虚拟现实暴露疗法减少与口吃相关的社交焦虑:结果预期、治疗联盟、在场和社会在场的作用

IF 3.2 Q2 COMPUTER SCIENCE, SOFTWARE ENGINEERING
Ian Chard, Nejra van Zalk, Lorenzo Picinali
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引用次数: 0

摘要

引言:尽管几项试验已经证明了虚拟现实暴露疗法(VRET)在减少社交焦虑方面的有效性,但人们对不同治疗设计中导致症状减轻的因素知之甚少。这些因素可能包括预期结果、治疗联盟、存在(在虚拟环境中的感知)和社交存在(与他人互动的感知)。我们报告了一项针对口吃患者社交焦虑的VRET试点试验的结果,并研究了这四个因素与治疗结果的关系。方法:报告社交焦虑加剧的口吃者(n=22)在通过网络广告招募后参加了试验。在为期三周的三次会议中,对参与者进行了远程VRET。每节课都针对表演性和互动性焦虑。虚拟治疗师帮助参与者参与治疗策略,同时指导他们进行练习。结果:研究结果表明,在治疗前后,在场和社交都与对负面评价的恐惧变化呈负相关。然而,存在、预期结果和治疗联盟与社交焦虑症状的变化呈正相关。此外,预期结果和治疗联盟与对负面评价变化的恐惧呈二次相关。然而,必须谨慎解释在场对社交焦虑的影响,以及在场和治疗联盟对负面评价恐惧的影响,因为这些影响还不足以达到足够的统计能力。治疗联盟并没有调节预期结果和治疗结果之间的关系。讨论:这些发现表明,当前的VRET协议对社交焦虑和对负面评价的恐惧有不同的影响。我们讨论存在如何成为这些混合联想的基础。我们还认为,对社交焦虑症状的意外积极影响可能是由于治疗策略不足,无意中鼓励了不适应的学习。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Virtual reality exposure therapy for reducing social anxiety associated with stuttering: the role of outcome expectancy, therapeutic alliance, presence and social presence
Introduction: Although several trials have demonstrated the effectiveness of Virtual Reality Exposure Therapy (VRET) for reducing social anxiety, there is little understanding about the factors that lead to symptom reduction across different treatment designs. Such factors may include outcome expectancy, therapeutic alliance, presence (perception of being in the virtual environment) and social presence (perception of interacting with others). We report on findings from a pilot trial of VRET targeting social anxiety in people who stutter, and examine the association of these four factors with treatment outcome.Methods: People who stutter reporting heightened social anxiety (n = 22) took part in the trial after being recruited via online adverts. Remotely delivered VRET was administered to participants in three sessions across three weeks. Each session targeted both performative and interactive anxiety. A virtual therapist helped participants to engage with treatment strategies, whilst also guiding them through exercises.Results: Findings showed that presence and social presence were both negatively related to changes in fear of negative evaluation between pre- and post-treatment. However, presence, outcome expectancy and therapeutic alliance were positively related to changes in social anxiety symptoms. Furthermore, outcome expectancy and therapeutic alliance were quadratically related to fear of negative evaluation change. Nevertheless, the effect of presence on social anxiety, and the effects of presence and therapeutic alliance on fear of negative evaluation must be interpreted with caution as these were not large enough to reach sufficient statistical power. Therapeutic alliance did not mediate the relationship between outcome expectancy and treatment outcome.Discussion: These findings suggest that the current VRET protocol affected social anxiety and fear of negative evaluation differently. We discuss how presence may underlie these mixed associations. We also suggest that the unexpected positive effects on social anxiety symptoms may have resulted from insufficient treatment strategies which inadvertently encouraged maladaptive learning.
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来源期刊
CiteScore
5.80
自引率
0.00%
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审稿时长
13 weeks
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