The DOI matches its Crossref record; 44 of the 45 references it cites were found in a registry or an index; none of the 45 sources its claims cite is checked for support yet.
Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: A three-arm randomised controlled trial
Open accessAbstract
Background: People with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive–behavioural therapy (CBT), could be an answer. Aims: To show that conducting VR exposure in CBT for SAD is effective and is more practical for therapists than conducting exposure in vivo. Method: Participants were randomly assigned to either VR exposure ( n = 17), in vivo exposure ( n = 22) or waiting list ( n = 20). Participants in the active arms received individual CBT for 14 weekly sessions and outcome was assessed with questionnaires and a behaviour avoidance test. (Trial registration number ISRCTN99747069.) Results: Improvements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list. Conducting exposure in VR was more effective at post-treatment than in vivo on the primary outcome measure and on one secondary measure. Improvements were maintained at the 6-month follow-up. VR was significantly more practical for therapists than in vivo exposure. Conclusions: Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Improvements were maintained at the 6-month follow-up.”
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In the paper
“The time6 conditions interactions and contrasts revealed that CBT with in virtuo exposure was more effective at follow-up on the LSAS-SR only (Fig. 2).”
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In the paper
“VR was significantly more practical for therapists than in vivo exposure.”
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In the paper
“The superiority of in virtuo exposure that we observed on some of the measures has not been found in these previous studies on SAD 21,23,24”
What the sources say
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In the paper
“while treatment credibility was not a significant predictor.”
Strength:plain· not yet calibratedn = 59Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The difference between both active conditions did not approach statistical significance (w 2 (1) = 0.33, not significant).”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“working alliance was a strong and significant predictor of change in LSAS-SR in the CBT with in virtuo exposure condition (t = 72.52,P50.05, sr = 70.52)”
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In the paper
“All gains were maintained at the 6-month follow-up.”
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In the paper
“There were no statistical differences in the attrition rate between the two groups (Fisher's exact test P = 0.67).”
Strength:plain· not yet calibratedn = 59Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“In the case of SAD, CBT with in virtuo exposure could offer several advantages compared with traditional CBT. 14”
What the sources say
- Not checked yetcites [14] source
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- It may state two separate claims as one. 35
- Probably not a substantial claim. 39
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In the paper
“As regards the 6-month follow-up analyses, there was a significant time effect across all outcomes from pre-treatment to follow-up, and no significant change between post-treatment and follow-up (Table 4).”
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In the paper
“Planned contrasts revealed significantly decreased scores in the active treatment conditions compared with the waiting list, and no differences between CBT conditions across all outcomes except the LSAS-SR and the SPS, where CBT with in virtuo exposure was more effective than CBT with in vivo exposure.”
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Conducting exposure in VR was more effective at post-treatment than in vivo on the primary outcome measure and on one secondary measure.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Analyses with the waiting-list condition revealed statistically significant effects of time and time6condition interaction across all outcome measures (Table 3).”
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Improvements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list.”
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“How practical and effortless it was for therapists conducting the exposure, as measured with the SWEAT, was rated at 15. 24”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“the success rates were much higher and consistent with other studies on SAD than those found by Kampmann et al. 24”
What the sources say
- Not checked yetcites [24] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Reliable change from pre-to post-treatment was observed in 76.5% (n = 13/17) of participants who had received CBT with in virtuo exposure, 68.3% (n = 15/22) who had received CBT with in vivo exposure, and 30.0%(n = 6/20) in the waiting-list condition (w 2 (2) = 9.78, P50.01).”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At post-treatment, VR was more effective than traditional exposure on the main outcome measure (LSAS-SR) and one of the five secondary outcome measures (SPS, a global assessment of social anxiety).The latter difference did not reach the corrected significance level at follow-up.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“VR was neither more nor less effective than traditional exposure on the behavioural measure and on the measures of fear of social interactions, fear of negative evaluation and depressive mood.”
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Results on the SWEAT are now providing this information.”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The success rate in terms of reliable change index was high and similar in both active treatment conditions.”
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None of the sources cited for this claim have been checked yet.
In the paper
“First, results on the SWEAT revealed that conducting exposure was simpler in VR, making it possible to exploit the exposure experiences more.”
