International Journal of Behavioral Sciences

International Journal of Behavioral Sciences

Design and Validation of a Virtual Reality Software Package and Investigating its Effect on the Severity of Obsessive and Depressive Symptoms of Women Suffering from Washing Compulsion

Document Type : Original Article

Authors
1 Department of Psychology, Faculty of Humanistic Science, Arak University, Arak, Iran
2 Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Iran
Abstract
Introduction: The aim of the present study was to develop and validate a virtual reality software package and to investigate its effect on the obsessive and depressive symptoms of women with washing compulsion.
Method: The present study consisted of two phases. The research method of the first phase was validation. At this stage, five psychology and virtual reality experts were selected purposefully, and the Cohen's kappa coefficient (κ) was analyzed in the software review. In the second phase, a quasi-experimental study on 22 women suffering from washing compulsion in Isfahan in 2022 which were selected by available sampling were randomly assigned to experimental and control groups, of whom seven remained in each group. The instruments namely the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Beck Depression Inventory (BDI) were completed in the pre-test, post-test and one month follow-up and their results were analyzed using SPSS 27 software using the multivariate covariance method.
Results: The content validity coefficient of the package was calculated as 0.9. The results of the second phase showed that the package was effective in reducing the obsessive symptoms of patients (P<0.05) and its effect continued over time (P<0.05); however, it was not useful in reducing the depression scores (P<0.05).
Conclusion: This method because of its ability to induce anxiety and its generalizability to real-world settings increases commitment to treatment and can be used to strengthen the impact of the exposure method for treatment of obsessive-compulsive patients.
Keywords

