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Cited by 223Virtual Reality Applications and ImpactsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDigital Mental Health Interventions

The role of presence in virtual reality exposure therapy

Open access
Price, Matthew, Anderson, Page·2007·Journal of Anxiety Disorders
DOI 10.1016/j.janxdis.2006.11.002PMC PMC3670421
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Abstract

A growing body of literature suggests that virtual reality is a successful tool for exposure therapy in the treatment of anxiety disorders. Virtual reality (VR) researchers posit the construct of presence, defined as the interpretation of an artificial stimulus as if it were real, to be a presumed factor that enables anxiety to be felt during virtual reality exposure therapy (VRE). However, a handful of empirical studies on the relation between presence and anxiety in VRE have yielded mixed findings. The current study tested the following hypotheses about the relation between presence and anxiety in VRE with a clinical sample of fearful flyers: (1) presence is related to in-session anxiety; (2) presence mediates the extent that pre-existing (pre-treatment) anxiety is experienced during exposure with VR; (3) presence is positively related to the amount of phobic elements included within the virtual environment; (4) presence is related to treatment outcome. Results supported presence as a factor that contributes to the experience of anxiety in the virtual environment as well as a relation between presence and the phobic elements, but did not support a relation between presence and treatment outcome. The study suggests that presence may be a necessary but insufficient requirement for successful VRE.

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Crossref · 10.1016/j.janxdis.2006.11.002

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  • Research on sense of presence and reality judgment has been conducted in VRET.

    “Research on the sense of presence and reality judgments has been conducted in VRET (Gromer et al., 2019; Cummings and Bailenson, 2016, Price and Anderson, 2007; Baños et al., 2000), but no studies have been found in the literature on these topics in ICBTs.”

    From An internet-based treatment for flying phobia using 360° images: A feasibility pilot study (2022) · cites this paper as Price and Anderson, 2007

    The Abstract and Discussion describe this study as research on presence during virtual reality exposure therapy. The paper defines presence as interpreting an artificial environment as if it were real, but our copy does not show that it separately studied reality judgments. (LLM, conf=0.83)

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  • Although presence is linked to the anxiety experienced during exposure, there is no direct relationship between sense of presence and treatment outcomes.

    “In terms of treatment efficacy, research has also suggested that, although presence is linked to the anxiety experienced during the exposure, there is no direct relationship between sense of presence and treatment outcomes (Price et al., 2011; Price and Anderson, 2007; Tardif et al., 2019).”

    From An Internet-based treatment for Flying Phobia using 360° images: Study protocol for a feasibility pilot study (2021) · cites this paper as Price and Anderson, 2007

  • Studies show unclear relationships between presence and emotions; some found significant positive correlations, some did not, and some found negative correlations.

    “However, studies show unclear relationships between presence and emotions. Some studies found significant positive correlations, [56,57], some did not [54,58,59], and some even found negative correlations [60,61].”

    From Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review (2017) · cites this paper as [56]

  • Price and Anderson found that presence contributed to the experience of anxiety and was associated with peak fear ratings during the first VRET session, but they did not find a relationship between presence and treatment response.

    “Price and Anderson [56] reported similar results for fear of flying: presence contributed to the experience of anxiety, and it was associated with peak fear ratings during the first VRET session, but they did not find a relationship between presence and treatment response.”

    From Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review (2017) · cites this paper as [56]

  • Presence is a necessary but insufficient requirement for symptom reduction.

    “suggesting that presence is a necessary but insufficient requirement for symptom reduction (Price and Anderson 2007), congruent with the 2004 study.”

    From Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy (2021) · cites this paper as Price and Anderson 2007

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Cites

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Research works printed but not linked: 3

  1. First MB, Gibbon M, Spitzer RL, Williams JBW. Structured clinical interview for the DSM-IV-TR axis 1 disorders. Biometrics Research Department; New York: 2002. [Google Scholar]
  2. Levin DN, Cook EW, Lang PJ. Fear imagery and fear behavior: psychophysiological analysis of clients receiving treatment for anxiety disorders. Psychophysiology. 1982;19:571–572. [Google Scholar]
  3. Scott W. Fear of flying inventory. In: Kellar P, Hayman S, editors. Innovantions of clinical practice. Vol. 7. Publisher Resource Exchange; 1987. [Google Scholar]

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Related

Authors
Price, M., & Anderson, P.
Affiliations
Georgia State University (US)
Corresponding author
Anderson, Page
ORCID
Venue
Journal of Anxiety Disorders
Publisher
Elsevier BV
Published
2007
Volume
21
Issue
5
Pages
742-751
ISSN
0887-6185 (ISSN-L)
DOI
10.1016/j.janxdis.2006.11.002
PMC
PMC3670421
OpenAlex
W2033913146
Cited by
223
References
25
Citations by year
2026: 10 · 2025: 15 · 2024: 18 · 2023: 17 · 2022: 23 · 2021: 15 · 2020: 19 · 2019: 14 · 2018: 18 · 2017: 7 · 2016: 8 · 2015: 8 · 2014: 13 · 2013: 7 · 2012: 10
FWCI
4.27
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Anxiety Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R41MH58493-01, R41MH058493)
Topics
  • Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
virtual reality exposure therapy, presence, anxiety, fear of flying, aviophobia, phobic stimuli, treatment outcomes, anxiety disorders, virtual worlds
MeSH terms
Adaptation, Psychological, Adult, Agoraphobia, Aircraft, Desensitization, Psychologic, Fear, Female, Humans, Male, Phobic Disorders, User-Computer Interface, Panic Disorder, Outcome Assessment, Health Care

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