November 5, 2018

Joseph McGuire is determined to change status quo treatments for young people with anxiety and obsessive-compulsive disorder (OCD). “Even with the best treatments available to us,” says the Johns Hopkins clinical psychologist and researcher, “outcomes for adolescents with anxiety or OCD aren’t great. And, even those teens who exhibit significant improvement often still have lingering symptoms.”

McGuire is conducting a virtual reality (VR) study—one of only a handful of such studies—to understand how adolescents acquire and eliminate fear—key aspects underlying the emergence and treatment of anxiety and OCD. The VR technology is a head-mounted display that portrays realistic and interactive computer-generated environments.

To perform the study, McGuire will evaluate whether adolescents (with and without these psychiatric conditions) become afraid of abstract stimuli, such as colored lamps, in an immersive VR environment. The adolescents will then go through steps to eliminate learned fear—which parallels the cognitive-behavioral treatment process. After that, McGuire will use immersive VR to place adolescents in a new virtual environment with the same abstract stimuli to investigate whether they experience a fear response.

If McGuire can identify which aspects of fear extinction are most challenging for adolescents with anxiety or OCD, he can devise strategies to spark associations that better inhibit fear across settings. This is important because fears related to anxiety and OCD are often experienced in one setting—for example, home or school—but are regularly treated in another context, such as a therapist’s office.

“If we can improve our understanding of how adolescents acquire and eliminate fear across settings, it would lead to better clinical outcomes,” McGuire explains. “Immersive VR provides an engaging opportunity to get kids involved in therapy and to help researchers study learning processes that apply in the real world. It seems like a natural fit for young people.”

The study is based on McGuire’s previous research on fear conditioning and extinction learning in adolescents with OCD. He expects the study to last for several years.

Read McGuire’s latest published paper on this approach to cognitive behavioral therapy for children and teens.

To refer patients for the study, please contact jfmcguire@jhmi.edu.