Can Virtual Art and Attachment Priming Decrease Pain and Social Disconnection Among Individuals Living with Chronic Pain and Loneliness? A Randomized Controlled Trial Using a Non-Immersive Virtual Reality Serious Game (Preprint)

Abstract

Pain is a leading cause of disability around the world and severely impacts quality of life for millions of Americans. Arts engagement and virtual reality serious games represent promising non-pharmacological self-management treatment approaches to chronic pain. This study is the first randomized controlled trial to explore the impact of a browser-based virtual art museum serious game on pain and social disconnection among individuals living with chronic pain and loneliness.

To test the joint and separate effects of exposure to virtual art and attachment figure priming on pain and social disconnection among individuals living with chronic pain and loneliness.

This randomized controlled trial employed a 2 (virtual artwork present, absent) by 2 (secure attachment, avoidant attachment prime) repeated measures factorial online experimental design with a hanging control condition. Mediation and moderation analyses examined how feelings about the social world triggered by the artwork and frequency of museum visits impacted the effects of the interventions on pain and social disconnection.

This study enrolled 311 participants. Mean age 42.78 years old (SD = 13.11, Min = 18, Max = 76) and 60.2% women. Post-test pain was lower than pre-test pain for the artwork present and absent conditions. Similarly, post-test pain was lower than pre-test pain for the secure and avoidant priming conditions. Relative to the control group, artwork present and absent conditions had decreased post-test pain compared with the control group. The secure attachment and avoidant attachment priming conditions also had lower post-test pain scores relative to the hanging control group. Moreover, social disconnection decreased from pre- to post-test for both the artwork present and the secure attachment conditions. Relative to the control group, post-test social disconnection was lower for the artwork present and secure attachment priming condition. The artwork-secure attachment and artwork-avoidant attachment conditions had lower post-test pain scores compared with the control group. Social disconnection decreased from pre- to post-test for the artwork-secure attachment and no artwork-secure attachment conditions. Post-test social disconnection was lower for the artwork present-secure attachment condition compared with the control group. Feelings about the social world and frequency of museum visits played a mediating and moderating role in these effects. Positive feelings about the social world were associated with decreased pain and social disconnection, and these effects operated on individuals exposed to virtual artwork at low, medium, and high frequency of physical museum visits.

Relative to a control group, visiting a virtual art museum reliably decreased pain and social disconnection among individuals living with chronic pain and loneliness. Engaging with virtual artwork that triggers positive feelings about the social world may mitigate the burden of chronic pain.

Trial Registration: ClinicalTrials.gov NCT05310747 and OSF - https://osf.io/q7un3