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Examining the Use of Virtual Reality to Support Mindfulness Skills Practice in Mood and Anxiety Disorders: Mixed Methods Study.

Rebecca Blackmore, Claudia Giles, Hailey Tremain, Ryan Kelly, Fiona Foley, Kathryn Fletcher, Maja Nedeljkovic, Greg Wadley, Elizabeth Seabrook, Neil Thomas

Journal of Medical Internet Research December 6, 2024 DOI: 10.2196/45640 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Mixed methods study Qualitative Peer reviewed
Sample size 28
Population Adults with a primary diagnosis of major depressive disorder, bipolar disorder, or anxiety disorder
Intervention VR-supported mindfulness practice
Duration Single brief session
Topics Depression Meditation Anxiety
Keywords Anxiety disorders Bipolar disorder Mood disorders Virtual reality
Citations 23
Key points VR-supported mindfulness significantly increased state mindfulness and reduced negative affect and state anxiety in individuals with mood or anxiety disorders, with no significant change in positive affect.

Abstract

Virtual reality (VR) has been proposed as a technology to support mindfulness practice through promoting increased engagement and presence. The proposed benefits of this technology have been largely unexamined with clinical populations. Further research is required to understand its clinical potential and utility in improving and managing mental health symptoms. This study aims to investigate the proximal impacts of a single, brief, VR-supported mindfulness practice for individuals with a mood or anxiety disorder and to understand user experiences, which may affect the acceptability and efficacy of VR mindfulness for this population. This mixed methods study recruited 28 participants with a primary diagnosis of major depressive disorder, bipolar disorder, or anxiety disorder. Participants completed a mindfulness practice wearing a VR headset that was presenting an omnidirectional video of a forest scene, which was overlaid with a guided audio voiceover. Before and after the practice, measures were completed assessing state mindfulness (Toronto Mindfulness Scale), affect (Positive and Negative Affect Schedule), and anxiety (State-Trait Anxiety Inventory Y-1; n=27). Semistructured interviews were then held inquiring about the user experience and were analyzed using thematic analysis (n=24). After completing the VR-supported mindfulness practice, both measures of state mindfulness on the Toronto Mindfulness Scale, mean curiosity and decentering, increased significantly (Cohen d=1.3 and 1.51, respectively; P<.001). Negative affect on the Positive and Negative Affect Schedule (Cohen d=0.62; P=.003) and State-Trait Anxiety Inventory Y-1 state anxiety (Cohen d=0.84; P<.001) significantly reduced. There was no significant change in positive affect (Cohen d=0.29; P=.08). Qualitative analysis of interviews identified 14 themes across 5 primary theme categories. The results suggested that being mindful during the use of the app was experienced as relatively effortless because of the visual and immersive elements. It was also experienced as convenient and safe, including when compared with prior traditional experiences of mindfulness. Participants also identified the uses for VR-supported mindfulness in managing emotions and symptoms of mental illness. The results provide preliminary evidence that VR-supported mindfulness can improve emotional states and manage mental health symptoms for those with mood or anxiety disorders. It offers some potential clinical applications for those with mood or anxiety disorders for exploration within future research.

Comparable studies

Other qualitative studies on anxiety, most cited first.

Study Year Design Participants
LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects Patients with anxiety associated with life-threatening diseases 2014 Prospective follow-up with qualitative content analysis n = 10
An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care Primary care patients with recurrent depression or recurrent depression and anxiety 2006 Exploratory mixed methods study n = 13
Cancer at the Dinner Table: Experiences of Psilocybin-Assisted Psychotherapy for the Treatment of Cancer-Related Distress Adult participants with clinically elevated anxiety associated with a cancer diagnosis 2017 Qualitative study using interpretative phenomenological analysis n = 13
Extended difficulties following the use of psychedelic drugs: A mixed methods study Participants who reported extended difficulties following psychedelic experiences 2023 Convergent mixed-method study n = 608
Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program Interdisciplinary palliative care team staff 2017 Observational mixed-method pilot evaluation n = 28

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