Controlling Social Stress in Virtual Reality Environments

International Journal of Creative Interfaces and Computer Graphics, 2013

Anxiety is an increasingly common feeling in our society; it can be very debilitating and, if not properly treated, can evolve to more serious health problems. This paper describes a low-cost Virtual Reality solution to support the treatment of social anxiety, more specifically the anxiety of speaking in front of an audience. Our application involves: i) a simulation that takes place in a virtual auditorium inhabited by animated virtual humans with controllable behaviours; ii) an interface which allows the therapist to control these behaviors and a set of features and events of the simulation, inducing different levels of distress in the patients. The use of Virtual Reality environments for the treatment of phobias emerged in the 90s and usually implies expensive special purpose hardware. Our challenge was to conceive a low-cost solution, easy to install and use for people without expertise in informatics.

2002

This paper presents a study about the use of virtual reality techniques Social Anxiety Disorder therapy. The final idea of this technique is to treat social phobic people only by short time exposition in a dedicated stress environment parameterized in real-time. The technique is applied to the problematic of speaking in public with a symbolic representation of an audience. Nevertheless, the same methodology can be used to treat different phobias.

… Conference on Virtual …, 2002

This paper presents a study about the use of virtual reality techniques Social Anxiety Disorder therapy. The final idea of this technique is to treat social phobic people only by short time exposition in a dedicated stress environment parameterized in real-time. The technique is applied to the problematic of speaking in public with a symbolic representation of an audience. Nevertheless, the same methodology can be used to treat different phobias.

BACKGROUND: Social Anxiety Disorder (SAD) is one of the most prevalent anxiety disorders in Europe and comprises the fear of public speaking as its typical sub-type. Cognitive-Behavioural Therapy (CBT) is the intervention of choice for SAD, and it includes exposure to anxiety-provoking stimuli to induce systematic desensitization and reduce anxiety. Similarly, exposure therapy per se has been used and found effective, although it is not as specific as CBT for the treatment of SAD. Interestingly, exposure to anxiety-provoking situations can be achieved in Virtual Environments (VEs) through the simulation of social situations allowing individuals with public speaking anxiety to live and develop real exposure-like reactions. The Virtual Reality Exposure Therapy (VRET) is the treatment of anxiety disorders based on such VEs. AIM: This article aims to provide an overview of the scientific literature related to the applications of Virtual Reality to the treatment of fear of public speaking. MATERIALS AND METHODS: We conducted the literature review on PubMed and Google Scholar for studies including the fear-of-publicspeaking VEs. RESULTS AND CONCLUSIONS: Reviewed studies addressed two main aspects: the design parameters of the VEs for adequate reactions to synthetic social stimuli, and the efficacy of VEs for fear of public speaking treatment. VEs resulted effective for triggering as-if-real reactions in relation to public speaking. VE-based exposures reduced public speaking anxiety measurements, decreased scores and maintained them at 3 month follow-up. Studies comparing VRET to pharmacological therapy are lacking, and there are few randomized controlled trials that compare VRET to CBT, especially on fear of public speaking treatment.

2016

This randomized controlled trial investigated the efficacy of a stand-alone virtual reality exposure intervention comprising verbal interaction with virtual humans to target heterogeneous social fears in participants with social anxiety disorder. Sixty participants (Mage = 36.9 years; 63.3% women) diagnosed with social anxiety disorder were randomly assigned to individual virtual reality exposure therapy (VRET), individual in vivo exposure therapy (iVET), or waiting-list. Multilevel regression analyses revealed that both treatment groups improved from pre-to postassessment on social anxiety symptoms, speech duration, perceived stress, and avoidant personality disorder related beliefs when compared to the waiting-list. Participants receiving iVET, but not VRET, improved on fear of negative evaluation, speech performance, general anxiety, depression, and quality of life relative to those on waiting-list. The iVET condition was further superior to the VRET condition regarding decreases in social anxiety symptoms at post- and follow-up assessments, and avoidant personality disorder related beliefs at follow-up. At follow-up, all improvements were significant for iVET. For VRET, only the effect for perceived stress was significant. VRET containing extensive verbal interaction without any cognitive components can effectively reduce complaints of generalized social anxiety disorder. Future technological and psychological improvements of virtual social interactions might further enhance the efficacy of VRET for social anxiety disorder.

Temas em Psicologia

Virtual reality (VR) has been shown to be eff ective in the treatment of anxiety disorders. The eff ects of a behavioral intervention procedure that included exposure to VR, diaphragmatic breathing, diff erential reinforcement, and functional analysis of behavior of participants with public speaking anxiety were investigated. The Virtua Therapy simulator with an Oculus Rift® was used for VR exposure. Six university students participated in the procedure involving the following sequence of sessions: initial interview and baseline measures (3-5), intervention (6), closure (1), follow-up (2). In the baseline sessions, the participants gave a speech in a room without an audience (avatars): in the intervention sessions and follow-up they spoke in a classroom or auditorium with an audience, and verbal consequences (feedback) were provided for appropriate speech pitch and speed. Verbal and non-verbal measures of behaviors were recorded. In the intervention sessions, functional analyses of everyday public speaking situations were performed. There was statistically signifi cant diff erence in the pre-and post-intervention data in the Self-Statements during Public Speaking Scale (improvement in self-evaluation) and improvement in speech quality. The conclusion was reached that the intervention procedure contributed to the reduction of anxiety.

