Aversive eye gaze during a speech in virtual environment in patients with social anxiety disorder

2017 ◽  
Vol 52 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Haena Kim ◽  
Jung Eun Shin ◽  
Yeon-Ju Hong ◽  
Yu-Bin Shin ◽  
Young Seok Shin ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Virtual Environment ◽  
Social Anxiety Disorder ◽  
Eye Gaze ◽  
Healthy Controls ◽  
Social Evaluation ◽  
Different Types ◽  
Gaze Behaviour

Objective: One of the main characteristics of social anxiety disorder is excessive fear of social evaluation. In such situations, anxiety can influence gaze behaviour. Thus, the current study adopted virtual reality to examine eye gaze pattern of social anxiety disorder patients while presenting different types of speeches. Methods: A total of 79 social anxiety disorder patients and 51 healthy controls presented prepared speeches on general topics and impromptu speeches on self-related topics to a virtual audience while their eye gaze was recorded. Their presentation performance was also evaluated. Results: Overall, social anxiety disorder patients showed less eye gaze towards the audience than healthy controls. Types of speech did not influence social anxiety disorder patients’ gaze allocation towards the audience. However, patients with social anxiety disorder showed significant correlations between the amount of eye gaze towards the audience while presenting self-related speeches and social anxiety cognitions. Conclusion: The current study confirms that eye gaze behaviour of social anxiety disorder patients is aversive and that their anxiety symptoms are more dependent on the nature of topic.

scholarly journals Appropriate Number of Treatment Sessions in Virtual Reality-Based Individual Cognitive Behavioral Therapy for Social Anxiety Disorder

2021 ◽  
Vol 10 (5) ◽  
pp. 915
Author(s):  
Hyu Seok Jeong ◽  
Jee Hyun Lee ◽  
Hesun Erin Kim ◽  
Jae-Jin Kim
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioral Therapy ◽  
Social Anxiety Disorder ◽  
Behavioral Therapy ◽  
Early Termination ◽  
Cognitive Behavioral ◽  
Significant Group ◽  
Extension Group

Virtual reality (VR) was introduced to maximize the effect of cognitive behavioral therapy (CBT) by efficiently performing exposure therapy. The purpose of this study was to find out whether VR-based individual CBT with relatively few treatment sessions is effective in improving social anxiety disorder (SAD). This therapy was applied to 115 patients with SAD who were retrospectively classified into 43 patients who completed the nine or 10 sessions normally (normal termination group), 52 patients who finished the sessions early (early termination group), and 20 patients who had extended the sessions (session extension group). The Brief Fear of Negative Evaluation Scale (BFNE) scores tended to decrease in all groups as the session progressed, and the slope of decrease was the steepest in the early termination group and the least steep in the session extension group. Severity of social anxiety in the last session and symptom reduction rate showed no significant group difference. Our findings suggest that short-term VR-based individual CBT of nine to 10 sessions may be effective. When the therapeutic effect is insufficient during this period, the additional benefit may be minimal if the session is simply extended. The improvement in the early termination group suggests that even shorter sessions of five or six can also be effective.

Feasibility of Virtual Reality Environments for Adolescent Social Anxiety Disorder

2016 ◽  
Vol 26 (7) ◽  
pp. 825-835 ◽  
Author(s):  
Danielle E. Parrish ◽  
Holly K. Oxhandler ◽  
Jacuelynn F. Duron ◽  
Paul Swank ◽  
Patrick Bordnick
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder

Using Virtual Reality in the Treatment of Social Anxiety Disorder: Technological Proposal

2021 ◽  
pp. 369-374
Author(s):  
Carlos Ramos-Galarza ◽  
Pamela Acosta-Rodas ◽  
Jaime Moscoso-Salazar ◽  
Omar Condor-Herrera ◽  
Jorge Cruz-Cárdenas
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder

Orbitofrontal hyperactivity in social anxiety disorder patients: An fmri study

2011 ◽  
Vol 26 (S2) ◽  
pp. 179-179 ◽  
Author(s):  
R. Sladky ◽  
C. Kraus ◽  
J. Tröstl ◽  
S. Kasper ◽  
R. Lanzenberger ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Orbitofrontal Cortex ◽  
Posterior Cingulate Cortex ◽  
Functional Coupling ◽  
Healthy Controls ◽  
Brain Volumes ◽  
Significant Difference ◽  
Image Position

IntroductionSocial anxiety disorder (SAD) refers to persistent fear of social situations in which the person is exposed to possible scrutiny by others. Anxiety disorders are associated with dysbalanced inhibition within the limbic system towards threatening stimuli (Phillips 2003). It has been shown SAD patients are particularly sensitive towards faces displaying harsh emotions (Phan 2006).ObjectivesIn this study we used fMRI to investigate activation differences between 14 SAD patients and 15 matched healthy controls. The subjects performed a facial emotion discrimination paradigm including a control condition using shape discrimination (modified version of Hariri 2002).AimsThe aim of this study was to investigate emotion task-specific differences in brain activation of patients and healthy controls.MethodsAfter clinical assessment, 225 whole-brain volumes (TR = 1.8s) were acquired on a Siemens TRIO 3T MR scanner and analyzed using SPM8.ResultsThe paradigm activated the amygdalae, the fusiform gyri, the posterior cingulate cortex and the orbitofrontal cortex (OFC) (A). There was a hyperactivation of the OFC in patients compared to healthy controls (B). We found no significant difference in the amygdalae or fusiforme gyrus.ConclusionAlthough not in a social threat situation, SAD patients showed more activity in the orbitofrontal cortex. In contrast to other studies we found no differences in other brain areas indicating an optimized control condition. According to the functional coupling between prefrontal areas and the amygdalae, these data are consistent with an increased effort in down-regulating amygdalar activation by the orbitofrontal cortex.

