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Virtual reality body exposure therapy for anorexia nervosa. a single case study

Abstract:

Exposure-based interventions have been proposed as an appropriate method for the treatment of fear of gaining weight (FGW) and body image disturbance (BID) in the treatment of anorexia nervosa (AN). However, exposure-based therapies have notable limitations (e.g., negative initial reaction in patients or higher risk of dropout). The use of virtual reality (VR)-based exposure techniques may overcome these limitations. This study provides initial evidence of the usefulness of a VR-based exposure therapy in the treatment of a 14-year-old female adolescent with AN. Over five exposure sessions, the patient was embodied in a virtual representation of her own silhouette whose weight was progressively increased. FGW, body anxiety, drive for thinness, BID, and Body Mass Index (BMI) were assessed before and after the intervention, and at 3-month follow-up. FGW, body anxiety and full body illusion (FBI) were also assessed at the beginning of each session. The patient was exposed to the immersive virtual scenario using a VR head mounted display (HMD-HTC-VIVE). After the intervention there was a clear reduction in FGW, drive for thinness, body-related anxiety, and BID. BMI rose slightly over the course of the intervention. FBI levels also rose progressively in each exposure session. However, these changes were not fully maintained at follow-up, when the improvement was lower than that achieved immediately post-treatment. This innovative VR-based exposure procedure achieved promising results for targeting FGW and AN symptoms in a short time. To pursue this study further, and to assess the effectiveness of this new VR software, a larger controlled clinical trial will be conducted.