Virtual Reality for Fear of Heights

Overseen By Michael Otto, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Boston University Charles River Campus

Disqualifiers: Previous participation

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

44 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how background music can enhance virtual reality therapy for individuals with a fear of heights. It involves exposure therapy, which gradually helps participants face their fear, and tests whether adding instrumental music from popular movies increases its effectiveness. Students at Boston University who struggle with a fear of heights and are comfortable using touch screen devices might be suitable for this study.

As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could improve therapeutic techniques for overcoming fears.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that virtual reality exposure therapy (VRET) is generally safe for treating fear of heights. Studies have found that people are not more likely to quit this therapy compared to traditional methods, indicating it is well-tolerated.

For the version that includes music, similar VR therapies with added sound have been tested. These studies did not find any extra safety concerns, and participants usually handle the experience well.

Overall, both versions of the VR exposure treatment—with or without music—are considered safe. Participants can feel reassured knowing that these treatments have been studied and do not show significant safety issues. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using virtual reality (VR) for treating the fear of heights because it offers a new way to tackle this common phobia through immersive exposure that feels real yet safe. Unlike traditional therapy, which might involve imagining heights or using photos, VR can simulate actual height experiences in a controlled environment. Adding non-lyrical music from popular movies as a background element may enhance relaxation and reduce anxiety during exposure, making the process more comfortable and potentially more effective. This innovative approach could pave the way for a more engaging and accessible treatment option for those struggling with acrophobia.

What evidence suggests that this trial's treatments could be effective for fear of heights?

Studies have shown that virtual reality (VR) exposure therapy effectively treats fear of heights, also known as acrophobia. Research indicates that VR helps individuals gradually face their fear in a safe and controlled setting, reducing discomfort over time.

In this trial, one treatment arm involves VR exposure therapy with background music. The idea is that enjoyable, non-lyrical music might enhance the VR experience and amplify the therapy's calming effects. While the exact impact of music on VR therapy for fear of heights remains unclear, this approach draws on the proven benefits of music in reducing anxiety.

In another treatment arm, participants undergo VR exposure therapy without background music. Studies have shown that even without music, VR exposure therapy can significantly reduce the fear of heights. Specifically, a three-session VR exposure program effectively lowers fear, making it easier for participants to handle heights in real life. ^{2 3 5 6 7}

Who Is on the Research Team?

Laura Long, PhD

Principal Investigator

Boston University

Are You a Good Fit for This Trial?

This trial is for adults over 18 who are students at Boston University, can read English, and are comfortable using a computer or touchscreen device. For the second phase, they must have a significant fear of heights as indicated by scoring at least 45.45 on the Acrophobia Questionnaire Anxiety Subscale.

Inclusion Criteria

I am currently enrolled at Boston University.

I can read English and understand the consent form.

My fear of heights score is 45.45 or higher.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (in-person)

Assessment and Intervention

In-person assessment and brief VR exposure intervention for participants with elevated acrophobia

1 day

1 visit (in-person)

Follow-up

Participants are monitored for acrophobia outcomes one week after the intervention

1 week

1 visit (online)

What Are the Treatments Tested in This Trial?

Interventions

• Exposure Intervention Plus Music Induction
• Exposure Intervention With No Music Induction

Trial Overview The study tests if adding non-lyrical music to a VR exposure therapy helps people overcome their fear of heights more effectively than just the VR therapy alone.

How Is the Trial Designed?

Group I: Exposure Intervention without Background Music Experimental Treatment 1 Intervention

Participants will undergo VR heights exposure without background music.

Group II: Exposure Intervention with Non-Lyrical, Liked Background Music Experimental Treatment 1 Intervention

Participants will be presented with a list of instrumental songs without lyrics from popular movies. Participants will then rank the songs in order of those they would like to hear the most. During VR heights exposure the participants' highest-ranked songs will be played in the background at a low volume.

Who Is Running the Clinical Trial?

Boston University Charles River Campus

Lead Sponsor

Trials

125

Recruited

14,100+

Published Research Related to This Trial

In a study involving 31 participants with specific phobias, both cognitive-behavioral therapy (CBT) combined with virtual reality exposure therapy (VRET) and CBT with real image exposure significantly reduced anxiety and phobia levels, with effects maintained at a 3-month follow-up.

Despite the reduction in subjective anxiety, brain imaging (fMRI) revealed that certain brain areas still showed signs of fear response, particularly the amygdala, indicating that while therapy was effective, some fear responses persisted at the neural level.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia. Álvarez-Pérez, Y., Rivero, F., Herrero, M., et al.[2021]

Virtual Reality Exposure Therapy (VRET) shows promising effectiveness for treating anxiety disorders, PTSD, and phobias, comparable to traditional in-person exposure therapies, based on various studies.

VRET offers advantages such as easier access to therapy, enhanced patient anonymity, and greater therapist control over exposure scenarios, although further research is needed to address existing limitations in the current studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Virtual reality exposure therapy for post-traumatic stress disorders, obsessive-compulsive disorders and anxiety disorders: Indications, added value and limitations]. Lognoul, M., Nasello, J., Triffaux, JM.[2021]

In a study with 23 participants, virtual reality (VR) exposure therapy significantly reduced spider phobia symptoms, with 83% of participants showing clinically significant improvement after an average of four one-hour sessions.

