19.2 Virtual Reality and Social Anxiety in College-Aged Young Adults: Implications for Enhancing Diagnostic Precision and CBT

Abstract

Social anxiety disorder (SAD), which is prominent in college-age young adults (YAs), is disabling and associated with increased risk for comorbidity and long-term dependencies. Accurate diagnosis is hampered by underreporting of symptoms when observational data are absent. We report on the feasibility, acceptability, and use of a novel virtual reality (VR) designed to enhance diagnostic precision of SAD in YAs through contextually rich behavioral assessment tests (BATs). In a BAT, the patient is exposed to an anxiety stimulus (eg, snake, public speaking), allowing for the quantification of anxiety ratings, cognitions, and observation of behavioral responses (eg, escape). VR is a credible method of exposing patients to difficult-to-create scenarios for assessment and treatment. Our VR involves fluid interaction with the avatars in common college situations, allowing for increasing levels of challenge as the clinician controls a range of avatars’ verbalizations and movements in response to the participant, and can vary the anxiety-producing aspects of these interactions as needed.