The reflection of application of technological processes in clinical psychology: Comparison of the roles of virtual reality, in vivo and imaginal exposure in reducing fear of contamination in university students

Although the use of virtual reality technology in the assessment and treatment of obsessive compulsive disorder (OCD) has a recent history, there have been studies that provide promising results regarding the effectiveness of virtual reality in OCD treatment. The aim of this research project is to compare the effectiveness of virtual reality exposure with in vivo and imaginal exposure in reducing the fear of contamination which is frequently observed in OCD. To achieve this aim, exposure tasks were created for contamination concerns, and these tasks, in which overall dirtiness gradually increased, were transferred to a virtual reality environment. The sample of the pilot study consisted of 23 undergraduate students between the ages of 18- 22. After the pilot study, the Vancouver Obsessive Compulsive Inventory-Contamination Subscale (VOCI-CS) was administered to 843 university students aged between 18-37 to identify participants with high levels of fear of contamination. Among the participants who scored 1.5 standard deviations above the VOCI-CS group mean and did not have any clinical diagnosis, 48 participants were randomly assigned to Virtual Reality Exposure (n=12), In Vivo Exposure (n=12), Imaginal Exposure (n=12) and Control Group (n=12). On average, 5 exposure sessions were carried out with the participants in the exposure groups, once a week. Results of the pilot study indicated that virtual reality tasks were successful in triggering anxiety, disgust, and the urge to wash. The results of the exposure study showed that virtual reality exposure was effective in reducing OCD symptom severity, contamination related OCD symptoms, trait anxiety levels, disgust propensity and sensitivity, contamination cognitions, as well as reducing negative emotions and increasing psychological well being. Findings indicated that there was no significant difference between virtual reality exposure and in vivo and imaginal exposure groups in terms of reducing the symptoms of contamination. Moreover, the gains achieved in the exposure groups were maintained the one-month period following the end of the exposure sessions. The results of this study indicate that virtual reality can be considered as an alternative and effective method to in vivo and imaginal exposure in reducing fear of contamination. Keywords Virtual reality, obsessive compulsive disorder, fear of contamination, virtual reality exposure, in vivo exposure, imaginal exposure