VR Mind and VR Mind+ Intervention

February 10, 2020 updated by: Tomorrow Sp. z o.o.

VR Mind™ and VR Mind +™ Intervention - Randomized, Open Label, Single Masking, Parallel Group Clinical Trial

The aim of the study is to assess the safety and efficacy of VR Mind and VR Mind + interventions.

Study Overview

Detailed Description

In this study, investigators will test the software developed by Tomorrow Sp. z o. o., named VR Mind and VR Mind+. The software utilizes the concept of virtual reality exposure therapy to treat social anxiety disorder. The aim of the study is to assess the safety and efficacy of VR Mind and VR Mind + interventions.

The research consists of fourteen sessions. The first and the last session will be dedicated to participant assessment. Subsequent sessions 2-13 will be performed according to the therapy protocol for each arm. Control group of participants (active comparative arm) will receive standard treatment for social anxiety disorder - cognitive behavioral therapy based on the protocol developed by the Principal Investigator [protocol adapted from the approach of Clark and Wells (Mayo-Wilson, Dias, Mavranezouli, 2014)]. Experimental group 1 will receive cognitive behavioral therapy with exposure in virtual environment. Experimental group 1 and control group were designed to be as similar as possible, with the exception of the modality for the delivery of exposure. All treatment session will be led by licensed therapist.

Participants of the experimental group 2 will independently conducts the self-therapy process. The intervention will consist of 12 therapeutic sessions. At each of the 12 sessions, the participant will selects a specific scenario of social situations that arouse fear (e.g. public speaking, job interview or other situations from everyday life).

Because of the risk of simulator sickness (e.g., headaches, nausea), exposure trials will last no longer than 20 minutes for each session.

Study Type

Interventional

Enrollment (Actual)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Warsaw, Poland, 03-913
        • Tomorrow Sp. z o. o.
      • Warsaw, Poland
        • Gabinet Psychoterapii

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 50 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Confirmed DSM-IV-TR criteria for Social Anxiety Disorder (SAD).
  • Signing informed consent
  • Unchanged doses of psychotropic medications within 3 months prior to baseline assessment and no change is anticipated

Exclusion Criteria:

  • occurrence of SAD symptoms inconsistent with DSM-IV-TR criteria and with psychiatric interview (SCID-I; Structured Clinical Interview)
  • psychosis,
  • bipolar disorder,
  • mental retardation
  • pregnancy,
  • drug addiction,
  • alcohol addiction,
  • psychoactive substances addiction,
  • participating in the experimental session while intoxicated
  • (current) neurological treatment of chronic disease of central nervous system,
  • epilepsy,
  • paroxysmal vertigo,
  • presence of suicidal thoughts, tendencies or attempts,
  • participant is taking drugs from benzodiazepine group, other sedatives, narcotic drugs
  • current CBT treatment for Social Anxiety Disorder

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group 1: VR Mind+
Virtual Reality Exposure Therapy VR Mind+
Virtual Reality Exposure Self-Therapy led by a participant
Experimental: Group 2: VR Mind
Virtual Reality Exposure Therapy VR Mind
Treatment with Virtual Reality Exposure Therapy led by a therapist
Active Comparator: Control group: CBT
Cognitive Behavioral Therapy
Standard treatment for social phobia led by a therapist

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Efficacy: Liebowitz Social Anxiety Scale - Liebowitz Social Anxiety Scale (LSAS; Liebowitz, 1987)
Time Frame: change from baseline: Pre-treatment at session 1, to session 9 (5 weeks) and to post-treatment at session 14 (7 weeks)
The scale is composed of 24 items, depicting various social situations. For each item, participants assess their fear (from 1 - "No fear" to 4 - "Severe") and avoidance (from 1 - "Never" to 4 - "Usually"). LSAS has 3 scores, summing the results for particular items - fear (0-72), avoidance (0-72) and total score (0-144).
change from baseline: Pre-treatment at session 1, to session 9 (5 weeks) and to post-treatment at session 14 (7 weeks)
Safety: Occurrence and severity of Simulator Sickness - Simulator Sickness Questionnaire (SSQ; Kennedy, Lane, Berbaum, Lilienthal, 1993)
Time Frame: Change from session to session with virtual reality exposure: at session 1, session 7 (4 weeks), session 8 (4 weeks), session 10 (5 weeks), session 11 (6 weeks) and session 12 (6 weeks)

