Improving the Approach-Avoidance Task in Virtual Reality Through Presence and Virtual Risk Situations

Automatic approach biases toward alcohol- and smoking-related cues have been implicated in the development and maintenance of addictive behaviors. Studies aiming at modifying such biases with the Approach-Avoidance Task (AAT) have shown promise in changing maladaptive approach tendencies for addiction-related cues and reducing addictive behavior. However, training effects tend to be small and partly inconsistent. For this reason, we have already developed and evaluated a VR-AAT to improve efficacy of the training. Results showed that our new VR-AAT did not change approach biases, nor other cognitive biases, but it was superior in reducing daily smoking, and both groups improved in other smoking- and health-related variables across time. To further investigate working mechanisms of Approach Bias Modification (ABM), in particular crucial training ingredients, we designed and implemented an extension for our VR-AAT application. This extension takes the form of a virtual bar, which in everyday life represents a risk situation in terms of alcohol and cigarette consumption. Combined with a high degree of presence, we hope to further improve training effectiveness as well as ecological validity. This article describes the theoretical background, the concept as well as the implementation of the virtual risk situation, and presents the planned study design.