Evidence map›Paper›PMID 42037481›Full record

Trial reportPsychological medicine2026

Treatment effect modifiers of virtual reality-based versus standard cognitive behavioral therapy for paranoia in schizophrenia spectrum disorders: an exploratory moderator analysis of clinical and demographic characteristics in the FaceYourFears trial.

Mads Juul Christensen, Ditte Lammers Vernal, Ulrik Nykjær Jeppesen, Carsten Hjorthøj, Jan Mainz, Amy Pinkham, Stephen Austin, Wim Veling, Thomas Ward, Merete Nordentoft and 1 more

Abstract readEquivalence TrialMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Psychological medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mads Juul ChristensenDepartment of Psychiatry, https://ror.org/02jk5qe80Aalborg University Hospital, Aalborg, North Denmark Region, Denmark.ORCID 0009-0008-2788-5642
Ditte Lammers VernalDepartment of Psychiatry, https://ror.org/02jk5qe80Aalborg University Hospital, Aalborg, North Denmark Region, Denmark.ORCID 0000-0001-5096-2281
Ulrik Nykjær JeppesenDepartment of Psychology, https://ror.org/035b05819University of Copenhagen, Denmark.ORCID 0000-0002-9481-1554
Carsten HjorthøjDepartment of Public Health, https://ror.org/035b05819University of Copenhagen, Denmark.ORCID 0000-0002-6943-4785
Jan MainzDepartment of Psychiatry, https://ror.org/02jk5qe80Aalborg University Hospital, Aalborg, North Denmark Region, Denmark.ORCID 0000-0003-0242-9233
Amy PinkhamSchool of Behavioral and Brain Sciences, https://ror.org/049emcs32University of Texas at Dallas, USA.ORCID 0000-0003-2803-4520
Stephen AustinDepartment of Psychology, https://ror.org/035b05819University of Copenhagen, Denmark.ORCID 0000-0001-5988-0565
Wim VelingCentre of Psychiatry, University Medical Center Groningen, Faculty of Medical Sciences, https://ror.org/03cv38k47University of Groningen, Netherlands.ORCID 0000-0002-1364-9779
Thomas WardSouth London & Maudsley NHS Foundation Trust, London, UK.ORCID 0000-0002-7608-5755
Merete Nordentofthttps://ror.org/035b05819Copenhagen Research Centre for Mental Health (CORE), Capital Region, Denmark.ORCID 0000-0003-4895-7023
Louise Birkedal GlenthøjDepartment of Psychology, https://ror.org/035b05819University of Copenhagen, Denmark.ORCID 0000-0003-3621-8450

Funding

Danmarks Frie Forskningsfond 0134-00066BFonden til Lægevidenskabens Fremme L-2021-00244TrygFonden 148727
6 · The paper itself

Abstract

backgroundThis exploratory study examined baseline characteristics modifying treatment effects on paranoia in individuals diagnosed with schizophrenia spectrum disorders following a 10-session virtual reality-based cognitive behavioral therapy for psychosis (VR-CBTp) or standard CBTp.

methodsAll participants in the FaceYourFears trial were included (

resultsAcross treatments, higher baseline avolition, safety behavior, delusion severity, and cognitive biases were associated with end-of-treatment paranoia. Moderation analyses revealed interactions for avolition, delusion severity, and negative other-beliefs. Although avolition and delusion severity were associated with poorer outcomes overall, individuals with high avolition and those with moderate-to-high delusion severity improved more in VR-CBTp than CBTp, whereas participants with lower delusion severity showed better outcomes in CBTp. No demographic (age, gender, education, and occupation) or other clinical characteristics (diagnosis, paranoia, social anxiety, depression, anhedonia, total negative symptoms, functioning, core beliefs, or interpersonal trauma) were significantly associated with outcome.

conclusionsThis exploratory study generates hypotheses for future research, including VR-CBTp's potential to engage individuals with high avolition. Given the modest effects and largely nonsignificant findings, both CBTp and VR-CBTp appear suitable for a wide range of individuals with paranoia, highlighting the importance of considering patient preferences.

Indexed as

Cognitive Behavioral TherapyParanoid DisordersPsychotic DisordersSchizophreniaVirtual Reality Exposure TherapyAdultDelusionsFemaleHumansMaleMiddle AgedTreatment Effect HeterogeneityTreatment OutcomeVirtual Realitycognitive behavioral therapydelusionseffect modifierimmersive virtual realityparanoiapsychosisschizophrenia spectrum disorders

Identifiers

PMID42037481
PMCPMC13125928

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.