International Journal of Human–Computer Interaction, 2019

Virtual reality has taken many great strides in the recent years. It is increasingly used and is an accepted means of delivering behavioral therapy for phobias and anxiety disorders. In this paper, we examine methods of virtual reality stress induction for use in treatment of somatoform and anxiety disorders, as well as the adequate measures of the evoked stress response. In total, 42 healthy subjects took part in testing as part of this study. The results show that electrodermal activity is more sensitive in capturing a subject reaction to non-interactive social environment simulation while cardiovascular parameters better reflect task-related stress. Furthermore, our results suggest a distinct relationship between electrodermal activity and anxiety and cardiovascular parameters and somatoform dissociation. These results can point to a possibility of virtual reality utilization in the research and treatment of disorders in which anxiety and somatization are important features. 1.1. Induction of social stress To our knowledge, the earliest published work on the topic of social stress induction in VR was in 1998 (North, North, & Coble, 1997) where the participants were placed in a virtual University auditorium and tutored in public speaking. Outcomes were assessed through self-reported scores and CONTACT Bojan Kerous

Journal of Psychiatric Nursing, 2019

A technological tool for treating social anxiety: Virtual reality C urrent technological developments can solve problems more quickly and effectively, makes our daily lives easier, and increase the speed and quality of communications. Technological developments such as robotic surgery and advanced imaging methods have a significant place in the medical sector. Technology is also used in mental health care. Web-based online intervention programs and virtual reality (VR) are significant examples of technological developments in this field. VR practices are based on scenarios created with three-dimensional graphics consist of a computer program that creates visuals, glasses that make the images more realistic and expert viewers in the background who provide feedback. Social anxiety disorder (SAD) is defined by the DSM-V as social phobia or anxiety, and it is common both clinically and socially. Although different rates have been reported by studies of its prevalence, the common belief is that SAD is a frequent problem. [1] A study conducted with a sample of college students determined that the annual prevalence of social phobia was 20.9%, and that its lifelong prevalence was 21.7%. [2] Treating social anxiety involves both medical interventions and cognitive behavioral therapy. However, with technological advances, VR has been used as a treatment in the last 20 years, and the number of studies of it has increased. [3-5] The significant components of using VR to treat social anxiety problems are the scenarios, protocols and VR Virtual reality-based interventions are the technological instruments that have been found to be effective and used in psychological services. They have been in use for more than 20 years. Virtual reality can be used to treat many mental health issues such as anxiety disorders, depressive moods, obsessive-compulsive disorder and post-traumatic stress disorder. These interventions are based on the exposure method. With the advances in ever-developing technological products and software, more realistic and effective interventions emerge, and programs are tested by many experimental studies. The studies of virtual reality-based interventions toward social anxiety disorder, for which the virtual reality practices are used the most commonly, were examined in this compilation, the current state of virtual reality use in Turkey was explained, and recommendations for future were presented.

Journal of Consulting and Clinical Psychology, 2013

This is the first randomized trial comparing virtual reality exposure therapy to in vivo exposure for social anxiety disorder. Method: Participants with a principal diagnosis of social anxiety disorder who identified public speaking as their primary fear (N ϭ 97) were recruited from the community, resulting in an ethnically diverse sample (M age ϭ 39 years) of mostly women (62%). Participants were randomly assigned to and completed 8 sessions of manualized virtual reality exposure therapy, exposure group therapy, or wait list. Standardized self-report measures were collected at pretreatment, posttreatment, and 12-month follow-up, and process measures were collected during treatment. A standardized speech task was delivered at pre-and posttreatment, and diagnostic status was reassessed at 3-month follow-up. Results: Analysis of covariance showed that, relative to wait list, people completing either active treatment significantly improved on all but one measure (length of speech for exposure group therapy and self-reported fear of negative evaluation for virtual reality exposure therapy). At 12-month follow-up, people showed significant improvement from pretreatment on all measures. There were no differences between the active treatments on any process or outcome measure at any time, nor differences on achieving partial or full remission. Conclusion: Virtual reality exposure therapy is effective for treating social fears, and improvement is maintained for 1 year. Virtual reality exposure therapy is equally effective as exposure group therapy; further research with a larger sample is needed, however, to better control and statistically test differences between the treatments.

Temas em Psicologia

Virtual Reality (VR) was used in this study as a therapeutic tool in a behavior-analytic intervention with two subjects who had social anxiety disorder. The goals were to assess the therapeutic effects of the intervention program and the VR simulator with regard to the ability to generate sense of presence and anxiety responses. The program consisted of: (a) initial session, (b) baseline, (c) intervention sessions with exposure to VR, (d) closing session, (e) follow up (up to one and three months after treatment). Sense of presence, anxiety and galvanic skin response were reported in each exposure therapy session and anxiety, depression and social phobia inventories were reported at the end of each stage. Functional analyses were formulated based on behaviors occurring in social contexts between sessions. The simulator produced anxiety and high levels of presence during exposure; and both participants had reduced levels of anxiety at the end of intervention and generalization to the natural context. In conclusion, behavior-analytic intervention with exposure to VR was effective and fostered a repertoire for coping with situations of social interaction.