Background: Cognitive Bias Modification of Interpretations (CBM-I) is a computerized intervention designed to change negatively biased interpretations of ambiguous information, which underlie and reinforce anxiety. The repetitive and monotonous features of CBM-I can negatively impact training adherence and learning processes. Objective: This proof-of-concept study aimed to examine whether performing a CBM-I training using mobile virtual reality technology (virtual reality Cognitive Bias Modification of Interpretations [VR-CBM-I]) improves training experience and effectiveness. Methods: A total of 42 students high in trait anxiety completed 1 session of either VR-CBM-I or standard CBM-I training for performance anxiety. Participants’ feelings of immersion and presence, emotional reactivity to a stressor, and changes in interpretation bias and state anxiety, were assessed. Results: The VR-CBM-I resulted in greater feelings of presence (P<.001, d=1.47) and immersion (P<.001, ηp 2 =0.74) in the training scenarios and outperformed the standard training in effects on state anxiety (P<.001, ηp 2 =0.3) and emotional reactivity to a stressor (P=.03, ηp 2 =0.12). Both training varieties successfully increased the endorsement of positive interpretations (P<.001, drepeated measures [drm]=0.79) and decreased negative ones. (P<.001, drm=0.72). In addition, changes in the emotional outcomes were correlated with greater feelings of immersion and presence. Conclusions: This study provided first evidence that (1) the putative working principles underlying CBM-I trainings can be translated into a virtual environment and (2) virtual reality holds promise as a tool to boost the effects of CMB-I training for highly anxious individuals while increasing users’ experience with the training application.

Additional Metadata
Keywords anxiety, emotional reactivity, interpretation bias, cognitive bias modification, virtual reality, head mounted display, immersion, presence
Persistent URL dx.doi.org/10.2196/11517, hdl.handle.net/1765/122388
Journal Jmir Mhealth and Uhealth
Citation
Otkhmezuri, B., Boffo, M., Siriaraya, P., Matsangidou, M., Wiers, R.W, Mackintosh, B., … Salemink, E. (2019). Believing is Seeing: A proof-of-concept study on using mobile Virtual Reality to boost the effects of Interpretation Bias Modification for anxiety. Jmir Mhealth and Uhealth, 6. doi:10.2196/11517