Detecting Fear of Heights Response to a Virtual Reality Environment Using Functional Near-Infrared Spectroscopy

To enable virtual reality exposure therapy (VRET) that treats anxiety disorders by gradually exposing the patient to fear using virtual reality (VR), it is important to monitor the patient's fear levels during the exposure. Despite the evidence of a fear circuit in the brain as reflected by functional near-infrared spectroscopy (fNIRS), the measurement of fear response in highly immersive VR using fNIRS is limited, especially in combination with a head-mounted display (HMD). In particular, it is unclear to what extent fNIRS can differentiate users with and without anxiety disorders and detect fear response in a highly ecological setting using an HMD. In this study, we investigated fNIRS signals captured from participants with and without a fear of height response. To examine the extent to which fNIRS signals of both groups differ, we conducted an experiment during which participants with moderate fear of heights and participants without it were exposed to VR scenarios involving heights and no heights. The between-group statistical analysis shows that the fNIRS data of the control group and the experimental group are significantly different only in the channel located close to right frontotemporal lobe, where the grand average oxygenated hemoglobin Δ[HbO] contrast signal of the experimental group exceeds that of the control group. The within-group statistical analysis shows significant differences between the grand average Δ[HbO] contrast values during fear responses and those during no-fear responses, where the Δ[HbO] contrast values of the fear responses were significantly higher than those of the no-fear responses in the channels located towards the frontal part of the prefrontal cortex. Also, the channel located close to frontocentral lobe was found to show significant difference for the grand average deoxygenated hemoglobin contrast signals. Support vector machine-based classifier could detect fear responses at an accuracy up to 70% and 74% in subject-dependent and subject-independent classifications, respectively. The results demonstrate that cortical hemodynamic responses of a control group and an experimental group are different to a considerable extent, exhibiting the feasibility and ecological validity of the combination of VR-HMD and fNIRS to elicit and detect fear responses. This research thus paves a way toward the a brain-computer interface to effectively manipulate and control VRET.

The Effects of Virtual Height Exposure on Postural Control and Psychophysiological Stress Are Moderated by Individual Height Intolerance

Virtual reality (VR) enables individuals to be exposed to naturalistic environments in laboratory settings, offering new possibilities for research in human neuroscience and treatment of mental disorders. We used VR to study psychological, autonomic and postural reactions to heights in individuals with varying intensity of fear of heights. Study participants (N = 42) were immersed in a VR of an unprotected open-air elevator platform in an urban area, while standing on an unstable ground. Virtual elevation of the platform (up to 40 m above the ground level) elicited robust and reliable psychophysiological activation including increased distress, heart rate, and electrodermal activity, which was higher in individuals suffering from fear of heights. In these individuals, compared with individuals with low fear of heights, the VR height exposure resulted in higher velocity of postural movements as well as decreased low-frequency (<0.5 Hz) and increased high-frequency (>1 Hz) body sway oscillations. This indicates that individuals with strong fear of heights react to heights with maladaptive rigidity of posture due to increased weight of visual input for balance control, while the visual information is less reliable at heights. Our findings show that exposure to height in a naturalistic VR environment elicits a complex reaction involving correlated changes of the emotional state, autonomic activity, and postural balance, which are exaggerated in individuals with fear of heights.

The Height of Reality: Using Virtual Reality Technology to Desensitize Acrophobia

<p>Virtual reality (VR) is a new up-and-coming technology on which to watch three dimensional films or play video games. However, the practical uses of virtual reality can spread much further than just media outputs. This research aims to explore one of the practical uses for virtual reality technology. VR has the potential to help patients living with psychological disorders, by reducing the anxiety that they experience to a more manageable level within a safe environment. This dissertation addresses the use of a virtual reality simulation to reduce the anxiety experienced by patients effected by acrophobia, known as the fear of heights. The preliminary research includes several in-depth interviews with psychologists and clinicians, as well as phobic patients to better understand the processes of gradual exposure rehabilitation. This method also determines how a virtual reality simulation may be effectively designed. The primary aim of this research is to build a VR simulation which will produce a conducive result in the anxiety levels of the participants’ mental health, within a familiar and comfortable environment. User-testing the simulation will further refine the program’s effectiveness. The outcome will be a program supported by existing virtual reality treatments for psychological disorders that ultimately reduces the anxiety experienced by participants.</p>

