Introduction
phobias, comorbidity, cognitive behavior, anxiety, depressive
DISORDERS
It is estimated that one in 10 people worldwide require mental health care at any one point in time, yet only nine mental health workers are available for every 10 000 people globally (World Health Organization, With the post-pandemic reopening of societies, novel challenges relating to ‘re-entry anxiety’ (American Psychological Association, VRET has shown effectiveness in reducing aviophobia symptoms (Cardoş, David, & David, To demonstrate the potential of fully automated mobile virtual reality cognitive behavior therapy (VR-CBT) for more complex disorders, and also its long-term potential, we examined the effectiveness of a VR-CBT app for aviophobia. Aviophobia is a heterogeneous condition with large variation in onset and acquisition characteristics and with high rates of comorbidity with other phobias and anxiety disorders. This makes aviophobia more difficult to treat than other phobias (Van Almen & Van Gerwen, We hypothesized that the VR-CBT app would demonstrate a greater reduction in flight anxiety, general anxiety, and depressive symptoms from pre- to post-treatment compared to the wait-list control condition, and that these effects would be maintained at 3-month and 12-month follow-up. Furthermore, we hypothesized that the app would be rated as user-friendly and satisfactory, and that a higher sense of presence in VR, higher perceived realism of VR, and higher user-friendliness would all be associated with a larger reduction in fear-of-flying symptoms at post-test.