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Moreover, psychotherapy itself can be perceived as highly frightening or a threat to their need for privacy. 6”
What the sources say
- Not checked yetcites [6] source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The trial was registered with ISRCTN: 99747069.”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Treatment standardisation was maximised using treatment manuals 44 and treatment fidelity was maximised through weekly supervisions from the principal investigator.”
What the sources say
- Not checked yetcites [44] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Adherence to research protocols was also assessed by independent raters who reviewed videos of therapy sessions based on a grid used in previous CBT studies. 45”
What the sources say
- Not checked yetcites [45]
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Compared with phobias, using VR with SAD requires a larger range of scenarios, cues eliciting social fears and virtual environments.”
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Therapists also have the possibility of varying the context of immersion (for example shops, restaurants) without ever leaving the office, allowing for complete confidentiality and maximising the generalisation of inhibitory learning. 15”
What the sources say
- Not checked yetcites [15] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, in vivo exposure exercises (for example asking for the time on the street, browsing in a shop) raise the same issues regarding arousal and loss of privacy as CBT in a group format and may be cumbersome for therapists”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Paradoxically, despite its frequency, severity and the existence of effective treatments, SAD remains largely undertreated. 2,3”
What the sources say
- Not checked yetcites [2] source
- Not checked yetcites [3]
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients with SAD seem to avoid healthcare services like they do other social interactions. 3,4”
What the sources say
- Not checked yetcites [3]
- Not checked yetcites [4] source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The institutional review board approved the protocol and all patients provided written informed consent after receiving a complete description of the study.”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Therapy in an individual setting can be an alternative to the group format that overcomes those limits. 11”
What the sources say
- Not checked yetcites [11]
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Intent-to-treat analyses based on data from all participants who completed the baseline assessment (Fig. 1) were conducted using the last-observation carried-forward for those who did not complete treatment.”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Patients with SAD often wait many years while their symptoms evolve before consulting, by which time complications have already occurred. [2][3]][4]”
What the sources say
- Not checked yetcites [2][3]][4]
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The use of virtual scenarios allows for controlled, manageable and reproducible social exposure.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“These technologies have been used extensively with specific phobias (such as fear of flying) but their applications now extend to more complex disorders (for example obsessive-compulsive disorder, generalised anxiety disorder). 13”
What the sources say
- Not checked yetcites [13]
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“all diagnoses were reviewed and confirmed by a second assessor”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The speech was video recorded and the patients' behaviour was evaluated using the Social Performance Rating Scale (SPRS) 32 by three independent assessors, masked to hypotheses and treatment conditions.”
What the sources say
- Not checked yetcites [32] source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These drawbacks of standard CBT can be overcome with an alternative medium of exposure: virtual reality (VR) or in virtuo exposure”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
In the paper
“They feel ashamed of their symptoms and fear discussing them with others, including healthcare professionals. 5”
What the sources say
- Not checked yetcites [5] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The consensus in the field of psychotherapy calls for cognitive-behavioural therapy (CBT) either in an individual or group format. 9,10”
What the sources say
- Not checked yetcites [9]
- Not checked yetcites [10] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Because of the need to manage a whole group of people, treatment may be less individualised and exposure difficult to handle for the therapist.”
What the sources say
- Not checked yetcites [11]
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“When planning the study, a power analysis was conducted using effect sizes from previous studies. 11,18,23”
What the sources say
- Not checked yetcites [11]
- Not checked yetcites [18]
- Not checked yetcites [23] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: In vivo exposure is the gold-standard condition for cognitive-behavioural therapy in social anxiety disorder.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Random assignments were generated with a random numbers table prior to recruitment.”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The primary outcome was identified before the study began as the total score on the Liebowitz Social Anxiety Scale-Self Reported version (LSAS-SR)”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“There are effective treatments for SAD that rely on medication or psychotherapy. [7][8]8][9]”
What the sources say
- Not checked yetcites [7][8]8][9]
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Paired t-tests were conducted for each session and none suggested a significant increase in SSQ scores (statistics not reported, all P40.2).”
