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Testing the effectiveness of virtual reality as a defusion technique for coping with unwanted thoughts

Abstract

Negative thoughts are experienced by as many as 80–99% of the population. These thoughts are associated with a variety of negative consequences, including negative mood, decreased task performance and the development of psychopathology. One technique employed in contextual behavioral therapies to help cope with negative thoughts is cognitive defusion. Cognitive defusion techniques undermine potential negative effects of thinking by teaching clients to get some distance from their thoughts. Virtual reality (VR) is the computer-generated simulation of a three-dimensional environment that users can interact in. VR is of increasing interest to applied psychologists due to its potential for exposure learning. One area where VR may be effective is helping people to cope with negative thoughts. The current study examined the impact of a VR task as a cognitive defusion technique on participants’ relationship with a negative self-referential thought (e.g., “I am a failure”). Thirty participants were randomly assigned to one of two conditions (i.e., defusion VR and control VR). Participants were tested pre- and post-VR task on a state measure of cognitive defusion and ratings of their self-referential negative thought. The results indicated that a defusion VR task facilitates the management of negative thoughts and leads to an increase in state defusion. The findings are discussed in terms of their implications for the use of VR techniques in dealing with negative thoughts.

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References

  • Atkins PW, Styles RG (2016) Measuring self and rules in what people say: exploring whether self-discrimination predicts long-term wellbeing. J Context Behav Sci 5(2):71–79

    Article  Google Scholar 

  • Belloch A, Morillo C, Lucero M, Cabedo E, Carrió C (2004) Intrusive thoughts in non-clinical subjects: the role of frequency and unpleasantness on appraisal ratings and control strategies. Clin Psychol Psychother 11(2):100–110

    Article  Google Scholar 

  • Bolderston H, Gillanders DT, Turner G, Taylor HC, Ní Mhaoileoin D, Coleman A (2018) The initial validation of a state version of the Cognitive Fusion Questionnaire. J Context Behav Sci. https://doi.org/10.1016/j.jcbs.2018.04.002

    Google Scholar 

  • Botella C, Herrero R, Castilla D, Vizcaíno Y (2013) Avances en eltratamiento psicológico de la fibromialgia: el uso de la realidad virtual para la inducción de emocionespositivas y la promoción de la activación comportamental. Un estudio piloto. Revista Argentina de Clinica Psicologica 22:111–120

    Google Scholar 

  • Clark DA, Rhyno S (2005) Unwanted intrusive thoughts in non clinical individuals: implications for clinical disorders. Guilford, New York

    Google Scholar 

  • Deacon BJ, Fawzy TI, Lickel JJ, Wolitzky-Taylor KB (2011) Cognitive defusion versus cognitive restructuring in the treatment of negative self-referential thoughts: an investigation of process and outcome. J Cognit Psychother 25(3):218

    Article  Google Scholar 

  • Difede J, Hoffman HG, Jayasinghe N (2002) Innovative use of virtual reality technology in the treatment of PTSD in the aftermath of September 11. Psychiatric Serv 53:1083–1085

    Article  Google Scholar 

  • Duff H, Larsson A, McHugh L (2016) Evaluations of self-referential thoughts and their association with components of Acceptance and Commitment Therapy. J Context Behav Sci 5(1):39–47

    Article  Google Scholar 

  • Emmelkamp PMG, Krijn M, Hulsbosch A, de Vries S, Schuemie MJ, Van Der Mast C (2002) Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia. Behav Res Ther 40:509–516

    Article  Google Scholar 

  • Falconer CJ, Rovira A, King JA, Gilbert P, Antley A, Fearon P, Ralph N, Slater M, Brewin C (2016) Embodying self-compassion within virtual reality and its effects on patients with depression. BJPsych Open 2:74–80

    Article  Google Scholar 

  • Felnhofer A, Kothgassner OD, Beutl L, Hlavacs H, Kryspin-Exner I (2012) Is virtual reality made for men only? Exploring gender differences in the sense of presence. In: Proceedings of the international society on presence research, pp 103–112

  • Foa EB, Keane TM, Friedman MJ, Cohen JA (2009) Effective treatments for PTSD: practice guidelines from the international society for traumatic stress studies. Guilford Press, New York

    Google Scholar 

  • Gaudiano BA (2011) Evaluating acceptance and commitment therapy: an analysis of a recent critique. Int J Behav Consult Therapy 7(1):54–65

    Article  Google Scholar 

  • Hayes SC, Strosahl KD, Wilson KG (1999) Acceptance and commitment therapy: an experiential approach to behavior change. Guilford Press, New York

    Google Scholar 

  • Hayes SC, Villatte M, Levin M, Hildebrandt M (2011) Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annu Rev Clin Psychol 7:141–168

