Effectiveness of a smartphone-based, augmented reality exposure app to reduce fear of spiders in real-life: A randomized controlled trial

Anja Zimmer; Nan Wang; Merle K Ibach; Bernhard Fehlmann; Nathalie S Schicktanz; Dorothée Bentz; Tanja Michael; Andreas Papassotiropoulos; Dominique J F de Quervain

doi:10.1016/j.janxdis.2021.102442

Effectiveness of a smartphone-based, augmented reality exposure app to reduce fear of spiders in real-life: A randomized controlled trial

J Anxiety Disord. 2021 Aug:82:102442. doi: 10.1016/j.janxdis.2021.102442. Epub 2021 Jul 2.

Authors

Anja Zimmer¹, Nan Wang¹, Merle K Ibach¹, Bernhard Fehlmann¹, Nathalie S Schicktanz¹, Dorothée Bentz¹, Tanja Michael², Andreas Papassotiropoulos³, Dominique J F de Quervain⁴

Affiliations

¹ Division of Cognitive Neuroscience, Faculty of Psychology, University of Basel, CH, Switzerland; Transfaculty Research Platform, University of Basel, CH, Switzerland.
² Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, D, Germany.
³ Division of Molecular Neuroscience, Faculty of Psychology, University of Basel, CH, Switzerland; Life Sciences Training Facility, Department Biozentrum, University of Basel, CH, Switzerland; University Psychiatric Clinics Basel, CH, Switzerland; Transfaculty Research Platform, University of Basel, CH, Switzerland.
⁴ Division of Cognitive Neuroscience, Faculty of Psychology, University of Basel, CH, Switzerland; University Psychiatric Clinics Basel, CH, Switzerland; Transfaculty Research Platform, University of Basel, CH, Switzerland. Electronic address: dominique.dequervain@unibas.ch.

PMID: 34246153
DOI: 10.1016/j.janxdis.2021.102442

Abstract

Although in vivo exposure therapy is highly effective in the treatment of specific phobias, only a minority of patients seeks therapy. Exposure to virtual objects has been shown to be better tolerated, equally efficacious, but the technology has not been made widely accessible yet. We developed an augmented reality (AR) application (app) to reduce fear of spiders and performed a randomized controlled trial comparing the effects of our app (six 30-min sessions at home over a two-week period) with no intervention. Primary outcome was subjective fear, measured by a Subjective Units of Distress Scale (SUDS) in a Behavioural Approach Test (BAT) in a real-life spider situation at six weeks follow-up. Between Oct 7, 2019, and Dec 6, 2019, 66 individuals were enrolled and randomized. The intervention led to significantly lower subjective fear in the BAT compared to the control group (intervention group, baseline: 7.12 [SD 2.03] follow-up: 5.03 [SD 2.19] vs. control group, baseline: 7.06 [SD 2.34], follow-up 6.24 [SD 2.21]; adjusted group difference -1.24, 95 % CI -2.17 to -0.31; Cohen's d = 0.57, p = 0.010). The repeated use of the AR app reduces subjective fear in a real-life spider situation, providing a low-threshold and low-cost treatment for fear of spiders.

Keywords: Behavioural approach test; Fear of spiders; Smartphone-based AR exposure app; Specific phobia; Stand-alone.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Animals
Augmented Reality*
Fear
Humans
Mobile Applications*
Smartphone
Spiders*