Abstract
Dentophobia can reduce visits to dental offices and, thereby endangering the oral health of individuals. The present study aimed to investigate the effects of virtual reality exposure therapy (VRET) on state-trait anxiety in individuals with dentophobia. This quasi-experimental research adopted a pretest-posttest control group design with a 45-day follow-up period. The statistical population included all individuals with dentophobia who visited dental offices in Isfahan, Tehran, and Shahrekord, Iran within 2020–21. The convenience sampling method was employed to select 40 participants as the research sample with respect to the inclusion and exclusion criteria. They were then randomly assigned to the experimental group and the control group equally (i.e., 20 participants per group). Participants in the experimental group attended eight 15-minute sessions of VRET, whereas those in the control group received no intervention. In fact, they were placed on a waiting list. To collect data, the state-trait anxiety inventory (STAI) was used. The multivariate analysis of covariance was used for data analysis. The results indicated the significant effect of the VRET on state-trait anxiety, as the posttest mean scores of state anxiety and trait anxiety decreased in the experimental group as opposed to the pretest scores (p < 0.01). Hence, the VRET can be considered an effective intervention in reducing state-trait anxiety in individuals with dentophobia.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Abdoli, N., Farnia, V., Salemi, S., Davarinejad, O., Ahmadi Jouybari, T., Khanegi, M., Alikhani, M., & Behrouz, B. (2020). Reliability and validity of Persian Version of state-trait anxiety inventory among High School Students. East Asian Arch Psychiatry, 30(2), 44–47. https://doi.org/10.12809/eaap1870
Ahmadpour, N., Randall, H., Choksi, H., Gao, A., Vaughan, C., & Poronnik, P. (2019). Virtual reality interventions for acute and chronic pain management. International Journal Of Biochemistry & Cell Biology, 114, 105568. https://doi.org/10.1016/j.biocel.2019.105568
Akkan, H., Kallem Seyyar, G., Aslan, B., & Karabulut, E. (2022). The effect of virtual reality-based therapy on fear of falling in multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord, 63, 103791. https://doi.org/10.1016/j.msard.2022.103791
Alahmari, K., Duh, H., & Skarbez, R. (2022). Outcomes of virtual reality technology in the management of generalised anxiety disorder: A systematic review and meta-analysis. Behaviour & Information Technology, 1–13. https://doi.org/10.1080/0144929X.2022.2118078
Aliakbari, M., Alipor, A., Ebrahimimoghadam, H., & Fekraty, M. (2017). The effect of virtual reality (VR) on psychological Disorders in Cancer Caseses. Military Caring Sciences Journal, 4(1), 49–57. https://doi.org/10.29252/mcs.4.1.49
Alshatrat, S. M., Alotaibi, R., Sirois, M., & Malkawi, Z. (2019). The use of immersive virtual reality for pain control during periodontal scaling and root planing procedures in dental hygiene clinic. Int J Dent Hyg, 17(1), 71–76. https://doi.org/10.1111/idh.12366
Anderson, P. L., & Molloy, A. (2020). Maximizing the impact of virtual reality exposure therapy for anxiety disorders. Curr Opin Psychol, 36, 153–157. https://doi.org/10.1016/j.copsyc.2020.10.001
Armfield, J. M., & Heaton, L. J. (2013). Management of fear and anxiety in the dental clinic: a review. Aust Dent J, 58(4), 390–407; quiz 531. https://doi.org/10.1111/adj.12118
Azimisefat, P., de Jongh, A., Rajabi, S., Kanske, P., & Jamshidi, F. (2022). Efficacy of virtual reality exposure therapy and eye movement desensitization and reprocessing therapy on symptoms of acrophobia and anxiety sensitivity in adolescent girls: A randomized controlled trial [Original Research]. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.919148. https://www.frontiersin.org/articles/
