Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure

Abstract

Virtual reality plays an increasingly important role in research and therapy of pathological fear. However, the mechanisms how virtual environments elicit and modify fear responses are not yet fully understood. Presence, a psychological construct referring to the ‘sense of being there’ in a virtual environment, is widely assumed to crucially influence the strength of the elicited fear responses, however, causality is still under debate. The present study is the first that experimentally manipulated both variables to unravel the causal link between presence and fear responses. Height-fearful participants (N = 49) were immersed into a virtual height situation and a neutral control situation (fear manipulation) with either high versus low sensory realism (presence manipulation). Ratings of presence and verbal and physiological (skin conductance, heart rate) fear responses were recorded. Results revealed an effect of the fear manipulation on presence, i.e., higher presence ratings in the height situation compared to the neutral control situation, but no effect of the presence manipulation on fear responses. However, the presence ratings during the first exposure to the high quality neutral environment were predictive of later fear responses in the height situation. Our findings support the hypothesis that experiencing emotional responses in a virtual environment leads to a stronger feeling of being there, i.e., increase presence. In contrast, the effects of presence on fear seem to be more complex: on the one hand, increased presence due to the quality of the virtual environment did not influence fear; on the other hand, presence variability that likely stemmed from differences in user characteristics did predict later fear responses. These findings underscore the importance of user characteristics in the emergence of presence.

Too Real to Be Virtual: Autonomic and EEG Responses to Extreme Stress Scenarios in Virtual Reality

“…The results showed a decrease of the parasympathetic and an increase Virtual reality evoked emotional reactions through the effects of immersion and the presence in VR environments. Previous studies have shown that in moderate-intensity stress, VR scenarios evoked a sympathetic activity [15][16][17][18]. In the present study, these data were confirmed; the current results showed that electrodermal amplitude and the number of fluctuations were increased in the most stressful ISS scenario in one subject, reflecting the increase in sympathetic activity.…”

“…Free movement in a VE increases the number of blinks and the amplitude of EDA, heart rate, and tachygastric power, and decreases bradygastric power, respiratory sinus arrhythmia, finger temperature, and respiratory rate [13,14]. Similar effects of sympathetic activation were found in the virtual Roller Coaster [15,16] or simulated in VR high places [17,18].…”

“…An alternative hypothesis is that flying over the city is a less realistic scenario, which caused a decrease of the effect of presence. In contrast, a stationary and more realistic plank at a height causes emotional and autonomous reactions [17,18].…”

Analysis of Usage Data from a Self-Guided App-Based Virtual Reality Cognitive Behavior Therapy for Acrophobia: A Randomized Controlled Trial

“…The results further demonstrated that post-test AQ scores depended quadratically on time spent practicing, but not with the number of sessions practiced, indicating that it might be more important to play one level for a longer period of time instead of practicing many VR levels. Moreover, it was shown that, in line with previous research, a higher presence was associated with better outcomes [23].…”

“…Only the relation between proportion of completed modules and outcome emerged as a consistent association [15,16]. Previous research into VR treatment indicated that presence plays an important role in the effectiveness of a program [23]). For example, in our study reporting the main results of this trial we found that a larger reduction in acrophobia symptoms was associated when the feeling of being present in the virtual environment was higher [1].…”