Abstract
SummaryAnxiety disorders are one of the most prevalent mental disorders in children and adolescents which may effectively be treated by several forms of exposure therapy. An emerging approach to exposure is virtual reality exposure therapy (VRET), but a literature search synthesis focusing specifically on the use of VRET in children and adolescents is still lacking. This systematic review sets out to provide an overview concerning VRET for the treatment of anxiety disorders in this age group. Four published trials covering an overall sample of 100 participants between the ages of 8 and 16 years were found during a systematic literature search and were included in the current review. Results reveal that participants show clinical improvements regarding anxiety symptoms after VRET. Nevertheless, the high potential of virtual reality as a tool for treating children and adolescents with anxiety disorders is contrasted by a considerable lack of controlled trials. Despite the evidence of VRET in adult samples, there is a need for more research with younger cohorts in order to be able to support this promising field of application.
Highlights
Anxiety disorders are considered to be one of the most prevalent clusters of disorders in children and adolescents with a lifetime prevalence of 28.8% [12]
A school-based study in Austria [26, 28] revealed that the lifetime prevalence of anxiety disorders was up to 15.5%, with an estimated prevalence of 7.3% for specific phobias (SPH), 3.5% for social anxiety disorders (SAD), and 1% for panic disorders (PD)
Exposure therapy has been supported as a first-line evidence-based treatment for most anxiety disorders, like SPH, SAD, PD, as well as for posttraumatic stress disorders (PTSD), and obsessive–compulsive disorders (OCD) [3]
Summary
Anxiety disorders are considered to be one of the most prevalent clusters of disorders in children and adolescents with a lifetime prevalence of 28.8% [12]. Research indicates that exposure therapy can be considered as a highly effective and efficacious treatment for children and adolescents with anxiety disorders [27] This therapy approach sets out to—on the one hand—activate the phobic structure upon exposure to the feared stimulus, and to—on the other hand—achieve symptom reduction by habituation following repeated confrontation with the according stimulus (in vivo or in sensu) [8]. These two classical methods of exposure therapy, in vivo (exposure to a real stimulus) and in sensu (exposure to an imaginal stimulus), were amended by a technology-mediated form of exposure: virtual reality exposure therapy (VRET). There is a significant difference in the physiological activation between patients and healthy controls during exposure to a feared stimulus in VR (e.g., Felnhofer et al [7])
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