Brahm, C. O., Lundgren, J., Carlsson, S. G., Nilsson, P., & Hägglin, C. (2019). Evaluation of the Jönköping dental fear coping model: A patient perspective. Acta Odontologica Scandinavica, 77(3), 238–247. https://doi.org/10.1080/00016357.2018.1564837
Burton, L., & Nkwo, C. (2022). Gender differences in the relationship between state and trait anxiety and Empathy. Current Psychology, 41(12), 8368–8373. https://doi.org/10.1007/s12144-022-03716-5
Carl, E., Stein, A. T., Levihn-Coon, A., Pogue, J. R., Rothbaum, B., Emmelkamp, P., Asmundson, G. J. G., Carlbring, P., & Powers, M. B. (2019). Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal Of Anxiety Disorders, 61, 27–36. https://doi.org/10.1016/j.janxdis.2018.08.003
Elphinston, R. A., Vaezipour, A., Fowler, J. A., Russell, T. G., & Sterling, M. (2022). Psychological therapy using virtual reality for treatment of driving phobia: A systematic review. Disability And Rehabilitation, 1–13. https://doi.org/10.1080/09638288.2022.2069293
El-Qirem, F. A., Malak, M. Z., Bani Salameh, A. K., Ali, R., & Alsswey, A. (2022). Effect of virtual reality therapy on stress and anxiety symptoms, and physiological measures among University students: An experimental study in Jordan. Current Psychology. https://doi.org/10.1007/s12144-022-02939-w
Emmelkamp, P. M. G., Meyerbröker, K., & Morina, N. (2020). Virtual reality therapy in social anxiety disorder. Curr Psychiatry Rep, 22(7), 32. https://doi.org/10.1007/s11920-020-01156-1
Fang, Y. M., & Huang, Y. J. (2021). Comparison of the usability and flow experience of an exercise promotion virtual reality programme for different age groups. Behaviour & Information Technology, 40(12), 1250–1264. https://doi.org/10.1080/0144929X.2021.1938680
Feizollahi, Z., Asadzadeh, H., & Mousavi, S. R. (2022). Prediction of symptoms of psychosomatic Disorders in University Students based on perfectionism mediated by Smartphone Addiction. Caspian Journal of Health Research, 7(3), 151–158. https://doi.org/10.32598/CJHR.7.3.421.1.7
Feng, H., Li, C., Liu, J., Wang, L., Ma, J., Li, G., Gan, L., Shang, X., & Wu, Z. (2019). Virtual reality Rehabilitation Versus Conventional Physical Therapy for improving Balance and Gait in Parkinson’s Disease Patients: A Randomized Controlled Trial. Medical Science Monitor, 25, 4186–4192. https://doi.org/10.12659/msm.916455
Gottlieb, A., Doniger, G. M., Hussein, Y., Noy, S., & Plotnik, M. (2021). The efficacy of a virtual reality exposure therapy treatment for fear of Flying: A retrospective study. Frontiers In Psychology, 12, 641393. https://doi.org/10.3389/fpsyg.2021.641393
Gujjar, K. R., van Wijk, A., Kumar, R., & de Jongh, A. (2019). Efficacy of virtual reality exposure therapy for the treatment of dental phobia in adults: A randomized controlled trial. Journal Of Anxiety Disorders, 62, 100–108. https://doi.org/10.1016/j.janxdis.2018.12.001
Heinig, I., Knappe, S., Hoyer, J., Wittchen, H. U., Richter, J., Arolt, V., Deckert, J., Domschke, K., Hamm, A., Kircher, T., Lueken, U., Margraf, J., Neudeck, P., Rief, W., Straube, B., Ströhle, A., Pauli, P., & Pittig, A. (2022). Effective – and tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders. Behavior Therapy. https://doi.org/10.1016/j.beth.2022.11.001
Intrieri, R. C., & Newell, C. B. (2022). Anxiety sensitivity not distress tolerance as a predictor of generalized anxiety symptoms and worry. Current Psychology, 41(3), 1148–1158. https://doi.org/10.1007/s12144-020-00636-0
Klein, R. A. (2000). Virtual reality exposure therapy in the treatment of fear of Flying. Journal of Contemporary Psychotherapy, 30(2), 195–207. https://doi.org/10.1023/A:1026518813266
Knowles, K. A., & Olatunji, B. O. (2020). Specificity of trait anxiety in anxiety and depression: Meta-analysis of the state-trait anxiety inventory. Clinical Psychology Review, 82, 101928. https://doi.org/10.1016/j.cpr.2020.101928
