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A Virtual Reality-Based Cognitive Defusion Application for Youth Depression and Anxiety:Mixed Methods Experimental Study

Title: A Virtual Reality-Based Cognitive Defusion Application for Youth Depression and Anxiety:Mixed Methods Experimental Study
Authors: Bell, Imogen H; Li, Cassandra; Thompson, Andrew; Ellinghaus, Carli; O'Sullivan, Shaunagh; Reynolds, Kate Alexandra; Wadley, Greg; Liu, Yang; Bendall, Sarah; Gleeson, John; Valmaggia, Lucia; Alvarez-Jimenez, Mario
Source: Bell, I H, Li, C, Thompson, A, Ellinghaus, C, O'Sullivan, S, Reynolds, K A, Wadley, G, Liu, Y, Bendall, S, Gleeson, J, Valmaggia, L & Alvarez-Jimenez, M 2025, 'A Virtual Reality-Based Cognitive Defusion Application for Youth Depression and Anxiety : Mixed Methods Experimental Study', JMIR Mental Health, vol. 12, e70160, pp. e70160. https://doi.org/10.2196/70160
Publication Year: 2025
Collection: King's College, London: Research Portal
Subject Terms: Humans; Female; Male; Adolescent; Virtual Reality; Cognitive Behavioral Therapy/methods; Depression/therapy; Anxiety/therapy; Feasibility Studies; Young Adult
Description: Background: Third-wave psychological treatments such as acceptance and commitment therapy can be effective for improving depression and anxiety in youth. However, third-wave therapeutic techniques such as cognitive defusion can be abstract, challenging to learn, and difficult to apply in real-world settings. Translating these techniques into virtual reality (VR) may provide interactive, enjoyable, and concrete learning opportunities, potentially enhancing engagement and effectiveness. This study evaluated a novel VR application that translates the technique of cognitive defusion into a brief, gamified VR experience. Objective: The objectives of this study were to evaluate the feasibility, acceptability, usability, and safety of the VR cognitive defusion application; examine whether it could improve negative thinking and mood states; and understand how it compared to a non-VR cognitive defusion exercise. Methods: In a mixed methods experimental study, 20 young people completed both a VR and audio cognitive defusion exercise in a randomized order within a single session. Quantitative state-based measures were taken before and after each exercise, and a qualitative interview at the end focused on how the two experiences compared. Results: It was feasible to recruit participants, and all participants completed both exercises and assessments. Both the VR and audio exercises were acceptable to participants, with qualitative themes highlighting a preference for VR due to the novel and engaging format; however, there was a need for better guidance and more personalized environments. No severe adverse events were reported, although one participant experienced distress during the VR exercise. Pretest-posttest effects showed improvements in thought discomfort, cognitive defusion, and state anger for both the VR and audio conditions (P
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/40773283
DOI: 10.2196/70160
Availability: https://kclpure.kcl.ac.uk/portal/en/publications/5c629f12-bd81-47ab-b55d-b0d6581d8350; https://doi.org/10.2196/70160; https://kclpure.kcl.ac.uk/ws/files/349571369/mental-2025-1-e70160.pdf; https://www.scopus.com/pages/publications/105013147372
Rights: info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.4B3F26ED
Database: BASE