A clinical trial for fear of flying using biofeedback and virtual reality

Abstract

The present study examined an experimental behavioral therapy protocol using virtual reality for fear of flying (FOF) in comparison to the existing treatment protocol of exposure therapy. The experimental design was a single-blind, randomized, prospective clinical trial. Treatment was delivered to 40 participants seeking FOF treatment, during weekly individual 45-minute-sessions, delivered over eight consecutive weeks. Both groups received Virtual Reality (VR) as the method of stimulus exposure and biofeedback on autonomic functioning. The control group was treated with graded exposure, where participants were repeatedly exposed to flight situations via VR, while receiving continuous biofeedback on physiological sensations. The experimental group was treated using a counter-conditioning model where participants were repeatedly exposed to flight situations via VR, while engaging in relaxation techniques to counter the anxiety response, while receiving continuous biofeedback on physiological sensations. Assessment included relevant medication and sleep history, self-report anxiety measures and physiological responses of heart rate, respiratory rate and galvanic skin resistance. Outcome was based on subjective self-reports of anxiety and physiological responses. A main effect for both treatments was confirmed whereby a significant results on both the primary measure (FAMS (F [1, 38)] = 68.84, p < .001), as well as a significant outcome on a repeated measures multivariate analysis for all subsequent anxiety measures (Wilk's lambda (1,38), F = 60.42, p < 0.001).;Findings confirming a time X group interaction were mixed: A significant interaction on the FAM was not seen F (1, 38) = .497, p > .05, although a trend towards greater reduction by the experimental treatment group was exhibited. Further, the experimental treatment group exhibited a significantly greater reduction in comparison to the control group on the Flight Anxiety Situations Questionnaire (FAS), State-Trait Anxiety Inventory (STAI) and Galvanic Skin Resistance (GSR). Multivariate analysis for all measures revealed an overall significant interaction by group (Wilk's Lambda (1,38), F = 4.48, p < .05) in favor of the experimental treatment. It was concluded that while both treatments were effective in reducing flight anxiety findings suggest that the experimental treatment was more effective than the control warranting further investigation with a larger sample size.