Virtual reality exposure effect in acrophobia: psychological and physiological evidence from a single experimental session

Abstract

In recent years, virtual reality (VR) has gained attention from researchers in diverse fields, particularly in therapy of phobias. Currently, virtual reality exposure therapy therapy (VRET) is considered a promising cognitive-behavioral therapy technique. However, specific psychological and physiological responses of VR users to virtual exposure in such a context are still only vaguely explored. In this experimental study, we mapped VR exposure in a height environment in people with a moderate fear of heights–acrophobia. Thirty-six participants were divided into experimental and control groups–with and without psychological guidance during exposure. Participants' subjective level of anxiety was examined, and objective physiological response was captured via heart rate variability (HRV) measurement. Psychological assessments recorded an anticipated rise in participant anxiety following exposure to height; nevertheless, no distinctions were observed in self-reported anxiety concerning psychological guidance. Notably, objective physiological measures revealed that VR exposure prompts physiological responses akin to real-world scenarios. Moreover, based on the analysis of heart rate variability, participants who received psychological guidance were identified as better at compensating for anxiety compared to those without such support. These findings support VRET as a promising tool for psychotherapy and advocate for psychological guidance as beneficial in reducing anxiety and managing stress during exposure. The results may help improve our understanding of anxiety during exposure to phobic stimuli.In recent years, virtual reality (VR) has gained attention from researchers in diverse fields, particularly in therapy of phobias. Currently, virtual reality exposure therapy therapy (VRET) is considered a promising cognitive-behavioral therapy technique. However, specific psychological and physiological responses of VR users to virtual exposure in such a context are still only vaguely explored. In this experimental study, we mapped VR exposure in a height environment in people with a moderate fear of heights–acrophobia. Thirty-six participants were divided into experimental and control groups–with and without psychological guidance during exposure. Participants' subjective level of anxiety was examined, and objective physiological response was captured via heart rate variability (HRV) measurement. Psychological assessments recorded an anticipated rise in participant anxiety following exposure to height; nevertheless, no distinctions were observed in self-reported anxiety concerning psychological guidance. Notably, objective physiological measures revealed that VR exposure prompts physiological responses akin to real-world scenarios. Moreover, based on the analysis of heart rate variability, participants who received psychological guidance were identified as better at compensating for anxiety compared to those without such support. These findings support VRET as a promising tool for psychotherapy and advocate for psychological guidance as beneficial in reducing anxiety and managing stress during exposure. The results may help improve our understanding of anxiety during exposure to phobic stimuli.