Virtual Reality Self-help Treatment for Aviophobia: Protocol for a Randomized Controlled Trial

Jamie Rhiannon Fehribach; Marieke Bianca Jolien Toffolo; Ilja Cornelisz; Chris van Klaveren; Annemieke van Straten; Jean-Louis van Gelder; Tara Donker

doi:10.2196/22008

Virtual Reality Self-help Treatment for Aviophobia: Protocol for a Randomized Controlled Trial

JMIR Res Protoc. 2021 Apr 12;10(4):e22008. doi: 10.2196/22008.

Authors

Jamie Rhiannon Fehribach^{1

2}, Marieke Bianca Jolien Toffolo¹, Ilja Cornelisz^{3

4}, Chris van Klaveren^{3

4}, Annemieke van Straten^{1

2}, Jean-Louis van Gelder^{5

6}, Tara Donker^{1

2

7}

Affiliations

¹ Clinical Psychology, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
² Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
³ Methods and Statistics, Department of Education Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
⁴ Amsterdam Center for Learning Analytics, Amsterdam, Netherlands.
⁵ Department of Criminology, Max Planck Institute for the Study of Crime, Security and Law, Freiburg, Germany.
⁶ Institute of Education and Child Studies, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, Netherlands.
⁷ Laboratory of Biological and Personality Psychology, Department of Psychology, Albert Ludwigs-University of Freiburg, Freiburg, Germany.

PMID: 33843605
PMCID: PMC8076993
DOI: 10.2196/22008

Abstract

Background: Aviophobia (the fear of flying) can greatly impact the daily life functioning of people with the condition. Traditional exposure-based treatment is hampered by the limited availability of airplane practice situations, which is a result of economical and practical concerns. Easily accessible and low-cost virtual reality exposure therapy may address these challenges.

Objective: The purpose of our study is to investigate the effectiveness of ZeroPhobia: Aviophobia (a self-help mobile app-based treatment) in reducing flight anxiety symptoms and depressive and anxiety symptoms. We will also investigate the effects of usage intensity, the sense of immersion, inherent absorption ability, and perceived user-friendliness on the treatment effect.

Methods: Participants (N=114) who are aged 18-64 years and experience at least mild symptoms of aviophobia will be recruited from the general Dutch population and randomized into a treatment group or waitlist control group. By using their own phones and rudimentary mobile virtual reality headsets, participants will receive six modules of psychoeducation and cognitive behavioral therapy, which will include six levels of virtual reality exposure therapy over a period of 6 weeks. Assessments will be conducted at baseline, posttest (ie, after 6 weeks), and 3- and 12-month follow-ups. The primary outcome measure of our study is the Flight Anxiety Situations Questionnaire. The secondary outcome measures include anxiety and depression measures and additional covariates (including usage intensity, the degree of immersion, etc). We will test treatment effectiveness by conducting an intention-to-treat analysis and estimating average treatment effects on the treated. The mechanisms of treatment effect will also be explored.

Results: The study was funded on September 25, 2018. Ethical approval was received on October 11, 2019. Recruitment closed on May 7, 2020.

Conclusions: Our study will further the scientific understanding and clinical implications of technology's current ability to aid in providing effective, accessible treatment for the fear of flying.

Trial registration: Netherlands Trial Registry NL70238.029.19; https://www.trialregister.nl/trial/8257.

International registered report identifier (irrid): DERR1-10.2196/22008.

Keywords: aviophobia; cognitive behavioral therapy; exposure therapy; specific phobia; virtual reality.

©Jamie Rhiannon Fehribach, Marieke Bianca Jolien Toffolo, Ilja Cornelisz, Chris van Klaveren, Annemieke van Straten, Jean-Louis van Gelder, Tara Donker. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 12.04.2021.