@article{Caltabiano:2026,
author = {Caltabiano, A and Voruganti, A and Nesi, J and Krebs, G and Burke, T and Di, Simplicio M and Van, Zalk N},
journal = {JMIR Serious Games},
title = {Virtual reality-delivered exposure for contamination concerns in adults with obsessive-compulsive symptoms: a single-arm pilot study},
year = {2026}
}

Download

TY  - JOUR
AB  - Background: Exposure and response prevention is a first line intervention for obsessive compulsive disorder (OCD), yet many individuals with contamination concerns do not access care. Virtual reality exposure (VRET) may improve scalability and acceptability.Objective: This pilot study evaluated the feasibility and acceptability of a standardized single-session VRET protocol targeting contamination concerns, whether it elicited within-session anxiety and exploratory contamination symptom change at 1-month follow-up.Methods: We conducted a single-arm, pilot in adults with elevated contamination concerns and no formal OCD diagnosis, recruited via convenience sampling. Participants completed a baseline survey, an in-lab VRET session using a standardized virtual public toilet environment, and a follow-up survey. Outcomes included momentary anxiety (Subjective Units of Distress Scale) during exposure, affect (Positive and Negative Affect Schedule) across time points, and contamination symptoms (Obsessive Compulsive Inventory Revised contamination subscale) at baseline and follow-up. Usability (System Usability Scale; SUS) and VR sickness were also assessed. Within-session outcomes used repeated-measures ANOVA or Friedman tests; symptom change used paired t tests (alpha = .05); point estimates include 95% CIs. Missing data were addressed using multiple imputation (random forest; m = 5); 37.5% of participants did not complete the follow-up survey (overall missingness: 5.47%).Results: Sixteen participants were included (ages 18-32 years). Anxiety increased during exposure tasks and decreased after virtual hand washing in both trials (Exposure 1 Friedman’s Test: χ²(3) = 28.56, P < .001, W = 0.6); Exposure 2 repeated measures ANOVA: F(1.85, 27.81) = 5.35, P = .012, GES = 0.058 (Greenhouse-Geisser corrected). Negative and positive affect both changed significantly across time points (negative affect: Friedman’s Test: χ²(3) = 13.76, P = .003, W =
AU  - Caltabiano,A
AU  - Voruganti,A
AU  - Nesi,J
AU  - Krebs,G
AU  - Burke,T
AU  - Di,Simplicio M
AU  - Van,Zalk N
PY  - 2026///
SN  - 2291-9279
TI  - Virtual reality-delivered exposure for contamination concerns in adults with obsessive-compulsive symptoms: a single-arm pilot study
T2  - JMIR Serious Games
ER  - 

Download