Simulator sickness is expected adverse effect of the VR.Total SSQ score equal to or higher than 10 will be used as a preliminary cut-off for simulator sickness (Balk et al., 2013). Individual scores will be corrected for baseline (pre-VR) symptom severity. Only items with a pre-VR - post-VR increase will contribute to a final SSQ score. All post-intervention SSQ scores >10 will be analyzed further for its association with study drop-outs and other intervention required. The adverse effect will be classified as:

  • mild (no intervention required),
  • moderate (any intervention needed, e.g. session termination),
  • severe (hospitalization required),
  • life-threatening / death.

Some of the symptoms of anxiety may produce similar side effects as a simulator sickness. The results obtained in this case will be false positive. Therefore assessment of side effects for each case will be verified if the increase in SSQ score was triggered by rapid relapse of phobia symptoms.

Change from session to session with virtual reality exposure: at session 1, session 7 (4 weeks), session 8 (4 weeks), session 10 (5 weeks), session 11 (6 weeks) and session 12 (6 weeks)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical Global Impression
Time Frame: Pre-treatment at session 1
Clinical Global Impression (CGI; Guy, 1976) - is a single item, 7 point scale used by clinicians to assess the severity of illness, where 1 is labeled as "Normal, not at all ill" and 7 is labeled as "Among the most extremely ill patients".
Pre-treatment at session 1
Clinician Global Impressions of Improvement
Time Frame: Post-treatment, approximately 7 weeks after initial session
Global measure of change in severity of symptoms, ranging from 1 labeled as " Very much improved" to 7 labeled as "Very much worse".
Post-treatment, approximately 7 weeks after initial session
Patient Global Impression
Time Frame: Pre-treatment at session 1
Patient Global Impression - is a single item, 4 point scale used by patients to assess their impression of severity of their illness and quality of their functioning in everyday life, where 1 is labeled as "Normal" and 4 is labeled as "Severe".
Pre-treatment at session 1
Patient Global Impressions of Improvement
Time Frame: Post-treatment, approximately 7 weeks after initial session
Global measure of change in severity of symptoms, where 1 is labeled as "No change" and 7 is labeled as " Very much improved ".
Post-treatment, approximately 7 weeks after initial session
Beck Depression Inventory
Time Frame: Pre-treatment at session 1 to post-treatment at session 14 (7 weeks)

A 21-question multiple-choice self-report inventory for measuring the severity of depression. Each answer being scored on a scale value of 0 to 3. Higher total scores indicate more severe depressive symptoms. The standardized cutoffs used differ from the original:

0-13: minimal depression 14-19: mild depression 20-28: moderate depression 29-63: severe depression

Pre-treatment at session 1 to post-treatment at session 14 (7 weeks)

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Subjective Units of Distress
Time Frame: Change from session to session with virtual reality exposure during the course of six weeks
Subjective Units of Distress (SUD) SUD is a subjective measure of perceived fear in certain situation. The scale range is from 0 ("Totally relaxed) to 100 ("Highest distress/fear/anxiety/discomfort that you have ever felt").
Change from session to session with virtual reality exposure during the course of six weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Study Chair: Paweł Mierzejewski, prof., Scientific Council
  • Study Director: Przemysław Bieńkowski, prof., Scientific Council
  • Study Director: Tadeusz Parnowski, prof., Scientific Council
  • Study Director: Sławomir Murawiec, PH.D., Scientific Council
  • Principal Investigator: Izabela Stefaniak, M.D., Scientific Council

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 27, 2019

Primary Completion (Actual)

December 31, 2019

Study Completion (Actual)

December 31, 2019

Study Registration Dates

First Submitted

March 26, 2019

First Submitted That Met QC Criteria

March 27, 2019

First Posted (Actual)

March 29, 2019

Study Record Updates

Last Update Posted (Actual)

February 11, 2020

Last Update Submitted That Met QC Criteria

February 10, 2020

Last Verified

March 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • TRR/POIR.01.01.01-00-0636

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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