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. 2025 Aug 7;12:e70160. doi: 10.2196/70160

Table 2.

State-based measures before (T1) and after (T2) the virtual reality (VR; n=9) and audio (n=11) exercises with associated statistics.a


Before (T1), mean (SD) After (T2), mean (SD) Repeated measures statistics Cohen d (95% CI)



t test (df) P value
NTAb: thought negativity

VR 7.78 (1.39) 5.78 (2.22) 2.00 (8) .08 0.67 (−0.08 to 1.38)

Audio 9.18 (0.87) 6.64 (2.01) 5.37 (10) <.001 1.62 (0.69 to 2.52)
NTA: thought discomfort

VR 8.56 (1.33) 6.11 (2.67) 2.72 (8) .03 0.91 (0.10 to 1.67)

Audio 9.00 (1.18) 5.36 (1.75) 6.90 (10) <.001 2.08 (0.99 to 3.14)
NTA: thought accuracy

VR 7.33 (2.45) 5.78 (3.83) 1.90 (8) .09 0.63 (−0.10 to 1.34)

Audio 7.45 (2.30) 6.18 (2.09) 1.81 (10) .10 0.55 (−0.10 to 1.17)
NTA: thought importance

VR 8.56 (1.88) 7.22 (2.28) 1.60 (8) .15 0.53 (−0.18 to 1.22)

Audio 8.45 (1.81) 7.09 (2.88) 2.01 (10) .07 0.61 (−0.05 to 1.24)
SCFQc: defusion

VR 44.00 (4.72) 31.11 (12.41) 3.02 (8) .02 1.01 (−0.23 to 1.08)

Audio 43.27 (3.82) 26.09 (6.83) 10.31 (10) <.001 3.11 (1.63 to 4.56)
BSRId: rumination

VR 479.67 (201.35) 366.44 (231.47) 1.19 (8) .27 0.40 (−0.30 to 1.07)

Audio 605.00 (106.57) 410.55 (133.94) 6.14 (10) <.001 1.85 (0.84 to 2.83)
POMSe: tension

VR 15.44 (2.30) 13.33 (3.84) 1.20 (8) .27 0.40 (−0.29 to 1.07)

Audio 15.18 (3.25) 10.09 (3.65) 7.08 (10) <.001 2.13 (1.03 to 3.21)
POMS: depression

VR 15.33 (3.08) 12.33 (4.33) 2.11 (8) .07 0.70 (−0.05 to 1.42)

Audio 16.18 (3.28) 11.72 (2.83) 5.64 (10) <.001 1.70 (0.74 to 2.63)
POMS: anger

VR 10.78 (1.86) 6.67 (1.66) 4.14 (8) .003 1.38 (0.43 to 2.29)

Audio 9.64 (4.11) 6.00 (2.28) 4.98 (10) .001 1.50 (0.61 to 2.36)
POMS: fatigue

VR 13.22 (5.07) 12.33 (5.22) 1.40 (8) .20 0.47 (−0.24 to 1.15)

Audio 17.09 (2.21) 15.82 (3.57) 1.85 (10) .09 0.56 (−0.09 to 1.18)
POMS: confusion

VR 13.44 (2.70) 11.33 (3.91) 1.51 (8) .17 0.50 (−0.21 to 1.19)

Audio 12.82 (3.71) 9.82 (2.14) 3.93 (10) .003 1.19 (0.39 to 1.95)
POMS: vigor

VR 7.78 (3.49) 9.22 (3.70) −1.55 (8) .16 −0.52 (−1.20 to 0.20)

Audio 7.09 (2.26) 7.27 (3.17) −0.18 (10) .86 −0.05 (−0.64 to 0.54)
SUDSf: distress

VR 58.56 (30.00) 43.44 (25.58) 1.38 (8) .20 0.46 (−0.24 to 1.14)

Audio 59.36 (18.90) 35.09 (18.16) 4.96 (10) .001 1.49 (0.60 to 2.35)
TMSg,h state mindfulness: decentering subscale

VR i 24.00 (6.67)

Audio 26.27 (5.22)
TMS g state mindfulness: curiosity subscale

VR 21.44 (7.52)

Audio 22.91 (3.94)

aPositive effect sizes represent improvement.

bNTA: Negative Thought Assessment.

cSCFQ: State Cognitive Fusion Questionnaire.

dBSRI: Brief State Rumination Inventory.

ePOMS: Profile of Mood States–Adolescents.

fSUDS: Subjective Units of Distress Scale.

gCompleted after each exercise; therefore, there are no data from the “before” time point for this measure.

hTMS: Toronto Mindfulness Scale–State Version.

iNot applicable.