UniVRse: Protocol for a pilot randomised controlled trial of virtual reality cognitive-behaviour therapy for students with social anxiety
Open accessAbstract
BACKGROUND: Social anxiety is prevalent amongst university students. Cognitive-behaviour therapy (CBT), and graded exposure techniques in particular, is an effective intervention for social anxiety. However, there are a number of barriers preventing the delivery of CBT to students who are socially anxious. Delivering this intervention using virtual reality (VR) can address these implementation issues. We have co-developed with a group of students a VR-CBT intervention (UniVRse) specifically for members of this student group with social anxiety. METHODS/DESIGN: The present study is a pilot randomised controlled trial conducted in the United Kingdom of the UniVRse intervention compared to a wait-list control group. The aim of the trial is to determine whether a definitive trial is justified by assessing study recruitment, retention, and acceptability, as well as establishing the effect size on the co-primary outcomes for the definitive trial sample size calculation. We aim to recruit 90 socially anxious students-45 in each trial arm. The trial will adopt a mixed-methods approach. We will collect quantitative data at baseline (T0) and post-intervention 6 weeks later (T1). We will invite participants randomised to the intervention arm to complete a qualitative exit interview. DISCUSSION: The results of this pilot trial will be used to determine whether a definitive trial is justified, and to inform the refinement of the UniVRse programme and trial procedures. In the longer term, the UniVRse intervention has the potential to be an effective and accessible psychological intervention for students with social anxiety. TRIAL REGISTRATION: Clinicaltrials.gov, NCT05704868. Registered 30th January 2023.
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Hazell et al. [45] found that facilitating conditions (FC), such as therapist control and environmental safety, are the primary reasons students chose technology-based interventions over real-world experiences, and comprehensively analyzed the reasons why students accept or reject digital therapeutics.
“Moreover, Hazell et al. [45] found that facilitating conditions (FC), such as therapist control and environmental safety, are the primary reasons students chose technology-based interventions over real-world experiences, and comprehensively analyzed the reasons why students accept or reject digital therapeutics.”
From Advancing Undergraduate Student Mental Healthcare of Social Anxiety Disorder: Evaluating the Acceptance of AR-Assisted Cognitive Behavioral Therapy Through TAM-Based Constructs. (2026) · cites this paper as [45]
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Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · cited 1× · see citing works
“The qualitative data will be analysed using Thematic Analysis, following the Braun and Clarke protocols [71].”
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
Society and the Adolescent Self-Image
Rosenberg, M. (1965) · doi:10.1515/9781400876136 · Cited by 30,126 · see citing works
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995 · see citing works
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802 · see citing works
PSYCHOLOGICAL, EMPOWERMENT IN THE WORKPLACE: DIMENSIONS, MEASUREMENT AND VALIDATION.
Spreitzer, G. M. (1995) · Academy of Management Journal · doi:10.2307/256865 · Cited by 7,424 · see citing works
SPIRIT 2013 Statement: Defining Standard Protocol Items for Clinical Trials
Chan, A.-W., Tetzlaff, J. M., Altman, D. G., Laupacis, A., Gøtzsche, P. C., Krleža-Jerić, K., Hróbjartsson, A., Mann, H., Dickersin, K., Berlin, J. A., et al. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-3-201302050-00583 · Cited by 7,363 · cited 1× · see citing works
“The pilot trial protocol has been produced in line with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) [72, 73] and CONSORT [66, 67] guidelines.”
Simulator Sickness Questionnaire: An Enhanced Method for Quantifying Simulator Sickness
Kennedy, R. S., Lane, N. E., Berbaum, K. S., & Lilienthal, M. G. (1993) · The International Journal of Aviation Psychology · doi:10.1207/s15327108ijap0303_3 · Cited by 5,457 · cited 1× · see citing works
“(3) The Simulator Sickness Questionnaire (SSQ) [58] measures participants’ experience of side effects after using VR.”
CONSORT 2010 statement: extension to randomised pilot and feasibility trials
on behalf of the PAFS consensus group, Eldridge, S. M., Chan, C. L., Campbell, M. J., Bond, C. M., Hopewell, S., Thabane, L., & Lancaster, G. A. (2016) · Pilot and Feasibility Studies · doi:10.1186/s40814-016-0105-8 · Cited by 2,843 · cited 2× · see citing works
“The pilot trial protocol has been produced in line with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) [72, 73] and CONSORT [66, 67] guidelines.”
