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. 2023 Oct:166:25-31.
doi: 10.1016/j.jpsychires.2023.08.002. Epub 2023 Aug 9.

Augmenting group hoarding disorder treatment with virtual reality discarding: A pilot study in older adults

Hannah Raila  1 , Tatevik Avanesyan  2 , Keara E Valentine  2 , Brenden Koo  2 , Chloe Huang  2 , Yuri Tsutsumi  2 , Elisabeth Andreeff  2 , Tori Qiu  2 , Paula Andrea Muñoz Rodríguez  3 , Andrea Varias  2 , Maria Filippou-Frye  2 , Peter van Roessel  4 , Kim Bullock  2 , Vyjeyanthi S Periyakoil  5 , Carolyn I Rodríguez  6
Affiliations

Augmenting group hoarding disorder treatment with virtual reality discarding: A pilot study in older adults

Hannah Raila et al. J Psychiatr Res. 2023 Oct.

Abstract

Hoarding disorder is common and debilitating, especially in older adults, and novel treatment approaches are needed. Many current treatments emphasize skills related to discarding and decision-making about possessions, which can be practiced in the patient's home. However in many cases, in-home visits are unfeasible, or real-life discarding is too difficult. Virtual reality (VR) offers the ability to create a virtual "home" including 3D scans of the patient's actual possessions that can be moved or discarded. VR discarding is an alternative to in-home visits and an approach that provides a stepping stone to real-life discarding. VR has been successfully utilized to treat many disorders but tested minimally in hoarding disorder. In nine older adults with hoarding disorder, we tested an 8-week VR intervention administered to augment a 16-week Buried in Treasures group treatment. Individualized VR rooms were uniquely modeled after each patient's home. During clinician-administered VR sessions, patients practiced sorting and discarding their virtual possessions. The intervention was feasible to administer. Open-ended participant responses, examined by two independent evaluators, indicated that VR sessions were well-tolerated and that participants found them useful, with nearly all participants noting that VR helped them increase real-life discarding. Self-reported hoarding symptoms decreased from baseline to close, with seven of the nine participants showing reliable improvement in this timeframe and none showing deterioration. Results from this exploratory pilot study suggest that VR is a feasible way to simulate an at-home sorting and discarding experience in a manner that may augment skills acquisition. It remains an open question whether VR discarding practice yields greater improvement than existing treatments. VR for this population merits further clinical investigation.

Keywords: Clutter; Geropsychology; Hoarding; Virtual reality.

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Conflict of interest statement

Declaration of competing interest Funding Support This study was supported by a pilot project grant from NIH/NIAP30AG059307 (Center Grant PI: Dr. Periyakoil; Pilot Project Grantee: Dr. Rodriguez) and in part by a NIH/NIMH R01MH105461 (Dr. Rodriguez), and a NIH/NIMHT32MH019938 (Dr. Raila). Financial Disclosures In the last three years, CIR has been a consultant for Biohaven Inc., Osmind, and Biogen; received research grant support from Biohaven Inc.; received royalties from American Psychiatric Association Publishing; and received a stipend from American Psychiatric Association Publishing for her role as Deputy Editor at The American Journal of Psychiatry. The authors partnered with startup NeuroRehabVR for the creation of the virtual reality worlds. The other authors report no financial or other relationship relevant to the subject of this manuscript. Acknowledgements The authors would like to thank NeuroRehabVR for their partnership in the creation of the virtual reality worlds.

Figures

Figure 1.
Figure 1.
Timeline of interventions across 16 weeks.
Figure 2.
Figure 2.. Mean symptom change across Time Points.
Note. SIR=Saving Inventory Revised; CIR=Clutter Image Rating Scale; SCI=Saving Cognitions Inventory; DASS=Depression Anxiety Stress Scale.
See this image and copyright information in PMC

References

    1. Abramowitz JS, 2018. Getting over OCD: A 10-step workbook for taking back your life (2nd ed.). New York: Guilford Press.
    1. Birckhead B, Khalil C, Liu X, Conovitz S, Rizzo A, Danovitch I, Spiegel B, 2019. Recommendations for methodology of virtual reality clinical trials in health care by an international working group: iterative study. JMIR mental health, 6(1), e11973. - PMC - PubMed
    1. Chafe R, 2017. The value of qualitative description in health services and policy research. Healthcare policy, 12(3), 12. - PMC - PubMed
    1. Chasson GS, Hamilton CE, Luxon AM, De Leonardis AJ, Bates S, Jagannathan N, 2020. Rendering promise: Enhancing motivation for change in hoarding disorder using virtual reality. Journal of Obsessive-Compulsive and Related Disorders, 25, 100519.
    1. Devilly GJ, Borkovec TD, 2000. Psychometric properties of the credibility/expectancy questionnaire. Journal of behavior therapy and experimental psychiatry, 31(2), 73–86. - PubMed

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