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Assignments were concealed until the first therapy session began.”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“CBT with in virtuo exposure followed the same methodology as CBT with in vivo exposure, with the only difference that it exclusively used VR immersion to conduct exposure (i.e.no in vivo exposure).”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Rests on an assumption: Participants in the in virtuo condition complied with the instruction not to engage in any in vivo exposure.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results confirmed both hypotheses: conducting CBT with in virtuo exposure was effective and more practical for therapists than CBT with in vivo exposure.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Rests on an assumption: In vivo exposure is the gold-standard condition for cognitive-behavioural therapy in social anxiety disorder.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Behavioural assessments were chosen instead and support results found with self-reports.”
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Limiting exposure to talking to virtual characters and the absence of a cognitive component that facilitates how exposure is mentally processed by patients may explain why in virtuo exposure was less effective than in other published trials.”
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Patients improved significantly with treatment and improvements were maintained after 1 year.”
What the sources say
- Not checked yetcites [21] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“New virtual environments can now depict more complicated social interactions 15 and rely on virtual characters with promising artificial intelligence. 24”
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because conducting exposure in VR is less cumbersome and rapidly becoming more affordable, there should be an increase in acceptance of this technology.”
Strength:plain· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Rests on an assumption: Virtual reality is rapidly becoming more affordable.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One important contribution of this study is the use of a measure assessing the burden, challenges and costs of conducting exposure.”
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The absence of direct support from the therapist might have had a negative impact on the therapeutic alliance and thus might have reduced the efficacy of in virtuo exposure.”
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Previous studies have shown that giving a speech in front of a virtual audience can elicit distress and physiological arousal in patients with SAD. 17”
What the sources say
- Not checked yetcites [17]
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Numerous studies have also shown the efficacy of in virtuo exposure for treating fear about public speaking. [18][19]9][20]”
What the sources say
- Not checked yetcites [18][19]9][20]
Strength:boosted· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, the importance of the therapeutic alliance in predicting outcome highlights the importance of the therapists in conducting exposure.”
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Furthermore, the quality of the working alliance was not different in the two treatment conditions. 22”
What the sources say
- Not checked yetcites [22] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Results revealed that participants in both treatment conditions improved from pre-to postassessment on social anxiety, avoidance, speech duration during a behavioural assessment task, perceived stress, and avoidant personality disorder related beliefs when compared with the waiting-list control group. 24”
What the sources say
- Not checked yetcites [24] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nevertheless, conducting an RCT with all stimuli perfectly matched between conditions would increase the validity of the trial.”
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“First, the lack of clinical evaluations by independent assessors masked to the study raises the potential issues of the objectivity of clinical assessments using questionnaires.”
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“These results support what has been found with other anxiety disorders 13 and show that CBT combined with exposure in VR is an effective and efficient alternative to classical individual CBT, acutely and in the long term.”
What the sources say
- Not checked yetcites [13]
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, individual exposure with VR may be more enticing to patients disinclined from social exposure or sensitive to strict confidentiality concerning their disorder.”
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“However, CBT with in vivo exposure was found superior to CBT with in virtuo exposure on multiple variables (such as social anxiety, personality disorder related beliefs).”
What the sources say
- Not checked yetcites [24] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“However, this was a study on the specific phobia of heights, the exposure scenarios were limited to three situations”
What the sources say
- Not checked yetcites [46]
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
In vivo exposure is the gold-standard condition for cognitive-behavioural therapy in social anxiety disorder.
“large with the gold-standard condition (i.e.Cohen's f of 0.4, for a total n of 78).”
The paper relies on this without support.
Participants in the in virtuo condition complied with the instruction not to engage in any in vivo exposure.
“Participants in the in virtuo condition were instructed not to engage in any exposure in vivo.”
The paper relies on this without support.
Group CBT is as effective as individual CBT and is widely used.
“although the group format is equally effective and widely used”
The paper relies on this without support.
Therapists may be reluctant to adopt virtual reality.
“Therapists may be reluctant to use VR”
The paper relies on this without support.
Virtual reality is rapidly becoming more affordable.
“rapidly becoming more affordable”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations.”
From Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results. (2026) · cites this paper as Bouchard et al., 2017
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In addition, therapists have no control over in vivo treating context, which can elevate patient arousal and raise privacy issues (Bouchard et al., 2017; Stangier et al., 2003).”
From Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results. (2026) · cites this paper as Bouchard et al., 2017
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The virtual reality method of treating anxiety-related disorders is effective and especially useful for tackling social anxiety.”
From Fear and Anxiety in COVID-19: Preexisting Anxiety Disorders (2021) · cites this paper as Bouchard et al., 2017
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“While both exposure conditions were of comparable efficacy regarding most outcome measures, VRET exceeded the in vivo condition in the primary outcome measure, with significantly greater symptom reductions in patients receiving exposure in virtuo.”
From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Bouchard et al., 2017
The cited source says what the claim attributes to it.
In the citing paper
“Exposure-based interventions addressing social fears can be resource-intensive and time-consuming due to the need to facilitate exposure exercises often outside the safety of a standardized, closely measured and accompanied environment (Reeves et al., 2022; Bouchard et al., 2017).”
From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Bouchard et al., 2017
The cited source says what the claim attributes to it.
In the citing paper
“Apart from public speaking situations, job interviews comprised a considerable amount of exposure situations (e.g., Bouchard et al., 2017; Stefaniak et al., 2022; Kampmann et al., 2016b).”
From Virtual Reality exposure therapy in the treatment of public speaking anxiety and social anxiety disorder (2024) · cites this paper as Bouchard et al., 2017
The cited source says what the claim attributes to it.
In the citing paper
“Virtual reality (VR) exposure in CBT holds potential as an alternative therapeutic technique for treating phobias and social anxiety in adults (Bouchard et al., 2017; Chesham et al., 2018; Horigome et al., 2020; Wechsler et al., 2019) and children (Beele et al., 2024; Man et al., 2024; Parrish et al., 2016; Wong Sarver et al., 2014).”
From Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results. (2026) · cites this paper as Bouchard et al., 2017
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“as is the case of the study of Bouchard et al. (2017), in which 9 of the treatment sessions were not recorded because of technical issues.”
From Virtual reality and psychedelics for the treatment of psychiatric disease: A systematic literature review (2020) · cites this paper as Bouchard et al. (2017)
Experimental — accuracy not yet measuredIn the citing paper
“Bouchard et al. [20] is the only study presenting findings in favor of VRET condition.”
From Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review (2017) · cites this paper as [20]
In the citing paper
“Contrary to this expectation, studies of patients treated with VRET and in vivo exposure therapy for social anxiety disorder found no significant difference between interventions as measured by the WAI [10-12].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
In-vivo addiction percentage is incorrect
MinorTwo participants in the in-vivo group of 22 represent 9.1%, not the reported 3.4%.
Reported 3.4 · recomputed 9.090909
“| Addiction | 5 (8.5) | 1 (5.9) | 2 (3.4) | 1 (5.0) | | | |”
White participants' overall percentage is too high
MinorThe table reports 55 White participants out of a total sample of 59. That is 93.2%, not 94.8%.
Reported 94.8 · recomputed 93.220339
“| White, n (%) | 55 (94.8) | 17 (100.0) | 21 (95.5) | 17 (85.0) | 5.88 | | |”
Low-income percentage does not match the count
MinorSixteen of the 59 participants is 27.1%, rather than the reported 21.1%.
Reported 21.1 · recomputed 27.118644
“| Low income, n (%) | 16 (21.1) | 4 (23.5) | 5 (22.7) | 7 (35.0) | 2.93 | | |”
Medication percentage does not match the sample size
MinorThe reported nine participants represent 15.3% of the stated total sample of 59, not 16.7%.
Reported 16.7 · recomputed 15.254237
“| Medication, n (%) | 9 (16.7) | 2 (11.8) | 3 (13.6) | 4 (20.0) | 1.58 | | |”
Addiction count does not equal the group counts
MinorThe three group counts for addiction add to four participants, whereas the total column reports five.
Reported 5 · recomputed 4
“| Addiction | 5 (8.5) | 1 (5.9) | 2 (3.4) | 1 (5.0) | | | |”
Citations
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“30 Potential associated depressive symptoms were also measured using the Beck Depression Inventory (BDI-II).”
