Avoidance of social threat: Evidence from eye movements during a public speaking challenge using 360°- video

The impact of audience dynamics on public speaking anxiety in virtual scenarios: An online survey

BACKGROUND

Public speaking is one of the most commonly feared situations reported in both community and university samples. Despite extensive theoretical models and empirical studies aimed at delineating the underlying factors of Public Speaking Anxiety (PSA), the specific variables contributing to its onset remain incompletely characterised.

METHODS

The research involved 297 participants from an AmazonTurk survey, engaging with virtual public speaking scenarios differentiated by audience size, engagement levels, and room spatial dimensions. Participants' anticipated anxiety levels were quantitatively assessed across these scenarios, enabling a comprehensive exploration of the interaction between situational variables and PSA, thereby providing a framework to explore the influence of audience size, engagement, and spatial dimensions on PSA.

RESULTS

The mixed-effect model revealed a significant interaction among audience size, audience engagement, and room spatial dimensions. Further analyses using principal axis factoring and multiple regression identified three main factors: F1 (Engagement in a Large Audience), F2 (Confinement or Evaluation Anxiety), and F3 (Audience Disengagement). These factors significantly predict PSA scores.

CONCLUSIONS

This study reveals that PSA is influenced by a complex interplay of audience size, room dimensions, and audience engagement. The finding underscores the viable way to incorporate these situational variables in both empirical investigations and therapeutic interventions. Specifically, it introduces a novel framework for standardising audience size relative to room capacity.

A randomised controlled test in virtual reality of the effects on paranoid thoughts of virtual humans' facial animation and expression

Virtual reality (VR) is increasingly used in the study and treatment of paranoia. This is based on the finding that people who mistakenly perceive hostile intent from other people also perceive similar threat from virtual characters. However, there has been no study of the programming characteristics of virtual characters that may influence their interpretation. We set out to investigate how the animation and expressions of virtual humans may affect paranoia. In a two-by-two factor, between-groups, randomized design, 122 individuals with elevated paranoia rated their perceptions of virtual humans, set in an eye-tracking enabled VR lift scenario, that varied in facial animation (static or animated) and expression (neutral or positive). Both facial animation (group difference = 102.328 [51.783, 152.872], p < 0.001,η p 2 = 0.125) and positive expressions (group difference = 53.016 [0.054, 105.979], p = 0.049,η p 2 = 0.033) led to less triggering of paranoid thoughts about the virtual humans. Facial animation (group difference = 2.442 [- 4.161, - 0.724], p = 0.006,η p 2 = 0.063) but not positive expressions (group difference = 0.344 [- 1.429, 2.110], p = 0.681,η p 2 = 0.001) significantly increased the likelihood of neutral thoughts about the characters. Our study shows that the detailed programming of virtual humans can impact the occurrence of paranoid thoughts in VR. The programming of virtual humans needs careful consideration depending on the purpose of their use.

Attentional heterogeneity in social anxiety disorder: Evidence from Hidden Markov Models

There is some evidence for heterogeneity in attentional processes among individuals with social anxiety. However, there is limited work considering how attentional processes may differ as a mechanism in a naturalistic task-based context (e.g., public speaking). In this secondary analysis we tested attentional heterogeneity among individuals diagnosed with social anxiety disorder (N = 21) in the context of a virtual reality exposure treatment study. Participants completed a public speaking challenge in an immersive 360°-video virtual reality environment with eye tracking at pre-treatment, post-treatment, and at 1-week follow-up. Using a Hidden Markov Model (HMM) approach with clustering we tested whether there were distinct profiles of attention pre-treatment and whether there were changes following the intervention. As a secondary aim we tested whether the distinct attentional profiles at pre-treatment predicted differential treatment outcomes. We found two distinct attentional profiles pre-treatment that we characterized as audience-focused and audience-avoidant. However, by the 1-week follow-up the two profiles were no longer meaningfully different. We found a meaningful difference between HMM groups for fear of public speaking at post-treatment b = -8.54, 95% Highest Density Interval (HDI) [-16.00, -0.90], Bayes Factor (BF) = 8.31 but not at one-week follow-up b = -5.83, 95% HDI [-13.25, 1.81], BF = 2.28. These findings provide support for heterogeneity in attentional processes among socially anxious individuals, but our findings indicate that this may change following treatment. Moreover, our results offer preliminary mechanistic evidence that patterns of avoidance may be specifically related to poorer treatment outcomes for virtual reality exposure therapy.

