1
|
Tan YL, Chang VYX, Ang WHD, Ang WW, Lau Y. Virtual reality exposure therapy for social anxiety disorders: a meta-analysis and meta-regression of randomized controlled trials. ANXIETY, STRESS, AND COPING 2024:1-20. [PMID: 39161295 DOI: 10.1080/10615806.2024.2392195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/25/2024] [Accepted: 08/09/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Virtual reality exposure therapy offers a unique opportunity to treat social anxiety disorder. This meta-analysis aims to evaluate the effectiveness of virtual reality exposure therapy compared to waitlist comparators or other interventions for individuals with social anxiety disorder in alleviating anxiety symptoms. METHODS A three-step comprehensive search for the randomized controlled trials of virtual reality exposure therapy was conducted from inception to 7 December 2023. The overall effect was measured using Hedges' g and determined using t-statistics at a significance level of p < 0.05. Sensitivity, subgroup, and meta-regression analyses were carried out. RESULTS A total of 17 randomized control trials were retrieved from nine electronic databases. Virtual reality exposure therapy has greater efficacy than waitlist comparators in reducing anxiety symptoms at post-intervention and follow-up assessment. Virtual reality exposure therapy demonstrates a similar effect to other interventions at post-intervention and follow-up assessment. We observed a greater effect for participants with symptomatic social anxiety when we combined the intervention with cognitive behavioral therapy compared to its counterpart. Meta-regression analyses found no significant covariate. CONCLUSIONS Overall, virtual reality exposure therapy can provide supplementary therapy for improving anxiety symptoms. Additional high-quality and large-scale trials with long-term follow-up are needed.
Collapse
Affiliation(s)
- Yi Ling Tan
- Nursing Department, Raffles Hospital, Singapore
| | | | - Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Wei Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ying Lau
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Regions of China
| |
Collapse
|
2
|
Jingili N, Oyelere SS, Nyström MBT, Anyshchenko L. A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression. Front Digit Health 2023; 5:1239435. [PMID: 38026832 PMCID: PMC10661329 DOI: 10.3389/fdgth.2023.1239435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
This systematic review aims to assess the effectiveness of virtual reality (VR) and gamification interventions in addressing anxiety and depression. The review also seeks to identify gaps in the current VR treatment landscape and provide guidelines for future research and development. A systematic literature search was conducted using Scopus, Web of Science, and PubMed databases, focusing on studies that utilized VR and gamification technology to address anxiety and depression disorders. A total of 2,664 studies were initially identified, 15 of those studies fulfilled the inclusion criteria for this systematic review. The efficacy of VR in addressing anxiety and depression was evident across all included studies. However, the diversity among VR interventions highlights the need for further investigation. It is advised to incorporate more diverse participant samples and larger cohorts and explore a broader spectrum of therapeutic approaches within VR interventions for addressing anxiety and depression to enhance the credibility of future research. Additionally, conducting studies in varying socioeconomic contexts would contribute to a more comprehensive understanding of their real-world applicability.
Collapse
Affiliation(s)
- Nuru Jingili
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Skellefteå, Sweden
| | - Solomon Sunday Oyelere
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Skellefteå, Sweden
| | - Markus B. T. Nyström
- Department of Health, Education and Technology Division, Luleå University of Technology, Luleå, Sweden
| | - Lina Anyshchenko
- Department of Health, Education and Technology Division, Luleå University of Technology, Luleå, Sweden
| |
Collapse
|
3
|
Cheng C, Ebrahimi OV. Gamification: a Novel Approach to Mental Health Promotion. Curr Psychiatry Rep 2023; 25:577-586. [PMID: 37801212 PMCID: PMC10654169 DOI: 10.1007/s11920-023-01453-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE OF REVIEW Gamification has emerged as a novel technique for improving mental health and enhancing treatment effectiveness. This paper provides an overview of gamification approaches to mental health intervention, identifies factors that may be related to variations in treatment effectiveness, and discusses possible strategies for tailoring gamified interventions to clients' needs. RECENT FINDINGS Recent research has documented the potential of gamified mental health interventions for bolstering mental wellness and mitigating psychological symptoms. However, their effectiveness may vary depending on study design-related factors and gender-specific considerations. Literature reviews have also identified yet-to-be resolved issues surrounding the possible strengths and weaknesses of the personalization versus standardization of gamification, as well as the potential benefits of gamification for increasing engagement versus the potential risks of over-engagement and behavioral addiction to gamified components. This review highlights the need for careful planning and execution of gamified mental health interventions to optimize their effectiveness and suitability for meeting clients' individual needs and preferences.
