Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis

Abstract

Virtual reality exposure therapy (VRET) is a promising intervention for the treatment of the anxiety disorders. The main objective of this meta-analysis is to compare the efficacy of VRET, used in a behavioral or cognitive-behavioral framework, with that of the classical evidence-based treatments, in anxiety disorders. A comprehensive search of the literature identified 23 studies (n = 608) that were included in the final analysis. The results show that in the case of anxiety disorders, (1) VRET does far better than the waitlist control; (2) the post-treatment results show similar efficacy between the behavioral and the cognitive behavioral interventions incorporating a virtual reality exposure component and the classical evidence-based interventions, with no virtual reality exposure component; (3) VRET has a powerful real-life impact, similar to that of the classical evidence-based treatments; (4) VRET has a good stability of results over time, similar to that of the classical evidence-based treatments; (5) there is a dose-response relationship for VRET; and (6) there is no difference in the dropout rate between the virtual reality exposure and the in vivo exposure. Implications are discussed.

Virtual reality applications in forensic psychiatry

“…Contributions have greatly influenced anxiety disorders' assessment and treatment [15]. Recently, VR has also been used in forensic settings.…”

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

“…This recognition of the potential impact of VR technology has led to the emergence of a significant, albeit still maturing, research literature that documents the many clinical and research targets where VR can add value relative to traditional assessment and intervention methods. A short list of the areas where Clinical VR has been usefully applied includes fear reduction in persons with specific phobias (Morina et al, 2015; Opris et al, 2012; Parsons & Rizzo, 2008; Powers & Emmelkamp, 2008), treatment for posttraumatic stress disorder (Beidel, Frueh, Neer, & Lejuez, 2017; Botella et al, 2015; Difede & Hoffman, 2002; Difede et al, 2007, 2014; Maples-Keller et al, 2017; McLay et al, 2011; Rizzo et al, 2010, 2013, 2017; Rothbaum, Hodges, Ready, Graap, & Alarcon, 2001; Rothbaum et al, 2014), cue-exposure for addiction and relapse prevention (Hone-Blanchet, Wensing, & Fecteau, 2014; Yoon et al, 2014), depression (Falconer et al, 2016), paranoid delusions (Freeman et al, 2016), discomfort reduction in cancer patients undergoing chemotherapy (Schneider, Kisby, & Flint, 2010), acute pain reduction during wound care and physical therapy with burn patients (Hoffman et al, 2011), other painful procedures (Gold et al, 2006; Mosadeghi, Reid, Martinez, Rosen, & Spiegel, 2016), body image disturbances in patients with eating disorders (Riva, 2011), navigation and spatial training in children and adults with motor impairments (John, Pop, Day, Ritsos, & Headleand, 2017), functional skill training and motor rehabilitation in patients with central nervous system dysfunction (e.g. stroke, traumatic brain injury, spinal cord injury, cerebral palsy, multiple sclerosis, etc.)…”

Overcoming Public Speaking Anxiety of Software Engineers Using Virtual Reality Exposure Therapy

“…It consists of realtime computer graphics, body tracking devices as well as other sensory inputs to create a virtual environment for patients [28]. One of the major strengths of this technique is that VR environment provides emerging opportunities to individuals with an active participation in a three-dimensional world.…”

“…In other words, individuals suffering from anxiety demonstrate behavioral, affective, and cognitive reactions in a VR environment similar to those experienced with a live audience [30]. The underlying mechanism of VRET is based on systematically exposure individuals to feared stimuli that are relevant to context while avoidance is prevented [31,28].…”