Abstract
Acrophobia is characterized by intense fear in height situations. Virtual reality (VR) can be used to trigger such phobic fear, and VR exposure therapy (VRET) has proven effective for treatment of phobias, although it remains important to further elucidate factors that modulate and mediate the fear responses triggered in VR. The present study assessed verbal and behavioral fear responses triggered by a height simulation in a 5-sided cave automatic virtual environment (CAVE) with visual and acoustic simulation and further investigated how fear responses are modulated by immersion, i.e., an additional wind simulation, and presence, i.e., the feeling to be present in the VE. Results revealed a high validity for the CAVE and VE in provoking height related self-reported fear and avoidance behavior in accordance with a trait measure of acrophobic fear. Increasing immersion significantly increased fear responses in high height anxious (HHA) participants, but did not affect presence. Nevertheless, presence was found to be an important predictor of fear responses. We conclude that a CAVE system can be used to elicit valid fear responses, which might be further enhanced by immersion manipulations independent from presence. These results may help to improve VRET efficacy and its transfer to real situations.
Highlights
Exposure therapy is a cognitive behavioral technique for the treatment of anxiety disorders (Abramowitz et al, 2012)
To answer the question whether the presented virtual environments (VEs) was suitable for provoking acrophobia related fear responses, the relationship between a trait measure of acrophobic fear and the fear triggered by the VE was examined
A χ 2-test revealed that significantly more height anxious (HHA) (19 out of 55; 34, 5%) than low height anxious (LHA)
Summary
Exposure therapy is a cognitive behavioral technique for the treatment of anxiety disorders (Abramowitz et al, 2012). Recent research suggests that exposure therapy may be realized in virtual reality (VR), i.e., by exposing patients to computer-generated virtual environments (VEs) This so-called VR Exposure Therapy (VRET; see Bouchard et al, 2012) is convincingly effective for the treatment of phobic disorders (Parsons and Rizzo, 2008; Powers and Emmelkamp, 2008; Opris et al, 2012; Turner and Casey, 2014; Morina et al, 2015), and first promising results exist for other anxiety disorders as well as substance use disorders and eating disorders (HoneBlanchet et al, 2014; Freeman et al, 2017; Maples-Keller et al, 2017). Given these first promising results of VRET efficacy, it seems crucial to unravel the underlying mechanisms (Diemer et al, 2016) in order to optimize the treatment and enlarge the field of application
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