Cited by 147Virtual Reality Applications and ImpactsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDigital Mental Health Interventions

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Virtual reality exposure in anxiety disorders: Impact on psychophysiological reactivity

Diemer, Julia, Mühlberger, Andreas, Pauli, Paul, Zwanzger, Peter·2014·The World Journal of Biological Psychiatry

DOI 10.3109/15622975.2014.892632

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Abstract

OBJECTIVES: Anxiety disorders are among the most frequently encountered psychiatric disorders. Recommended treatments include cognitive behavioural therapy (CBT) and/or medication. In recent years, beneficial effects of virtual reality (VR) exposure therapy have been shown, making this technique a promising addition to CBT. However, the ability of VR to mimic threatening stimuli in a way comparable to in vivo cues has been discussed. In particular, it has been questioned whether VR is capable of provoking psychophysiological symptoms of anxiety. Since psychophysiological arousal is considered a prerequisite for effective exposure treatment, this systematic review aims to evaluate the evidence for the potential of VR exposure to evoke and modulate psychophysiological fear reactions. METHODS: PubMed and PsycINFO/Academic Search Premier databases were searched. Thirty-eight studies investigating challenge or habituation effects were included. RESULTS: VR exposure does provoke psychophysiological arousal, especially in terms of electrodermal activity. Results on psychophysiological habituation in VR are inconclusive. Study design and methodological rigour vary widely. CONCLUSIONS: Despite several limitations, this review provides evidence that VR exposure elicits psychophysiological fear reactions in patients and healthy subjects, rendering VR a promising treatment for anxiety disorders, and a potent research tool for future investigations of psychophysiological processes and their significance during exposure treatment.

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“This presence has also been identified as a crucial facilitator of VR’s potential to evoke behavioural (Slater, 2009), physiological (Diemer et al., 2014; Halbig & Latoschik, 2021) and affective (Somarathna et al., 2022) responses resembling those observable in real life – even when the virtual is…”

Authors: Diemer, J., Mühlberger, A., Pauli, P., & Zwanzger, P.
Affiliations: University Hospital Münster (DE)
University of Regensburg (DE)
University of Würzburg (DE)
Corresponding author: Diemer, Julia
ORCID: Diemer, Julia
Mühlberger, Andreas
Pauli, Paul
Zwanzger, Peter
Venue: The World Journal of Biological Psychiatry
Publisher: Informa UK Limited
Published: 2014-03-25
Volume: 15
Issue: 6
Pages: 427-442
ISSN: 1562-2975 (ISSN-L)
1814-1412
DOI: 10.3109/15622975.2014.892632
OpenAlex: W2093057972
Cited by: 146
References: 66
Citations by year: 2026: 15 · 2025: 12 · 2024: 12 · 2023: 13 · 2022: 15 · 2021: 15 · 2020: 13 · 2019: 20 · 2018: 8 · 2017: 4 · 2016: 13 · 2015: 5
FWCI: 1.93
Type: journal article
Language: en
Open access: closed
Locations: The World Journal of Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: Deutsche Forschungsgemeinschaft
H2020 European Research Council
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, anxiety disorders, psychophysiological arousal, fear conditioning, electrodermal activity, habituation, cognitive behavioral therapy, virtual reality exposure, threat simulation
MeSH terms: Anxiety Disorders, Humans, Virtual Reality Exposure Therapy

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Virtual reality exposure in anxiety disorders: Impact on psychophysiological reactivity

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