A cognitive model of social phobia
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Maximizing exposure therapy: An inhibitory learning approach
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“In accordance with the inhibitory learning model, 15 the focus of the exposure was to develop new, non-threatening and adaptive interpretations of feared social situations, negative evaluation, rejection, embarrassment, loss of social status or being perceived as inadequate.”
InfluentialCredibility of analogue therapy rationales
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Flagged first, then by citations
1 of the 45 references couldn’t be matched to a known paper.
Research works printed but not linked: 6
- Bouchard, 2001, Exploring new dimensions in the assessment of virtual reality induced side effects, J Computer Inform Techn, 1, 20
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Cited by
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Items 101–200 of 355
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Pfaller, M. A., Kroczek, L. O. H., Lange, B., Fülöp, R., Müller, M., & Mühlberger, A. (2021) · Frontiers in Virtual Reality · doi:10.3389/frvir.2021.741138 · Cited by 26
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van Balkom, T. D., Berendse, H. W., van der Werf, Y. D., Twisk, J. W. R., Peeters, C. F. W., Hoogendoorn, A. W., Hagen, R. H., Berk, T., van den Heuvel, O. A., & Vriend, C. (2022) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2022.02.018 · Cited by 26
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Jeong, H. S., Lee, J. H., Kim, H. E., & Kim, J.-J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10050915 · Cited by 26
Virtual reality as a platform for research in gambling behaviour
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Hawajri, O., Lindberg, J., & Suominen, S. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2190051 · Cited by 28
Ryu, J., Han, S., Hwang, S. M., Lee, J., Do, S.-H., Kim, J., & Park, J. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.849541 · Cited by 24
Paul, M., Bullock, K., Bailenson, J., & Burns, D. (2023) · JMIR Mental Health · doi:10.2196/52326 · Cited by 19
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Virtual reality efficiency as exposure therapy for alcohol use: A systematic literature review
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Social Anxiety, Fear of Negative Evaluation, and Distress in a Virtual Reality Environment
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Self-citationHolmberg, T., Eriksen, T. L., Petersen, R., Frederiksen, N., Damgaard-Sørensen, U., & Lichtenstein, M. (2020) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2019.0295 · Cited by 20
Virtual reality exposure therapy for reducing school anxiety in adolescents: Pilot study
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Kuleli, D., Tyson, P. J., Davies, N., & Zeng, B. (2025) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2025.100524 · Cited by 28
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Die Entwicklung virtueller Realität als Expositionsverfahren
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The efficacy of psychotherapy for social anxiety disorder, a systematic review and meta-analysis
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Individualised Virtual Reality for Supporting Depression: Feedback from Mental Health Professionals
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Self-citationVirtual Reality Interventions for Mental Health
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Clinical virtual reality in mental health and rehabilitation: a brief review of the future!
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Self-citationHeart Rate Prediction from Head Movement during Virtual Reality Treatment for Social Anxiety
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Metadata
- Authors
- Bouchard, S., Dumoulin, S., Robillard, G., Guitard, T., Klinger, É., Forget, H., Loranger, C., & Roucaut, F. X.
- Affiliations
- Université du Québec en Outaouais (CA)
- Corresponding author
- Bouchard, Stéphane
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2017-04
- Volume
- 210
- Issue
- 4
- Pages
- 276-283
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2565451694
- Cited by
- 354
- References
- 45
- Citations by year
- 2026: 28 · 2025: 38 · 2024: 45 · 2023: 48 · 2022: 39 · 2021: 51 · 2020: 39 · 2019: 31 · 2018: 25 · 2017: 10
- FWCI
- 31.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canada Research Chairs (950-10762)
- Social Sciences and Humanities Research Council of Canada (10762)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- social anxiety disorder, virtual reality exposure, in vivo exposure, cognitive behavioral therapy, exposure therapy, treatment avoidance, maintenance therapy, cost-effectiveness
- MeSH terms
- Phobia, Social, Adult, Female, Humans, Implosive Therapy, Male, Middle Aged, User-Computer Interface, Cognitive Behavioral Therapy, Outcome Assessment, Health Care
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