Levy, F., Leboucher, P., Rautureau, G., & Jouvent, R. (2016). E-virtual reality exposure therapy in acrophobia: A pilot study. Journal Of Telemedicine And Telecare, 22(4), 215–220. https://doi.org/10.1177/1357633x15598243
Lindner, P., Dagöö, J., Hamilton, W., Miloff, A., Andersson, G., Schill, A., & Carlbring, P. (2021). Virtual reality exposure therapy for public speaking anxiety in routine care: A single-subject effectiveness trial. Cognitive Behaviour Therapy, 50(1), 67–87. https://doi.org/10.1080/16506073.2020.1795240
Lognoul, M., Nasello, J., & Triffaux, J. M. (2020). [Virtual reality exposure therapy for post-traumatic stress disorders, obsessive-compulsive disorders and anxiety disorders: Indications, added value and limitations]. Encephale, 46(4), 293–300. https://doi.org/10.1016/j.encep.2020.01.005
Majidi, E., & Manshaee, G. (2021). Effects of Virtual Reality Exposure Therapy on Dentophobia in Clients of Dental Offices in Isfahan, Tehran, and Shahrekord (Iran) [Research Article]. 15(4),e115684. https://doi.org/10.5812/ijpbs.115684
Mäkinen, H., Haavisto, E., Havola, S., & Koivisto, J. M. (2022). User experiences of virtual reality technologies for healthcare in learning: An integrative review. Behaviour & Information Technology, 41(1), 1–17. https://doi.org/10.1080/0144929X.2020.1788162
Qian, J., McDonough, D. J., & Gao, Z. (2020). The effectiveness of virtual reality Exercise on Individual’s physiological, psychological and rehabilitative outcomes: A systematic review. International journal of environmental research and public health, 17(11), https://doi.org/10.3390/ijerph17114133
Qin, Z., Zhou, C., Zhu, Y., Wang, Y., Cao, H., Li, W., & Huang, Z. (2022). Virtual reality for hypertension in tooth extraction: A Randomized Trial. Journal Of Dental Research, 101(4), 400–406. https://doi.org/10.1177/00220345211049393
Quagliato, L. A., de Matos, U. M. A., & Nardi, A. E. (2022). Lifetime psychopathology in the offspring of parents with anxiety disorders: A systematic review. Journal Of Affective Disorders, 319, 618–626. https://doi.org/10.1016/j.jad.2022.09.049
Rimer, E., Husby, L. V., & Solem, S. (2021). Virtual reality exposure therapy for fear of Heights: Clinicians’ attitudes become more positive after trying VRET. Frontiers In Psychology, 12, 671871. https://doi.org/10.3389/fpsyg.2021.671871
Rothbaum, B. O., Hodges, L. F., Kooper, R., Opdyke, D., Williford, J. S., & North, M. (1995). Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. American Journal Of Psychiatry, 152(4), 626–628. https://doi.org/10.1176/ajp.152.4.626
Rothbaum, B. O., Hodges, L., Watson, B. A., Kessler, C. D., & Opdyke, D. (1996). Virtual reality exposure therapy in the treatment of fear of flying: A case report. Behaviour Research And Therapy, 34(5–6), 477–481. https://doi.org/10.1016/0005-7967(96)00007-1
Salehi, E., Mehrabi, M., Fatehi, F., & Salehi, A. (2020). Virtual reality therapy for Social Phobia: A scoping review. Studies In Health Technology And Informatics, 270, 713–717. https://doi.org/10.3233/shti200253
Seligman, L. D., Hovey, J. D., Chacon, K., & Ollendick, T. H. (2017). Dental anxiety: An understudied problem in youth. Clinical Psychology Review, 55, 25–40. https://doi.org/10.1016/j.cpr.2017.04.004
Shindova, M. P., & Belcheva, A. B. (2021). Dental fear and anxiety in children: A review of the environmental factors. Folia Med (Plovdiv), 63(2), 177–182. https://doi.org/10.3897/folmed.63.e54763
Sivrikaya, E. C., Yilmaz, O., & Sivrikaya, P. (2021). Dentist–patient communication on dental anxiety using the social media: A randomized controlled trial. Scandinavian Journal of Psychology, 62(6), 780–786. https://doi.org/10.1111/sjop.12769
Spielberger, C. D. (1986). State-trait anxiety inventory: Bibliography (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.
