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Raila H, Avanesyan T, Valentine KE, Koo B, Huang C, Tsutsumi Y, Andreeff E, Qiu T, Muñoz Rodríguez PA, Varias A, Filippou-Frye M, van Roessel P, Bullock K, Periyakoil VS, Rodríguez CI. Augmenting group hoarding disorder treatment with virtual reality discarding: A pilot study in older adults. J Psychiatr Res 2023; 166:25-31. [PMID: 37716272 PMCID: PMC10803069 DOI: 10.1016/j.jpsychires.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/26/2023] [Accepted: 08/08/2023] [Indexed: 09/18/2023]
Abstract
Hoarding disorder is common and debilitating, especially in older adults, and novel treatment approaches are needed. Many current treatments emphasize skills related to discarding and decision-making about possessions, which can be practiced in the patient's home. However in many cases, in-home visits are unfeasible, or real-life discarding is too difficult. Virtual reality (VR) offers the ability to create a virtual "home" including 3D scans of the patient's actual possessions that can be moved or discarded. VR discarding is an alternative to in-home visits and an approach that provides a stepping stone to real-life discarding. VR has been successfully utilized to treat many disorders but tested minimally in hoarding disorder. In nine older adults with hoarding disorder, we tested an 8-week VR intervention administered to augment a 16-week Buried in Treasures group treatment. Individualized VR rooms were uniquely modeled after each patient's home. During clinician-administered VR sessions, patients practiced sorting and discarding their virtual possessions. The intervention was feasible to administer. Open-ended participant responses, examined by two independent evaluators, indicated that VR sessions were well-tolerated and that participants found them useful, with nearly all participants noting that VR helped them increase real-life discarding. Self-reported hoarding symptoms decreased from baseline to close, with seven of the nine participants showing reliable improvement in this timeframe and none showing deterioration. Results from this exploratory pilot study suggest that VR is a feasible way to simulate an at-home sorting and discarding experience in a manner that may augment skills acquisition. It remains an open question whether VR discarding practice yields greater improvement than existing treatments. VR for this population merits further clinical investigation.
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Affiliation(s)
- Hannah Raila
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Department of Psychology, University of California Santa Cruz, Santa Cruz, CA, USA.
| | - Tatevik Avanesyan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Keara E Valentine
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Brenden Koo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Chloe Huang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Yuri Tsutsumi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Elisabeth Andreeff
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Tori Qiu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Paula Andrea Muñoz Rodríguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Andrea Varias
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Maria Filippou-Frye
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Peter van Roessel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Kim Bullock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Vyjeyanthi S Periyakoil
- Department of Medicine, Stanford University, Palo Alto, CA, USA; Extended Care and Palliative Medicine Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Carolyn I Rodríguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
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