Behavioral activation intervention for depression in virtual reality environment: Software development and effectiveness study

This study was conducted to evaluate the effect of a virtual reality-based behavioral activation intervention on reducing depression symptoms. Considering that depression negatively affects the daily functionality of individuals, an interactive behavioral activation intervention was developed in a virtual reality environment and the effectiveness of this intervention was tested. A randomized controlled experimental design was used in the study. The sample consisted of 50 participants with moderate to high levels of depression (experimental group = 25, control group = 25). The experimental group received a behavioral activation intervention in a virtual reality environment for 4 weeks, while the control group was placed on a waiting list. The intervention was delivered through virtual reality goggles in the morning. In the virtual reality environment, participants were made to simulate their morning routines, such as waking up, tidying the room, preparing breakfast and getting dressed. Behavioral Inhibition System and Behavioral Activation System Scale, Beck Depression Inventory, Difficulty in Emotion Regulation Scale-Short Form 16, Presence Scale for Virtual Reality Application and Beck Anxiety Inventory were used in the data collection process. In the data analysis phase, Mixed Design Repeated Measures ANOVA was used for behavioral activation and behavioral inhibition variables, and F1-LD-F1 design analysis was used for depression and emotion regulation variables. For depression symptom level, when the time and group interaction was taken into consideration, the symptom level decreased after the intervention (p < 0.01). In terms of behavioral activation scores, when time and group interaction were taken into consideration, an increase in the activation scores of the participants was found after the intervention (p<0.01). In terms of behavioral inhibition scores, when time and group interaction were taken into consideration, there was a decrease in the inhibition scores of the participants after the intervention (p<0.05). Finally, in terms of emotion regulation scores, no significant difference was found after the intervention when time and group interaction was taken into consideration (p>0.05). In conclusion, virtual reality supported behavioral activation intervention was found to be effective in reducing depression symptom level, decreasing behavioral inhibition scores and increasing behavioral activation scores. The study suggests that virtual reality technology may be a potential complementary intervention method in reducing the symptom level of depression. In the future, it is recommended to conduct more comprehensive research on virtual reality-supported intervention approaches.