Virtual reality-based exposure with 360° video as part of cognitive behavioral therapy for social anxiety disorder: a three-arm randomized controlled trial
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013), p = 0.1839. However, CBT-ExpVR was more effective than RlxVR, β = −11.537, 95% CI (−16.163, −6.911), p < 0.0001. Dropout rates post-treatment were 16% (CBT-ExpVR), 38% (CBT-Exp), and 20% (RlxVR). No harms were registered during the study. Conclusion CBT-ExpVR represents an effective treatment for SAD comparable to standard CBT treatment. CBT-ExpVR was reported as less costly and requiring less effort by the therapist compared to CBT-Exp. Thus, VR-based exposure might pave the way for a broader implementation of exposure in psychotherapeutic interventions for social anxiety by providing easy and low-cost access to exposure scenarios. Clinical Trials Registration https://clinicaltrials.gov/study/NCT03973541 , identifier NCT03973541.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it