Results in the treatment of anxiety disorders

Studies on the use of virtual reality exposure in acrophobia (fear of high places) have begun since the 1990s. A 1995 study showed that a sample of students exposed to virtual reality compared to a control group showed a reduction in the fear of height. The result, however, has been questioned since during the experimentation some students also underwent in vivo exposures (Rothbaum et al., 1995). Subsequently, a series of controlled studies confirmed the effectiveness of virtual reality exposure in the treatment of acrophobia. In comparison to the in vivo exposure, no differences emerged in the improvements produced on the symptoms (Emmelkamp et al., 2001; Emmelkamp et al., 2002; Krijn et al., 2004). In two studies, however, a substantial number of dropouts emerged due to a low perception of presence during virtual reality exposure (Emmelkamp et al., 2002; Krijn et al., 2004).

In specific phobias, virtual reality exposure therapy (VRET) has allowed a less threatening alternative to in vivo exposure and more practical than imaginative exposure. In fact, during the in vivo sessions, when the patients have to face the threatening stimulus, about 27% of them refuse the therapy and interrupt it while only 3% refuse the exposure in virtual reality. If compared to patients with specific phobias, they choose virtual reality exposure in 76% of cases (García-Palacios et al., 2007). As far as efficacy is concerned, virtual reality exposure has been applied and has proven effective in many specific phobias. A meta – analysis by Powers and Emmelkamp (2008) suggests that within the specific phobia domain not only virtual reality exposure is shown to be highly effective when compared with control groups, but also has a slightly higher efficacy than vivo (Powers & Emmelkamp, ​​2008).
For the treatment of arachnophobia, a tactile stimulus was also integrated into the virtual image of a spider, reproducing the hairy surface of the arachnid, which expands the emotional activation produced (Peperkorn & Muhlberger, 2013). This method used first in a single case study (Carlin et al., 1997) was then reproduced in a 2002 study. In this study, subjects treated with virtual reality exposure and tactile stimulation achieved improvements in all measurements used with respect to subjects on the waiting list (Garcia-Palacios et al., 2002). Comparing the efficacy of in vivo exposure and virtual reality exposure in arachnophobic patients, there are no differences between the two therapies if not a greater improvement on cognitive beliefs on spiders in subjects treated in vivo (Michaliszyn D et al., 2010)

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