The Height of Reality: Using Virtual Reality Technology to Desensitize Acrophobia

<p>Virtual reality (VR) is a new up-and-coming technology on which to watch three dimensional films or play video games. However, the practical uses of virtual reality can spread much further than just media outputs. This research aims to explore one of the practical uses for virtual reality technology. VR has the potential to help patients living with psychological disorders, by reducing the anxiety that they experience to a more manageable level within a safe environment. This dissertation addresses the use of a virtual reality simulation to reduce the anxiety experienced by patients effected by acrophobia, known as the fear of heights. The preliminary research includes several in-depth interviews with psychologists and clinicians, as well as phobic patients to better understand the processes of gradual exposure rehabilitation. This method also determines how a virtual reality simulation may be effectively designed. The primary aim of this research is to build a VR simulation which will produce a conducive result in the anxiety levels of the participants’ mental health, within a familiar and comfortable environment. User-testing the simulation will further refine the program’s effectiveness. The outcome will be a program supported by existing virtual reality treatments for psychological disorders that ultimately reduces the anxiety experienced by participants.</p>

Virtual Reality Exposure Therapy for Fear of Heights: Clinicians’ Attitudes Become More Positive After Trying VRET

BackgroundVirtual reality exposure therapy (VRET) has the potential to solve logistic challenges when treating specific phobias. However, VRET has yet to see a large-scale implementation in clinical settings despite positive findings in treatment trials. This may partly be due to attitudes and lack of experience among clinicians, but also because of expensive and stationary VR solutions.ObjectiveThis study tested whether modern, wireless, commercially available VR equipment with controller-free hand tracking could induce and reduce discomfort using scenarios designed for fear of heights. Also, the study tested if clinicians’ attitudes toward using VR in therapy changed after trying it themselves.MethodAttitudes to using VR in therapy and discomfort ratings were assessed for 74 clinicians before and after completing two VR scenarios. In addition, 54 non-clinicians completed the same scenarios. Participants were not diagnosed with acrophobia.ResultsThe VR scenarios induced discomfort comparable to participants’ reported fear of heights in real life. Repeated training reduced discomfort. Positive attitudes toward use of VR in therapy was predicted by previous experience with VR, as well as positive attitudes toward novel technology and exposure therapy. Clinicians’ attitudes became more favorable after trying VRET themselves. Clinicians reported a range of possible advantages and disadvantages of using VR in therapy.ConclusionVRET for fear of heights was able to induce and reduce discomfort in clinicians and non-clinicians, and clinicians’ attitudes toward using VRET become more positive after trying VRET for themselves. The latest generation of VR solutions has potential to improve clinical availability and treatment options. Future research should explore how VRET can be implemented in clinical settings.

A brief novel intervention for acrophobia (fear of heights)

ObjectiveTo investigate a unique brief intervention, which offers a combination of neuro-linguistic programming and practical graded exposure therapy, to overcome a fear of heights.BackgroundA fear of heights or acrophobia is common and often deters people from perusing activities like climbing. It can also interfere with routine activities of daily living.Case reportThis two-day intervention is set in the Peak District (Derbyshire, UK) and works with a maximum of eight individuals to four instructors. The first half-day involves working with a psychotherapist using neurolinguistic programing techniques. The next 1.5 days involves graded exposure using abseiling over gradually increasing heights, to a final height of approximately 40 feet.DiscussionAll eight individuals on the two-day course felt their fear of highs had significantly decreased. All eight individuals would recommend this intervention to others suffering from a fear of heights.ConclusionIt is noteworthy that the group undergoing this intervention were self-selected and highly motivated to overcome their fear of heights. The sample size was small and outcome measures were subjective. However, this is a novel and effective approach to helping people overcome their fear of heights. Further research with larger sample sizes would be beneficial in further assessing the impact of this intervention.Declaration: Permission was granted by the organizers of this intervention to submit an abstract to conference. There are no conflicts of interests. This intervention is run by a private company ‘Will4Adventure’, I have no finical or other interests in this company. I privately funded my own place on this course.