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Cited by 127Virtual Reality Applications and ImpactsSocial Robot Interaction and HRIAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Causal interactive links between presence and fear in virtual reality height exposure

Open access
Gromer, Daniel, Reinke, Max, Christner, Isabel, Pauli, Paul·2019·Frontiers in Psychology
DOI 10.3389/fpsyg.2019.00141PMC PMC6363698
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Abstract

Virtual reality plays an increasingly important role in research and therapy of pathological fear. However, the mechanisms how virtual environments elicit and modify fear responses are not yet fully understood. Presence, a psychological construct referring to the ‘sense of being there’ in a virtual environment, is widely assumed to crucially influence the strength of the elicited fear responses, however, causality is still under debate. The present study is the first that experimentally manipulated both variables to unravel the causal link between presence and fear responses. Height-fearful participants (N = 49) were immersed into a virtual height situation and a neutral control situation (fear manipulation) with either high versus low sensory realism (presence manipulation). Ratings of presence and verbal and physiological (skin conductance, heart rate) fear responses were recorded. Results revealed an effect of the fear manipulation on presence, i.e. higher presence ratings in the height situation compared to the neutral control situation, but no effect of the presence manipulation on fear responses. However, the presence ratings during the first exposure to the high quality neutral environment were predictive of later fear responses in the height situation. Our findings support the hypothesis that experiencing emotional responses in a virtual environment leads to a stronger feeling of being there, i.e., increase presence. In contrast, the effects of presence on fear seem to be more complex: on the one hand, increased presence due to the quality of the virtual environment did not influence fear; on the other hand, presence variability that likely stemmed from differences in user characteristics did predict later fear responses. These findings underscore the importance of user characteristics in the emergence of presence.

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  • When a scenario engaged with the emotions, the sense of presence increased, and presence was a significant predictor of emotional responses.

    “The studies carried out in this field with VRET showed that, when a scenario engaged with the emotions, the sense of presence increased, and at the same time, presence was a significant predictor of emotional responses (Gromer et al., 2019; Riva et al., 2007).”

    From An internet-based treatment for flying phobia using 360° images: A feasibility pilot study (2022) · cites this paper as Gromer et al., 2019

    The Discussion (Effects of Fear on Presence; page unavailable) reports that the fear-inducing height scenario increased presence. The Results (Exploratory Correlations and Cross-Lagged Panel Models; page unavailable) show that initial presence significantly predicted later fear, but only in the high-sensory-realism group. The claim extends this conditional finding to emotional responses generally. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • 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 Gromer et al., 2019

    The Introduction (page unavailable) discusses research on presence in virtual reality exposure therapy, and the Results measure presence during virtual height exposure. The paper does not itself study reality judgments as a separate topic; its References list another study on presence and reality judgment as predictors of treatment efficacy. Thus Gromer et al. supports the presence portion, but not both topics as research it conducted. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • The relationship between fear and presence has been recently studied, confirming a bidirectional relationship and concluding that although presence did not have a direct causal relationship with fear, interpersonal variability of users in presence was linked to it and predicted later fear responses.

    “The relationship between fear and presence has been recently studied (Gromer et al., 2019), confirming this bidirectional relationship and concluding that although presence did not have a direct causal relationship with fear, interpersonal variability of users in presence was linked to it and predicted later fear responses.”

    From An Internet-based treatment for Flying Phobia using 360° images: Study protocol for a feasibility pilot study (2021) · cites this paper as Gromer et al., 2019

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    Experimental — accuracy not yet measured

  • Visual realism is not an important factor in presence.

    “There is also evidence that visual realism is not an important factor in presence (Gromer 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 Gromer et al., 2019

    The Discussion (Effects of Sensory Realism on Presence) suggests that costly efforts to achieve high realism may not be necessary to induce presence, and one presence questionnaire found no difference between conditions. But the Results report significantly higher presence ratings in the high-sensory-realism condition. The study manipulated visual detail and sound together, so it does not establish that visual realism is unimportant. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The precise nature of the association between self-rated distress and sense of presence during exposure, and in particular the direction of causality, remains poorly understood.

    “however, the precise nature of the association, and in particular the direction of causality [35], remains poorly understood.”

    From Experiences of gamified and automated virtual reality exposure therapy for spider phobia: qualitative study (2020) · cites this paper as [35]

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2 of the 71 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Quero S. Salvador S. Baños R. M. García-Palacios A. Botella C. Serrano B. (2008). “ Components of presence and reality judgement as predictors of treatment efficacy,” in Proceedings of the 11th Annual International Workshop on Presence, Padova, 56– 61.
  2. Schuemie M. J. Bruynzeel M. Drost L. Brinckman M. Haan G. D. Emmelkamp P. M. G. (2000). “ Treatment of acrophobia in virtual reality: a pilot study,” in Conference Proceedings Euromedia 2000, eds Broeckx F. Pauwels L. (Antwerp: Euromedia), 271– 275.

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Authors
Gromer, D., Reinke, M., Christner, I., & Pauli, P.
Affiliations
University of Würzburg (DE)
Corresponding author
Pauli, Paul
ORCID
Venue
Frontiers in Psychology
Publisher
Frontiers Media SA
Published
2019-01-30
Volume
10
Pages
141-141
ISSN
1664-1078 (ISSN-L)
DOI
10.3389/fpsyg.2019.00141
PMC
PMC6363698
OpenAlex
W2913352542
Cited by
127
References
71
Citations by year
2026: 15 · 2025: 21 · 2024: 15 · 2023: 11 · 2022: 16 · 2021: 27 · 2020: 17 · 2019: 5
FWCI
15.37
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Online Publication Service of Würzburg University (Würzburg University) (submittedVersion, cc-by)
  • OSF Preprints (OSF Preprints) (submittedVersion)
Funders
Volkswagen Foundation (AZ 94 102)
Topics
  • Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
  • Social Sciences › Psychology › Social Psychology › Social Robot Interaction and HRI
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
presence, fear response, virtual reality exposure therapy, skin conductance, heart rate, user characteristics, fear conditioning

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