Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 28:10:55.
doi: 10.3389/fpsyg.2019.00055. eCollection 2019.

Evaluation of a Mindfulness-Based Intervention With and Without Virtual Reality Dialectical Behavior Therapy® Mindfulness Skills Training for the Treatment of Generalized Anxiety Disorder in Primary Care: A Pilot Study

Affiliations

Evaluation of a Mindfulness-Based Intervention With and Without Virtual Reality Dialectical Behavior Therapy® Mindfulness Skills Training for the Treatment of Generalized Anxiety Disorder in Primary Care: A Pilot Study

María V Navarro-Haro et al. Front Psychol. .

Abstract

Generalized Anxiety Disorder (GAD) is a very prevalent disorder in primary care (PC). Most patients with GAD never seek treatment, and those who do seek treatment often drop out before completing treatment. Although it is an understudied treatment, Mindfulness-Based Interventions (MBIs) indicate preliminary efficacy for the treatment of GAD symptoms, but many patients with GAD present other associated symptoms (e.g., attention deficits) that complicate the treatment. Virtual Reality DBT® Mindfulness Skills learning has recently been developed to make learning mindfulness easier for patients with emotion dysregulation who have trouble concentrating. Virtual Reality (VR) might serve as a visual guide for practicing mindfulness as it gives patients the illusion of "being there" in the 3D computer generated world. The main goal of this study was to evaluate the effect of two MBIs (a MBI in a group setting alone and the same MBI plus 10 min VR DBT® Mindfulness skills training) to reduce GAD symptoms. A secondary aim was to explore the effect in depression, emotion regulation, mindfulness, and interoceptive awareness. Other exploratory aims regarding the use of VR DBT® Mindfulness skills were also carried out. The sample was composed of 42 patients (roughly half in each group) with GAD attending PC visits. After treatment, both groups of patients showed significant improvements in General Anxiety Disorder measured by the GAD-7 using mixed regression models [MBI alone (B = -5.70; p < 0.001; d = -1.36), MBI+VR DBT® Mindfulness skills (B = -4.38; p < 0.001; d = -1.33)]. Both groups also showed significant improvements in anxiety, depression, difficulties of emotion regulation and several aspects of mindfulness and interoceptive awareness. Patients in the group that received additional 10 min VR DBT Mindfulness Skills training were significantly more adherent to the treatment than those receiving only standard MBI (100% completion rate in MBI + VR vs. 70% completion rate in MBI alone; Fisher = 0.020). Although randomized controlled studies with larger samples are needed, this pilot study shows preliminary effectiveness of MBI to treat GAD, and preliminary evidence that adjunctive VR DBT® Mindfulness Skills may reduce dropouts.

Keywords: dialectical behavior therapy; generalized anxiety disorder; mindfulness; virtual reality; virtual reality mindfulness.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Flow chart.
FIGURE 2
FIGURE 2
A screenshot of DBT VR MindfulRiverWorld. Image by bigenvironments.com, copyright Hunter Hoffman, UW, www.vrpain.com.

Similar articles

Cited by

References

    1. Allgulander C. (2006). Generalized anxiety disorder: what are we missing? Eur. Neuropsychopharmacol. 16 101–108. 10.1016/j.euroneuro.2006.04.002 - DOI - PubMed
    1. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edn Washington, DC: American Psychiatric Association; 10.1176/appi.books.9780890425596 - DOI
    1. Baer R. A., Smith G. T., Hopkins J., Krietemeyer J., Toney L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment 13 27–45. 10.1177/1073191105283504 - DOI - PubMed
    1. Baños R. M., Botella C., Alcañiz M., Liaño V., Guerrero B., Rey B. (2004). Immersion and emotion: their impact on the sense of presence. Cyberpsychol. Behav. 7 734–741. 10.1089/cpb.2004.7.734 - DOI - PubMed
    1. Botella C., Serrano B., Baños R. M., Garcia-Palacios A. (2015). Virtual reality exposure-based therapy for the treatment of post-traumatic stress disorder: a review of its efficacy, the adequacy of the treatment protocol, and its acceptability. Neuropsychiatr. Dis. Treat. 11 2533–2545. 10.2147/NDT.S89542 - DOI - PMC - PubMed

LinkOut - more resources