Exposure and Response Prevention in Virtual Reality for Patients with Contamination-Related Obsessive–Compulsive Disorder: a Case Series

Miegel, Franziska; Bücker, Lara; Kühn, Simone; Mostajeran, Fariba; Moritz, Steffen; Baumeister, Anna; Lohse, Luzie; Blömer, Jannik; Grzella, Karsten; Jelinek, Lena

doi:10.1007/s11126-022-09992-5

Cited by 10 publications

(7 citation statements)

References 61 publications

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“…Miegel et al [17] aimed to investigate the use of iVRET with a protocol implementing response prevention (VERP) in treating patients with contamination-related OCD (C-OCD), primarily experiencing disgust. Patients underwent VERP treatment over six weeks, involving four consecutive exposure sessions.…”

Section: Obsessive-compulsive Disorder (Ocd)mentioning

confidence: 99%

“…The classic exposure therapy approach, as well as recent approaches that implement VRET, have a strong impact on the extinction of this aberrant sense of disgust, as reported by several studies on clinical populations [17][18][19][20][21][22][23][24] and even on at-risk healthy populations [25][26][27][28][29]. VRET uses virtual reality technology to expose patients to situations that may trigger feelings of disgust, helping them manage their emotions.…”

Section: Introductionmentioning

confidence: 99%

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Virtual Reality Exposure Therapy for Treating Fear of Contamination Disorders: A Systematic Review of Healthy and Clinical Populations

Ferraioli,

Culicetto,

Cecchetti

et al. 2024

Brain Sciences

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Virtual Reality Exposure Therapy (VRET), particularly immersive Virtual Reality Exposure Therapy (iVRET), has gained attraction as an innovative approach in exposure therapy (ET), notably for some anxiety disorders with a fear of contamination component, such as spider phobia (SP) and obsessive–compulsive disorder (OCD). This systematic work investigates iVRET’s effectiveness in modulating disgust emotion—a shared aberrant feature across these disorders. Recent reviews have evaluated VRET’s efficacy against in vivo ET. However, emerging evidence also highlights iVRET’s potential in diminishing atypical disgust and related avoidance behaviors, expanding beyond traditional fear-focused outcomes. Our systematic synthesis, adhering to PRISMA guidelines, aims to fill this gap by assessing iVRET’s efficacy in regulating disgust emotion within both clinical and at-risk populations, identified through standardized questionnaires and subjective disgust ratings. This research analyzes data from eight studies on clinical populations and five on healthy populations, offering an insight into iVRET’s potential to mitigate the aberrant disgust response, a common transdiagnostic feature in varied psychopathologies. The findings support iVRET’s clinical relevance in disgust management, providing evidence for a broader therapeutic application of iVRET and pointing out the need for more focused and complete investigations in this emergent field.

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Section: Obsessive-compulsive Disorder (Ocd)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Virtual Reality Exposure Therapy for Treating Fear of Contamination Disorders: A Systematic Review of Healthy and Clinical Populations

Ferraioli,

Culicetto,

Cecchetti

et al. 2024

Brain Sciences

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“…To-date there have been no published clinical trials of VR-based therapy for OCD. However, there have been several case reports [ 157 ] and case series [ 158 , 159 ] that suggest benefits of using VR for exposures exercises in the context of ERP/CBT for OCD. In addition, proof-of-concept studies have examined the degree that VR environments can elicit emotional responses in those with OCD, in the interest of gauging the potential utility of using these methods for ERP/CBT [ 160 - 163 ].…”

Section: Novel Digital Interventions In Obsessive-compulsive Disordermentioning

confidence: 99%

Psychotherapies and digital interventions for OCD in adults: What do we know, what do we need still to explore?

Feusner

Laposa

Richter

et al. 2023

Comprehensive Psychiatry

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“…Additionally, the development of VR environments takes a lot of time and money. Achieving a sufficient degree of sense of presence (i.e., the feeling that the virtual environment is actually real) can be a particular challenge as patients know at a cognitive level that they are in a completely virtual environment (Miegel et al, 2022) where they-viewed rationally-do not have to expect real consequences (e.g., they will not really be contaminated after touching the dirty door handle in the VR). It is therefore crucial to engage users on an emotional level and thereby increase the sense of presence.…”

Section: Use Of Virtual Reality In Exposure Treatmentsmentioning

confidence: 99%

Mixed results for exposure and response prevention therapy in mixed reality for patients with contamination‐related obsessive‐compulsive disorder: A randomized controlled pilot study

et al. 2023

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IntroductionTechnology‐supported exposure and response prevention (ERP) for patients with obsessive‐compulsive disorder (OCD) as tested in clinical research, holds promise but also has limitations. The present study aims to overcome these limitations by using mixed reality for ERP (MERP). The objectives of this pilot study were to evaluate the safety, feasibility, and acceptance of MERP and to identify possible obstacles.MethodsTwenty inpatients with contamination‐related OCD were recruited and randomized to two conditions: MERP (six sessions in 3 weeks) and care as usual treatment. Patients were assessed before treatment (baseline), after the 3‐week intervention period (post), as well as 3 months after post assessment (follow‐up) regarding symptomatology (Y‐BOCS).ResultsResults showed a similar reduction in symptomatology in both groups from baseline to post. Regarding safety, no clinically significant deterioration was detected in the MERP group. Patients' evaluation of the MERP was heterogeneous. The qualitative feedback provided helpful indications for further development of the software. Sense of presence was below the midpoint of the scales.ConclusionThis is the first study evaluating a MERP for patients with OCD that shows cautious evidence for the acceptance and safety of MERP. The results of the subjective evaluation suggest revisions of the software.

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Exposure and Response Prevention in Virtual Reality for Patients with Contamination-Related Obsessive–Compulsive Disorder: a Case Series

Cited by 10 publications

References 61 publications

Virtual Reality Exposure Therapy for Treating Fear of Contamination Disorders: A Systematic Review of Healthy and Clinical Populations

Virtual Reality Exposure Therapy for Treating Fear of Contamination Disorders: A Systematic Review of Healthy and Clinical Populations

Psychotherapies and digital interventions for OCD in adults: What do we know, what do we need still to explore?

Mixed results for exposure and response prevention therapy in mixed reality for patients with contamination‐related obsessive‐compulsive disorder: A randomized controlled pilot study

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