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

Tanya Guitard,Claude Bélanger,Maxine Berthiaume,Stéphane Bouchard

doi:10.3390/jcm8030309

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.

Highlights

In the treatment of anxiety disorders, exposure is defined as “any procedure that confronts the person with a stimulus which typically elicits an undesirable behavior or an unwanted emotional response” [1] (p. 121)
Studies have demonstrated that, compared to people who do not suffer from an anxiety disorder, immersions in virtual reality (VR) can elicit anxiety in people suffering from specific phobia [5], and from obsessive-compulsive disorder characterized by fear of contamination [6] or by checking behaviors [7]
Exclusion criteria consisted of: (a) suffering from an anxiety disorder other than generalized anxiety disorder (GAD) as primary diagnosis; (b) suffering from claustrophobia, because the experimentation was held in an immersive CAVE-Like system, a rather confined area; (c) use of benzodiazepines, because of the impact this type of medication might have on the variables measured; and (d) suffering from any of the following health issues: diseases related to the inner ear or vestibular system, cardiovascular diseases or circulatory disorders, migraines, blood pressure disorders or diabetes

Summary

Introduction

In the treatment of anxiety disorders, exposure is defined as “any procedure that confronts the person with a stimulus which typically elicits an undesirable behavior or an unwanted emotional response” [1] (p. 121). In the treatment of anxiety disorders, exposure is defined as “any procedure that confronts the person with a stimulus which typically elicits an undesirable behavior or an unwanted emotional response” [1] Studies have demonstrated that, compared to people who do not suffer from an anxiety disorder, immersions in virtual reality (VR) can elicit anxiety in people suffering from specific phobia [5], and from obsessive-compulsive disorder characterized by fear of contamination [6] or by checking behaviors [7]. Several studies, summarized in literature reviews (e.g., [8]) and meta-analyses (e.g., [9,10,11]), have documented the relevance and efficacy of using VR to conduct exposure ( called in virtuo exposure, [12]) in the treatment of anxiety disorders

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