Reducing Social Avoidance Among Adolescents With Special Educational Needs
- Conditions
- Social AnxietySocial Avoidant Behavior
- Interventions
- Behavioral: VR Social Avoidance Intervention
- Registration Number
- NCT06450665
- Lead Sponsor
- The Hong Kong Polytechnic University
- Brief Summary
The goal of this clinical trial is to examine the effectiveness of a Virtual Reality (VR) social avoidance intervention in reducing social avoidance symptoms among adolescents with special educational needs. Participants will complete tasks in the VR scenario with increasing difficulty and learn that they can cope in situations that they previously avoid. We hypothesize that, comparing with usual care (i.e. waitlist control), the intervention group will experience a significant reduction on social avoidance symptoms after treatment and this benefit will persist till 1-month follow-up.
- Detailed Description
Over the past 25 years, VR has been used to complement therapist-delivered psychological interventions, primarily exposure therapy for anxiety related disorders. VR renders real-world social interactions simulation, which allows users to experience an anxiety provoking situation with a greater sense of control. In Hong Kong, with the lack of mental health professionals being a perennial problem, VR-based interventions offer the potential to substantially reduce the treatment time and cost, as well as to increase access to evidence-based psychological interventions.
The Virtual Reality (VR) social avoidance intervention used in the current study is designed based on cognitive-behavioral approach with a virtual coach acting as the therapist. It is designed in tandem with input from Hong Kong users to ensure the scenario can resonate with them.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 208
- Age 16-19
- Can read traditional Chinese and understand Cantonese
- Self-report on experiencing social avoidance symptoms
- History of photosensitive epilepsy
- Impairment of stereoscopic vision
- Balance problems
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description VR Social Avoidance Intervention VR Social Avoidance Intervention The intervention group will go through three 30-minute VR sessions over a period of 3 weeks. Participants will need to complete a baseline survey before the VR sessions and a post-intervention survey after the VR sessions, as well as a 1-month follow-up survey.
- Primary Outcome Measures
Name Time Method Social Anxiety Session Change Index (SASCI) After each session of VR intervention An adapted version of the 4-item SASCI will be used to track the intermediate changes for the VR sessions (i.e., a per session update of improvement/ deterioration of level of social avoidance) on four dimensions: anxiety, avoidance, concern about humiliation and embarrassment, and interference, using a 7-point Likert-type scale ranging from 1 (much less than the start of treatment) to 4 (not different from the start of treatment) to 7 (much more than the start of treatment), with lower score indicating less anxiety after the treatment.
Gatineau Presence Questionnaire (GPQ) 4th week This is a 4-item scale (Laforest et al., 2016) designed to assess the feeling of presence experienced in a virtual environment. Sample items include "the impression of being here", "appraising the experience as being real". Scale point ranges from 0 to 100, with higher score indicating more feeling of presence experienced in a virtual environment.
Brief Fear of Negative Evaluation Scale (bFNE) 1st week, 4th week, 8th week This is a 12-item scale that measures the fear associated with being evaluated unfavorably while anticipating or participating in a social situation, including apprehension about receiving negative evaluation, avoidance of being evaluated, and the expectation of being negatively evaluated with a 5-point Likert-type rating scale, ranging from 1 (not at all characteristic of me) to 5 (extremely characteristic of me). Higher score indicates higher level of fear of Negative Evaluation.
Generalized Anxiety Disorder Assessment (GAD-7) 1st week, 4th week, 8th week To assess the extent to which respondents are bothered by anxiety related symptoms using a 4-point Likert scale from 0 (not at all) to 3 (nearly every day), with higher score indicating higher level of anxiety symptoms.
Oxford Behavioural Avoidance Task - HK (OBAT-HK) 1st week, 4th week, 8th week This is a 16-item scale, a local adaptation of Freeman's OBAT to assess the extent of which participants feel anxious in everyday situations, and the extent to which they try to avoid those situations. Examples of the situations are: approach another pedestrian to ask for direction, ask the bus driver about which stop you should get off, etc. Participants first answer a question concerning if they could do a specific task right now and then rate the level of distress if they have to perform the task straightaway from 0 (no distress) to 10 (extremely distress), with higher score indicating higher level of social anxiety.
Working Alliance Inventory applied to VR and AR (WAI-VAR) 4th week This is a 12-item scale designed to assess therapeutic alliance between the virtual/augmented reality program and the users. Scale points range from 1 (never) to 7 (always), with higher score indicating higher level of adaptation to the VR environment.
Patient Health Questionnaire (PHQ-9) 1st week, 4th week, 8th week To assess the extent to which respondents are bothered by depression related symptoms using a 4-point Likert scale from 0 (not at all) to 3 (nearly every day), with higher score indicating higher level of depressive symptoms.
Work and Social Adjustment Scale (WSAS) 1st week, 4th week, 8th week An adapted version of the 5-item WSAS will be used to measure the extent to which respondents' psychological problem impact their various aspects of life. It is rated on an 8-point Likert scale ranges from 0 (not at all impaired) to 8 (severely impaired). Higher score indicates higher level of impact on various aspects of life caused by psychological problems.
Social Interaction Anxiety Scale-6 (SIAS-6) 1st week, 4th week, 8th week, and after each session of VR intervention This 6-item scale (Peters et al., 2012), which is a shortened version of the 20-item SIAS (Mattick, \& Clarke, 1998), measures individuals' self-report distress when interacting with others. It runs on a 5-point Likert scale from 0 (not at all characteristics or true of me) to 4 (extremely characteristics or true of me), with higher score indicating higher tendency of social interaction anxiety.
Social presence (SPSQ) 4th week The five-item social presence questionnaire measures how much participants perceived the virtual human in the room to be like an actual person. Participants rated on a Likert-type scale (from -3 to +3). A positive social presence score indicates that the participant perceived the virtual human as conscious and aware, whereas a negative score indicates that the participant perceived the virtual human as unconscious and unaware.
Social phobia (SPS-6) 1st week, 4th week, 8th week This 6-item scale (Peters et al., 2012), which is a shortened version of the 20-item SPS (Mattick \& Clarke, 1998), measures individuals' self-report anxiety associated with the performance of various tasks while being scrutinized by others (e.g., working, eating, drinking, writing, using public toilets). It runs on a 5-point Likert scale from 0 (not at all characteristics or true of me) to 4 (extremely characteristics or true of me), with higher score indicating higher tendency of social phobia.
Self-esteem (RSE) 1st week, 4th week, 8th week Rosenberg's Self-Esteem Scale is the standard measure of self-esteem in psychological research. It is composed of 10 items, 5 of which are negatively worded. Scale point ranges from 1="strongly agree" to 4="strongly disagree".
Mental health related Quality of Life (REQoL-20) 1st week, 4th week, 8th week The 20-item scale measures quality of life with positively and negatively worded items in seven themes: activity, hope, belonging and relationships, self-perception, well-being, autonomy, and physical health. The item responses were captured on a five-point Likert scale ranging from 0 (none of the time) to 4 (most or all of the time).
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Department of Applied Social Sciences, PolyU
ðŸ‡ðŸ‡°Hong Kong, Hong Kong