Effectiveness of a smartphone-based, augmented reality exposure app to reduce fear of spiders in real-life: A randomized controlled trial

Zimmer, A.; Wang, Nan; Ibach, Merle K.; Fehlmann, Bernhard; Schicktanz, Nathalie; Bentz, Dorothée; Michael, Tanja; Papassotiropoulos, Andreas; Quervain, Dominique J.-F. de

doi:10.1016/j.janxdis.2021.102442

Cited by 24 publications

(22 citation statements)

References 31 publications

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“…An effect size of Cohen`s d = 1.11 / 1.12 was found from a meta-analysis of VR treatments for different phobias, including fear of spiders [ 11 , 12 ]. AR exposure therapy is still under-researched, but Botella and colleagues [ 24 ] explored small animal phobia using AR and found an effect size of d = 0.80 and the recent study by Zimmer and colleagues [ 26 ] found an effect size of d = 0.57. Because ZeroPhobia: Arachnophobia is both self-guided as well as outside of researcher overview, we have taken a similar effect size of d = 0.60.…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies in similar samples have shown that studies with ARET can safely be carried out, without a significant risk for unwanted effects (e.g. [ 18 , 24 , 26 ]). Additionally, previous research on ZeroPhobia: Acrophobia demonstrated that the ZeroPhobia app can be safely carried out without serious adverse effects–e.g.…”

Section: Methodsmentioning

confidence: 99%

“…However, De Witte and colleagues [ 18 ] did not test the effectiveness of this app as an intervention for small animal fears, but only the level of anxiety that could be induced. Only one, very recent, study tested the effectiveness of a smartphone-based, AR exposure application for treatment of spider fear in a natural, real-life setting [ 26 ]. Participants were asked to train with the application for at least 30 minutes per week during a total period of six weeks.…”

Section: Introductionmentioning

confidence: 99%

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Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial

et al. 2022

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Background Fear of spiders, or Arachnophobia, is one of the most common specific phobias. The gold standard treatment, in vivo exposure therapy, is effective, but comes with significant limitations, including restricted availability, high costs, and high refusal rates. Novel technologies, such as augmented reality, may help to overcome these limitations and make Exposure Therapy more accessible by using mobile devices. Objective This study will use a Randomized Controlled Trial design to investigate whether ZeroPhobia: Arachnophobia, a 6-week Augmented Reality Exposure Therapy smartphone self-help application, can effectively reduce spider phobia symptoms. Additionally, we will examine user-friendliness of the application and the effect of usage intensity and presence on treatment outcome. Methods This study is registered in the Netherlands Trial Registry under NL70238.029.19 (Trial NL9221). Ethical approval was received on October 11, 2019. One-hundred-twelve participants (age 18–64, score ≥ 59) on the Fear of Spiders Questionnaire [FSQ] will be recruited from the general Dutch population and randomly assigned to a treatment or waitlist control group. The ZeroPhobia application can be accessed on users’ smartphone. Baseline, post-test (i.e., at six weeks), 3- and 12-month follow-up assessments will be done, each including the Fear of Spiders Questionnaire as the main outcome measure as well as additional measures of anxiety, depression, user-friendliness, and presence as secondary measures and covariates. Results The study was funded on September 25, 2018. Data collection started in September 2021 and the study is expected to run until September 2022. Conclusions Our study will improve our understanding of the efficacy and feasibility of providing Exposure Therapy for spider phobia using an Augmented Reality self-help application, with the intention of making mental health care more accessible.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial

et al. 2022

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“…This is known as the renewal effect [ 11 , 12 ]. Augmented reality (AR) has recently emerged as a rapidly developing technology that has substantial potential [ 13 , 14 ] for treating addiction, including tobacco use [ 15 ]. AR involves the real-time insertion of digitally-created images into a user’s natural environment as viewed through a screen or headset.…”

