Virtual reality body exposure and attentional bias modification in the treatment of adolescents with anorexia nervosa

Anorexia nervosa (AN) is a severe psychiatric disorder characterized by intense fear of gaining weight and persistent body image disturbance. Virtual reality–based mirror exposure therapy (VR-MET) may reduce body-related fear through embodied exposure, while attentional bias modification training (A...

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Bibliographic Details
Authors: Ascione, Mariarca, Carulla-Roig, Marta, Meschberger-Annweiler, Franck-Alexandre, Serrano Troncoso, Eduardo, Blasco Martínez, Anna, Guerrero Álvarez, Fernando, Miquel, Helena, Mendoza-Medialdea, María Teresa, Porras-García, Bruno, Ferrer, Marta (Ferrer García), Moreno Sánchez, Manuel, Gutiérrez Maldonado, José
Format: article
Status:Published version
Publication Date:2026
Country:España
Institution:Universidad de Oviedo (UNIOVI)
Repository:Dipòsit Digital de la UB
OAI Identifier:oai:dnet:ubarcelona__::a20d86cd1aa2d716f613fe78b20d1eec
Online Access:https://hdl.handle.net/2445/229297
Access Level:Open access
Keyword:Adolescents
Seguiment de la mirada
Realitat virtual en la medicina
Anorèxia nerviosa
Teenagers
Eye tracking
Virtual reality in medicine
Anorexia nervosa
Description
Summary:Anorexia nervosa (AN) is a severe psychiatric disorder characterized by intense fear of gaining weight and persistent body image disturbance. Virtual reality–based mirror exposure therapy (VR-MET) may reduce body-related fear through embodied exposure, while attentional bias modification training (ABMT) may enhance exposure learning by promoting balanced attentional allocation. This controlled clinical study tested the hypothesis that adjunctive VR-MET would improve clinical outcomes beyond treatment as usual (TAU) alone, and that preceding VR-MET with ABMT would produce additional benefits in adolescent females with AN. Seventy-five female adolescents with AN were allocated to TAU, TAU+VR-MET or TAU+ABMT+VR-MET. Assessments were conducted pre- and post-intervention. Outcomes included eye-tracking indices of attentional bias (number of fixations, complete fixation time), state anxiety and fear of gaining weight, BMI and eating disorder–related measures. Compared with TAU alone, both VR-based conditions showed greater reductions in state anxiety and fear of gaining weight. State body dissatisfaction decreased significantly only in the TAU+VR-MET group. No significant changes were observed for BMI or most trait-level eating disorder measures. ABMT did not enhance clinical outcomes beyond VR-MET. Within the short-term assessment window, adjunctive VR-MET was associated with reductions in state-dependent emotional responses in adolescents with AN. Effects on trait-level symptoms were limited, and ABMT did not confer additional benefit in this unselected sample. Fully randomized studies with larger samples, extended exposure protocols, and follow-up assessments are needed to determine durability and broader clinical impact.