Design and analysis of pilot studies: recommendations for good practice
Lancaster, G. A., Dodd, S., & Williamson, P. R. (2004) · Journal of Evaluation in Clinical Practice · doi:10.1111/j..2002.384.doc.x · Cited by 2,572 · cited 1× · see citing works
“In line with recommendations for pilot RCTs [68–70], we will not test any experimental hypotheses comparing the trial arms.”
Liebowitz, M. R. (2015) · Modern Trends in Pharmacopsychiatry · doi:10.1159/000414022 · Cited by 2,266 · see citing works
A question of belonging: Race, social fit, and achievement.
Walton, G. M., & Cohen, G. L. (2007) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.92.1.82 · Cited by 2,163 · cited 1× · see citing works
“We will pilot the following constructs that have been selected as potential explanatory mechanisms for the hypothesised outcomes of the trial intervention: (1) The Question of Belonging (QoB) [53] measures the extent to which students feel a part of their university community.”
Whitehead, A. L., Julious, S. A., Cooper, C. L., & Campbell, M. J. (2016) · Statistical Methods in Medical Research · doi:10.1177/0962280215588241 · Cited by 1,936 · cited 1× · see citing works
“The recruitment target is based on guidance by Whitehead et al. [38] that 25 participants per arm are needed for a pilot trial prior to a main trial to detect a small–medium effect size, while allowing for an attrition rate of up to 40%.”
Psychometric properties of the Social Phobia Inventory (SPIN): New self-rating scale
Connor, K. M., Davidson, J. R. T., Churchill, L. E., Sherwood, A., Weisler, R. H., & Foa, E. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.176.4.379 · Cited by 1,624 · cited 1× · see citing works
“We are piloting two co-primary outcome measures: (1) the Social Phobia Inventory (SPIN) [40]; and (2) the Hazell University-Specific Social Anxiety Scale (HUS-SAS).”
A 30-item schedule for assessing assertive behavior
Rathus, S. A. (1973) · Behavior Therapy · doi:10.1016/s0005-7894(73)80120-0 · Cited by 1,017 · see citing works
Assessment of the cortisol awakening response: Expert consensus guidelines
Stalder, T., Kirschbaum, C., Kudielka, B. M., Adam, E. K., Pruessner, J. C., Wüst, S., Dockray, S., Smyth, N., Evans, P., Hellhammer, D. H., et al. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.10.010 · Cited by 967 · cited 1× · see citing works
“In line with best practice guidance, to monitor sampling accuracy participants will also be asked to wear an activity-monitoring device to bed prior to the three collection days so we can verify the participants’ sleep and wake times [61].”
Sheldon, E., Simmonds-Buckley, M., Bone, C., Mascarenhas, T., Chan, N., Wincott, M., Gleeson, H., Sow, K., Hind, D., & Barkham, M. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.03.054 · Cited by 644 · see citing works
The Liebowitz social anxiety scale as a self-report instrument: a preliminary psychometric analysis
Baker, S. L., Heinrichs, N., Kim, H.-J., & Hofmann, S. G. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00060-2 · Cited by 640 · cited 1× · see citing works
“The HUS-SAS is inspired by the Liebowitz Social Anxiety Scale (LSAS) [43, 44], in which respondents rate their fear and avoidance of different social situations.”
Stress and the higher education student: a critical review of the literature
Robotham, D., & Julian, C. (2006) · Journal of Further and Higher Education · doi:10.1080/03098770600617513 · Cited by 436 · cited 1× · see citing works
“Amongst students, there are additional sequelae that arise because of the pressure to be ‘sociable’ when at university [12, 13].”
A Cognitive Behavioral Model of Social Anxiety Disorder
Heimberg, R. G., Brozovich, F. A., & Rapee, R. M. (2010) · Social Anxiety · doi:10.1016/b978-0-12-375096-9.00015-8 · Cited by 407 · cited 3× · see citing works
“The Heimberg model [22] provides the framework for one approach to cognitive-behaviour therapy (CBT) for social anxiety, specifically the use of psychoeducation and graded exposure techniques as recommended by National Institute of Health and Care Excellence (NICE) guidelines [24].”