The VR treatment was effective compared to a waiting list control group, which showed no improvements, and importantly, there were no dropouts from the VR therapy, indicating good participant retention and safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality in the treatment of spider phobia: a controlled study. Garcia-Palacios, A., Hoffman, H., Carlin, A., et al.[2019]

Virtual reality exposure therapy (VRET) significantly outperforms waitlist controls in treating anxiety disorders, indicating its effectiveness as an intervention.

When compared to traditional evidence-based treatments, VRET shows similar efficacy and stability of results over time, suggesting it can be a viable alternative or complement to existing therapies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Opriş, D., Pintea, S., García-Palacios, A., et al.[2012]

A meta-analysis of 14 clinical trials showed that virtual reality exposure therapy (VRET) significantly improves behavioral assessments in patients with specific phobias, with a strong effect size of g = 1.23 after treatment.

VRET was found to be as effective as traditional in vivo exposure therapy, indicating that it can produce meaningful behavior changes in real-life situations, making it a valuable treatment option for specific phobias.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments. Morina, N., Ijntema, H., Meyerbröker, K., et al.[2018]

Virtual reality exposure therapy (VRET) is an innovative approach to treating specific phobias, such as fear of flying or driving, using three-dimensional computer simulations to help patients gradually desensitize to their fears.

Over the past 15 months, nearly 500 VRET sessions have been conducted, demonstrating the potential effectiveness of this method in helping patients habituate to phobic stimuli, building on established principles of exposure therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical observations during virtual reality therapy for specific phobias. Wiederhold, BK., Wiederhold, MD.[2009]

Virtual reality exposure therapy (VR therapy) is an effective treatment for specific phobias, including dental anxiety, as it allows patients to confront their fears in a controlled virtual environment.

Research shows that after undergoing VR therapy, patients with dental anxiety experienced reduced treatment anxiety and avoidance, and six months later, they no longer exhibited signs of specific phobia, enabling them to receive standard dental care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Are VR headsets effective in reducing dental anxiety?] Borsjé, C.[2022]

In a study involving 55 patients with panic disorder and agoraphobia, both virtual reality exposure therapy (VRET) and traditional exposure in vivo were found to be significantly more effective than no treatment, but VRET did not outperform exposure in vivo on most measures.

While VRET and exposure in vivo showed similar therapeutic processes, exposure in vivo was slightly more effective, suggesting that VRET may not be the best option for treating agoraphobia at this time due to its higher costs and lack of long-term follow-up data.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality exposure therapy does not provide any additional value in agoraphobic patients: a randomized controlled trial. Meyerbroeker, K., Morina, N., Kerkhof, GA., et al.[2019]

This study will compare the effectiveness of traditional one-session exposure therapy (OST) with a new gamified virtual reality (VR) exposure therapy for treating spider phobia in 100 participants, assessing outcomes at multiple time points up to a year after treatment.

The use of VR therapy aims to improve accessibility and engagement in treatment, potentially making it a more effective and acceptable option for individuals reluctant to seek traditional therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Single-session gamified virtual reality exposure therapy for spider phobia vs. traditional exposure therapy: study protocol for a randomized controlled non-inferiority trial. Miloff, A., Lindner, P., Hamilton, W., et al.[2019]

A survey of 162 students with a high fear of spiders showed that a significant majority (81% in Study 1 and 89% in Study 2) preferred virtual reality (VR) exposure therapy over traditional in vivo exposure therapy.

The findings suggest that VR exposure therapy could be an effective way to encourage more individuals with phobias to seek treatment, potentially increasing access to effective therapeutic options.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Redefining therapeutic success with virtual reality exposure therapy. Garcia-Palacios, A., Hoffman, HG., See, SK., et al.[2022]

Citations

1. withpower.com withpower.com/trial/phase-acrophobia-5-2024-b451d

Virtual Reality for Fear of Heights Exposure-based cognitive behavior therapy is an efficacious treatment for acrophobia (fear of heights) and has been delivered effectively in a virtual ...

2. centerwatch.com centerwatch.com/clinical-trials/listings/NCT06468878/virtual-reality-intervention-for-fear-of-heights

Virtual Reality Intervention for Fear of Heights The present study is designed to evaluate the effects of liked, non-lyrical background music on the efficacy of a brief VR exposure intervention ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5421394/

The use of virtual reality technology in the treatment ... This article is to review the available literature regarding the effectiveness of incorporating VR within the psychiatric treatment of a wide range of ...

4. frontiersin.org frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.671871/full

Virtual Reality Exposure Therapy for Fear of Heights Conclusion: VRET for fear of heights was able to induce and reduce discomfort in clinicians and non-clinicians, and clinicians' attitudes toward ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT04850989

Efficacy of Virtual Reality Exposure Therapy Scripts for ... The purpose of this study is to test the efficacy virtual reality videos to facilitate exposure therapy in social anxiety disorder (SAD).

6. clinicaltrials.gov clinicaltrials.gov/study/NCT06468878

Virtual Reality Intervention for Fear of Heights The goal of this clinical trial is to compare acrophobia (fear of heights) outcomes for VR exposure therapy in college students with elevated acrophobia when ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT04975854

Virtual Reality Exposure Therapy for Acrophobia The aim of this study is to examine the efficacy of virtual reality exposure therapy (VRET) as a treatment for specific phobia (acrophobia).