia) will be recruited from the Dutch general population and randomized to receive treatment or waitlist control. Using their own phone and rudimentary mobile virtual reality headset, participants will receive six modules of psychoeducation and elements of cognitive behavioral therapy, including six levels of virtual reality exposure therapy over a period of six weeks. Assessments occur at baseline, post-test (6 weeks), and 3- and 12-month follow-ups. The primary outcome of this research is the Flight Anxiety Situations Questionnaire. Secondary outcomes include measurements of anxiety and depression, as well as additional covariates (including usage intensity, degree of immersion, etc.). We will test the effectiveness using Intention to Treat (ITT) and Average Treatment effects on the Treated (ATT) analysis. Mechanisms of treatment effect will also be explored. RESULTS Funded on 25 September 2018. Ethical approval received on 11 October 2019. Recruitment closed on 7 May 2020. CONCLUSIONS The present study will further scientific understanding and clinical implications of technology’s current ability to aid in effective, accessible treatment for fear of flying. CLINICALTRIAL Netherlands Trial Registry, NL70238.029.19, 2019-11-04, https://www.trialregister.nl/trial/8257

Download Full-text

Virtual Reality Self-help Treatment for Aviophobia: Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/22008 ◽

2021 ◽

Vol 10 (4) ◽

pp. e22008

Author(s):

Jamie Rhiannon Fehribach ◽

Marieke Bianca Jolien Toffolo ◽

Ilja Cornelisz ◽

Chris van Klaveren ◽

Annemieke van Straten ◽

...

Keyword(s):

Virtual Reality ◽

Treatment Effect ◽

Exposure Therapy ◽

Anxiety Symptoms ◽

Secondary Outcome ◽

Control Group ◽

Fear Of Flying ◽

Virtual Reality Exposure Therapy ◽

Self Help ◽

Virtual Reality Exposure

Background Aviophobia (the fear of flying) can greatly impact the daily life functioning of people with the condition. Traditional exposure-based treatment is hampered by the limited availability of airplane practice situations, which is a result of economical and practical concerns. Easily accessible and low-cost virtual reality exposure therapy may address these challenges. Objective The purpose of our study is to investigate the effectiveness of ZeroPhobia: Aviophobia (a self-help mobile app–based treatment) in reducing flight anxiety symptoms and depressive and anxiety symptoms. We will also investigate the effects of usage intensity, the sense of immersion, inherent absorption ability, and perceived user-friendliness on the treatment effect. Methods Participants (N=114) who are aged 18-64 years and experience at least mild symptoms of aviophobia will be recruited from the general Dutch population and randomized into a treatment group or waitlist control group. By using their own phones and rudimentary mobile virtual reality headsets, participants will receive six modules of psychoeducation and cognitive behavioral therapy, which will include six levels of virtual reality exposure therapy over a period of 6 weeks. Assessments will be conducted at baseline, posttest (ie, after 6 weeks), and 3- and 12-month follow-ups. The primary outcome measure of our study is the Flight Anxiety Situations Questionnaire. The secondary outcome measures include anxiety and depression measures and additional covariates (including usage intensity, the degree of immersion, etc). We will test treatment effectiveness by conducting an intention-to-treat analysis and estimating average treatment effects on the treated. The mechanisms of treatment effect will also be explored. Results The study was funded on September 25, 2018. Ethical approval was received on October 11, 2019. Recruitment closed on May 7, 2020. Conclusions Our study will further the scientific understanding and clinical implications of technology’s current ability to aid in providing effective, accessible treatment for the fear of flying. Trial Registration Netherlands Trial Registry NL70238.029.19; https://www.trialregister.nl/trial/8257. International Registered Report Identifier (IRRID) DERR1-10.2196/22008

Download Full-text