Bouchard, S., Dumoulin, S., Robillard, G., Guitard, T., Klinger, É., Forget, H., Loranger, C., & Roucaut, F. X. (2017) · British Journal of Psychiatry · doi:10.1192/bjp.bp.116.184234 · Cited by 354 · see citing works
Psychological treatment of social anxiety disorder: a meta-analysis
Acarturk, C., Cuijpers, P., van Straten, A., & de Graaf, R. (2009) · Psychological Medicine · doi:10.1017/s0033291708003590 · Cited by 333 · see citing works
Montgomery, P., Grant, S., Mayo-Wilson, E., MacDonald, G., Michie, S., Hopewell, S., & Moher, D. (2018) · Trials · doi:10.1186/s13063-018-2733-1 · Cited by 294 · cited 2× · see citing works
“The pilot trial protocol has been produced in line with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) [72, 73] and CONSORT [66, 67] guidelines.”
Robillard, G., Bouchard, S., Fournier, T., & Renaud, P. (2003) · CyberPsychology & Behavior · doi:10.1089/109493103769710497 · Cited by 272 · cited 1× · see citing works
“An additional benefit of VR is that patients are more willing to engage in the exposure work as they know it is not real, yet they none-theless mentally and physically respond as if it is [30].”
Methacholine test and the diagnosis of asthma
Cockcroft, D. W., & Nair, P. K. (2012) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2012.05.050 · Cited by 259 · see citing works
Attentional focus in social anxiety disorder: Potential for interactive processes
Schultz, L. T., & Heimberg, R. G. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2008.04.003 · Cited by 212 · see citing works
The impact of social anxiety on student learning and well-being in higher education
Russell, G. C., & Topham, P. (2012) · Journal of Mental Health · doi:10.3109/09638237.2012.694505 · Cited by 191 · cited 1× · see citing works
“Social anxiety can also undermine academic functioning [8], including hindering learning [18] and reducing communication with teaching staff [19]; ultimately resulting in poorer educational attainment [20] and impeding the student experience [19].”
The Social Ties That Bind: Social Anxiety and Academic Achievement Across the University Years
Brook, C. A., & Willoughby, T. (2015) · Journal of Youth and Adolescence · doi:10.1007/s10964-015-0262-8 · Cited by 183 · cited 1× · see citing works
“Social anxiety can also undermine academic functioning [8], including hindering learning [18] and reducing communication with teaching staff [19]; ultimately resulting in poorer educational attainment [20] and impeding the student experience [19].”
Virtual reality exposure therapy for social anxiety disorder: a systematic review and meta-analysis
Horigome, T., Kurokawa, S., Sawada, K., Kudo, S., Shiga, K., Mimura, M., & Kishimoto, T. (2020) · Psychological Medicine · doi:10.1017/s0033291720003785 · Cited by 160 · see citing works
Russell, G. C., & Shaw, S. R. (2009) · Journal of Mental Health · doi:10.1080/09638230802522494 · Cited by 152 · see citing works
Schry, A. R., & White, S. W. (2013) · Addictive Behaviors · doi:10.1016/j.addbeh.2013.06.014 · Cited by 150 · cited 1× · see citing works
“Being socially anx-ious is associated with reduced wellbeing [14] and self-esteem [15], and increased risk of alcohol-related problems [16] amongst students.”
Jenkins, P. E., Ducker, I., Gooding, R., James, M., & Rutter-Eley, E. (2021) · Journal of American College Health · doi:10.1080/07448481.2019.1709474 · Cited by 147 · see citing works
Meta-analysis of the efficacy of virtual reality exposure therapy for social anxiety
Chesham, R. K., Malouff, J. M., & Schutte, N. S. (2018) · Behaviour Change · doi:10.1017/bec.2018.15 · Cited by 135 · cited 1× · see citing works
“The treatment effects are equivalent to real-world exposure [32], and, in some studies, have even been found to be superior, with longer-lasting effects [34].”
