Examining inter-personal distance in Virtual Reality in patients with persisting psychopathology and a control group in order to assess the association with attachment styles. Differences in gender will also be examined. Primary research question…
ID
Source
Brief title
Condition
- Personality disorders and disturbances in behaviour
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
8.1.a Main study parameter/endpoint
The dependent variables are virtual distance and reaction times. Virtual
distance in meters will be collected through the Virtual Reality software.
(Steenbakkers et al., 2019).
Reaction times will be collected through the Virtual Reality software.
(Steenbakkers et al., 2019).
The independent variable is attachment style, specifically anxious attachment
style and avoidant attachment style. The Dutch version of the Experiences in
Close Relationships - Revised (ECR-R) consisting out of 36 items was used to
measure these dimensions of insecure attachment styles (Fraley, Waller,
Brennan, 2000; Sibley & Liu, 2004). Participants were asked to think about
their close relationships, without focusing on a speciWc partner, and rate the
extent to which each item accurately described their feelings in such
relationships using a 7-point scale ranging from 1 (not at all) to 7 (very
much). Eighteen items measured attachment-related anxiety (e.g., I worry about
being abandoned) and 18 items measured avoidance (e.g., I prefer not to show a
partner how I feel deep down). The reliability and validity of the two
subscales have been repeatedly demonstrated (e.g., Mikulincer & Shaver, 2007)
8.1.b Secondary study parameters/endpoints (if applicable)
Self reported anxiety was measured using a short and Dutch version of the
State and Trait Anxiety Inventory (STAI) consisting out of 6 items using a 4
point scale ranging from *not at all* to *a lot* (Marteau & Bekker, 1992).
Skin conductance level will be measured (Boucsein, 2012; Dindo & Fowles, 2008;
Bekedek & Kaernbach 2010) using two Ag-AgCl electrodes of approximately 1 cm²
attached to the hand palm of the participant. The non-dominant hand of the
participant will be used. Between the two electrodes a weak voltage of 0,5V
will be applied. The participants cannot feel such a weak voltage. The
difference in resistance between the two electrodes measured with the low
voltage indicates changes in arousal. At the start of the task baseline skin
conductance will be measured while the participants watches a photograph of a
landscape. The VU-AMS platform (www.vu-ams.nl) was used to measure this
physiological data.
Heartrate variability (HRV) will also be measured using the VU-AMS platform.
Two Ag-AgCl elekctrodes of approximately 2 cm2 will be attached to both lower
arms of the participants
Secondary outcome
8.1.c Other study parameters (if applicable)
Information about autonomy, emotion regulation, DSM-5 classification, age, sex,
treatment method, previous treatments, and medication is also collected as they
might be confounding variables.
Information about age, previous treatments, medication and DSM-5 classification
will be collected from the patient*s medical file with their consent.
The Dutch version of the Autonomy-Connectedness Scale-30 (ACS-30) was used to
measure autonomy (Bekker & Van Assen, 2006, 2008). This scale consists out of
30 items using a 7 point Likert-scale ranging from *completely disagree* to
*completely agree*.,
The Dutch version of the Social Interaction Anxiety Scale (SIAS) was used to
measure social anxiety (Mattick & Clarke, 1998). This scale consists out of 19
items using a 5 point scale ranging from *not at all* to *a lot*.
Background summary
Rationale: Insecure attachment style is a major predicting factor in
psychopathology, such as personality disorders. More insight in the attachment
style of patients could help diagnosing and treating psychopathology. Currently
there are few ways of measuring attachment style in adults. The most reliable
option is the Adult Attachment Interview (AAI), which is time consuming and
costly. Other questionnaires rely on self-report, which could be biased because
of diminished reflective capabilities specifically within the population of
patients with personality disorders. This study aims to explore the possibility
for measuring more objectively behaviors related to attachment style, such as
interpersonal distance and differences in reaction time due to attention shifts
influenced by attachment style.
Study objective
Examining inter-personal distance in Virtual Reality in patients with
persisting psychopathology and a control group in order to assess the
association with attachment styles. Differences in gender will also be
examined.
Primary research question and hypotheses: 1.1. Does attachment style relate to
interpersonal distance in a Distance Closeness Paradigm in Virtual Reality?
• a. Individuals with a higher score on an avoidant attachment style, keep more
distance towards others (in this case; the avatar in Virtual Reality), compared
with securely and anxiously attached individuals. There is a positive
correlation between avoidant attachment style and interpersonal distance.
