Exploring the role of clinical and demographic characteristics on the effects of virtual reality cognitive behavioral therapy for psychosis : A moderator analysis
(2025) In Acta Psychiatrica Scandinavica 151(3). p.293-303- Abstract
Background: Virtual Reality cognitive behavioral therapy (VR-CBT) has proven to be an effective treatment method for paranoia and anxiety in psychosis. However, it is unknown, which individuals benefit most from VR-CBT. Previous studies examined factors affecting the treatment effect of regular CBTp, including illness duration, paranoia, depression, and pre-therapy avoidance behaviors, but results are inconsistent. The study aims to investigate the factors that influence the effectiveness of VR-CBT. Methods: A total of 95 participants with a psychotic disorder and at least moderate paranoia (GTPS >40) were included in this explorative study. Data were collected as part of a multicenter randomized controlled trial in which... (More)
Background: Virtual Reality cognitive behavioral therapy (VR-CBT) has proven to be an effective treatment method for paranoia and anxiety in psychosis. However, it is unknown, which individuals benefit most from VR-CBT. Previous studies examined factors affecting the treatment effect of regular CBTp, including illness duration, paranoia, depression, and pre-therapy avoidance behaviors, but results are inconsistent. The study aims to investigate the factors that influence the effectiveness of VR-CBT. Methods: A total of 95 participants with a psychotic disorder and at least moderate paranoia (GTPS >40) were included in this explorative study. Data were collected as part of a multicenter randomized controlled trial in which participants were assigned to VR-CBT or treatment as usual (TAU). The VR-CBT group received 16 sessions of individual treatment. A moderator analysis was conducted to examine the influence of baseline demographic (age, gender, and education level) and clinical characteristics (duration of illness, paranoia, anxiety, depression, safety behavior, self-esteem, and social functioning) on treatment effects of paranoia and anxiety as measured with questionnaires and the experience sampling method (ESM) directly after treatment (12 weeks after baseline). Results: More use of safety behavior at baseline resulted in greater benefits of VR-CBT on paranoid ideation and ESM paranoia. A higher age was associated with greater benefits of VR-CBT on social anxiety but not paranoia outcomes. There was no consistent evidence of moderation by any of the other sociodemographic or clinical variables for paranoid ideation and social anxiety. Conclusions: Our findings suggest that a diverse spectrum of patients, with different backgrounds and symptom severity may be able to benefit from VR-CBT. VR-CBT can be recommended to a broad spectrum of patients with psychotic disorders, and particularly those with high levels of safety behaviors, including severe avoidance, seem to benefit more.
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- author
- Berkhof, M. ; van der Stouwe, E. C.D. ; Pot-Kolder, R. M.C.A. ; van der Gaag, M. ; Veling, W. and Geraets, C. N.W. LU
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cognitive behavioral therapy, paranoia, Psychosis, virtual reality
- in
- Acta Psychiatrica Scandinavica
- volume
- 151
- issue
- 3
- pages
- 293 - 303
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85195545532
- pmid:38853472
- ISSN
- 0001-690X
- DOI
- 10.1111/acps.13713
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2024 The Author(s). Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.
- id
- 9563431c-1ec1-4f0f-aa03-c573ce247191
- date added to LUP
- 2024-10-21 10:49:43
- date last changed
- 2025-07-15 09:39:10
@article{9563431c-1ec1-4f0f-aa03-c573ce247191,
abstract = {{<p>Background: Virtual Reality cognitive behavioral therapy (VR-CBT) has proven to be an effective treatment method for paranoia and anxiety in psychosis. However, it is unknown, which individuals benefit most from VR-CBT. Previous studies examined factors affecting the treatment effect of regular CBTp, including illness duration, paranoia, depression, and pre-therapy avoidance behaviors, but results are inconsistent. The study aims to investigate the factors that influence the effectiveness of VR-CBT. Methods: A total of 95 participants with a psychotic disorder and at least moderate paranoia (GTPS >40) were included in this explorative study. Data were collected as part of a multicenter randomized controlled trial in which participants were assigned to VR-CBT or treatment as usual (TAU). The VR-CBT group received 16 sessions of individual treatment. A moderator analysis was conducted to examine the influence of baseline demographic (age, gender, and education level) and clinical characteristics (duration of illness, paranoia, anxiety, depression, safety behavior, self-esteem, and social functioning) on treatment effects of paranoia and anxiety as measured with questionnaires and the experience sampling method (ESM) directly after treatment (12 weeks after baseline). Results: More use of safety behavior at baseline resulted in greater benefits of VR-CBT on paranoid ideation and ESM paranoia. A higher age was associated with greater benefits of VR-CBT on social anxiety but not paranoia outcomes. There was no consistent evidence of moderation by any of the other sociodemographic or clinical variables for paranoid ideation and social anxiety. Conclusions: Our findings suggest that a diverse spectrum of patients, with different backgrounds and symptom severity may be able to benefit from VR-CBT. VR-CBT can be recommended to a broad spectrum of patients with psychotic disorders, and particularly those with high levels of safety behaviors, including severe avoidance, seem to benefit more.</p>}},
author = {{Berkhof, M. and van der Stouwe, E. C.D. and Pot-Kolder, R. M.C.A. and van der Gaag, M. and Veling, W. and Geraets, C. N.W.}},
issn = {{0001-690X}},
keywords = {{cognitive behavioral therapy; paranoia; Psychosis; virtual reality}},
language = {{eng}},
number = {{3}},
pages = {{293--303}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Psychiatrica Scandinavica}},
title = {{Exploring the role of clinical and demographic characteristics on the effects of virtual reality cognitive behavioral therapy for psychosis : A moderator analysis}},
url = {{http://dx.doi.org/10.1111/acps.13713}},
doi = {{10.1111/acps.13713}},
volume = {{151}},
year = {{2025}},
}