In this study, we present a framework to develop and evaluate a virtual reality exposure therapy system with biofeedback toward scorpion phobia treatment. The system is developed based on the methodology for the development of virtual reality educational environments; usability is evaluated with the System Usability Scale (SUS), the affects are measured with the Positive and Negative Affect Schedule (PANAS), and the biofeedback heart rate is measured in real time using a wearable device and the HypeRate app. A descriptive study was conducted with a non-probabilistic convenience sample of undergraduate students. The non-clinical sample consisted of 51 participants (11 women and 40 men) (mean = 20.75, SD = 2.42 years). The system usability score was 75.49, higher than the average of 68. For positive affects, the average value of the overall sample was 28.18, while for negative affects it was 13.67. The results of this preliminary study, while not determining that the system could currently be applied in clinical settings, demonstrate however that the system can initially be considered as a pre-feasibility study, and if the limitations of the unbalanced non-clinical sample are addressed, it could be used in the future for this purpose. The main contribution is the proposed framework to integrate usability and affects evaluation, as well as biofeedback in a VRET system toward scorpion phobia treatment.
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