Collapse
Affiliation(s)
- Cecilia Cheng
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Omid V Ebrahimi
- Department of Clinical Psychology, University of Oslo, Oslo, Norway
- Research Institute, Modum Bad Psychiatric Hospital, Vikersund, Norway
| |
Collapse
|
4
|
Jingili N, Oyelere SS, Ojwang F, Agbo FJ, Nyström MBT. Virtual Reality for Addressing Depression and Anxiety: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095621. [PMID: 37174141 PMCID: PMC10178384 DOI: 10.3390/ijerph20095621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023]
Abstract
Virtual reality is an emerging field in mental health and has gained widespread acceptance due to its potential to treat various disorders, such as anxiety and depression. This paper presents a bibliometric analysis of virtual reality (VR) use in addressing depression and anxiety from 1995 to 2022. The study analysed 1872 documents using the Scopus database, identifying the field's most relevant journals and authors. The results indicate that using VR for addressing anxiety and depression is a multidisciplinary field with a wide variety of research topics, leading to significant collaborative research in this area. The Annual Review of Cybertherapy and Telemedicine was identified as the most relevant journal, while Behavior Research and Therapy was found to be the most cited journal. The analysis of keywords suggests that there is more research on using VR for anxiety and related disorders than for depression. Riva G. was identified as the top author in producing research outputs on VR-AD, and the University of Washington emerged as the leading institution in scientific outputs on VR-AD. Thematic and intellectual analyses helped identify the main themes within the research domain, providing valuable insight into the current and future directions of the field.
Collapse
Affiliation(s)
- Nuru Jingili
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, 93187 Skellefteå, Sweden
| | - Solomon Sunday Oyelere
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, 93187 Skellefteå, Sweden
| | - Frank Ojwang
- Faculty of Social Sciences, University of Lapland, 96300 Rovaniemi, Finland
| | - Friday Joseph Agbo
- School of Computing, University of Eastern Finland, 80100 Joensuu, Finland
- School of Computing and Data Science, Willamette University, Salem, OR 97301, USA
| | - Markus B T Nyström
- Department of Health, Education and Technology Division, Luleå University of Technology, 97187 Luleå, Sweden
| |
Collapse
|
5
|
Rubin M, Gebhardt ES, Malloy L, Telch MJ. Multimodal Remote Research on Social Anxiety Using a New Teleconferencing Paradigm. COGNITIVE THERAPY AND RESEARCH 2023; 47:423-430. [PMID: 37168697 PMCID: PMC10097519 DOI: 10.1007/s10608-023-10371-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 05/13/2023]
Abstract
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.
Collapse
Affiliation(s)
- Mikael Rubin
- Department of Psychology, The University of Texas at Austin, Austin, TX USA
- Department of Psychology, Palo Alto University, Palo Alto, CA USA
| | - Eli S. Gebhardt
- Department of Psychology, The University of Texas at Austin, Austin, TX USA
| | - Luna Malloy
- Department of Psychology, The University of Texas at Austin, Austin, TX USA
| | - Michael J. Telch
- Department of Psychology, The University of Texas at Austin, Austin, TX USA
| |
Collapse
|
6
|
Lee HJ, Stein MB. Update on treatments for anxiety-related disorders. Curr Opin Psychiatry 2023; 36:140-145. [PMID: 36480651 DOI: 10.1097/yco.0000000000000841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW This review examines recent evidence that informs the treatment of anxiety-related disorders. RECENT FINDINGS In addition to selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and benzodiazepines, agomelatine has demonstrated efficacy in treating generalized anxiety disorder (GAD). Other novel products, such as ketamine, psilocybin and cannabidiol, are in the process of gathering evidence in support of the treatment of anxiety disorders. In psychological therapy, various psychological treatments for anxiety disorders, such as mindfulness-based intervention, acceptance and commitment therapy, psychodynamic therapy, emotion-focused therapy and dialectical behavioural therapy, have been tried. Still, most therapies have not proven superior to cognitive behavioural therapy (CBT). In very preliminary findings: Repetitive transcranial magnetic stimulation (rTMS) was effective in GAD; transcranial direct current stimulation (tDCS) was effective for social anxiety disorder (SAD) and GAD and augmented exposure therapy for specific fears. Internet and mobile-based interventions have comparable efficacy to face-to-face therapy. SUMMARY Pharmacotherapy of anxiety disorders is expanding to novel products. Despite trying other psychological therapies for anxiety disorders, most therapies were comparable to but not superior to CBT. rTMS and tDCS were also used and show early promise for GAD, but further studies are needed. Most internet or mobile app based psychological therapies were based on CBT, and some can be considered as alternatives to in-person face-to-face therapy.