• b. Individuals with a higher score on an anxious attachment style, keep less
distance towards others (in this case the avatar in Virtual Reality), compared
with securely and avoidantly attached individuals. There is a negative
correlation between avoidant attachment style and interpersonal distance.
Secondary hypotheses:
• 1.2. Individuals with a higher score on an avoidant attachment style, have an
increased skin conductance level and increased heartrate variability, but do
not report increased anxiety.
• 1.3. Individuals with a higher score on anxious attachment style, have an
increased skin conductance level and increased heartrate variability and report
higher anxiety levels.
• 1.4. No differences are expected between male and female participants.
• 1.5 The control group is expected to have generally lower scores then the
patient population, although no differences in correlations are expected.
• 1.6 There is a positive correlation between an avoidant attachment style and
autonomy.
• 1.7 There is a negative correlation between anxious attachment style and
autonomy.
Primary research question and hypotheses 2.2: Is the relation between
attachment style and interpersonal distance mediated (strengthened) when using
positive attachment priming?
• a. Individuals with a higher score on an avoidant attachment style, keep less
distance towards others (in this case; the avatar in Virtual Reality) in the
priming condition when compared with the control condition.
• b. Individuals with a higher score on an anxious attachment style, keep more
distance towards others (in this case the avatar in Virtual Reality) in the
priming condition when compared with the control condition.
• c. The same correlations are expected for the control group, although lower
differences are expected compared to the patient population.
Examining reaction time in an attention task, while patients are exposed to
different facial expressions and tasks to increase the cognitive load
(remembering a 7 digit number) in Virtual Reality in order to assess the
association between reaction time and attachment style.
Primary research question and hypotheses 3: Does attachment style relate to
reaction time from insecure attached patients due to changes in attention?
• a. Avoidantly attached patients will have an increased reaction time when an
avatar is present in the same visual area as the target, but a decreased
reaction time for targets presented away from the avatar because of a
disengaging attachment style which results in avoiding the avatar, when
compared with securely and anxiously attached individuals.
• b. Anxiously attached patients will have a decreased reaction time when an
avatar is present in the same visual area as the target, but an increased
reaction time for targets presented away from the avatar because of an engaging
attachment style which results in a focus on the avatar, when compared with
securely and avoidantly attached individuals.
• c. Securely attached patients will have no difference in reaction time
between the two target presentation locations, no matter the location of the
avatar, when compared to anxiously and avoidantly attached individuals.
Secondary hypotheses: Cognitive load influences reaction time.
• 3.2. For avoidantly attached patients: The negative effect on reaction time
when an avatar is present in the same area as the target is negated by a high
cognitive load. The reaction time normalises towards reaction times of securely
attached individuals (restores to the values in the control condition in which
no avatar is present).
• 3.3. For anxiously attached patients: The positive effect on reaction time
when an avatar is present in the same area as the target is negated by a high
cognitive load. The reaction time normalises towards reaction times of securely
attached individuals (restores to the values in the control condition in which
no avatar is present).
• 3.4. For securely attached individuals: no changes are expected.
• 3.5. The same correlations are expected for the control group, although lower
differences are expected compared to the patient population.
*
Study design
The current study has a between-groups and within-subject design
comparing the interpersonal distance between both sexes. Furthermore, reaction
time is measured multiple times within a subject. Patients complete online
questionnaires at home and participate in a social task in Virtual Reality at a
location of GGZ Breburg.
The full procedure and measurements are described in the Methods section.
Study burden and risks
Risks are non existent.
Stidstraat 1
Teteringen 4847NJ
NL
Stidstraat 1
Teteringen 4847NJ
NL
Listed location countries
Age
Inclusion criteria
Inclusion criteria
In order to be eligible to participate in this study, a subject must meet all
of the following criteria:
• DSM-5 classification for personality disorder, eating disorder, depression
and/or anxiety.
• Age of 18+.
Exclusion criteria
Exclusion criteria
A potential subject who meets any of the following criteria will be excluded
from participation in this study:
• A currenct psychotic episode
• Under influence of a substance or medicine influencing judgement,
hallucinations or the senses.
• Mental retardation.
• Insufficient Dutch language skills.
• Blindness or very poor eye sight.
• Autism.
• PTSD type 1.
- Social anxiety
- Score of >34 on SIAS questionnaire
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL70182.028.19 |