Exploring the Use of Computer Games and Virtual Reality in Exposure Therapy for Fear of Driving Following a Motor Vehicle Accident
Abstract
Specific phobia, situational type-driving, induced by accident (accident phobia) occurs in 18-38% of those involved in a vehicular accident of sufficient severity to warrant referral to the emergency departments of a general hospital. The objective is to investigate, in an open study, the effectiveness of the combined use of computer generated environments involving driving games (game reality [GR]) and a virtual reality (VR) driving environment in exposure therapy for the treatment of driving phobia following a motor vehicle accident (MVA) program. Fourteen subjects who met DSM-IV criteria for Simple Phobia/Accident Phobia and were referred from the emergency department of a general hospital were exposed to a Virtual Driving Environment (Hanyang University Driving Phobia Environment) and computer driving games (London Racer/Midtown Madness/Rally Championship). Patients who experienced "immersion" (i.e., a sense of presence with heightened anxiety) in one of the driving simulations (defined as an increase in SUD ratings of 3 and/or an increase of heart rate > 15 BPM in a 1-h trial session of computer simulation driving) were exposed to a cognitive behavioral program of up to 12 1-h sessions involving graded driving simulation tasks with self-monitoring, physiological feedback, diaphragmatic breathing and cognitive reappraisal. Subjects were assessed at the beginning and end of therapy with measurements of: physiological responsivity (heart rate), subjective ratings of distress (SUD), rating scales for severity of fear of driving (FDI), Posttraumatic Stress Disorder (CAPS) and depression (HAM-D) and achievement of target behaviors. Of all patients 7/14 (50%) became immersed in the driving environments. This immersed group (n = 7) completed the exposure program. Pre- and post-treatment comparisons showed significant post treatment reductions on all measures SUDS (p = 0.008), FDI (p = 0.008), CAPS (p = 0.008), HR (p = 0.008), CAPS (p = 0.008), HAM-D (p = 0.031). Further analysis of the FDI showed significant reductions in all three subscales: travel distress (p = 0.008), travel avoidance (p = 0.008), and maladaptive driving strategies (p = 0.016). The findings of this study suggest that VR and GR may have a useful role in the treatment of driving phobia post-accident even when co-morbid conditions such as post-traumatic stress disorder and depression are present.
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Significant reductions in depression were found when virtual reality exposure interventions were used for specific driving phobia and acrophobia.
“Significant reductions in depression were also found when interventions were used for specific driving phobia30 and acrophobia.38”
From Game-based digital interventions for depression therapy: a systematic review and meta-analysis (2014) · cites this paper as [30]
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- Authors
- Walshe, D. G., Lewis, E. J., Kim, S. I., O'Sullivan, K., & Wiederhold, B. K.
- Affiliations
- University College Cork (IE)
- St. Stephens Hospital, Cork, Ireland
- Hanyang University (KR)
- Department of Statistics, University College Cork, Ireland
- Virtual Reality Medical Center (US)
- Venue
- CyberPsychology & Behavior
- Publisher
- SAGE Publications
- Published
- 2003-06
- Volume
- 6
- Issue
- 3
- Pages
- 329-334
- ISSN
- 1094-9313 (ISSN-L)
- 1557-8364
- OpenAlex
- W2001533827
- Cited by
- 193
- References
- 6
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 8 · 2022: 10 · 2021: 11 · 2020: 9 · 2019: 10 · 2018: 11 · 2017: 16 · 2016: 8 · 2015: 5 · 2014: 15 · 2013: 7 · 2012: 9
- FWCI
- 7.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CyberPsychology & Behavior (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hanyang University
- Pfizer Pharmaceuticals
- 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 › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- motor vehicle accidents, virtual reality exposure therapy, driving simulation, specific phobia, immersion, cognitive behavioral therapy, post-traumatic stress disorder, depression, heart rate, self-monitoring, cognitive reappraisal, diaphragmatic breathing, physiological feedback, avoidance behavior, emergency department referral, treatment outcome predictors
- MeSH terms
- Accidents, Traffic, Automobile Driving, Computer Graphics, Fear, Female, Heart Rate, Humans, Male, Phobic Disorders, Photic Stimulation, Therapy, Computer-Assisted, Time Factors, User-Computer Interface, Video Games, Diagnostic and Statistical Manual of Mental Disorders
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