Virtual Reality Exposure Therapy for treating social anxiety in stuttering: A scoping review

2021 ◽  
Author(s):  
Ian Chard ◽  
Nejra van Zalk
Keyword(s):  
Virtual Reality ◽  
Social Anxiety ◽  
Public Speaking ◽  
Exposure Therapy ◽  
Treatment Success ◽  
Future Research ◽  
Effective Technique ◽  
Virtual Reality Exposure Therapy ◽  
Research Questions ◽  
Virtual Reality Exposure

Virtual Reality Exposure Therapy (VRET) has been shown to be an effective technique for reducing social anxiety. People who stutter are at greater risk of developing heightened social anxiety. Cognitive behavior therapy protocols have shown promise in reducing social anxiety in people who stutter, but no studies have investigated VRET targeting social anxiety associated with stuttering. The aim of the current review is to provide an overview of VRET techniques used to treat social anxiety and insights into how VRET might be adopted in the case of comorbid stuttering and social anxiety. Twelve studies were reviewed to understand key distinctions in VRET protocols used to treat social anxiety. Distinctions include exercises targeting public speaking vs. general social anxiety, computer-generated virtual environments vs. 360 video, and therapist guided vs. automated VRET. An overview of wider research questions surrounding VRET is then presented to aid the understanding of treatment success and outline important directions for future research. Based on the review findings, suggestions are made regarding VRET design for stuttering. In sum, VRET should be tailored to situations and cognitive-behavioral processes that underlie the experience of social anxiety amongst people who stutter, with automated VRET using a virtual therapist a potentially suitable format for delivering treatment.

scholarly journals Cloud Based Virtual Reality Exposure Therapy Service for Public Speaking Anxiety

Information ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 62 ◽  
Author(s):  
Justas Šalkevičius ◽  
Audronė Miškinytė ◽  
Lukas Navickas
Keyword(s):  
Virtual Reality ◽  
Public Speaking ◽  
Exposure Therapy ◽  
Behavioral Therapy ◽  
Public Speaking Anxiety ◽  
Speaking Anxiety ◽  
Virtual Reality Exposure Therapy ◽  
Skin Response ◽  
Virtual Reality Exposure ◽  
Therapy Service

Public speaking anxiety is commonly treated using cognitive behavioral therapy. During the therapy session, the patient is either asked to vividly imagine and describe the feared stimulus or is confronted with it in the real world. Sometimes, however, it can be hard to imagine the object of fear or to create a controllable environment that contains this stimulus. Virtual reality exposure therapy (VRET) can help solve these problems by placing the patient in a simulated 3D environment. While standalone VRET applications have been investigated for more than 25 years, we are analyzing the viability of a cloud-based VRET system. In this paper, we discuss the architectural and technical choices made in order to create a mobile and lightweight solution that can be easily adapted by any psychology clinic. Moreover, we are analyzing data gathered from 30 participants who have undergone a VRET session for public speaking anxiety. Finally, the collected psychophysiological signals including galvanic skin response (GSR) and skin temperature are processed and investigated in order to evaluate our cloud-based VRET system.

scholarly journals Behavioral and Magnetoencephalographic Correlates of Fear Generalization Are Associated with Responses to Later Virtual Reality Exposure Therapy in Spider Phobia

2021 ◽  
Author(s):  
Kati Roesmann ◽  
Elisabeth J. Leehr ◽  
Joscha Boehnlein ◽  
Christian Steinberg ◽  
Fabian Seeger ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Exposure Therapy ◽  
Treatment Success ◽  
Post Treatment ◽  
Spider Phobia ◽  
Virtual Reality Exposure Therapy ◽  
Fear Generalization ◽  
Spatio Temporal ◽  
Pre Treatment ◽  
Virtual Reality Exposure

As overgeneralization of fear is a pathogenic marker of anxiety disorders, we investigated whether pre-treatment levels of fear generalization in spider-phobic patients are associated with their response to exposure-based treatment, in order to identify pre-treatment correlates of treatment success. Ninety patients with spider phobia completed pre-treatment clinical and magnetoencephalography (MEG) assessments, one session of virtual reality exposure therapy, and a post-treatment clinical assessment. Based on the primary outcome (30% symptom reduction in self-reported symptoms from pre- to post-treatment) they were categorized as responders or non-responders. In a pre-treatment MEG fear generalization paradigm involving fear conditioning with two unconditioned stimuli (UCS), we obtained fear ratings, UCS-expectancy ratings, and event-related fields to conditioned stimuli (CS+, CS-) and 7 different generalization stimuli (GS) on a perceptual continuum from CS+ to CS-. Prior to treatment, non-responders showed behavioral overgeneralization indicated by more linear generalization gradients in fear ratings. Analyses of MEG source estimations revealed that non-responders showed a decline of their (inhibitory) frontal activations to safety-signaling CS- and GS compared to CS+ over time, while responders maintained these activations at early (<300ms) and late processing stages. Results provide initial evidence that pre-treatment differences of behavioral and neural markers of fear generalization are associated with later responses to behavioral exposure. Findings demonstrate the relevance of inhibitory learning functions and their spatio-temporal neural reflections in this interplay. Findings stimulate research on mechanism-based augmentation strategies for behavioral therapies.

