Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Effectiveness of Virtual Reality Software on Improvement of Blood-Injection Phobia in Children and Adolescents

Document Type : Original Article (s)

Authors
Mostafa Najafi 1
Seyed Ahmadreza Razian 2
Hossein Garavand 3
Shahla Akuchekian 1
1 Associate Professor, Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Computer, School of Engineering, University of Isfahan, Isfahan, Iran
3 Student of Medicine, Student Research, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22122/jims.v36i468.8792
Abstract
Background: Blood-injection phobia is a chronic and debilitating disorder in children and adolescents which can be associated with anxiety avoidance of many essential treatments. Although there are some current recommended treatments for blood-injection phobia, little evidence is available on the virtual reality therapy. Therefore, in this study we aimed to investigate the effect of virtual reality therapy on blood-injection phobia among children and adolescents.Methods: In this quasi-experimental study, 31 children and adolescents aged 6 to 18 years with the diagnosis of blood-injection phobia were investigated. All children received 12 sessions of working with virtual reality software. The children's anxiety level was assessed using Spielberger and specific symptoms of blood-injection phobia questionnaires. Statistical analysis was performed using SPSS software.Findings: After working with the software, the mean scores of state, trait, and state-trait anxiety and also blood-injection phobia in children were significantly lower than their levels before working with the software (P < 0.050 for all). There was a direct and significant correlation between age and the degree of reduction of situational anxiety (r = +0.60, P < 0.001).Conclusion: Virtual reality therapy can effectively reduce state, trait, and state-trait anxiety and also blood-injection phobia in children and adolescents. However, further studies are required to determine the best version of virtual reality software for blood-injection phobia.
Keywords
Adolescent
Blood
Child, Injections
Phobic disorders
Virtual reality
  1. Clark GI, Rock AJ. Processes contributing to the maintenance of flying phobia: A narrative review. Front Psychol 2016; 7: 754.
  2. Al-Agroudi MA, Ahmed SA, Morsy TA. Intervention program for nursing staff regarding approach to a patient with spider phobia and/or bite. J Egypt Soc Parasitol 2016; 46(1): 167-78.
  3. Ayala ES, Meuret AE, Ritz T. Treatments for blood-injury-injection phobia: A critical review of current evidence. J Psychiatr Res 2009; 43(15): 1235-42.
  4. Sadahiro T, Tamura Y, Mitamura H, Fukuda K. Blood-injection-injury phobia: Profound sinus arrest. Int J Cardiol 2013; 168(2): e74-e75.
  5. Meuret AE, Simon E, Bhaskara L, Ritz T. Ultra-brief behavioral skills trainings for blood injection injury phobia. Depress Anxiety 2017; 34(12): 1096-105.
  6. Djokovic J, Milovanovic B, Milovanovic JR, Milovanovic O, Stojic I, Mrvic S, et al. Translation of the medical fear survey to serbian: psychometric properties. Hippokratia 2016; 20(1): 44-9.
  7. Simon E, Meuret AE, Ritz T. Sympathetic and parasympathetic cardiac responses to phobia-relevant and disgust-specific emotion provocation in blood-injection-injury phobia with and without fainting history. Psychophysiology 2017; 54(10): 1512-27.
  8. Maples-Keller JL, Yasinski C, Manjin N, Rothbaum BO. Virtual reality-enhanced extinction of phobias and post-traumatic stress. Neurotherapeutics 2017; 14(3): 554-63.
  9. Kampmann IL, Emmelkamp PM, Morina N. Meta-analysis of technology-assisted interventions for social anxiety disorder. J Anxiety Disord 2016; 42: 71-84.
  10. Spielberger CD, Gorsuch RL. Manual for the State-trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1983.
  11. Page AC, Bennett K, Carter O, Smith J, Woodmore K. The Blood-Injection Symptom Scale (BISS): Assessing a structure of phobic symptoms elicited by blood and injections. Behav Res Therapy 1997; 35(5):457-64.
  12. Oar EL, Farrell LJ, Waters AM, Conlon EG, Ollendick TH. One session treatment for pediatric blood-injection-injury phobia: A controlled multiple baseline trial. Behav Res Ther 2015; 73: 131-42.
  13. Gebara CM, Barros-Neto TP, Gertsenchtein L, Lotufo-Neto F. Virtual reality exposure using three-dimensional images for the treatment of social phobia. Rev Bras Psiquiatr 2016; 38(1): 24-9.
  14. Raghav K, Van Wijk AJ, Abdullah F, Islam MN, Bernatchez M, De Jongh A. Efficacy of virtual reality exposure therapy for treatment of dental phobia: A randomized control trial. BMC Oral Health 2016; 16: 25.
  15. Botella C, Fernandez-Alvarez J, Guillen V, Garcia-Palacios A, Banos R. Recent progress in virtual reality exposure therapy for phobias: A systematic review. Curr Psychiatry Rep 2017; 19(7): 42.
  16. Choy Y, Fyer AJ, Lipsitz JD. Treatment of specific phobia in adults. Clin Psychol Rev 2007; 27(3): 266-86.
  17. Pallavicini F, Argenton L, Toniazzi N, Aceti L, Mantovani F. Virtual reality applications for stress management training in the military. Aerosp Med Hum Perform 2016; 87(12): 1021-30.
Journal of Isfahan Medical School
Volume 36, Issue 468 - Serial Number 468
January and February 2018
Pages 111-117

  • Receive Date 14 September 2017
  • Accept Date 06 April 2022