JMIR Publications

ABSTRACT

Background:

Background:

To our knowledge, no specialized research has been designed to treat ailurophobia (fear of cats) either in Iran or outside Iran. This reason, along with excuses such as the high number of people with ailurophobia and the lack of design of gamified virtual reality (VR) environments that have used cheap and easily accessible biofeedback tools, motivated us to design a gamified VR exposure therapy augmented with biofeedback. We supposed such a tool, compared to a similar tool without biofeedback, has more positive effects.

Objective:

Objective:

To design a smartphone gamified VR exposure therapy augmented with cheap and accessible biofeedback tools for animal phobia, case study ailurophobia.

Methods:

Methods:

To assess the efficacy of the designed tool, first, the participants were divided into biofeedback and without biofeedback groups; the possible four positive effects were identified: 1) intrinsic motivation, 2) simulating fear situations, 3) controlling stressful circumstances and eliminating therapists’ presence and mitigating catastrophic thoughts, and 4) preliminary effects of the game on ailurophobia treatment. Different research instruments were used to assess the effects. Also, the mean scores between the two groups and ANOVA: single factor and ANOVA: two-factor with replication were used to analyze and interpret the data. The game was also evaluated using a five-point Likert questionnaire designed by three existing system usability scales, assessing user experience, VR experience, and game playability. Twenty-nine people were identified to participate in the study, of which ten people participated in the study. The rest either did not meet the inclusion criteria, or we did not have access to them for various reasons.

Results:

Results:

Our results showed that the designed tool positively impacted the identified effects and can normalize seeing and interacting with cats. Also, the game from game playability and system usability scale obtained good scores. However, it needs some improvement in engagement and therapeutic aspects.

Conclusions:

Conclusions:

We concluded that the game, with some improvements, can be used for treating animal phobias remotely or in clinics. Also, by adapting fear elements, the game could be used to treat different animal phobias and other specific phobias. Another critical point is that the games that aim to treat phobias. At the same time, they should have the most similarity with real animals and their behaviors, should not use action and combat scenarios or use them very little so as not to institutionalize fear.