A Novel Transdiagnostic Approach to the Prevention of Eating Disorders Using Virtual Reality: Preliminary Evaluation of the H.O.M.E. Intervention

Abstract

“Virtual reality” (VR) has been used effectively in clinical psychology to improve existing treatments and prevention protocols for many psychopathologies, including eating disorders (EDs). However, no VR software was developed to concurrently tackle dysfunctional eating behaviours and three third wave cognitive–behavioural transdiagnostic factors linked to EDs: psychological inflexibility, emotion dysregulation and experiential avoidance. This preliminary study is aimed at evaluating potential effects of a new VR-based preventive intervention (H.O.M.E.—How to Observe and Modify Emotions) in improving selected outcomes of transdiagnostic factors and dysfunctional eating behaviours in the general population (GP) with ED risk compared to a waiting list (WL). N = 40 GP participants with ED risk were screened (using the SCOFF and Eating Disorder Examination Questionnaire (EDE-Q)) and randomised into VR (n = 20) or WL (n = 20) groups. Before and after intervention and at 3- and 6-month follow-up, participants completed EDE-Q, Difficulties in Emotion Regulation Scale—brief version (DERS-16) for emotion dysregulation, Acceptance and Action Questionnaire II (AAQ-II) for psychological inflexibility and Multidimensional Psychological Flexibility Inventory (MPFI) experiential avoidance scale. H.O.M.E. improved scores in all EDE-Q subscales (EDE-Q-total: p = 0.003; EDE-Q-restraint: p = 0.028; EDE-Q-eating concerns: p = 0.035; EDE-Q-shape concerns: p = 0.003; EDE-Q-weight concerns: p = 0.023), AAQ-II (p = 0.005), DERS-16-total (p = 0.006), DERS-16-difficulty in engaging in goal-directed behaviours (p = 0.008), and DERS-16-limited access to emotion regulation strategies (p = 0.001), with results greater than WL and maintained at follow-ups. Results showed potential for H.O.M.E. to represent a feasible tool to prevent EDs. Given the similarity between VR and technologies used in everyday life, H.O.M.E. may help in engaging young individuals with ED risk towards psychological support before ED onset.