Social anxiety in college students
Purdon, C. L., Antony, M. M., Monteiro, S., & Swinson, R. P. (2001) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(01)00059-7 · Cited by 114 · see citing works
Beets, M. W., von Klinggraeff, L., Weaver, R. G., Armstrong, B., & Burkart, S. A. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00909-w · Cited by 111 · cited 1× · see citing works
“Although the primary aim of the pilot trial is to address feasibility questions, it is also important to determine whether there is a signal of efficacy in favour of the trial intervention to further justify the need for a definitive trial [37].”
Archbell, K. A., & Coplan, R. J. (2022) · Journal of Emotional and Behavioral Disorders · doi:10.1177/10634266211060079 · Cited by 95 · cited 1× · see citing works
“Social anxiety can also undermine academic functioning [8], including hindering learning [18] and reducing communication with teaching staff [19]; ultimately resulting in poorer educational attainment [20] and impeding the student experience [19].”
Bouchard, S., Berthiaume, M., Robillard, G., Forget, H., Daudelin-Peltier, C., Renaud, P., Blais, C., & Fiset, D. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.739742 · Cited by 90 · cited 1× · see citing works
“…concerns regarding the conceptual overlap between the side effects of VR and the symptoms of anxiety, which may lead to measurement error, we will use the revised scoring and factor structure proposed by Bouchard et al. [59], which has demonstrated strong internal consistency (Cronbach’s α = 0.87).”
InfluentialPilot randomized trial of self-guided virtual reality exposure therapy for social anxiety disorder
Zainal, N. H., Chan, W. W., Saxena, A. P., Taylor, C. B., & Newman, M. G. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.103984 · Cited by 84 · cited 1× · see citing works
“Again, these self-guided versions of VR exposure produce equivalent large treatment effects [35].”
Lifestyle Practice among Malaysian University Students
Al-Naggar, R. A., Bobryshev, Y. V., & Noor, N. A. B. M. (2013) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2013.14.3.1895 · Cited by 75 · see citing works
Meta-analysis of virtual reality exposure therapy for social anxiety disorder
Morina, N., Kampmann, I., Emmelkamp, P., Barbui, C., & Hoppen, T. H. (2023) · Psychological Medicine · doi:10.1017/s0033291721001690 · Cited by 75 · cited 1× · see citing works
“Meta-analyses have evidenced large treatment effects of VR exposure for social anxiety disorder in the general population [31–33].”
Bray, A., Byrne, P. J., & O’Kelly, M. (2020) · Thinking Skills and Creativity · doi:10.1016/j.tsc.2020.100700 · Cited by 68 · cited 1× · see citing works
“(5) The Short Instrument for measuring students’ Confidence with Key Skills (SICKS) [50] measures students’ confidence in their educational skills.”
SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials)
Moher, D., & Chan, A. (2014) · Guidelines for Reporting Health Research: A User's Manual · doi:10.1002/9781118715598.ch7 · Cited by 66 · cited 1× · see citing works
“The pilot trial protocol has been produced in line with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) [72, 73] and CONSORT [66, 67] guidelines.”
Öztürk, A., & Mutlu, T. (2010) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2010.12.398 · Cited by 63 · cited 1× · see citing works
“Being socially anx-ious is associated with reduced wellbeing [14] and self-esteem [15], and increased risk of alcohol-related problems [16] amongst students.”
Beaton, E. A., Schmidt, L. A., Ashbaugh, A. R., Santesso, D. L., Antony, M. M., McCabe, R. E., Segalowitz, S. J., & Schulkin, J. (2006) · Personality and Individual Differences · doi:10.1016/j.paid.2006.02.020 · Cited by 61 · cited 1× · see citing works
“There is also evidence that being socially anxious is associated with alterations in the hypothalamic–pituitary–adrenal (HPA) axis, which is the major stress response system [17].”
High cortisol awakening response and cortisol levels moderate exposure-based psychotherapy success
Meuret, A. E., Trueba, A. F., Abelson, J. L., Liberzon, I., Auchus, R. J., Bhaskara, L., Ritz, T., & Rosenfield, D. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.10.008 · Cited by 50 · cited 1× · see citing works
“There is also some evidence of synchronous changes in cortisol levels following CBT [28] or exposure therapy [29] for anxiety.”
Bullying and social anxiety experiences in university learning situations
Porhölä, M., Almonkari, M., & Kunttu, K. (2019) · Social Psychology of Education · doi:10.1007/s11218-019-09496-4 · Cited by 49 · cited 1× · see citing works
“Social anxiety may be global, affecting students in all social situations, or context-specific, presenting only when students are in the university environment [21].”