Examination of gaze behaviour in social anxiety disorder using a virtual reality eye-tracking paradigm: protocol for a casecontrol study

INTRODUCTION

Social anxiety disorder (SAD) has an early onset, a high lifetime prevalence, and may be a risk factor for developing other mental disorders. Gaze behaviour is considered an aberrant feature of SAD. Eye-tracking, a novel technology device, enables recording eye movements in real time, making it a direct and objective measure of gaze behaviour. Virtual reality (VR) is a promising tool for assessment and diagnostic purposes. Developing an objective screening tool based on examination of gaze behaviour in SAD may potentially aid early detection. The objective of this current study is, therefore to examine gaze behaviour in SAD utilising VR.

METHODS AND ANALYSIS

A case-control study design is employed in which a clinical sample of 29 individuals with SAD will be compared with a matched healthy control group of 29 individuals. In the VR-based eye-tracking paradigm, participants will be presented to stimuli consisting of high-res 360° 3D stereoscopic videos of three social-evaluative tasks designed to elicit social anxiety. The study will investigate between-group gaze behaviour differences during stimuli presentation.

ETHICS AND DISSEMINATION

The study has been approved by the National Committee on Health Research Ethics for the Capital Region of Denmark (H-22041443). The study has been preregistered on OSF registries: https://doi.org/10.17605/OSF.IO/XCTAKAll participants will be provided with written and oral information. Informed consent is required for all the participants. Participation is voluntarily, and the participants can at any time terminate their participation without any consequences. Study results; positive, negative or inconclusive will be published in relevant scientific journals.

Perspectives on emotional memory images and the persistence of pain

Multiple influences prevent recovery from pain. Our viewpoint is that non-conscious emotional memory images (EMIs) triggers outdated stress responses contributing to the intractability of pain. In this perspectives article we explore the concept that EMIs contribute to the persistence of pain. We contend that psychophysiological "stress" responses, resulting from first-time, novel and unprecedented pernicious or adverse events form EMIs within very short time frames (split-second learning). Subsequently, these EMIs are re-triggered in daily living, "re-playing" stress responses. We postulate that EMIs continually "raise the alarm" to socio-ecological stimuli by re-triggering the HPA-axis and amplifying neural input associated with threat, fear, anxiety, and pain, creating a debilitating state of psychophysiological dis-ease. We position the EMI within a philosophical debate on the nature and locus of memory and explain how the EMI, irrespective of whether it is a "thing" or a metaphor, can create a basis of understanding for the client to grasp. We describe a therapeutic approach (Split-Second Unlearning) to "clear" EMIs and the "stickiness" of pain and help people embark on a healing journey. This involves surveillance of clients for micro-expression(s) signifying an in-the-moment stress response, representative of the presence of an EMI, and encouraging the client to become a curious observer within/of their own experience. This helps the client detach their EMI from its stress response. We contend that this occurs rapidly without the need to get bogged down in a whole-life narrative. We advocate further exploration of our EMI model of dis-ease in the context of intractable pain.

Multimodal Remote Research on Social Anxiety Using a New Teleconferencing Paradigm

Background

Social anxiety is a prevalent mental health concern. Models of social anxiety incorporate multifaceted components from cognitive appraisals to attention as factors maintaining the disorder. Multimodal research investigating multiple facets of social anxiety simultaneously offers an important avenue to advance our understanding of the disorder.

Methods

The current study tested a novel, internet-based simulated teleconferencing interaction social stressor challenge and included the collection of self-report, eye-tracking, and auditory vocal data during the challenge. Participants (N = 262) completed two interactions. The pre-recorded male and female audience members (assigned to display interest or uninterest) discussed a topic and then prompted the participant to speak on that topic.

Results

Fidelity indices revealed that most participants rated the interactions with the simulated audience as realistic; reported heightened subjective distress during the simulated teleconferencing interactions; and correctly rated audience members' level of interest. As predicted, social anxiety predicted participants' subjective distress during the simulated teleconferencing interactions. Findings from audio vocal and eye tracking analyses largely corresponded to prior research - indicating that social anxiety influences audio vocal responses and patterns of attention during social stressors.

Conclusions

Taken together, these findings suggest that the simulated teleconferencing interaction framework introduced here offers a potentially useful approach for the remote investigation of mechanisms underpinning social anxiety.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10371-y.

