Investigating approach-avoidance behavior regarding affective stimuli is important in broadening the understanding of one of the most common psychiatric disorders, social anxiety disorder. Many studies in this field rely on approach-avoidance tasks, which mainly assess hand movements, or interpersonal distance measures, which return inconsistent results and lack ecological validity. Therefore, the present study introduces a virtual reality task, looking at avoidance parameters (movement time and speed, distance to social stimulus, gaze behavior) during whole-body movements. These complex movements represent the most ecologically valid form of approach and avoidance behavior. These are at the core of complex and natural social behavior. With this newly developed task, the present study examined whether high socially anxious individuals differ in avoidance behavior when bypassing another person, here virtual humans with neutral and angry facial expressions. Results showed that virtual bystanders displaying angry facial expressions were generally avoided by all participants. In addition, high socially anxious participants generally displayed enhanced avoidance behavior towards virtual people, but no specifically exaggerated avoidance behavior towards virtual people with a negative facial expression. The newly developed virtual reality task proved to be an ecological valid tool for research on complex approach-avoidance behavior in social situations. The first results revealed that whole body approach-avoidance behavior relative to passive bystanders is modulated by their emotional facial expressions and that social anxiety generally amplifies such avoidance.

Physical distance is a prominent feature in face-to-face social interactions and allows regulating social encounters. Close interpersonal distance (IPD) increases emotional responses during interaction and has been related to avoidance behavior in social anxiety. However, a systematic investigation of the effects of IPD on subjective experience combined with measures of physiological arousal and behavioral responses during real-time social interaction has been missing. Virtual Reality allows for a controlled manipulation of IPD while maintaining naturalistic social encounters. The present study investigates IPD in social interaction using a novel paradigm in Virtual Reality. Thirty-six participants approached virtual agents and engaged in short interactions. IPD was varied between 3.5 and 1 m by manipulating the distance at which agents reacted to the participant's approach. Closer distances were rated as more arousing, less pleasant, and less natural than longer distances and this effect was significantly modulated by social anxiety scores. Skin conductance responses were also increased at short distances compared to longer distances. Finally, an interaction of IPD and social anxiety was observed for avoidance behavior, measured as participants' backward motion during interaction, with stronger avoidance related to close distances and high values of social anxiety. These results highlight the influence of IPD on experience, physiological response, and behavior during social interaction. The interaction of social anxiety and IPD suggests including the manipulation of IPD in behavioral tests in Virtual Reality as a promising tool for the treatment of social anxiety disorder.

Background: Exposure therapy involves exposure to feared stimuli and is considered to be the gold-standard treatment for anxiety disorders. While its application in Virtual Reality (VR) has been very successful for phobic disorders, the effects of exposure to virtual social stimuli in Social Anxiety Disorder are heterogeneous. This difference has been linked to demands on realism and presence, particularly social presence, as a pre-requisite in evoking emotional experiences in virtual social interactions. So far, however, the influence of social presence on emotional experience in social interactions with virtual agents remains unknown.Objective: We investigated the relationship between realism and social presence and the moderating effect of social presence on the relationship between agent behavior and experienced emotions in virtual social interaction.Methods: Healthy participants (N = 51) faced virtual agents showing supportive and dismissive behaviors in two virtual environments (short interactions and oral presentations). At first, participants performed five blocks of short one-on-one interactions with virtual agents (two male and two female agents per block). Secondly, participants gave five presentations in front of an audience of 16 agents. In each scenario, agent behavior was a within subjects factor, resulting in one block of neutral, two blocks of negative, and two blocks of positive agent behavior. Ratings of agent behavior (valence and realism), experience (valence and arousal), and presence (physical and social) were collected after every block. Moderator effects were investigated using mixed linear models with random intercepts. Correlations were analyzed via repeated measures correlations.Results: Ratings of valence of agent behaviors showed reliable relationships with experienced valence and less reliable relationships with experienced arousal. These relationships were moderated by social presence in the presentation scenario. Results for the interaction scenario were weaker but potentially promising for experimental studies. Variations in social presence and realism over time were correlated but social presence proved a more reliable moderator.Conclusion: Our findings emphasize the role of social presence for emotional experience in response to specific agent behaviors in virtual social interactions. While these findings should be replicated with experimental designs and in clinical samples, variability in social presence might account for heterogeneity in efficacy of virtual exposure to treat social anxiety disorder.

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