Stein Duker, L. I., Grager, M., Giffin, W., Hikita, N., & Polido, J. C. (2022). The relationship between Dental fear and anxiety, General Anxiety/Fear, sensory over-responsivity, and oral Health Behaviors and Outcomes: A conceptual model. International journal of environmental research and public health, 19(4), https://doi.org/10.3390/ijerph19042380
Tack, C. (2021). Virtual reality and chronic low back pain. Disability And Rehabilitation. Assistive Technology, 16(6), 637–645. https://doi.org/10.1080/17483107.2019.1688399
Tejera, D. M., Beltran-Alacreu, H., Cano-de-la-Cuerda, R., Leon Hernández, J. V., Martín-Pintado-Zugasti, A., Calvo-Lobo, C., Gil-Martínez, A., & Fernández-Carnero, J. (2020). Effects of virtual reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in patients with non-specific chronic Neck Pain: A Randomized Clinical Trial. International journal of environmental research and public health, 17(16), https://doi.org/10.3390/ijerph17165950
Tsoulou, V., Karamolegou, E., Kourakos, M., Vasilopoulos, G., & Polikandrioti, M. (2019). Association of state and trait anxiety between patients who had Undergone traumatic amputation and their family caregivers. The International Journal Of Lower Extremity Wounds, 18(2), 176–185. https://doi.org/10.1177/1534734619848580
van Dis, E. A. M., Landkroon, E., Hagenaars, M. A., van der Does, F. H. S., & Engelhard, I. M. (2021). Old fears die hard: Return of Public speaking fear in a virtual reality Procedure. Behavior Therapy, 52(5), 1188–1197. https://doi.org/10.1016/j.beth.2021.01.005
Vasser, M., & Aru, J. (2020). Guidelines for immersive virtual reality in psychological research. Curr Opin Psychol, 36, 71–76. https://doi.org/10.1016/j.copsyc.2020.04.010
Veeraboina, N., Doshi, D., Kulkarni, S., Patanapu, S. K., Dantala, S. N., & Adepu, S. (2020). Association of state and trait anxiety with oral health status among adult dental patients. Acta Bio-Medica : Atenei Parmensis, 91(3), e2020070. https://doi.org/10.23750/abm.v91i3.8986
Xiong, J., Hsiang, E. L., He, Z., Zhan, T., & Wu, S. T. (2021). Augmented reality and virtual reality displays: emerging technologies and future perspectives. Light: Science & Applications, 10(1), 216. https://doi.org/10.1038/s41377-021-00658-8
Zhang, Q., Fu, Y., Lu, Y., Zhang, Y., Huang, Q., Yang, Y., Zhang, K., & Li, M. (2021). Impact of virtual reality-based therapies on Cognition and Mental Health of Stroke Patients: Systematic review and Meta-analysis. Journal Of Medical Internet Research, 23(11), e31007. https://doi.org/10.2196/31007
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The written consent has been obtained from all participants. The Ethics Review Board of Islamic Azad University-Isfahan (Khorasgan) Branch, approved the present study (code: IR.IAU.KHUISF.REC.1399.167).
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Majidi, E., Manshaee, G. Effects of virtual reality exposure therapy on state-trait anxiety in individuals with dentophobia. Curr Psychol 43, 2425–2431 (2024). https://doi.org/10.1007/s12144-023-04485-5
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DOI: https://doi.org/10.1007/s12144-023-04485-5