Collapse
Affiliation(s)
- Hyun Jeong Lee
- Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang, South Korea
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
7
|
Chard I, Van Zalk N, Picinali L. Virtual reality exposure therapy for reducing social anxiety in stuttering: A randomized controlled pilot trial. Front Digit Health 2023; 5:1061323. [PMID: 36845336 PMCID: PMC9947508 DOI: 10.3389/fdgth.2023.1061323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
We report on findings from the first randomized controlled pilot trial of virtual reality exposure therapy (VRET) developed specifically for reducing social anxiety associated with stuttering. People who stutter with heightened social anxiety were recruited from online adverts and randomly allocated to receive VRET (n = 13) or be put on a waitlist (n = 12). Treatment was delivered remotely using a smartphone-based VR headset. It consisted of three weekly sessions, each comprising both performative and interactive exposure exercises, and was guided by a virtual therapist. Multilevel model analyses failed to demonstrate the effectiveness of VRET at reducing social anxiety between pre- and post-treatment. We found similar results for fear of negative evaluation, negative thoughts associated with stuttering, and stuttering characteristics. However, VRET was associated with reduced social anxiety between post-treatment and one-month follow-up. These pilot findings suggest that our current VRET protocol may not be effective at reducing social anxiety amongst people who stutter, though might be capable of supporting longer-term change. Future VRET protocols targeting stuttering-related social anxiety should be explored with larger samples. The results from this pilot trial provide a solid basis for further design improvements and for future research to explore appropriate techniques for widening access to social anxiety treatments in stuttering.
Collapse
Affiliation(s)
- Ian Chard
- Design Psychology Lab, Dyson School of Design Engineering, Imperial College London, London, United Kingdom,Correspondence: Ian Chard
| | - Nejra Van Zalk
- Design Psychology Lab, Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| | - Lorenzo Picinali
- Audio Experience Design Group, Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| |
Collapse
|
8
|
Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, Blumenthal N, Li M, Asché L, Jonas S, Bey K, Schulze M, Steffens M, Pensel MC, Guth M, Rohlfsen F, Ekhlas M, Lügering H, Fileccia H, Pakos J, Lux S, Philipsen A, Braun N. Virtual reality in the diagnostic and therapy for mental disorders: A systematic review. Clin Psychol Rev 2022; 98:102213. [PMID: 36356351 DOI: 10.1016/j.cpr.2022.102213] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/21/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Virtual reality (VR) technologies are playing an increasingly important role in the diagnostics and treatment of mental disorders. OBJECTIVE To systematically review the current evidence regarding the use of VR in the diagnostics and treatment of mental disorders. DATA SOURCE Systematic literature searches via PubMed (last literature update: 9th of May 2022) were conducted for the following areas of psychopathology: Specific phobias, panic disorder and agoraphobia, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, eating disorders, dementia disorders, attention-deficit/hyperactivity disorder, depression, autism spectrum disorder, schizophrenia spectrum disorders, and addiction disorders. ELIGIBILITY CRITERIA To be eligible, studies had to be published in English, to be peer-reviewed, to report original research data, to be VR-related, and to deal with one of the above-mentioned areas of psychopathology. STUDY EVALUATION For each study included, various study characteristics (including interventions and conditions, comparators, major outcomes and study designs) were retrieved and a risk of bias score was calculated based on predefined study quality criteria. RESULTS Across all areas of psychopathology, k = 9315 studies were inspected, of which k = 721 studies met the eligibility criteria. From these studies, 43.97% were considered assessment-related, 55.48% therapy-related, and 0.55% were mixed. The highest research activity was found for VR exposure therapy in anxiety disorders, PTSD and addiction disorders, where the most convincing evidence was found, as well as for cognitive trainings in dementia and social skill trainings in autism spectrum disorder. CONCLUSION While VR exposure therapy will likely find its way successively into regular patient care, there are also many other promising approaches, but most are not yet mature enough for clinical application. REVIEW REGISTRATION PROSPERO register CRD42020188436. FUNDING The review was funded by budgets from the University of Bonn. No third party funding was involved.
