JMIR Publications

ABSTRACT

Background:

Introduction: Social Anxiety Disorder (SAD) is a long-term and overwhelming fear of social situations that can affect work, school, and other daily activities. Although cognitive behavioral therapy (CBT) is effective, few seek treatment, and many drop out. This may be due to the component of exposure inherent to CBT, where the patient confronts feared stimuli outside the therapists’ office, which they otherwise try to avoid. As a replacement, research has investigated the effectiveness of virtual reality-based exposure with good results. However, few studies have investigated the feasibility of virtual reality (VR) tools utilizing mixed methodology prior to assessing efficacy.

Objective:

The aims of the current study were to assess the usability, feasibility, and presence of four 360o virtual environments and whether these were able to evoke anxiety in patients with SAD.

Methods:

Methods:

Ten adult participants with SAD and ten healthy controls were recruited for one experimental session (age range 21-32 years, 60% males). Questionnaire- and interview data was collected and analyzed. A mixed methods triangulation design was applied to analyze and compare data.

Results:

Results:

Participants with SAD experienced increased anxiety when exposed in VR and environments were considered relevant and useful as an exposure tool. Participants with SAD reported higher anxiety levels than controls during exposure; however, significant differences in anxiety over time was only found in two of four environments. While presence scores were acceptable in both groups, SAD participants scored significantly lower than controls. Qualitative analyses highlight this finding within the SAD group, where some participants experienced presence reduction due to being observed while in VR and in situations with reduced interaction in VR.

Conclusions:

Discussion: VR exposure with 360o videos seems to be useful as a first step of exposure therapy for SAD-patients Future exploration in the clinical application of VR-based exposure for SAD as well as means of increasing presence within the virtual environments may be useful.