  1. Yani FY, Samanik S. Obsessive Compulsive Disorder As Seen In The Main Character Of Every Last Word Novel By Tamara Ireland Stone. Linguistics and Literature Journal. 2023;4(1):73-88. DOI: https://doi.org/10.33365/llj.v4i1.1975
  2. Pampaloni I, Marriott S, Pessina E, Fisher C, Govender A, Mohamed H, et al. The global assessment of OCD. Comprehensive psychiatry. 2022;118:152342. https://doi.org/10.1016/j.comppsych.2022.152342
  3. Carmi L, Brakoulias V, Arush OB, Cohen H, Zohar J. A prospective clinical cohort-based study of the prevalence of OCD, obsessive compulsive and related disorders, and tics in families of patients with OCD. BMC psychiatry. 2022;22(1):190. doi: 10.1186/s12888-022-03807-4
  4. Rezazadeh Z, Zarani F. Obsessive-compulsive disorder and related cultural issues in Iran: a Systematic Review. Rooyesh-e-Ravanshenasi Journal (RRJ). 2022;11(2):45-58. DOR: 20.1001.1.2383353.1401.11.2.1.0
  5. Fineberg Naomi AM, Apergis-Schoute Annemieke M, Vaghi MM, Bullmore Edward T, Sahakian Barbara J, Robbins Trevor W. Mapping Compulsivity in the DSM-5 Obsessive Compulsive and Related Disorders: Cognitive Domains, Neural Circuitry And Treatment. 2017. https://doi.org/10.1093/ijnp/pyx088
  6. De Silva P. Obsessive-compulsive disorder. The handbook of adult clinical psychology: Routledge; 2014. p. 511-46.
  7. Abramowitz JS, Jacoby RJ. Obsessive-compulsive and related disorders: A critical review of the new diagnostic class. Annual review of clinical psychology. 2015;11(1):165-86. https://doi.org/10.1146/annurev-clinpsy-032813-153713
  8. Ferrando C, Selai C. A systematic review and meta-analysis on the effectiveness of exposure and response prevention therapy in the treatment of obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders. 2021;31:100684. DOI: 10.1016/j.jocrd.2021.100684
  9. Mataix‐Cols D, de la Cruz LF, Nordsletten AE, Lenhard F, Isomura K, Simpson HB. Towards an international expert consensus for defining treatment response, remission, recovery and relapse in obsessive‐compulsive disorder. World Psychiatry. 2016;15(1):80. DOI 10.1002/wps.20299
  10. Storch EA, McGuire JF, McKay D. The clinician's guide to cognitive-behavioral therapy for childhood obsessive-compulsive disorder: Academic Press; 2018. DOI 10.1016/C2016-0-00955-5
  11. Neshat Doost H, Molavi H, Abedi M, Isfahani M. The Effects of Exposure and Response Prevention by Self-treatment Method on Reduction of Obsessive-Compulsive Symptoms. Clinical Psychology and Personality. 2007;5(1):1-10.DOR: 20.1001.1.23452188.1386.5.1.1.5
  12. Twohig MP, Abramowitz JS, Smith BM, Fabricant LE, Jacoby RJ, Morrison KL, et al. Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial. Behaviour research and therapy. 2018;108:1-9. https://doi.org/10.1016/j.brat.2018.06.005
  13. Laforest M, Bouchard S, Crétu A-M, Mesly O. Inducing an anxiety response using a contaminated virtual environment: validation of a therapeutic tool for obsessive–compulsive disorder. Frontiers in ICT. 2016;3:18. https://doi.org/10.3389/fict.2016.00018
  14. Hamad A, Jia B. How virtual reality technology has changed our lives: an overview of the current and potential applications and limitations. International journal of environmental research and public health. 2022;19(18):11278. anyrecover-mac_installer (1).zip
  15. Emmelkamp PM, Meyerbröker K. Virtual reality therapy in mental health. Annual review of clinical psychology. 2021;17(1):495-519. https://doi.org/10.1146/annurev-clinpsy-081219-115923
  16. Rasti J, Manshaee G, Eslami P. Design and validation of virtual reality exposure therapy software for treatment of flying phobia. Knowledge Res Appl Psychol. 2018;19(4):27-35.
  17. Carl E, Stein AT, Levihn-Coon A, Pogue JR, Rothbaum B, Emmelkamp P, et al. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of anxiety disorders. 2019;61:27-36. https://doi.org/10.1016/j.janxdis.2018.08.003
  18. Musalek M, Vasek L, editors. Possibilities of using virtual reality as a means for therapy from fear of spiders. MATEC Web of Conferences; 2019: EDP Sciences. DOI:10.1051/matecconf/201929201041
  19. Manshaee G, Eslami P, Hajebrahimi Z. Efficacy of virtual reality exposure therapy in reducing anxiety symptoms in Iranian individuals with flying phobia. Clinical Psychology and Personality. 2020;16(2):191-9. DOI: 10.22070/CPAP.2020.2870
  20. Belloch A, Cabedo E, Carrió C, Lozano-Quilis JA, Gil-Gómez JA, Gil-Gómez H. Virtual reality exposure for OCD: is it feasible? Revista de Psicopatología y Psicología Clínica. 2014;19(1). DOI: 10.5944/RPPC.VOL.19.NUM.1.2014.12981
  21. Tao H, Wang C, Guo J, Guo M. Comorbidity between neurotic depression and post-traumatic stress disorder (PTSD). World Journal of Neuroscience. 2020;10(3):135-40. DOI: 10.4236/wjns.2020.103015
