A transdiagnostic approach to the use of virtual reality in the prevention of eating disorders

“Virtual reality” (VR) proved to be a useful tool to improve existing psychological treatments and prevention protocols for many psychopathologies, including eating disorders (EDs). While VR-based interventions can reduce ED-related symptomatology, no VR software was developed to concurrently tackle three third-wave cognitive-behavioural transdiagnostic factors linked to EDs: psychological flexibility, emotion regulation, experiential avoidance. The clinical severity of EDs and perfectible success rates of traditional psychotherapies warrant innovative preventive interventions. This Ph.D research project includes three experimental studies aimed at: (Study-1) exploring the acceptability of an innovative VR software (H.O.M.E.–How to Observe and Modify Emotions) designed to tackle these transdiagnostic factors and ED symptoms in the general population (GP) with ED risk; (Study-2) evaluating the feasibility of the 6-sessions H.O.M.E. VR-based preventive intervention in improving transdiagnostic factors and ED symptoms in this population, also compared to a waiting-list and at 3- and 6-months follow-ups; and (Study-3) at qualitatively investigating subjective opinions regarding H.O.M.E. in completers. N=134 GP individuals with ED risk were screened using online psychometric screening questionnaires. n=30 took part in Study-1, n=40 in Study-2 (n=20 VR-group, n=20 waiting-list). Study-3 included all n=20 participants of Study-2 VR-group. In Study-1 H.O.M.E. resulted acceptable, producing low cybersickness, satisfactory user experience, but low sense of presence. In Study-2 the H.O.M.E. intervention improved ED symptoms, emotion regulation strategies, and psychological flexibility in VR-group, also when compared to waiting-list, with results maintained at follow-ups. In Study-3, participants evaluated H.O.M.E. positively, as it subjectively improved their dysfunctional eating behaviors, coping strategies and transdiagnostic factors, and encouraged them to seek psychological support. Results showed that H.O.M.E. represents a well-accepted, feasible, and positively evaluated tool to prevent EDs. Since people with ED risk rarely seek help due to stigma, H.O.M.E may help engage young individuals with ED risk towards psychological support before the onset of the disorder.