Virtual reality martial arts training: a path to aggression regulation in children with oppositional defiant disorder (ODD)

This study examined whether virtual reality (VR)-based martial arts training, operationalized as supervised VR-based boxing, was associated with lower post-intervention aggression among boys with Oppositional Defiant Disorder (ODD). A quasi-experimental pre-test/post-test active-control design was employed with 84 boys aged 7–10 years who were assigned through a non-random, availability- and feasibility-based procedure to either the experimental group ( n = 42) or the control group ( n = 42). The experimental group completed 12 supervised sessions of VR-based boxing over four weeks using Meta Quest 3 headsets and The Thrill of the Fight, whereas the control group participated in a time- and attention-matched structured non-VR physical activity program. Aggression was assessed before and immediately after the intervention using the parent-completed Children’s Aggression Questionnaire. After controlling for the corresponding baseline scores, analysis of covariance revealed significant group effects for overall aggression, F(1, 81) = 20.36, p < 0.001, ηp² = 0.20; verbal aggression, F(1, 81) = 18.81, p < 0.001, ηp² = 0.19; physical aggression, F(1, 81) = 19.25, p < 0.001, ηp² = 0.19; relational aggression, F(1, 81) = 17.50, p < 0.001, ηp² = 0.18; and impulsive anger, F(1, 81) = 15.31, p < 0.001, ηp² = 0.16. Baseline-adjusted pairwise comparisons indicated significantly lower post-test aggression scores in the VR-based boxing group across all outcomes. These findings suggest that supervised VR-based boxing, as the specific martial arts format evaluated in this study, may warrant consideration as an adjunct approach to aggression regulation in boys with ODD.