Accounting for unequal access to higher education: The role of social identity factors
Nieuwenhuis, M., Manstead, A. S. R., & Easterbrook, M. J. (2019) · Group Processes & Intergroup Relations · doi:10.1177/1368430219829824 · Cited by 45 · cited 1× · see citing works
“(2) The Identification with University (IwU) [54] measures the extent to which students perceive being a university student is consistent with their social identity.”
Pini, S., Dell’Osso, L., Abelli, M., Carlini, M., Mengali, F., Carpita, B., Macchi, E., Gorrasi, F., Tognetti, R., & Massimetti, G. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s59348 · Cited by 45 · see citing works
Barrera, T. L., Szafranski, D. D., Ratcliff, C. G., Garnaat, S. L., & Norton, P. J. (2016) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465814000630 · Cited by 42 · cited 1× · see citing works
“Exposure-based techniques are an essential component of effective CBT for social anxiety [25], and have been demonstrated to be equally as effective in improving social anxiety as other cognitive-behavioural techniques such as cognitive restructuring [26].”
Carleton, R. N., Collimore, K. C., Asmundson, G. J. G., McCabe, R. E., Rowa, K., & Antony, M. M. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.09.003 · Cited by 39 · cited 1× · see citing works
“The validation of the original five-factor solu-tion of the SPIN has been inconsistent [41].”
Multivariate and normative data pertaining to the RAS with the college population
Nevid, J. S., & Rathus, S. A. (1978) · Behavior Therapy · doi:10.1016/s0005-7894(78)80150-6 · Cited by 37 · cited 1× · see citing works
“The RAS has 30 items with a 6-point Likert scale and established strong split-half reliability ( r = 0.77; p < 0.01) [48].”
InfluentialLucena, F. J. H., Díaz, I. A., Reche, M. P. C., Torres, J. M. T., & Rodríguez, J. M. R. (2020) · Journal of Personalized Medicine · doi:10.3390/jpm10010014 · Cited by 37 · cited 1× · see citing works
“The authors found that virtual exposure to a public speaking scenario reduced public-speaking anxiety and physiological anxiety symptoms [36].”
Social Anxiety in Relation to Self-Esteem among University Students in Jordan
Murad, O. S. (2020) · International Education Studies · doi:10.5539/ies.v13n2p96 · Cited by 33 · cited 1× · see citing works
“Being socially anx-ious is associated with reduced wellbeing [14] and self-esteem [15], and increased risk of alcohol-related problems [16] amongst students.”
Bergin, A. D. G., Valentine, A., Rennick-Egglestone, S., Slade, M., Hollis, C., & Hall, C. (2022) · JMIR Mental Health · doi:10.2196/42501 · Cited by 32 · see citing works
Self-citationAvison, W. R., & Rosenberg, M. (1981) · Canadian Journal of Sociology / Cahiers canadiens de sociologie · doi:10.2307/3340091 · Cited by 31 · cited 1× · see citing works
“The RSES has 10 items with a 4-point Likert scale, and well-established strong internal consistency (Cronbach’s α s ≥ 0.77) [52].”
InfluentialLatent dimensions of social anxiety disorder: A re-evaluation of the Social Phobia Inventory (SPIN)
Campbell-Sills, L., Espejo, E., Ayers, C. R., Roy-Byrne, P., & Stein, M. B. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.09.007 · Cited by 29 · cited 1× · see citing works
“More recent research instead supports a three-factor model [42], with all subscales demonstrating strong internal consistency (Cronbach’s α s ≥ 0.77).”
InfluentialPersistence of anxiety disorders and concomitant changes in cortisol
Dierckx, B., Dieleman, G. C., Tulen, J. H. M., Treffers, P. D. A., Utens, E. M. W. J., Verhulst, F. C., & Tiemeier, H. W. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2012.04.001 · Cited by 26 · cited 1× · see citing works
“There is also some evidence of synchronous changes in cortisol levels following CBT [28] or exposure therapy [29] for anxiety.”
