Virtual reality exposure therapy for fear of driving: analysis of clinical characteristics, physiological response, and sense of presence

Abstract

Objective: To investigate the reactions of women with driving phobia to a therapeutic program of scheduled virtual reality exposure treatment (VRET) sessions. Methods: The study intervention consisted of a computer game with car-driving scenarios that included several traffic situations. We investigated the participants' sense of presence, subjective distress, and physiological responses during eight virtual-reality exposures. We also evaluated clinical characteristics, driving cognitions, and quality of life in the participants. Results: Thirteen women were selected. Eight were able to complete the protocol. After VRET, there was a decrease in the frequency of distorted thoughts and state anxiety scores, as well as a slight improvement in quality of life. Subjective discomfort scores, heart rate variation, and sense of presence scores confirmed that there was sense of presence in the virtual reality environment. Conclusion: All patients showed some degree of improvement and demonstrated different levels of anxiety in subsequent in vivo driving experiences. Our findings suggest that VRET could be used to facilitate in vivo exposure, because it can induce presence/immersion and reduce anxiety in patients with specific phobia. Furthermore, VRET is not associated with any type of risk.

Longitudinal associations between internalizing symptoms and driving avoidance in newly licensed adolescents

“…Further, incorporating strategies to teach healthy coping mechanisms for anxious drivers into the curriculum is warranted. Few studies suggest what specific kinds of coping mechanisms may ameliorate anxiety related to driving, however, some work has explored the effectiveness of virtual reality exposure therapy (VRET) in the treatment of driving anxiety (Costa et al, 2018; Kaussner et al, 2020; Wald & Taylor, 2000; Zinzow et al, 2018), as this allows exposure to a driving environment without risking the safety of driver or passenger.…”

“…The literature examining anxiety and driving behavior is highly diverse and intersectional, spanning the fields of clinical and traffic psychology, among others (Ball et al, 1998; Ehlers et al, 1994; Schoettle & Sivak, 2014; Wiederhold & Wiederhold, 2010). Anxiety responses in driving behavior may be specific to the act of driving in some individuals, while in others experiencing anxiety symptoms while driving occurs within the broader context of other patterns of anxiety and avoidance, such as Generalized Anxiety Disorder (GAD), panic disorder with agoraphobia (Taylor et al, 2008), and PTSD (Costa et al, 2018). It is essential to point out that the specific domain of driving anxiety is highly variable and is characterized by a combination of anxious symptomology often accompanied with avoidance behavior (i.e., avoidance of driving under certain conditions or of the general act of driving), ranging in levels of severity.…”

Activación psicofisiológica de pacientes con zoofobias ante un ambiente de realidad virtual

“…De igual manera, esta sensación de presencia es la herramienta empleada para el procesamiento de los temores. Costa et al (2018) reportan que las puntaciones de malestar subjetivos, la variación en la frecuencia cardiaca y las puntuaciones de sensación de presencia, confirman que los participantes experimentaron sensación de estar dentro del entorno virtual. Así mismo, un trabajo publicado recientemente por Distefano et al (2020) muestra que los entornos utilizados generan suficiente sensación de presencia, aunque esto no evidencia relación significativa con el grado de ansiedad percibida por los participantes.…”

Virtual Reality Exposure Therapy for Driving Phobia Disorder: System Design and Development

“…In the Kaussner et al VRET pilot study, anxiety and habituation during the VRET sessions were assessed using ratings on subjective units of a distress scale as well as the heart rate [20]. Costa et al used subjective discomfort scores and heart rate to measure subjects' physiological response and sense of presence [21]. Additionally, in Claudio et al's fear of driving in tunnels research, questionnaires measured the outcome of the experiment and no real-time data was collected [22].…”

“…After the experiment, subjects were determined to be more confident with their driving ability. Six out of eight subjects were willing to conduct in vivo exposure after VRET [21]. A VRET experiment for driving phobia related to fear of driving in tunnels was conducted.…”