The lack of dissemination seems to be partly rooted in the core element of exposure treatment, namely ‘exposure to the feared stimulus’. The current gold-standard to treat fear of heights is in vivo exposure therapy, where patients expose themselves with the feared stimuli 8, 9. Nonetheless, treatment seeking and uptake in clinical practice is still limited 3, despite existing treatment options with high success rates for acute symptom improvement in up to 80% of patients.
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Affected people report a considerable impact on interpersonal interactions and quality of life in general 7. This might lead to a profound impact on daily life and can result in functional impairment for the sufferers. Compared to other specific phobias, these triggers are widespread, including not only unusual encounters as high mountains or cliffs, but also daily life encounters, such as stairs, terraces, bridges, apartments, and offices located in high buildings 6. For those affected, exposure to height situations sets off strong emotional and physiological reactions, such as intense fear or panic and accelerated heart rate, often resulting in avoidance of specific height triggers 1, 4. Repeated use of our stand-alone, smartphone-based VR exposure app reduces avoidance behavior and fear, providing a low-threshold treatment for fear of heights.įear of heights is a common problem with a lifetime prevalence of around 20–30% and with around 5% of the general population meeting diagnostic criteria of the American and international classification for specific phobia (natural-environmental type: heights) 1, 2, 3, 4, 5. After phase 2, but not phase 1, participants in the Easy Heights condition showed significantly higher BAT scores compared to participants in the control condition (Cohen’s d = 1.3, p = 0.0001). Primary outcome was performance in a real-life Behavioral Avoidance Test (BAT) on a lookout tower after a single 1-h app use (phase 1) and after additional repeated (6 × 30 min) app use at home (phase 2). We recruited 70 participants with fear of heights, aged 18–60 years.
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We performed a single-blind, parallel group, randomized controlled trial. Objective of this study was to develop a stand-alone, smartphone-based VR exposure app- Easy Heights-and to test its effectiveness in a real-life situation. Demonstration of effectiveness in real-life situations of such apps is crucial, but lacking so far. Smartphone-based virtual reality (VR) applications (apps) might help to counter low utilization rates of available treatments for fear of heights.