Clinical trial NCT05887141: Self-compassion and Self-criticism: a Virtual Reality Intervention
Official title: Self-compassion and Self-criticism: a Virtual Reality Intervention
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Self-Criticism
Keywords: Virtual Reality
self-criticism
self-compassion
perspective change
Cognitive Behavioral Therapy
Lead sponsor: University Medical Center Groningen
Sponsor class: OTHER
Collaborators: name: PPO
name: University of Groningen
First posted: 2023-06-02
Enrollment: 136
Sex: ALL
Minimum age (years): 17
Maximum age (years): 30
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Two independent substudies, each with two arms. N=68 per substudy (N=136 total)
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to investigate two independent Virtual Reality interventions for self-criticism and self-compassion and the use of perspective-change in these interventions.

Detailed description: The current study will use two novel Virtual Reality (VR) exercises that will be investigated through two independent sub-studies. First of all, an exercise that uses the CBT (Cognitive Behavioral Therapy) technique called 'Double standards'. People with excessive self-criticism often set higher standards for themselves, which makes them more critical towards themselves. A way to distance from this, to enable a more nuanced reflection, is to ask the patient what they would say to a friend having those same negative thoughts about themselves. Doing this utilizing a role play in a realistic VR environment of which the avatar has the characteristics of a friend, the effect could be even stronger. Furthermore, VR offers the chance to switch perspectives, in which the participants receive their own compassionate comments from the perspective of the friend, and experience themselves as a good friend.

The second exercise, 'Self-criticism avatar', has common grounds with the (two-)chair exercises of schema therapy and the voice dialogue method in which a patient enters a dialogue between one's inner voices. In the VR exercise, the participant will be able to choose a virtual character with a voice that represents their own inner critic and that gives them their own self-criticism. By assertively and strictly speaking up to the inner critic, after which the virtual character becomes smaller and smaller until it backs down, the participant can experience a sense of control over their self-criticism, which leaves more room for self-compassion. A discussion with the inner critic enables a more nuanced image with more self-compassion. The switch in perspective after the role-play allows the participant to see himself/herself speaking assertively to the avatar, which can strengthen the increase in self-compassion and decrease in self-criticism.

Switching of perspectives is a relatively new technique within VR, that can be of added value to regular psychological therapies. Regular psychological therapies use switching of perspectives by switching roles in a physical role-play between a therapist and a patient or in a group. Furthermore, imaginative switches of perspective are used in, for example, schema therapy or imagery rescripting. Even though this can bring new insight into another perspective, it is not possible to replay the role play where the participant can see himself/herself from someone else's perspective. This is, however, possible through VR.

The current study will investigate the two beforementioned VR exercises using two independent sub-studies, to determine whether they contribute to self-compassion and if the switch in perspective is of added value. This will be done by comparing two conditions for each VR exercise; one with a switch in perspective and one without a switch in perspective. The study aims to answer the following research questions:

* Do the two VR-self compassion exercises have a positive effect on self-compassion (increase) and self-criticism (decrease)?
* Is the switch in perspective for the exercise 'Double standards of added value? In other words: is receiving one's own compassionate response of added value in addition to showing compassion to a vulnerable other.
* Is the switch in perspective for the exercise 'self-criticism avatar' of added value? In other words: is watching oneself in a strong and resilient manner of added value in addition to assertively speaking up to one's inner critic?

Eligibility criteria: Inclusion Criteria:

* Enrolled in a study
* Score above 20 (\>20) on the subscale 'Inadequate self' of the FSCRS questionnaire

Exclusion Criteria:

* N/A

Primary outcomes:
measure: Self-Criticism and Self-Compassion Scales (SCCS) - Change in Self-Criticism
timeFrame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
measure: Self-Criticism and Self-Compassion Scales (SCCS) - Change in Self-Compassion
timeFrame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Secondary outcomes:
measure: Change in negative affect
timeFrame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
measure: Change in positive affect
timeFrame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
measure: Change in self-compassion and self-esteem
timeFrame: Right before (Timepoint 1) and directly after (Timepoint 2) the +/- 60 minute intervention
Other outcomes:
measure: Demographics
timeFrame: Screening
measure: Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS)
timeFrame: Screening
measure: Evaluation questions
timeFrame: Directly after the +/- 60 minute intervention (Timepoint 2)
measure: Igroup Presence questionnaire (IPQ)
timeFrame: Directly after the +/- 60 minute intervention (Timepoint 2)
measure: Schema Mode Inventory, short version (SMI)
timeFrame: Right before the +/- 60 minute intervention (Timepoint 1)
measure: Suicide Probability Scale - Suicide Ideation
timeFrame: Right before the +/- 60 minute intervention (Timepoint 1)
Locations:
city: Groningen
country: Netherlands
facility: University Medical Center Groningen
Study officials:
affiliation: University Medical Center Groningen
name: Elise van der Stouwe
role: PRINCIPAL_INVESTIGATOR
References: