Mindfulness training in virtual reality for Borderline Personality Disorder symptoms: An analogue study

Mindfulness training delivered via virtual reality (VR) reduces borderline personality disorder (BPD) symptoms and increases mindfulness skills as effectively as real-world settings. In two studies, participants listened to a pre-recorded mindfulness audio while viewing either a virtual green space, a real green space, or audio alone. BPD symptoms decreased and mindfulness improved from before to after the session, with no significant differences among conditions, and effects mostly persisted at one- or two-week follow-up. VR-based mindfulness interventions may improve accessibility and engagement for patients who struggle with concentration.

Study at a glance

Abstract

Borderline Personality Disorder (BPD) is a severe, complex condition that has significant adverse effects on the physical, social, and economic well-being of patients. The mindfulness skills training module of Dialectical Behaviour Therapy (DPT) as a stand-alone treatment is an effective treatment for BPD. However, borderline patients often fail to engage in mindfulness interventions due to struggles with concentration. Virtual Reality (VR) is a new modality for the administration of mindfulness training that holds great potential in increasing engagement and access, however whether the effects of virtual environments can match that of real scenarios and traditional mindfulness practices for BPD symptoms remains unknown. In Study 1, participants (N = 58) listened to a pre-recorded mindfulness audio while either looking at a virtual green space or a real green space in a single session. In Study 2, participants (N = 26) listened to the recording under three conditions (audio-only, audio and real green space, and audio and virtual green space) and underwent three mindfulness sessions. Measures of BPD symptoms and mindfulness skills were obtained pre- and post-sessions, and at one-week follow-up in Study 1 and two-week follow up in Study 2. Results from both studies showed a significant reduction in the same BPD measure and increase in mindfulness from pre- to post-intervention, with no significant difference among conditions. This effect was mostly maintained at the follow-up. Results of both studies suggest that VR interventions including DBT based mindfulness skills training could be effectively exploited to reduce BPD symptoms by enhancing accessibility, increasing engagement and avoiding dropouts.