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Effectiveness of a Participatory and Interactive Virtual Reality Intervention in Patients With Social Anxiety Disorder: Longitudinal Questionnaire Study

  • Kim, Hyun-Jin1, 2
  • Lee, Seulki2
  • Jung, Dooyoung3
  • Hur, Ji-Won4
  • Lee, Heon-Jeong4
  • Lee, Sungkil5
  • Kim, Gerard J4
  • Cho, Chung-Yean6
  • Choi, Seungmoon7
  • Lee, Seung-Moo6
  • Cho, Chul-Hyun1, 2
  • 1 Chungnam National University, Daejeon
  • 2 Chungnam National University Sejong Hospital, Sejong
  • 3 Ulsan National Institute of Science and Technology, Ulsan
  • 4 Korea University, Seoul
  • 5 Sungkyunkwan University, Suwon
  • 6 Korea National University of Arts, Seoul
  • 7 Pohang University of Science and Technology, Pohang
Published Article
Journal of Medical Internet Research
JMIR Publications Inc.
Publication Date
Oct 06, 2020
DOI: 10.2196/23024
PMID: 33021481
PMCID: PMC7576535
PubMed Central
External links


Background Social anxiety disorder (SAD) is characterized by excessive fear of negative evaluation and humiliation in social interactions and situations. Virtual reality (VR) treatment is a promising intervention option for SAD. Objective The purpose of this study was to create a participatory and interactive VR intervention for SAD. Treatment progress, including the severity of symptoms and the cognitive and emotional aspects of SAD, was analyzed to evaluate the effectiveness of the intervention. Methods In total, 32 individuals with SAD and 34 healthy control participants were enrolled in the study through advertisements for online bulletin boards at universities. A VR intervention was designed consisting of three stages (introduction, core, and finishing) and three difficulty levels (easy, medium, and hard) that could be selected by the participants. The core stage was the exposure intervention in which participants engaged in social situations. The effectiveness of treatment was assessed through Beck Anxiety inventory (BAI), State‐Trait Anxiety Inventory (STAI), Internalized Shame Scale (ISS), Post-Event Rumination Scale (PERS), Social Phobia Scale (SPS), Social Interaction Anxiety Scale (SIAS), Brief-Fear of Negative Evaluation Scale (BFNE), and Liebowitz Social Anxiety Scale (LSAS). Results In the SAD group, scores on the BAI ( F =4.616, P =.009), STAI-Trait ( F =4.670, P =.004), ISS ( F =6.924, P =.001), PERS-negative ( F =1.008, P <.001), SPS ( F =8.456, P <.001), BFNE ( F =6.117, P =.004), KSAD ( F =13.259, P <.001), and LSAS ( F =4.103, P =.009) significantly improved over the treatment process. Compared with the healthy control group before treatment, the SAD group showed significantly higher scores on all scales ( P <.001), and these significant differences persisted even after treatment ( P <.001). In the comparison between the VR treatment responder and nonresponder subgroups, there was no significant difference across the course of the VR session. Conclusions These findings indicated that a participatory and interactive VR intervention had a significant effect on alleviation of the clinical symptoms of SAD, confirming the usefulness of VR for the treatment of SAD. VR treatment is expected to be one of various beneficial therapeutic approaches in the future. Trial Registration Clinical Research Information Service (CRIS) KCT0003854;

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