Section: Introductionmentioning

confidence: 99%

“…76% of low-income populations own a smartphone in the U.S. [ 18 ]), AR has great clinical and therapeutic potential in accessibility and affordability. AR has been applied to CET for phobias and has demonstrated preliminary [ 13 , 14 , 19 ] and comparable efficacy in reducing fear and anxiety in small animal phobias when compared to in-vivo exposure [ 19 ]. However, the applicability of AR for the treatment of addiction has not yet been tested.…”

Section: Introductionmentioning

confidence: 99%

Augmented reality as a novel approach for addiction treatment: development of a smoking cessation app

et al. 2022

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Objective Augmented reality (AR) is a rapidly developing technology that has substantial potential as a novel approach for addiction treatment, including tobacco use. AR can facilitate the delivery of cue exposure therapy (CET) such that individuals can experience the treatment in their natural environments as viewed via a smartphone screen, addressing the limited generalizbility of extinction learning. Previously, our team developed a basic AR app for smoking cessation and demonstrated the necessary mechanisms for CET. Specifically, we showed that the AR smoking cues, compared to neutral cues, elicited substantial cue reactivity (i.e. increased urge) and that repeated exposure to the AR smoking cues reduced urge (i.e. extinction) in a laboratory setting. Here we report the next step in the systematic development of the AR app, in which we assessed the usability and acceptability of the app among daily smokers in their natural environments. Method Daily smokers ( N = 23, 78.3% female, Mean Age = 43.4, Mean Cigarettes/Day = 14.9), not actively quitting, were instructed to use the AR app in locations and situations where they smoke (e.g. home, bar) at least 5 times per day over one week. The study is registered in clinicaltrials.gov (NCT04101422). Results Results indicated high usability and acceptability. Most of the participants (73.9%) used the AR app on at least 5 days. Participants found the AR cues realistic and well-integrated in their natural environments. The AR app was perceived as easy to use (Mean = 4.1/5) and learn (mean of 2 days to learn). Overall satisfaction with the app was also high. Secondary analyses found that 56.5% reported reduced smoking, with an average 26% reduction in cigarettes per day at follow-up. Conclusions These findings set the stage for a randomized controlled trial testing the AR app as an adjuvant therapy for treating tobacco dependence, with potential applicability to other substances. KEY MESSAGE This study found that the augmented reality (AR) smartphone application that utlized cue exposure treatment for smoking cessation was perceived as easy to use and learn in the natural, day-to-day environment of daily smokers. Findings set the stage for a larger clinical trial testing the AR app as an adjuvant therapy for treating tobacco dependence, with potential applicability to other addictive behaviors.

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Investigating the efficacy of attentional bias modification on individuals with spider phobia through the emotional attention network test

Teng

2022

J Clin Psychol

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Objectives This study aimed to investigate the attention network function of spider phobics before and after attentional bias modification (ABM) through conduction of an emotional attention network test (eANT). Methods Scores from an eANT, an approach–avoidance task, and various scales were used to examine the training effect of a single ABM session among participants (30 individuals with spider phobia and 30 controls). Results At baseline, alertness scores in response to spider images were higher in the phobia group than in the control group (x̄ = 51.81 vs. 30.35 ms). After ABM, this score decreased in the phobia group, indicating their lower susceptibility to distraction by images of spiders. However, ABM training did not considerably alleviate their fear of and avoidance behavior toward spiders. Conclusion This study elucidates the (1) vigilance–avoidance pattern among individuals with spider phobia when encountering spider‐related stimuli and (2) change in underlying attentional mechanisms after ABM training.

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Effectiveness of a smartphone-based, augmented reality exposure app to reduce fear of spiders in real-life: A randomized controlled trial

Cited by 24 publications

References 31 publications

Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial

Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial

Augmented reality as a novel approach for addiction treatment: development of a smoking cessation app

Investigating the efficacy of attentional bias modification on individuals with spider phobia through the emotional attention network test

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