VR for Hope: A Brief VR Self-help Protocol to Enhance Hope and Well-being in Young Adults

Catholic University of the Sacred Heart40 enrolled

Overview

The objective of this study is to evaluate the feasibility of a brief self-help protocol based on immersive Virtual Reality (VR) to promote hope and psychological well-being in young adults while enhancing their mentalization capacity. The intervention consists of five sessions. The first session will be conducted in person and features an immersive VR experience, while the subsequent sessions will be delivered in a self-help format via audio and video materials. The intervention is designed to guide participants through personal reflection on key aspects of individual experience, such as hope and the understanding of one's own and others' mental states. Participants will complete self-report questionnaires before (T0) and after (T1) the intervention to assess levels of hope, psychological well-being, and mentalization capacity.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Healthy Participants Young Adults

Interventions

VR for Hope implements a structured five-session protocol delivered over one week, centered on an immersive metaphorical virtual scenario titled "The River and the Leaf." Each exercise is linked to a specific symbolic element of the digital environment. In every session, participants first explore the virtual scenario and then complete a brief 10-minute guided exercise delivered through a prerecorded audio track, focusing on a particular symbolic element of the environment. Session 1 is conducted in person using immersive virtual reality; after experiencing the VR scenario, participants are guided to identify their achieved goals and their personal resources. Sessions 2-5 are completed remotely via smartphone and lead participants through different metaphorical elements of the virtual experience (e.g., the serene river, the sinking and resurfacing leaf, and the rose garden) to reflect on personal experiences, obstacles, personal resources, mentalization, and future achievements.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 30 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 18 and 30 years. * Native Italian speakers or individuals with excellent comprehension of spoken and written Italian. Exclusion Criteria: * History of neurological disorders, presence of clinically significant maladaptive personality traits.

Outcomes

Primary Outcomes

Adult Hope Scale (AHS)

The Adult Hope Scale (AHS) (Snyder et al., 1991; Italian version translated by Alfieri et al., 2023) is a 12-item measure assessing dispositional hope in adults. The construct of hope is based on two core components: the ability to sustain motivation and determination to achieve meaningful goals (agency) and the capacity to identify pathways and strategies to overcome obstacles along the way (pathways). The scale consists of statements rated on a 4-Likert scale that assess both cognitive and affective aspects of hope. Total scores range from 8 to 32, where higher scores reflect a greater level of hope.

Time frame: This questionnaire will be administered at T0 (baseline) and T1 (post-intervention - one week after the baseline assessment and immediately following the final exercise of the intervention).

Certainty about Mental States Questionnaire (CAMSQ)

The Certainty about Mental States Questionnaire (CAMSQ) (Müller et al., 2023; Italian version currently under validation by De Salve et al.) is a self-report measure of perceived mentalizing, defined as the ability to interpret one's own and others' mental states. The questionnaire consists of 20 items rated on a 7-point Likert scale ranging from 1 (never) to 7 (always). The instrument assesses two dimensions of mentalizing: certainty about one's own mental states and certainty about others' mental states. The scale was translated into Italian using a back-translation procedure, approved by the original German authors, and uploaded to the Open Science Framework (OSF). Higher scores reflect a greater level of perceived mentalizing.

Flourishing Scale (FS)

The Flourishing Scale (FS) developed by Ryan and Deci (2001; Italian version Di Fabio, 2010), aims to investigate the elements that make up psychological well-being, including relationships, self-esteem, life purpose, and optimism. It consists of 8 items, and each is positively worded, and responses are measured on a 7-step Likert scale, where 1 means "strongly disagree" and 7 means "strongly agree." The score range is from 8 to 56 and higher scores reflect a greater level of flourishing.

Mental Health Continuum Short Form (MHC-SF)

The Mental Health Continuum Short Form (MHC-SF) was developed by Keyes (2002; Petrillo et al., 2015) to measure emotional, social, and psychological well-being. The scale consists of 14 items, which can be answered using a 6-point Likert scale, where 0 indicates "never" and 5 "every day." To assess the three dimensions, the questionnaire is divided into three subscales: the Emotional Well-Being scale (EWB, items 1-3), the Social Well-Being scale (SWB, items 4-8), and the Psychological Well-Being scale (PWB, items 9-14). Higher scores on the MHC-SF indicate greater well-being.

Secondary Outcomes

Personality Inventory for DSM-5 - Brief Form (PID-5-BF)

The Personality Inventory for DSM-5 - Brief Form (PID-5-BF) (Italian version by Fossati et al., 2017) is a self-report questionnaire developed to assess functioning across five personality domains: Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism. The instrument consists of 25 items rated on a four-point scale ranging from 0 (Very False or Often False) to 3 (Very True or Often True). Higher average scores in each of the 5 domains indicate higher levels of the specific pathological personality trait.

Time frame: This questionnaire will be administered at T0 (baseline).

Perceived usefulness and pleasantness of the exercises

Two ad hoc items to investigate perceived usefulness and pleasantness of the exercise just done. After each activity of the intervention, participants will be asked to rate perceived usefulness and pleasantness through a 7-step Likert scale where 1 corresponds to "very little" and 7 to "very much."

Time frame: These items will be administered immediately after each of the 5 activities of the intervention.

Satisfaction and acceptability of the intervention

Participants' satisfaction with the intervention will be assessed through two ad hoc items designed to evaluate overall appreciation of the activities and the perceived ease of completing the remote sessions. Responses will be rated on a 5-point Likert scale ranging from 1 (not at all) to 5 (very much).

Time frame: These items will be administered at T1 (post-intervention - one week after the baseline assessment and immediately following the final exercise of the intervention).