Participant views on involvement in a trial of social recovery cognitive–behavioural therapy
Notley, C. J., Christopher, R., Hodgekins, J., Byrne, R. E., French, P., & Fowler, D. G. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.146472 · Cited by 26 · see citing works
What Brings You Here? Exploring Why Young Adults Seek Help for Social Anxiety
Hjeltnes, A., Moltu, C., Schanche, E., & Binder, P. (2015) · Qualitative Health Research · doi:10.1177/1049732315596151 · Cited by 18 · cited 1× · see citing works
“Social anxiety in any population can be a life-limiting condition due to its psychological and physiological impacts, including loneliness, isolation, and relationship difficulties [9–11].”
Kim, S. S. Y., Liu, M., Qiao, A., & Miller, L. C. (2021) · Health Communication · doi:10.1080/10410236.2021.1912890 · Cited by 16 · see citing works
Katerelos, M., Hawley, L. L., Antony, M. M., & McCabe, R. E. (2008) · Behavior Modification · doi:10.1177/0145445507309302 · Cited by 12 · cited 1× · see citing works
“Progression through exposure hierarchies is directly associated with reductions in social anxiety symptoms [27].”
Glanaghy, E. M., Jackson, J.-L., Morris, P. G., Prentice, W. M., Dougall, N. J., & Hutton, P. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2648 · Cited by 7 · cited 1× · see citing works
“(2) The Edinburgh Adverse Effects of Psychological Therapy (EDAPT) [57] measures participants’ experience of side effects after receiving psychological therapy.”
Flagged first, then by citations
Research works printed but not linked: 5
- [7]Al-Naggar RA, Bobryshev Y v, Alabsi M. Perfectionism and social anxiety among university students in Malaysia. ASEAN J Psychiatr. 2013;14(1):51–8.
- [24]NICE. Social anxiety disorder: recognition, assessment and treatment. London: National Institute for Health and Care Excellence (NICE); 2013. 39960994
- [39]Department for Business E& IS. The safety of domestic virtual reality systems: a literature review. London; 2020.
- [62]Elliott R, Slatick E, Urman M. Qualitative change process research on psychotherapy: alternative strategies. Psychologische Beiträge. 2001;43(3):69–111. Available from: http://search.proquest.com/openview/a0e961b9dd139438a4a8f170d5566a08/1?pq-origsite=gscholar&cbl=43472. Cited 9 Mar 2017.
- [70]Skivington K, Matthews L, Simpson SA, Craig P, Baird J, Blazeby JM, et al. A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. The BMJ. 2018;2021(374):1–11. PMC8482308 34593508
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Zhou, Z., Zhou, Y., Ouyang, B., Man, S. S., & Chan, A. H. S. (2026) · Healthcare · doi:10.3390/healthcare14131978
“Moreover, Hazell et al. [45] found that facilitating conditions (FC), such as therapist control and environmental safety, are the primary reasons students chose technology-based interventions over real-world experiences, and comprehensively analyzed the reasons why students accept or reject digital…”
- Authors
- Hazell, C. M., Malinowski, J., Edwards, B., Bergin, A. D. G., Berry, C., Flynn, M., Smyth, N., & Birkett, J.
- Affiliations
- University of Surrey (GB)
- King's College London (GB)
- University of East London (GB)
- University of Nottingham (GB)
- Brighton and Sussex Medical School (GB)
- University of Westminster (GB)
- Corresponding author
- Hazell, Cassie M.
- Malinowski, Josie
- Edwards, Bethany
- Bergin, Aislinn D. Gómez
- Berry, Clio
- Flynn, Maria
- Smyth, Nina
- Birkett, Jo
- Venue
- Pilot and Feasibility Studies
- Published
- 2026-02-05
- Volume
- 12
- Issue
- 1
- Pages
- 25-25
- ISSN
- 2055-5784 (ISSN-L)
- PMC
- PMC12896344
- OpenAlex
- W7127912423
- Cited by
- 1
- References
- 57
- Citations by year
- 2026: 1
- FWCI
- 7.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Pilot and Feasibility Studies (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repository@Nottingham (University of Nottingham) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Funders
- Office for Students (DMH05)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Keywords
- social anxiety, university students, virtual reality, cognitive behavioral therapy, graded exposure, acceptability, recruitment and retention, sample size determination, psychological intervention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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