Exposure to a Standardized Catastrophic Scenario in Virtual Reality or a Personalized Scenario in Imagination for Generalized Anxiety Disorder

Abstract

The cognitive behavioral treatment of generalized anxiety disorder (GAD) often involves exposing patients to a catastrophic scenario depicting their most feared worry. The aim of this study was to examine whether a standardized scenario recreated in virtual reality (VR) would elicit anxiety and negative affect and how it compared to the traditional method of imagining a personalized catastrophic scenario. A sample of 28 participants were first exposed to a neutral non-catastrophic scenario and then to a personalized scenario in imagination or a standardized virtual scenario presented in a counterbalanced order. The participants completed questionnaires before and after each immersion. The results suggest that the standardized virtual scenario induced significant anxiety. No difference was found when comparing exposure to the standardized scenario in VR and exposure to the personalized scenario in imagination. These findings were specific to anxiety and not to the broader measure of negative affect. Individual differences in susceptibility to feel present in VR was a significant predictor of increase in anxiety and negative affect. Future research could use these scenarios to conduct a randomized control trial to test the efficacy and cost/benefits of using VR in the treatment of GAD.

Virtual Reality exposure therapy for public speaking anxiety in routine care: a single-subject effectiveness trial

“…Future research should investigate the prevalence of this, and also to test the added benefit of tailored over non-tailored VR exposure scenarios in terms of efficacy. One recent study showed that exposure to standardized VR worry scenarios is equally effective in reducing anxiety as exposure to personalized imagined scenarios (Guitard et al, 2019). Further, most past VRET trials have had limited tailoring capabilities yet still report large effect sizes (Carl et al, 2019;Fodor et al, 2018;Opriş et al, 2012), suggesting that tailoring is not a requirement for effect, although this does not exclude the possibility of larger effects with tailored stimuli material.…”

The Effect of Cycling Through a Projection-Based Virtual Environment System on Generalized Anxiety Disorder

“…As GAD brings several negative effects to patients in many living conditions [40], it is quite difficult to create a scenario of VE that allows people with GAD to relax. To make patients with GAD feel relaxed, the scenarios of VE must be able to reduce many different personalization concerns experienced by patients with GAD.…”

Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy

“…A recent survey study on attitudes towards VR among practicing CBT clinicians found that those who worked clinically with neuropsychiatric disorders, personality disorders, and psychosomatic disorders were more inclined to report that VR could be used with the respective disorder (Lindner et al 2019d), suggesting that novel clinical applications of VR are indeed possible. The VR field is currently expanding rapidly, including new research on innovative VR treatments for disorders that have previously received little attention like depression (Migoya-Borja et al 2020;Schleider et al 2019), sleep problems (Lee and Kang 2020), and worry (Guitard et al 2019). Recent work has also studied how VR can be used for modifying cognitions (Silviu Matu 2019) and feared self-perceptions (Wong 2019), in approach-avoidance training for obesity (Kakoschke 2019), and to treat aggressive behavior in children (Alsem 2019), revealing how VR has matured into a flexible, innovative treatment tool.…”

“…This question has however received surprisingly little research attention thus far. One recent study compared exposure to standardized catastrophic scenarios in VR, to imaginal exposure with personalized scenarios, and found no difference in evoked anxiety (Guitard et al 2019), suggesting that perfect tailoring is at least not necessary. A study on (360°v ideo) VR relaxation found a strong correlation between averages preference rating of different virtual nature environments and average improvement in positive mood (Gao et al 2019).…”