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.

scholarly journals Meta-Analysis of the Efficacy of Virtual Reality Exposure Therapy for Social Anxiety

2018 ◽  
Vol 35 (3) ◽  
pp. 152-166 ◽  
Author(s):  
Rachel K. Chesham ◽  
John M. Malouff ◽  
Nicola S. Schutte
Keyword(s):  
Virtual Reality ◽  
Social Anxiety ◽  
Exposure Therapy ◽  
Meta Analysis ◽  
Psychological Problem ◽  
Imaginal Exposure ◽  
Virtual Reality Exposure Therapy ◽  
Meta Analyses ◽  
Virtual Reality Exposure

AbstractSocial anxiety is a common, debilitating psychological problem. In the present study, two meta-analyses examined the efficacy of virtual reality exposure therapy for social anxiety. The first meta-analysis tested whether virtual reality exposure therapy reduces social anxiety more than a waitlist control condition. The results of the first meta-analysis, consisting of six studies and 233 participants, showed a significant overall effect size, indicating that virtual reality exposure therapy was effective in reducing social anxiety. The second meta-analysis tested whether the standard treatment for social anxiety, which includes in vivo or imaginal exposure, leads to greater effects than virtual reality exposure therapy. The second meta-analysis, consisting of seven studies and 340 total participants, showed essentially no difference in effect sizes between virtual reality exposure and in vivo or imaginal exposure. The results of the two meta-analyses support the use of virtual reality in the treatment of social anxiety.

scholarly journals The Simulation Game—Virtual Reality Therapy for the Treatment of Social Anxiety Disorder: A Systematic Review

2021 ◽  
Vol 18 (24) ◽  
pp. 13209
Author(s):  
Pasquale Caponnetto ◽  
Sergio Triscari ◽  
Marilena Maglia ◽  
Maria C. Quattropani
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Social Anxiety Disorder ◽  
Exposure Therapy ◽  
Reality Therapy ◽  
Virtual Reality Exposure Therapy ◽  
Virtual Reality Exposure

(1) Background: With the term Virtual reality (VR) we refer to a three-dimensional environment generated by the computer, in which subjects interact with the environment as if they were really inside it. The most used VR tools are the so-called HMD (head-mounted display) which make it possible to achieve what theorists define “direct mediated action”. The aim of our systematic review is specifically to investigate the applications of virtual reality therapy for the treatment of social anxiety disorder, also known as social phobia. The most common treatment for social anxiety disorder is represented by “in vivo exposure therapy” (iVET). This method consists of exposing the participant, in a gradual and controlled way, to anxious stimuli, with the goal to change the subject’s response to the object or situation that is causing the fear. However, the main flaw of “in Vivo therapies” is represented by both the huge costs involved and the possible disturbance variables that can hinder the execution of the therapeutic treatment. Virtual reality exposure therapy could therefore, if confirmed in its effectiveness, constitute a solution to eliminate these two defects demonstrated by “in vivo exposure therapy”. The goal is to use VR as a means for the clinician to build a tailor-made path for the participant in order to make him acquire “in virtual” those skills necessary for a good adaptation in the “real” world. (2) Methods: From February 2021 until the date of submission of the article (September 2021), we conducted a systematic review aiming to verify the effectiveness of virtual reality exposure therapy (VRET) for the treatment of SAD. (3) Results: We identified a total of 205 unique articles. Among these, 20 full-text articles were assessed for eligibility and 5 of these met the eligibility criteria and were, therefore, included in the final systematic review. (4) Conclusions: Virtual reality therapies proved to be a valid alternative to the acquisition of social skills suitable for improving the symptoms of SAD. Although there has not been a significant difference between VRET and iVET, the low costs and flexibility of VRET open up new scenarios for achieving greater psychophysical well-being.

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