Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trial
IntroductionWe previously found that self-guided Virtual Reality Exposure Therapy (VRET) improved Public Speaking Anxiety (PSA) and reduced heartrate. Elevated heartrate characterises social anxiety and the self-guided VRET seemed to reduce heartrate. Thus, receiving continuous biofeedback about phy...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1467141/full |
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| author | Preethi Premkumar Nadja Heym James A. C. Myers Phoebe Formby Steven Battersby Alexander Luke Sumich David Joseph Brown |
| author_facet | Preethi Premkumar Nadja Heym James A. C. Myers Phoebe Formby Steven Battersby Alexander Luke Sumich David Joseph Brown |
| author_sort | Preethi Premkumar |
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| description | IntroductionWe previously found that self-guided Virtual Reality Exposure Therapy (VRET) improved Public Speaking Anxiety (PSA) and reduced heartrate. Elevated heartrate characterises social anxiety and the self-guided VRET seemed to reduce heartrate. Thus, receiving continuous biofeedback about physiological arousal during the VRET could help socially anxious individuals to manage their anxiety. The present study aimed to determine whether biofeedback enhances the responsiveness of VRET.MethodsSeventy-two individuals with high self-reported social anxiety were randomly allocated to VRET-plus-biofeedback (n=38; 25 completers) or VRET alone (n=35; 25 completers). Three hour-long VRET sessions were delivered over three consecutive weeks. During each session, participants delivered a 20-minute public speech in front of a virtual audience. Participants in the VRET-plus-biofeedback group received biofeedback on heartrate and frontal alpha asymmetry (FAA) within the virtual environment and were asked to lower their arousal accordingly. Participants in both groups completed psychometric assessments of social anxiety after each session and at one-month follow-up.ResultsPSA improved by the end of treatment and overall social anxiety improved one month after the VRET across both groups. The VRET-plus-biofeedback group showed a steadier reduction in FAA in the first VRET session and a greater reduction in self-reported arousal across the three sessions than the VRET-alone group.ConclusionBiofeedback can steady physiological arousal and lower perceived arousal during exposure. The benefits of self-guided VRET for social anxiety are sustained one month after therapy. |
| format | Article |
| id | doaj-art-b54db22ca7214246ac3ae2cb70bcdd54 |
| institution | OA Journals |
| issn | 1664-0640 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj-art-b54db22ca7214246ac3ae2cb70bcdd542025-08-20T02:15:36ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402024-11-011510.3389/fpsyt.2024.14671411467141Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trialPreethi Premkumar0Nadja Heym1James A. C. Myers2Phoebe Formby3Steven Battersby4Alexander Luke Sumich5David Joseph Brown6Division of Psychology, London South Bank University, London, United KingdomDepartment of Psychology, Nottingham Trent University, Nottingham, United KingdomDepartment of Psychology, University of Sheffield, Sheffield, United KingdomDepartment of Psychology, Nottingham Trent University, Nottingham, United KingdomIndependent Researcher, Nottingham, United KingdomDepartment of Psychology, Nottingham Trent University, Nottingham, United KingdomDepartment of Computer Science, Nottingham Trent University, Nottingham, United KingdomIntroductionWe previously found that self-guided Virtual Reality Exposure Therapy (VRET) improved Public Speaking Anxiety (PSA) and reduced heartrate. Elevated heartrate characterises social anxiety and the self-guided VRET seemed to reduce heartrate. Thus, receiving continuous biofeedback about physiological arousal during the VRET could help socially anxious individuals to manage their anxiety. The present study aimed to determine whether biofeedback enhances the responsiveness of VRET.MethodsSeventy-two individuals with high self-reported social anxiety were randomly allocated to VRET-plus-biofeedback (n=38; 25 completers) or VRET alone (n=35; 25 completers). Three hour-long VRET sessions were delivered over three consecutive weeks. During each session, participants delivered a 20-minute public speech in front of a virtual audience. Participants in the VRET-plus-biofeedback group received biofeedback on heartrate and frontal alpha asymmetry (FAA) within the virtual environment and were asked to lower their arousal accordingly. Participants in both groups completed psychometric assessments of social anxiety after each session and at one-month follow-up.ResultsPSA improved by the end of treatment and overall social anxiety improved one month after the VRET across both groups. The VRET-plus-biofeedback group showed a steadier reduction in FAA in the first VRET session and a greater reduction in self-reported arousal across the three sessions than the VRET-alone group.ConclusionBiofeedback can steady physiological arousal and lower perceived arousal during exposure. The benefits of self-guided VRET for social anxiety are sustained one month after therapy.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1467141/fullsocial anxietylongitudinalperceived controlphysiological arousalpresence |
| spellingShingle | Preethi Premkumar Nadja Heym James A. C. Myers Phoebe Formby Steven Battersby Alexander Luke Sumich David Joseph Brown Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trial Frontiers in Psychiatry social anxiety longitudinal perceived control physiological arousal presence |
| title | Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trial |
| title_full | Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trial |
| title_fullStr | Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trial |
| title_full_unstemmed | Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trial |
| title_short | Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trial |
| title_sort | augmenting self guided virtual reality exposure therapy for social anxiety with biofeedback a randomised controlled trial |
| topic | social anxiety longitudinal perceived control physiological arousal presence |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1467141/full |
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