No evidence that gaze anxiety predicts gaze avoidance behavior during face-to-face social interaction

Eye contact is an indispensable social signal, yet for some individuals it is also a source of discomfort they fear and avoid. However, it is still unknown whether gaze anxiety actually produces avoidant gaze behavior in naturalistic, face-to-face interactions. Here, we relied on a novel dual eye-tracking setup that allows us to assess interactive gaze behavior. To investigate the effect of gaze anxiety on gaze behavior, we a priori created groups of participants reporting high or low levels of gaze anxiety. These participants (n = 51) then performed a semi-standardized interaction with a previously unknown individual reporting a medium level of gaze anxiety. The gaze behavior of both groups did not differ in either classical one-way, eye-tracking parameters (e.g. unilateral eye gaze), or interactive, two-way ones (e.g. mutual gaze). Furthermore, the subjective ratings of both participants' interaction did not differ between groups. Gaze anxious individuals seem to exhibit normal gaze behavior which does not hamper the perceived quality of interactions in a naturalistic face-to-face setup. Our findings point to the existence of cognitive distortions in gaze anxious individuals whose exterior behavior might be less affected than feared by their interior anxiety.

Virtual Reality Exposure Therapy for Treating Social Anxiety: A Scoping Review of Treatment Designs and Adaptation to Stuttering

Virtual Reality Exposure Therapy (VRET) has been shown to be an effective technique for reducing social anxiety. People who stutter are at greater risk of developing heightened social anxiety. Cognitive behavior therapy protocols have shown promise in reducing social anxiety in people who stutter, but no studies have investigated VRET targeting social anxiety associated with stuttering. The aim of the current review is to provide an overview of VRET techniques used to treat social anxiety and insights into how these techniques might be adopted in the case of comorbid stuttering and social anxiety. Twelve studies were reviewed to understand key distinctions in VRET protocols used to treat social anxiety. Distinctions include exercises targeting public speaking vs. general social anxiety, computer-generated virtual environments vs. 360° video, and therapist guided vs. automated VRET. Based on the review findings, we propose how certain features could be applied in the case of stuttering. Virtual therapists, inhibitory learning techniques and integration into speech therapy may be suitable ways to tailor VRET. Regardless of these different techniques, VRET should consider the situations and cognitive-behavioral processes that underlie the experience of social anxiety amongst people who stutter.

How to choose the size of facial areas of interest in interactive eye tracking

Advances in eye tracking technology have enabled the development of interactive experimental setups to study social attention. Since these setups differ substantially from the eye tracker manufacturer's test conditions, validation is essential with regard to the quality of gaze data and other factors potentially threatening the validity of this signal. In this study, we evaluated the impact of accuracy and areas of interest (AOIs) size on the classification of simulated gaze (fixation) data. We defined AOIs of different sizes using the Limited-Radius Voronoi-Tessellation (LRVT) method, and simulated gaze data for facial target points with varying accuracy. As hypothesized, we found that accuracy and AOI size had strong effects on gaze classification. In addition, these effects were not independent and differed in falsely classified gaze inside AOIs (Type I errors; false alarms) and falsely classified gaze outside the predefined AOIs (Type II errors; misses). Our results indicate that smaller AOIs generally minimize false classifications as long as accuracy is good enough. For studies with lower accuracy, Type II errors can still be compensated to some extent by using larger AOIs, but at the cost of more probable Type I errors. Proper estimation of accuracy is therefore essential for making informed decisions regarding the size of AOIs in eye tracking research.

Selective visual attention during public speaking in an immersive context

It has recently become feasible to study selective visual attention to social cues in increasingly ecologically valid ways. In this secondary analysis, we examined gaze behavior in response to the actions of others in a social context. Participants (N = 84) were asked to give a 5-minute speech to a five-member audience that had been filmed in 360° video, displayed in a virtual reality headset containing a built-in eye tracker. Audience members were coached to make movements that would indicate interest or lack of interest (e.g., nodding vs. looking away). The goal of this paper was to analyze whether these actions influenced the speaker's gaze. We found that participants showed reliable evidence of gaze towards audience member actions in general, and towards audience member actions involving their phone specifically (compared with other actions like looking away or leaning back). However, there were no differences in gaze towards actions reflecting interest (like nodding) compared with actions reflecting lack of interest (like looking away). Participants were more likely to look away from audience member actions as well, but there were no specific actions that elicited looking away more or less. Taken together, these findings suggest that the actions of audience members are broadly influential in motivating gaze behaviors in a realistic, contextually embedded (public speaking) setting. Further research is needed to examine the ways in which these findings can be elucidated in more controlled laboratory environments as well as in the real world.