Collapse
Affiliation(s)
- Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ann-Kathrin Thöne
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Pramme
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Nike Blumenthal
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mengtong Li
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Asché
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Stephan Jonas
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Marcel Schulze
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Maria Steffens
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Max Christian Pensel
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Matthias Guth
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Felicia Rohlfsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mogda Ekhlas
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Lügering
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Fileccia
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Julian Pakos
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
| |
Collapse
|
9
|
Gao J. Scales assessing L2 speaking anxiety: Development, validation, and application. Front Psychol 2022; 13:972671. [DOI: 10.3389/fpsyg.2022.972671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
Through featuring a historical review of the L2 speaking assessment scales applied in related studies, this paper targets at providing responses for the following three questions (a) How are the scales assessing L2 speaking anxiety developed and adapted in related research? (b) What are the frequently adopted methods for validating speaking anxiety scales? (c) How is L2 speaking anxiety represented and interpreted with a dynamic approach? Based on analyzing the development process of frequently-used scales for assessing test anxiety, foreign language classroom anxiety, and speaking anxiety, the author classified the scales into three categories: test-based scales measuring speaking anxiety, classroom-based scales measuring speaking anxiety, and activity-based scales measuring L2 speaking anxiety. As for the scale validation methods, Classical Testing Theory (CTT) and Rasch measurement were introduced as two major statistical paradigms for guaranteeing the reliability of the scales. This paper also summarizes the emerging themes generalized from research focusing speaking anxiety assessment, where the dynamic approach is discussed as a guideline to interpret the relationship among anxiety, language performance, and other factors involved in language learning. This paper ends with highlighting possible directions for anxiety-related research in the future, where technology intervention and the “positivity ratio” might become new attempts for pedagogical design.
Collapse
|
10
|
Rubin M, Muller K, Hayhoe MM, Telch MJ. Attention guidance augmentation of virtual reality exposure therapy for social anxiety disorder: a pilot randomized controlled trial. Cogn Behav Ther 2022; 51:371-387. [PMID: 35383544 PMCID: PMC9458616 DOI: 10.1080/16506073.2022.2053882] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/11/2022] [Indexed: 11/03/2022]
Abstract
Biased attention to social threats has been implicated in social anxiety disorder. Modifying visual attention during exposure therapy offers a direct test of this mechanism. We developed and tested a brief virtual reality exposure therapy (VRET) protocol using 360°-video and eye tracking. Participants (N = 21) were randomized to either standard VRET or VRET + attention guidance training (AGT). Multilevel Bayesian models were used to test (1) whether there was an effect of condition over time and (2) whether post-treatment changes in gaze patterns mediated the effect of condition at follow-up. There was a large overall effect of the intervention on symptoms of social anxiety, as well as an effect of the AGT augmentation on changes in visual attention to audience members. There was weak evidence against an effect of condition on fear of public speaking and weak evidence supporting a mediation effect, however these estimates were strongly influenced by model priors. Taken together, our findings suggest that attention can be modified within and during VRET and that modification of visual gaze avoidance may be casually linked to reductions in social anxiety. Replication with a larger sample size is needed.
Collapse
Affiliation(s)
- Mikael Rubin
- Department of Psychology, The University of Texas at Austin, TX, USA
| | - Karl Muller
- Center for Perceptual Systems, The University of Texas at Austin, TX, USA
| | - Mary M. Hayhoe
- Center for Perceptual Systems, The University of Texas at Austin, TX, USA
| | - Michael J. Telch
- Department of Psychology, The University of Texas at Austin, TX, USA
| |
Collapse
|
11
|
Chard I, van Zalk N. Virtual Reality Exposure Therapy for Treating Social Anxiety: A Scoping Review of Treatment Designs and Adaptation to Stuttering. Front Digit Health 2022; 4:842460. [PMID: 35281220 PMCID: PMC8913509 DOI: 10.3389/fdgth.2022.842460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/28/2022] [Indexed: 12/16/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Ian Chard
- Design Psychology Lab, Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| | | |
Collapse
|