Non-Immersive Virtual Environments for the Treatment of Hoarding Disorder: A Preliminary Randomized Controlled Trial With a Mixed Factorial Design Based on a Non-Clinical Sample
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 80
- 试验地点
- 1
- 主要终点
- Change in State Anxiety as measured by the State-Trait Anxiety Inventory (Y)- State subscale
研究概览
简要总结
This experimental trial investigates whether Virtual Reality Exposure (VRe) helps individuals reduce the difficulty of discarding personal possessions. It will also evaluate the psychological state impacts of the intervention. The main questions it aims to answer are:
Does exposure-based intervention (VRe) reduce emotional distress and improve willingness to discard personal items? What psychological reactions (such as anxiety or emotional responses) do participants experience during and after these interventions?
详细描述
Researchers will compare the effects of VRe to Imagination exposure (Ie) to determine which method is more effective in reducing discarding-related difficulties. The trial is specifically designed for individuals from the general population who do not meet the criteria for hoarding disorder but experience significant emotional discomfort when trying to part with certain belongings. This subclinical presentation of hoarding-like behavior is common and often unaddressed despite its impact on well-being and living space management.
Participants completed online assessments and screening procedures to determine eligibility. They then participated in a one-time, in-lab exposure session using VRe or Ie techniques. Based on a standardized rating scale, each participant brought a personal object they had previously identified as difficult to discard but not overly emotionally charged. During the session, they engaged in either an immersive visualization of discarding the item (Ie) or a guided interaction with a virtual simulation of discarding the item (VRe). Participants were evaluated on psychological (e.g., state anxiety, positive and negative affect) and behavioral outcomes (e.g., actual discarding behavior) before and after the exposure. At the end of the session, participants reported whether they intended to discard the physical object in real life.
This study follows a single-session randomized controlled trial (RCT) design with partial blinding of outcome assessors. While participants were aware of the intervention type they received due to the nature of the exposure task, the researchers responsible for scoring and analyzing outcome data were blinded to group allocation to minimize bias and expectancy effects. This design enhances the rigor and objectivity of outcome comparisons between groups.
This preliminary RCT adopts an exploratory approach due to the limited empirical research on using non-immersive VR for discarding behaviors, particularly in non-clinical populations. Prior findings suggest that VR-based interventions can simulate real-world behavior and reduce emotional reactivity in anxiety-related contexts. However, existing studies have primarily focused on immersive VR applications and clinical populations, such as individuals with specific phobias or PTSD. The current study aims to fill this gap by assessing the potential of non-immersive, more accessible VR platforms in promoting behavioral change related to possession management.
The specific objectives of the study are:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
participants were randomly assigned to one of the two experimental conditions. Randomization was conducted using a simple, computer-generated sequence via the "RAND" function in Excel, ensuring allocation concealment. The randomization was unrestricted, meaning no blocking or stratification procedures were employed. This approach ensured that each participant had an equal probability of assignment to either condition, regardless of enrollment order or participant characteristics. The random allocation sequence generation and participant enrollment were performed by two master 's-level psychology students. Blinding procedures were implemented to reduce bias. Although participants were aware of the intervention they received due to the nature of the exposure tasks, outcome assessors were blinded to group allocation. The researchers responsible for data analysis and interpretation were not involved in the delivery of the interventions and did not have access to identifying participants.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Adults individuals from general population.
排除标准
- •A score of 4 or higher on the self-report item of the Hoarding Rating Scale Self-Report, which assesses difficulty in discarding possessions;
- •No evident signs of suicidal ideation, based on the scores of the Beck Depression Inventory-II, nor indications of alcohol or substance abuse, psychotic spectrum disorders, depressive disorders, organic mental disorders, or conditions associated with cognitive impairment;
- •Participants must report difficulty in discarding certain objects. Moreover, individuals have to complete online monitoring questionnaires via PC or smartphone.
- •Participants had to fill out a custom questionnaire evaluating each object based on two parameters: importance and difficulty in discarding.
研究组 & 干预措施
Arm 1: Imagination Exposure Condition
Participants were asked to close their eyes and vividly imagine discarding the personal object they had previously selected. The procedure was guided verbally by the experimenter, who instructed participants to mentally visualize moving the object from their personal space to a trash bin. The aim was to evoke the emotions and cognitive reactions associated with discarding in a controlled, internalized format. Intervention Assigned: Behavioral: Imagination Exposure.
干预措施: Imagination Exposure (Behavioral)
Arm 2: Non-immersive Virtual Reality Exposure Condition
Participants interacted with a non-immersive, computer-based virtual environment displayed on a standard monitor. The environment simulated a household setting with various rooms and a trash bin located in a virtual garage. Participants navigated the space using a keyboard and mouse. They were presented with a digital representation of their own personal object, which had been previously photographed and embedded into the virtual scene. They were instructed to drag the object into the virtual trash bin, simulating the act of discarding. Intervention Assigned: Device: Non-immersive Virtual Reality Exposure.
干预措施: Non-immersive Virtual Reality Exposure (Device)
结局指标
主要结局
Change in State Anxiety as measured by the State-Trait Anxiety Inventory (Y)- State subscale
时间窗: Baseline (immediately before the intervention) and Post-intervention (immediately after completion of the single experimental session).
State anxiety is a psychological feature focused on how individuals experience at particular times (state anxiety). It will be assessed using the State subscale of the "State-Trait Anxiety Inventory (STAI-Y) State subscale", a validated self-report questionnaire commonly used in clinical and experimental research to measure transient levels of anxiety. Scores range from 20 to 80, with higher scores indicating greater state anxiety.
Change in Positive and Negative Affect as measured by the Positive and Negative Affect Schedule (PANAS)
时间窗: Baseline (immediately before the intervention) and Post-intervention (immediately after completion of the single experimental session).
Positive and negative affect will be assessed using the Positive and Negative Affect Schedule (PANAS), a validated self-report questionnaire consisting of 20 items. The scale includes two subscales: Positive Affect (10 items; scores range 10-50) and Negative Affect (10 items; scores range 10-50). Higher scores indicate greater intensity of the corresponding affective state.
Frequency of Discarding Behavior (Behavioral Observation)
时间窗: During the single experimental session (immediately after intervention).
Discarding behavior was assessed through direct behavioral observation during the experimental task. The measure consisted of recording whether participants discarded the personal object (in the imagination condition or in the virtual reality condition) and the frequency of this behavior within the single session.
次要结局
未报告次要终点