    Article  Google Scholar 

  • Healy HA, Barnes-Holmes Y, Barnes-Holmes D, Keogh C, Luciano C, Wilson K (2008) An experimental test of a cognitive defusion exercise: coping with negative and positive self-statements. Psychol Rec 58(4):623–640

    Article  Google Scholar 

  • Krijn M, Emmelkamp PMG, Ólafsson RP, Bouwman M, Van Gerwen LJ, Spinhoven P, Schuemie MJ, Der Mast Vam, Ch A (2007) Fear of flying treatment methods: virtual reality exposure vs. cognitive behavioral therapy. Aviat Space Environ Med 78:121–128

    Google Scholar 

  • Lamson R, Meisner M (1994) The effects of virtual reality immersion in the treatment of anxiety, panic and phobia of heights. In: Proceedings of the 2nd annual conference on virtual reality and persons with disabilities. Murphy, Northridge, pp 63–68

  • Larsson A, Hooper N, Osborne LA, Bennett P, McHugh L (2016) Using brief cognitive restructuring and cognitive defusion techniques to cope with negative thoughts. Behav Modif 40(3):452–482

    Article  Google Scholar 

  • Mandavia A, Masuda A, Moore M, Mendoza H, Donati MR, Cohen LL (2015) The application of a cognitive defusion technique to negative body image thoughts: a preliminary analogue investigation. J Context Behav Sci 4:86–95

    Article  Google Scholar 

  • Masuda A, Hayes SC, Sackett FC, Twohig MP (2004) Cognitive defusion and self-relevant negative thoughts: examining the impact of a ninety year old technique. Behav Res Ther 42:477–485

    Article  Google Scholar 

  • Masuda A, Twohig MP, Stormo AR, Feinstein AB, Chou YY, Wendell JW (2010) The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts. J Behav Ther Exp Psychiatry 41(1):11–17

    Article  Google Scholar 

  • Montraghi TE, Seim RV, Meyer EC, Morissette SB (2014) Virtual reality exposure therapy for treatment of post traumatic stress disorder: a methodological review using CONSORT guidelines. J Clin Psychol 70(3):197–208

    Article  Google Scholar 

  • North MM, North SM, Coble JR (1997) Virtual reality therapy for fear of flying. Am J Psychiatry 154:130

    Article  Google Scholar 

  • Opriş D, Pintea S, García-Palacios A, Botella C, Szamosközi Ş, David D (2012) Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depress Anxiety 29(2):85–93

    Article  Google Scholar 

  • Parsons TD, Rizzo AA (2008) Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: a meta-analysis. J Behav Ther Exp Psychiatry 39(3):250–261

    Article  Google Scholar 

  • Peñate W, Pitti CT, Bethencourt JM, de la Fuente J, Gracia R (2008) The effects of a treatment based on the use of virtual reality exposure and cognitive-behavioral therapy applied to patients with agoraphobia. Preliminary results. Int J Clin Health Psychol 8:5–22

    Google Scholar 

  • Rachman S, de Silva P (1978) Abnormal and normal obsessions. Behav Res Ther 16(4):233–248

    Article  Google Scholar 

  • Rizzo AA, Pair J, McNerney PJ, Eastlund E, Manson B, Gratch J, Hill R, Roy M, Swartout B (2004) From training to toy treatment: Design and development of a posttraumatic stress disorder virtual reality exposure therapy application for Iraq war veterans. In: Proceedings of the third annual international workshop for virtual rehabilitation. Lausanne, Switzerland, pp 35–42

  • Rothbaum BO, Hodges L, Kooper R (1997) Virtual reality exposure therapy. J Psychother Pract Res 6(3):219–226

    Google Scholar 

  • Shiri S, Feintuch U, Weiss N (2013) A virtual reality system combined with biofeedback for treating pediatric chronic headache—a pilot study. Pain Med 14:621–627

    Article  Google Scholar 

  • Wallach HS, Safir MP, Bar-Zvi M (2009) Virtual reality cognitive behavior therapy for public speaking anxiety: a randomized clinical trial. Behav Modif 33(3):314–338

    Article  Google Scholar 

  • Wiederhold BK, Wiederhold MD (2005) The effect of presence on virtual reality treatment. In: Wiederhold BK, Wiederhold MD (eds) Virtual reality therapy for anxiety disorders: advances in evaluation and treatment. American Psychological Association, Washington, pp 77–86

    Chapter  Google Scholar 

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Correspondence to Louise McHugh.

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Prudenzi, A., Rooney, B., Presti, G. et al. Testing the effectiveness of virtual reality as a defusion technique for coping with unwanted thoughts. Virtual Reality 23, 179–185 (2019). https://doi.org/10.1007/s10055-018-0372-1

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Keywords

  • Acceptance and commitment therapy
  • Cognitive defusion
  • Virtual reality
  • Negative thoughts
  • Randomized controlled trial