Impacts of Cues on Learning and Attention in Immersive 360-Degree Video: An Eye-Tracking Study

Immersive 360-degree video has become a new learning resource because of its immersive sensory experience. This study examined the effects of textual and visual cues on learning and attention in immersive 360-degree video by using eye-tracking equipment integrated in a virtual reality head-mounted display. Participants (n = 110) were randomly assigned to one of four conditions: (1) no cues, (2) textual cues in the initial field of view (FOV), (3) textual cues outside the initial FOV, and (4) textual cues outside the initial FOV + visual cues. The results showed that the cues (annotations or annotations + arrows) helped learners achieve better learning outcomes and spend more time focusing on the areas with cues. In addition, the study found a serious imbalance in the distribution of learners' attention in each region of the video. The attention directed to textual cues in the initial FOV is much higher than the attention directed to textual cues outside the initial FOV. Adding visual cues can effectively direct attention to textual cues outside the initial FOV and alleviate the imbalance of attention distribution. Consequently, adding cues to immersive 360-degree video can be an appropriate approach to promote learning and guide attention in immersive 360-degree video learning environments. This study provided new insights into the design and development of immersive 360-degree video instructional resources.

Look at the Audience? A Randomized Controlled Study of Shifting Attention From Self-Focus to Nonsocial vs. Social External Stimuli During Virtual Reality Exposure to Public Speaking in Social Anxiety

Background: Enhanced self-focused attention plays a central role in the maintenance and treatment of Social Anxiety and is targeted in contemporary cognitive behavioral therapy. Actual developments use Virtual Reality (VR) for behavioral training. However, no VR attention training combining exposure to public speaking with shifting attention from self-focus to external focus has been investigated, and no experimental evidence exists on different kinds of external cues as targets of attention. Therefore, we investigated the effects of an attention training during public speaking in VR and examined differential effects of an external focus on nonsocial vs. social stimuli. Methods: In this randomized controlled study, highly socially anxious participants were instructed to focus on either objects or the audience within a virtual speech task. We assessed the pre-post effects on affective reactions, self-perception, and attentional processes during public speaking as well as general Social Anxiety using subjective, physiological, and eye-tracking measures. Repeated-measures analyses of variance (ANOVAs) were calculated to detect changes from pretest to posttest over both groups, and time × group interaction effects. Results: Within the analysis sample (n = 41), anxiety during public speaking and fear of negative evaluation significantly decreased, with no significant differences between groups. No significant time effect, but a significant time × group effect, was found for the looking time proportion on the audience members' heads. Follow-up tests confirmed a significant increase in the social-focus group and a significant decrease in the nonsocial-focus group. For all other variables, except external focus and fear of public speaking, significant improvements were found over both groups. Further significant time x group effects were found for positive affect during public speaking, with a significant increase in the social focus, and no significant change in the nonsocial-focus group. Conclusion: Our findings suggest that attention training to reduce self-focus can be successfully conducted in VR. Both training versions showed positive short-term effects in the highly socially anxious, with particular advantages of an external social focus concerning eye contact to the audience and positive affect. Further research should investigate whether social focus is even more advantageous long term and if reinterpretations of dysfunctional beliefs could be achieved by not avoiding social cues.

Visual Attention Patterns of Socially Anxious Individuals When Using Facebook: An Eye Tracking Study

Social networking sites (SNSs) are an increasingly used medium for social interactions. For socially anxious individuals, SNS-based communication is often preferred over traditional face-to-face socializing. Yet, research on SNSs usage and social anxiety is still less common, with extant studies being mostly correlational among healthy nonanxious participants. Conversely, here, we examined differences in actual gaze patterns to social and nonsocial stimuli between socially anxious and nonanxious individuals while using Facebook. Socially anxious and nonanxious student participants freely viewed a genuine Facebook profile page designed for the present study, for 3.5 minutes, containing 12 social and 12 nonsocial picture stimuli. Gaze patterns on social and nonsocial areas of interest (AOIs) were explored. Subjective uneasiness experienced when viewing the social pictures and state anxiety were also assessed. Finally, 2 weeks following the task, we evaluated participants' willingness to participate in a follow-up (fictitious) study that required them to passively view their own Facebook profile, and then to actively use it. Results showed that compared with nonanxious participants, socially anxious participants demonstrated a viewing pattern less favoring social pictures, reflecting an attentional avoidance tendency. A significant inverse correlation between subjective uneasiness and percent of dwell time spent on the social AOI emerged. Socially anxious participants also reported higher levels of state anxiety, which was significantly positively correlated with uneasiness scores. Finally, socially anxious participants were also less willing to actively use their Facebook profile page. This study suggests that social anxious individuals are characterized by attentional and behavioral avoidance tendencies when using Facebook.