  22. Hofmeijer-Sevink MK, van Oppen P, van Megen HJ, Batelaan NM, Cath DC, van der Wee NJ, et al. Clinical relevance of comorbidity in obsessive compulsive disorder: the Netherlands OCD Association study. Journal of affective disorders. 2013;150(3):847-54. https://doi.org/10.1016/j.jad.2013.03.014
  23. Ghasemzadeh H, Karamghadiri N, Sharifi V, Norouzian M, Mojtabai R, Ebrahimkhani N. Cognitive, Neuropsychological, and Neurological Functions of obsessive patients with and without depressive symptoms compared to each other and normal group. Advances in Cognitive Science. 2005;7(3):1-15.
  24. Mohammadzadeh A KA. Comparison of depressant rumination in patients with major depressive and obsessive-compulsive disorders and normal people. . Behavioral science research 2017;15(1):21-7.
  25. Arntz A, Voncken M, Goosen AC. Responsibility and obsessive–compulsive disorder: An experimental test. Behaviour research and therapy. 2007;45(3):425-35. https://doi.org/10.1016/j.brat.2006.03.016
  26. F K. Improving the attention level of children with attention deficit disorder with the help of virtual reality technology based on real images. Dissertation for M.A. Isfahan: Isfahan University; 2018.
  27. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Archives of general psychiatry. 1989;46(11):1006-11. https://doi.org/10.1001/archpsyc.1989.01810110048007
  28. MOUSAVI MN, Atashpour H, Molavi H. The influence of mindfulness group training on the rate of obsessive-compulsive disorder symptoms. 2010.
  29. Izadi R, Abedi MR. Alleviation of obsessive symptoms in treatment-resistant obsessive-compulsive disorder using acceptance and commitment-based therapy. Feyz Medical Sciences Journal. 2013;17(3):275-86.
  30. Beck AT, Steer RA, Brown G. Beck depression inventory–II. Psychological assessment. 1996.
  31. Rajabi GR. Psychometric properties of beck depression inventory short form items (BDI-13). Journal of Iranian Psychologists. 2004.
  32. Waltz CF, Bausell BR. Nursing research: design statistics and computer analysis: Davis Fa; 1981.
  33. Dua D, Jagota G, Grover S. Management of obsessive–compulsive disorder with virtual reality-based exposure. Industrial Psychiatry Journal. 2021;30(1):179-81.
  34. Benzina N, Morgiève M, Euvrard M, Dos Santos JFA, Pelissolo A, Mallet L. Personalised 360o video exposure therapy for the treatment of obsessive-compulsive disorder: A single case study. French Journal of Psychiatry. 2020;1:31-8. https://doi.org/10.1016/j.fjpsy.2020.02.004
  35. Inozu M, Celikcan U, Akin B, Cicek NM. The use of virtual reality (VR) exposure for reducing contamination fear and disgust: Can VR be an effective alternative exposure technique to in vivo? Journal of Obsessive-Compulsive and Related Disorders. 2020;25:100518. DOI: 10.1016/j.jocrd.2020.100518
  36. Gega L. The virtues of virtual reality in exposure therapy. The British Journal of Psychiatry. 2017;210(4):245-6 DOI: 10.1192/bjp.bp.116.193300.
  37. Öst L-G, Havnen A, Hansen B, Kvale G. Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clinical psychology review. 2015;40:156-69. DOI: 10.1016/j.cpr.2015.06.003
  38. Fajnerová I, Francová A, Taranzová K, Darmová B, Kosová E, Stopková P. Virtual reality environment for exposure therapy in obsessive–compulsive disorder: a validation study. Virtual Reality. 2023;27(3):2691-701. https://doi.org/10.1007/s10055-023-00837-5
  39. Mathes BM, Day TN, Wilver NL, Redden SA, Cougle JR. Indices of change in exposure and response prevention for contamination-based OCD. Behaviour Research and Therapy. 2020;133:103707. https://doi.org/10.1016/j.brat.2020.103707
  40. İNÖZÜ MERMERKAYA M, Çelikcan U, Trak E, Üzümcü E, Nergiz H. Assessment of virtual reality as an anxiety and disgust provoking tool: The use of VR exposure in individuals with high contamination fear. Cyberpsychology-Journal of Psychosocial Research on Cyberspace. 2021;15(1). DOI: 10.5817/cp2021-1-7
  41. Dehn LB, Kater L, Piefke M, Botsch M, Driessen M, Beblo T. Training in a comprehensive everyday-like virtual reality environment compared to computerized cognitive training for patients with depression. Computers in Human Behavior. 2018;79:40-52. https://doi.org/10.1016/j.chb.2017.10.019
  42. Aliakbari M, Alipour A, Ebrahimimoghadam H, Fekraty M. The effect of Virtual Reality (VR) on psychological disorders in cancer cases. 2017.
  43. Henriques G, Leitenberg H. An experimental analysis of the role of cognitive errors in the development of depressed mood following negative social feedback. Cognitive Therapy and Research. 2002;26(2):245-60. DOI:10.1023/A:1014577904837