A cognitive reappraisal intervention for the reduction of anxiety in eating disorders: an experimental study with exposure in virtual reality

Eating disorders are serious psychological disorders that often involve the
experience of anxiety. Many individuals with eating disorders (EDs) use ED
behaviours (i.e. dieting, purging or binging) to regulate anxiety. Over time,
ED behaviours will function as an emotion regulation (ER) strategy. Empirical
studies suggest a greater use of maladaptive ER strategies and a reduced
utilization of adaptive ER strategies in populations with EDs compared to a
healthy population. Related to the important role of adaptive ER strategies in
the regulation of anxiety it appears crucial to train these strategies to
people with EDs. Most existing experiments that train adaptive emotion
regulation strategies for the reduction of anxiety are however conducted by
showing pictures and videos of anxious situations in a laboratory setting. This
limits the interaction between the individual and environment, resulting in a
reduced induction of anxiety. Virtual reality (VR) provides an alternative to
this exposure by reproducing a real life environment, and stimulating an
individual*s presence and interaction with that environment. Although there are
several benefits of VR in inducing anxiety and practicing adaptive ER
strategies like reappraisal, these elements are not combined in a study in the
ED field. Evidence from related psychological fields indicates that training ER
techniques in VR can be effective in the reduction of anxiety. These findings
have implications for ED research, by proposing that cognitive reappraisal
strategies can be effective in the reduction of anxiety when exposed to anxious
situations in VR.

The current study investigates the effectiveness of an intervention that
focusses on the adaptive emotion regulation strategy cognitive reappraisal for
people with EDs in the reduction of anxiety. This intervention will be compared
to a control task. Anxiety will be induced by exposing people with EDs to a VR
restaurant setting. Furthermore, the severity of the eating disorder and
existing emotion regulation strategies and the subtype of the eating disorder
will be examined to identify for which persons the intervention is effective in
the reduction of anxiety.

The study will have an experimental design. The experimental group will be
exposed to a cognitive reappraisal intervention in a VR restaurant. In the
control group people will be exposed to the same restaurant setting but they
will do a suppression task.

Burdens are remained at an acceptable level since participants* engagement in
the study includes a single session and takes approximately two hours. It is
possible that participants experience nausea during the experiment. To prevent
this, participants sit in the normal and the VR environment. When participants
participant in the experiment, they receive a Bol.com ¤10 gift card and travel
allowance

Burdens are remained at an acceptable level since participants* engagement in
the study includes a single session and takes approximately two hours, and the
questionnaire focussing on EDs can be completed at home. It is possible that
they experience nausea and some stress during the experiment. To prevent this,
participants sit in the normal and the VR environment. When participants
complete the experiment, they receive a Bol.com ¤20 gift card and travel
allowance.