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

Abstract

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