Key result
Virtual reality exposure reduces fear of heights and increases sympathetic activation versus in vivo exposure.
Why the study?
Exposure in vivo is effective for anxiety disorders but rarely implemented in outpatient settings, while the effect of virtual reality exposure on subjective symptom burden and physiological parameters remains questionable.
Does exposure in virtual reality reduce subjective symptom burden and affect physiological parameters compared to in vivo exposure in healthy participants with fear of heights?
RCT (n=33)
Randomized order
No
Does exposure in virtual reality reduce subjective symptom burden and affect physiological parameters compared to in vivo exposure in healthy participants with fear of heights?
Virtual reality exposure is an effective alternative to in vivo exposure for reducing subjective symptom burden in individuals with fear of heights, eliciting comparable or greater physiological activation.
Answers are grounded in this paper and cite their sources.
VR exposure may reduce acrophobia symptoms; leaves open equivalence to in vivo on subjective and physiological outcomes.
Exposure in vivo is a highly effective treatment for anxiety disorders and acrophobia in particular. Nevertheless, it is rarely implemented in outpatient treatment. Exposure in virtual reality (VR) might be an alternative but its effect on subjective symptom burden and physiological parameters is questionable. Therefore, in this study, N = 33 participants with fear of heights received both in vivo and VR exposure in a randomized order. Subjective symptom burden before and after each exposure as well as heart rate and heart rate variability (SDNN, LF/HF ratio) during exposure sessions were assessed. Linear mixed models were calculated with the effect of condition (VR vs. in vivo) and scenario on HR, SDNN and LF/HF ratio. Subjective symptom burden was significantly reduced after both exposure sessions (p = .002; p < .001). Heart rate was significantly higher during exposure scenarios than baseline (p < .001). SDNN and LF/HF ratio reflected a significantly higher general power of HRV and a significantly higher activation of the sympathetic nervous system during exposure sessions compared to baseline and during VR exposure compared to in vivo. All in all, VR exposure shows comparable or superior effects compared to in vivo exposure regarding acrophobic fears and physiological parameters.
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Renner et al. (2023) conducted an RCT in Fear of heights (n=33). Virtual reality (VR) exposure vs. In vivo exposure was evaluated on Acrophobia Questionnaire (AQ) score (ηp2 = 0.119, p=0.045). Virtual reality exposure significantly reduced subjective fear of heights and elicited higher sympathetic activation compared to in vivo exposure in healthy participants with acrophobia.
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