The Course of the Working Alliance during Virtual Reality and Exposure Group Therapy for Social Anxiety Disorder

2013 ◽  
Vol 43 (2) ◽  
pp. 167-181 ◽  
Author(s):  
Irene Ngai ◽  
Erin C. Tully ◽  
Page L. Anderson
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Group Therapy ◽  
Cognitive Behavioral Therapy ◽  
Working Alliance ◽  
Social Anxiety Disorder ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Exposure Group

Background: Psychoanalytic theory and some empirical research suggest the working alliance follows a “rupture and repair” pattern over the course of therapy, but given its emphasis on collaboration, cognitive behavioral therapy may yield a different trajectory. Aims: The current study compares the trajectory of the working alliance during two types of cognitive behavioral therapy for social anxiety disorder – virtual reality exposure therapy (VRE) and exposure group therapy (EGT), one of which (VRE) has been proposed to show lower levels of working alliance due to the physical barriers posed by the technology (e.g. no eye contact with therapist during exposure). Method: Following randomization, participants (N = 63) diagnosed with social anxiety disorder received eight sessions of manualized EGT or individual VRE and completed a standardized self-report measure of working alliance after each session. Results: Hierarchical linear modeling showed overall high levels of working alliance that changed in rates of growth over time; that is, increases in working alliance scores were steeper at the beginning of therapy and slowed towards the end of therapy. There were no differences in working alliance between the two treatment groups. Conclusion: Results neither support a rupture/repair pattern nor the idea that the working alliance is lower for VRE participants. Findings are consistent with the idea that different therapeutic approaches may yield different working alliance trajectories.

scholarly journals Social anxiety disorder and shame cognitions in psychosis

2012 ◽  
Vol 43 (1) ◽  
pp. 133-142 ◽  
Author(s):  
M. Michail ◽  
M. Birchwood
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Status ◽  
Social Anxiety Disorder ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Shame Proneness ◽  
Perceived Social Status ◽  
The Relationship

BackgroundSocial anxiety disorder (SAD) is surprisingly prevalent among people with psychosis and exerts significant impact on social disability. The processes that underlie its development remain unclear. The aim of this study was to investigate the relationship between shame cognitions arising from a stigmatizing psychosis illness and perceived loss of social status in co-morbid SAD in psychosis.MethodThis was a cross-sectional study. A sample of individuals with SAD (with or without psychosis) was compared with a sample with psychosis only and healthy controls on shame proneness, shame cognitions linked to psychosis and perceived social status.ResultsShame proneness (p < 0.01) and loss of social status (p < 0.01) were significantly elevated in those with SAD (with or without psychosis) compared to those with psychosis only and healthy controls. Individuals with psychosis and social anxiety expressed significantly greater levels of shame (p < 0.05), rejection (p < 0.01) and appraisals of entrapment (p < 0.01) linked to their diagnosis and associated stigma, compared to those without social anxiety.ConclusionsThese findings suggest that shame cognitions arising from a stigmatizing illness play a significant role in social anxiety in psychosis. Psychological interventions could be enhanced by taking into consideration these idiosyncratic shame appraisals when addressing symptoms of social anxiety and associated distress in psychosis. Further investigation into the content of shame cognitions and their role in motivating concealment of the stigmatized identity of being ‘ill’ is needed.

scholarly journals Attention Guidance Augmentation of Virtual Reality Exposure Therapy for Social Anxiety Disorder: A Pilot Randomized Controlled Trial

2021 ◽  
Author(s):  
Mikael Rubin ◽  
Karl Muller ◽  
Mary Hayhoe ◽  
Michael J Telch
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Visual Attention ◽  
Social Anxiety Disorder ◽  
Exposure Therapy ◽  
Mediation Effect ◽  
Virtual Reality Exposure Therapy ◽  
Weak Evidence ◽  
Virtual Reality Exposure

Biased attention to social threat has been implicated in social anxiety disorder. Modifying visual attention during exposure therapy offers a direct test of this mechanism. We developed and tested a brief virtual reality exposure therapy (VRET) protocol using 360º-video and eye tracking. Participants (N = 21) were randomized to either standard VRET or VRET + attention guidance training (AGT). Multi-level Bayesian models were used to test (1) whether there was an effect of condition over time and (2) whether post-treatment changes in gaze patterns mediated the effect of condition at follow-up. There was a large overall effect of the intervention on symptoms of social anxiety, as well as an effect of the AGT augmentation on changes in visual attention to audience members. There was weak evidence against an effect of condition on fear of public speaking and weak evidence supporting a mediation effect, however these estimates were strongly influenced by model priors. Taken together, our findings suggest that attention can be modified within and during VRET and that modification of visual gaze avoidance may be casually linked to reductions in social anxiety. Replication with a larger sample size is needed.

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