A Gamified Approach for Alcohol Use Disorder Therapy in Virtual Reality: A Randomized Trial

Alcohol Use Disorder (AUD) is a medical condition in which the affected person cannot control their own alcohol consumption. Traditional therapy methods, like Cue-Exposure Therapy (CET), exist, but high relapse rates show room for improvement. Modern technology, such as virtual reality (VR), provides new possibilities for therapy. This paper presents the continuation of development of a prototype designed to explore the following hypotheses: (1) VR-based CET can generate emotional, mental, and physiological reactions in patients in AUD therapy. (2) Different control options in the prototype result in differences in perceived immersion and motion sickness. To investigate the hypotheses, a prototype is updated with the inclusion of individualization, a new exposure scenario, and free walking as a new controlling option. Afterward, an exploratory feasibility study was conducted as a randomized trial with patients in AUD therapy. 58 participants were recruited for this study. Data were collected through standardized questionnaires and psychophysiological measurements. Results show significant decreases of negative emotions, anxiety and craving. Contrary, the perceived threat significantly increases from baseline to exposure. The interaction option "controller" provides a significantly higher challenge than "hand tracking" but no significant differences are found in perceived immersion and motion sickness. Between a baseline scenario and the exposure scenario, electrodermal activity of the skin significantly increases, suggesting physiological effects through virtual exposure. The results of the study offer various possibilities for future development, like inclusion of artificial intelligence and other human senses.