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Virtual reality (VR) technology can provide immersive cue exposure therapy (VR\u2010CET) and aversion therapy (VR\u2010AT). This study aimed to evaluate the efficacy of VR\u2010CET, VR\u2010AT and their combination on craving, emotional and sleep states, attentional bias and relapse rate in patients with\n                    <jats:sc>AD<\/jats:sc>\n                    . In this single\u2010centre randomized controlled trial, male inpatients with\n                    <jats:sc>AD<\/jats:sc>\n                    were randomly assigned to one of four groups: control, VR\u2010CET, VR\u2010AT or combined VR\u2010CET\u2009+\u2009AT (target\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200925 per group; 80 completed, 20 per group). The interventions spanned 15\u2009days with eight sessions (VR\u2010CET\u2009+\u2009AT ~20\u2009min\/session; others ~10\u2009min). Assessments were conducted before and after treatment using the Visual Analogue Scale (VAS), the Pennsylvania Alcohol Craving Scale (PACS), the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA) and the Pittsburgh Sleep Quality Index (PSQI). Eye\u2010tracking and grasping indices in VR environments were used to assess attentional bias (e.g., alcohol\u2010cue fixation time ratio). Relapse was evaluated by telephone at 4 and 12\u2009weeks post\u2010treatment. Statistical analyses used Shapiro\u2013Wilk tests and ANOVA\/Kruskal\u2013Wallis tests with appropriate post hoc comparisons (\n                    <jats:italic>\u03b1<\/jats:italic>\n                    \u2009=\u20090.05). All groups showed significant pre\u2010 to post\u2010treatment improvements in PACS, HAMD, HAMA, PSQI and VAS scores (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Between\u2010group comparisons at post\u2010treatment revealed significant differences in alcohol\u2010cue fixation time ratio (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), with the VR\u2010CET\u2009+\u2009AT group showing a lower fixation time ratio than the control group. VAS scores also differed among groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), with the control group showing higher values than the VR\u2010CET\u2009+\u2009AT group. Changes in alcohol\u2010cue fixation time ratio from pre\u2010 to post\u2010treatment were significantly greater in the VR\u2010CET\u2009+\u2009AT group than in the control group. Relapse rates at 4 and 12\u2009weeks (47\/80 reached by telephone follow\u2010up) did not significantly differ among groups (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&gt;\u20090.05). Combining VR\u2010CET with VR\u2010AT reduced craving (VAS) and attentional bias (alcohol\u2010cue fixation time ratio) beyond standard care, whereas all groups improved on clinical scales. Larger and longer trials are warranted to further clarify relapse outcomes.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    Chinese Clinical Trial Registry, ChiCTR2500110026. Registered 29 September 2025 (retrospectively registered)\n                  <\/jats:p>","DOI":"10.1111\/adb.70166","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:43:31Z","timestamp":1778114611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Virtual Reality\u2013Based Cue Exposure and Aversion Therapy for Alcohol Dependence: A Randomized Controlled Trial"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1000-3879","authenticated-orcid":false,"given":"Haoyu","family":"Zhao","sequence":"first","affiliation":[{"name":"The Second Affiliated Hospital of Henan Medical University  Xinxiang Henan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotong","family":"Ying","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Henan Medical University  Xinxiang Henan 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