{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:47:48Z","timestamp":1790632068871,"version":"4.1.0"},"reference-count":50,"publisher":"Cambridge University Press (CUP)","issue":"13","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291722003531_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Access to evidence-based psychological treatment is a challenge worldwide. We assessed the effectiveness of a fully automated aviophobia smartphone app treatment delivered in combination with a $5 virtual reality (VR) viewer.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722003531_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>In total, 153 participants from the Dutch general population with aviophobia symptoms and smartphone access were randomized in a single-blind randomized controlled trial to either an automated VR cognitive behavior therapy (VR-CBT) app treatment condition (<jats:italic>n<\/jats:italic> = 77) or a wait-list control condition (<jats:italic>n<\/jats:italic> = 76). The VR-CBT app was delivered over a 6-week period in the participants' natural environment. Online self-report assessments were completed at baseline, post-treatment, at 3-month and at 12-month follow-up. The primary outcome measure was the Flight Anxiety Situations Questionnaire (FAS). Analyses were based on intent-to-treat.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722003531_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>A significant reduction of aviophobia symptoms at post-test for the VR-CBT app compared with the control condition [<jats:italic>p<\/jats:italic> &lt; 0.001; <jats:italic>d<\/jats:italic> = 0. 98 (95% CI 0.65\u20131.32)] was demonstrated. The dropout rate was 21%. Results were maintained at 3-month follow-up [within-group <jats:italic>d<\/jats:italic> = 1.14 (95% CI 0.46\u20131.81)] and at 12-month follow-up [within-group <jats:italic>d<\/jats:italic> = 1.12 (95% CI 0.46\u20131.79)]. Six participants reported adverse effects of cyber sickness symptoms.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291722003531_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>This study is the first to show that fully automated mobile VR-CBT therapy delivered in a natural setting can maintain long-term effectiveness in reducing aviophobia symptoms. In doing so, it offers an accessible and scalable evidence-based treatment solution that can be applied globally at a fraction of the cost of current treatment alternatives.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291722003531","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T09:11:25Z","timestamp":1669367485000},"page":"6232-6241","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":20,"title":["Automated mobile virtual reality cognitive behavior therapy for aviophobia in a natural setting: a randomized controlled trial"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7470-8234","authenticated-orcid":false,"given":"T.","family":"Donker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.R.","family":"Fehribach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"van Klaveren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Cornelisz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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