Automated psychological therapy using virtual reality (VR) for patients with persecutory delusions: study protocol...

Area of Science:

• Psychiatry
• Psychology
• Virtual Reality Applications

Background:

• Persecutory delusions are a significant psychiatric issue linked to poor outcomes.
• A theoretical model suggests defense behaviors prevent processing disconfirmatory evidence, maintaining delusions.
• Virtual Reality (VR) offers a graded exposure to feared social situations, mitigating anxiety and facilitating relearning safety.

Purpose of the Study:

• To evaluate an automated VR cognitive therapy for persistent persecutory delusions in psychosis.
• To assess the efficacy of VR-based cognitive therapy compared to a VR relaxation control condition.
• To determine the scalability of automated VR therapy for psychosis treatment services.

Main Methods:

• Patients with persistent persecutory delusions will be randomized (1:1) to automated VR cognitive therapy or VR mental relaxation.
• Each VR treatment involves approximately four 30-minute sessions, with standard care continuing.
• The primary outcome is the degree of conviction in persecutory delusions at 4 weeks, with further assessments up to 24 weeks.

Main Results:

• The trial is designed to provide the first test of automated cognitive therapy within VR for psychosis patients.
• Interim analysis will determine if the trial proceeds to test 90 patients based on effect size (d > 0.1).
• Secondary outcomes include real-world distress, activity levels, suicidal ideation, and quality of life.

Conclusions:

• Automated VR cognitive therapy presents a potentially highly scalable treatment for psychosis services.
• This trial will offer crucial data on the effectiveness of VR interventions for persecutory delusions.