Abstract
Virtual reality (VR) enables individuals to be exposed to naturalistic environments in laboratory settings, offering new possibilities for research in human neuroscience and treatment of mental disorders. We used VR to study psychological, autonomic and postural reactions to heights in individuals with varying intensity of fear of heights. Study participants (N = 42) were immersed in a VR of an unprotected open-air elevator platform in an urban area, while standing on an unstable ground. Virtual elevation of the platform (up to 40 m above the ground level) elicited robust and reliable psychophysiological activation including increased distress, heart rate, and electrodermal activity, which was higher in individuals suffering from fear of heights. In these individuals, compared with individuals with low fear of heights, the VR height exposure resulted in higher velocity of postural movements as well as decreased low-frequency (<0.5 Hz) and increased high-frequency (>1 Hz) body sway oscillations. This indicates that individuals with strong fear of heights react to heights with maladaptive rigidity of posture due to increased weight of visual input for balance control, while the visual information is less reliable at heights. Our findings show that exposure to height in a naturalistic VR environment elicits a complex reaction involving correlated changes of the emotional state, autonomic activity, and postural balance, which are exaggerated in individuals with fear of heights.
Highlights
Correct postural control is essential for our daily living and requires accurate integration of visual, proprioceptive, and vestibular sensory information (Horak, 2006; Assländer and Peterka, 2014)
Our results show that exposure to height in Virtual reality (VR) reliably evokes a realistic experience accompanied by psychological distress, physiological stress response and changes in postural stability, which are all enhanced in individuals who suffer from fear of heights
We revealed a strong association between the measures of balance control and the markers of distress and autonomic arousal, confirming that postural adaptations are an integral part of the protective reaction to the threat of height
Summary
Correct postural control is essential for our daily living and requires accurate integration of visual, proprioceptive, and vestibular sensory information (Horak, 2006; Assländer and Peterka, 2014). Virtual Height: Fear and Posture for a loss of information from one or two of these sensory systems and failure to make timely and adequate adjustments in the balance control makes a person vulnerable to falls in a changing environment (Honeine and Schieppati, 2014). To maintain proper balance and produce corresponding postural commands is especially challenging for people with fear of heights. Height intolerance is thought to originate from an interaction between the psychological factors, mainly anxiety, and the physiological factors, such as a discrepancy between the visual, vestibular and somatosensory information used for the postural control (Teggi et al, 2019)
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