Exploring treatment moderators in a randomized clinical trial of virtual reality-based vs. standard cognitive behavioral therapy for paranoia.
Dawid Kruk, Elise C D van der Stouwe, Maureen Berkhof et al.
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In 30 seconds
This randomized clinical trial secondary analysis explored whether clinical and sociodemographic characteristics moderated response to virtual reality-based cognitive behavioral therapy for psychosis (VR-CBTp) versus standard CBTp. It included 81 individuals with a psychotic disorder and paranoid ideation, randomized to up to 16 sessions. Higher baseline momentary safety behaviors predicted greater VR-CBTp benefit for questionnaire- and experience-sampling measures of paranoia; baseline paranoid ideation also moderated momentary paranoia response in favor of VR-CBTp. Analyses were exploratory and did not correct for multiple comparisons.
Key findings
- Higher baseline momentary safety behaviors predicted greater VR-CBTp benefit for paranoid ideation and momentary paranoia.
- Baseline paranoid ideation moderated momentary paranoia response, favoring VR-CBTp.
- No moderation effects emerged for the other clinical or sociodemographic factors examined.
Why it matters
The findings suggest that safety behaviors and severity of paranoid ideation may help identify patients who could benefit more from VR-CBTp than standard CBTp. This is relevant to efforts to tailor psychological treatment, but the exploratory analyses provide preliminary rather than definitive evidence for treatment selection.
What to keep in mind
The moderator analyses were exploratory and did not correct for multiple comparisons; the secondary analysis included 81 participants.