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.

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.

Working alliance does not mediate the relation between outcome expectancy and symptom improvement following cognitive behavioural therapy for social anxiety disorder

2019 ◽  
Vol 12 ◽  
Author(s):  
Amanda A. Draheim ◽  
Page L. Anderson
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Working Alliance ◽  
Social Anxiety Disorder ◽  
Common Factors ◽  
Outcome Expectancy ◽  
Symptom Improvement ◽  
Virtual Reality Exposure Therapy ◽  
Virtual Reality Exposure

AbstractA small body of research shows that the working alliance mediates the relation between outcome expectancy and treatment response, but this model has not been applied to the treatment of social anxiety disorder. The present study tests the hypothesis that the working alliance mediates the relation between outcome expectancy and symptom improvement within a randomized controlled trial testing the efficacy of virtual reality exposure therapy for social anxiety disorder. A sample of 54 individuals diagnosed with social anxiety disorder completed eight sessions of virtual reality exposure therapy or exposure group therapy. Participants completed standardized self-report measures of outcome expectancy at the first session, of the working alliance at each session, and three measures of social anxiety symptoms at pre- and post-treatment. The working alliance did not mediate the relation between outcome expectancy and symptom improvement across time points, dependent measures, and treatment type. Bayes factors were calculated for the relation between the working alliance and symptom reduction, while controlling for outcome expectancy and therapist effects. Results were inconclusive. These null findings are intriguing and urge further study of the mechanisms through which common factors relate to treatment response. Utilization of Bayesian analyses may help to clarify the nature of these relations.Key learning aims (1)Readers will consider the role of common factors in treatment for social anxiety disorder.(2)Readers will learn about how different common factors may interact with each other.(3)Readers will be encouraged to consider how the therapeutic relationship may manifest in a unique manner in treatment for social anxiety.

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 Experiences of Gamified and Automated Virtual Reality Exposure Therapy for Spider Phobia: Qualitative Study

10.2196/17807 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e17807 ◽  
Author(s):  
Philip Lindner ◽  
Alexander Rozental ◽  
Alice Jurell ◽  
Lena Reuterskiöld ◽  
Gerhard Andersson ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorders ◽  
Exposure Therapy ◽  
Real Life ◽  
Spider Phobia ◽  
Semistructured Interview ◽  
User Experiences ◽  
Virtual Reality Exposure Therapy ◽  
Virtual Reality Exposure

Background Virtual reality exposure therapy is an efficacious treatment of anxiety disorders, and recent research suggests that such treatments can be automated, relying on gamification elements instead of a real-life therapist directing treatment. Such automated, gamified treatments could be disseminated without restrictions, helping to close the treatment gap for anxiety disorders. Despite initial findings suggesting high efficacy, very is little is known about how users experience this type of intervention. Objective The aim of this study was to examine user experiences of automated, gamified virtual reality exposure therapy using in-depth qualitative methods. Methods Seven participants were recruited from a parallel clinical trial comparing automated, gamified virtual reality exposure therapy for spider phobia against an in vivo exposure equivalent. Participants received the same virtual reality treatment as in the trial and completed a semistructured interview afterward. The transcribed material was analyzed using thematic analysis. Results Many of the uncovered themes pertained directly or indirectly to a sense of presence in the virtual environment, both positive and negative. The automated format was perceived as natural and the gamification elements appear to have been successful in framing the experience not as psychotherapy devoid of a therapist but rather as a serious game with a psychotherapeutic goal. Conclusions Automated, gamified virtual reality exposure therapy appears to be an appealing treatment modality and to work by the intended mechanisms. Findings from the current study may guide the next generation of interventions and inform dissemination efforts and future qualitative research into user experiences.

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