The Effectiveness of Self-Guided Virtual-Reality Exposure Therapy for Public-Speaking Anxiety

Journal article


Premkumar, P., Heym, Nadja, Brown, David Joseph, Battersby, Steven, Sumich, Alexander, Huntington, Bethany, Daly, Rosie and Zysk, Eva (2021). The Effectiveness of Self-Guided Virtual-Reality Exposure Therapy for Public-Speaking Anxiety. Frontiers in Psychiatry. 12, p. 694610. https://doi.org/10.3389/fpsyt.2021.694610
AuthorsPremkumar, P., Heym, Nadja, Brown, David Joseph, Battersby, Steven, Sumich, Alexander, Huntington, Bethany, Daly, Rosie and Zysk, Eva
AbstractObjectives: Self-guided virtual-reality exposure therapy (VRET) is a psychological intervention that enables a person to increase their own exposure to perceived threat. Public-speaking anxiety (PSA) is an anxiety-provoking social situation that is characterized by fear of negative evaluation from an audience. This pilot study aimed to determine whether self-guided VRET (1) increases exposure to PSA-specific virtual social threats, and (2) reduces anxiety, arousal, heartrate and PSA over repeated exposure. Methods: Thirty-two University students (27 completers) with high self-reported public-speaking anxiety attended 2 weekly self-guided VRET sessions. Each session involved the participant delivering a 20-min speech in a virtual classroom. Participants were able to increase their exposure to virtual social threat through the audience size, audience reaction, number of speech prompts, and their own salience in the virtual classroom at 4-min intervals. Participants' heartrates and self-reported anxiety and arousal were monitored during these intervals. Participants completed psychometric assessments after each session and 1 month later. Results: Participants increased their exposure to virtual social threat during each VRET session, which coincided with a reduction in heartrate and self-reported anxiety and arousal. Improvement in PSA occurred post-treatment and 1 month later. The in-session improvement in anxiety correlated with reductions in fear of negative evaluation post-treatment and 1 month later. Conclusions: Increased self-exposure to virtual social threat from self-guided VRET relieves anxiety and shows immediate reductions in subjective and physiological arousal during application, but also yields sustained improvement in PSA.
KeywordsPsychiatry; virtual audience; heart rate; negative evaluation; perceived control; social anxiety; head-mounted display
Year2021
JournalFrontiers in Psychiatry
Journal citation12, p. 694610
PublisherFrontiers Media
ISSN1664-0640
Digital Object Identifier (DOI)https://doi.org/10.3389/fpsyt.2021.694610
Publication dates
Print19 Aug 2021
Online19 Aug 2021
Publication process dates
Deposited01 Sep 2021
Accepted30 Jun 2021
Accepted author manuscript
File Access Level
Open
Additional information

First published by Frontiers Media

Licensehttp://creativecommons.org/licenses/by/4.0/
Permalink -

https://openresearch.lsbu.ac.uk/item/8xvw4

Download files


Accepted author manuscript
  • 196
    total views
  • 214
    total downloads
  • 9
    views this month
  • 4
    downloads this month

Export as

Related outputs

Multiscale Fluctuation Dispersion Entropy of EEG as a Physiological Biomarker of Schizotypy
Zandbagleh, A., Azami, H., Mirzakuchaki, S., Daliri, M. R., Sanei, S. and Premkumar, P. (2023). Multiscale Fluctuation Dispersion Entropy of EEG as a Physiological Biomarker of Schizotypy. IEEE Access. pp. 110124 - 110135. https://doi.org/10.1109/ACCESS.2023.3321868
The relationships between expressed emotion, cortisol, and EEG alpha asymmetry
Wang, G.Y., Crook-Rumsey, M., Sumich, A., Dulson, D., Gao,T. T. and Premkumar, P. (2023). The relationships between expressed emotion, cortisol, and EEG alpha asymmetry. Physiology and Behavior. 269 (114276). https://doi.org/10.1016/j.physbeh.2023.114276
Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning
Rahman, M.A., Brown, D.J., Mahmud, M., Harris, M., Shopland, N., Heym, N., Sumich, A., Turabee, Z. B., Standen, B., Downes, D., Xing,Y., Thomas, C., Haddick, S., Premkumar, P., Nastase, S., Burton, A. and Lewis, J. (2023). Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning. Brain Informatics. 10 (14). https://doi.org/10.1186/s40708-023-00193-9
Reflecting on the experiential journey: Creating, developing and understanding leadership in Equality, Diversity and Inclusion within a Faculty
Premkumar, P., Leadley-Meade, Z., Moorley, C., Rye, S., Clegg, D. and Alasia, S. (2023). Reflecting on the experiential journey: Creating, developing and understanding leadership in Equality, Diversity and Inclusion within a Faculty. Equality, Diversity and Inclusion Conference 2023: The Shoulders of Giants: Listening, Learning and Improving our Practice.
Tensor factorization approach for ERP-based assessment of schizotypy in a novel auditory oddball task on perceived family stress
Zandbagleh, A, Mirzakuchaki, S., Daliri, M.R., Premkumar, P., Carretié, L. and Saeid Sanei, S. (2022). Tensor factorization approach for ERP-based assessment of schizotypy in a novel auditory oddball task on perceived family stress. Journal of Neural Engineering. https://doi.org/10.1088/1741-2552/aca69f
Conceptualising mental illness among University students of African, Caribbean and similar ethnic heritage in the United Kingdom
Dare, T., Jidong, D. E. and Premkumar, P. (2022). Conceptualising mental illness among University students of African, Caribbean and similar ethnic heritage in the United Kingdom. Ethnicity & health. 28 (7), pp. 522-543. https://doi.org/10.1080/13557858.2022.2104817
What is next for the neurobiology of temperament, personality and psychopathology?
Trofimova, I., Bajaj, S., Bashkatov, S. A., Blair, J., Brandt, A., , Chan, R. C. K., Clemens, B., Corr, P. J., Cyniak-Cieciura, M., Demidova, L., Filippi, C. A., Garipova, M., Habel, U., Haines, U., Heym, N., Hunter, K., Jones, N. A., Kanen, J., Kirenskaya, A., Kumari, V., Lenzoni, S., Lui, S. S. Y., Mathur,A., McNaughton, N., Mize, K. D., Mueller, E., Netter, P., Paul, K., Plieger, T., Premkumar, P., Raine, A., Reuter, M., Robbins, T. W., Samylkin, D., Storozheva, Z., Sulis, W., Sumich, A., Tkachenko, A., Valadez, E. A., Wacker, J., Wagels, L., Wang, L.-L., Zawadzki, B. and Pickering, A. D. (2022). What is next for the neurobiology of temperament, personality and psychopathology? Current Opinion in Behavioral Sciences. 45 (101143). https://doi.org/10.1016/j.cobeha.2022.101143
Classification of Low and High Schizotypy Levels via Evaluation of Brain Connectivity
Zandbagleh, A., Mirzakuchaki, S, Daliri, M.R., Premkumar, P. and Sanei, S. (2022). Classification of Low and High Schizotypy Levels via Evaluation of Brain Connectivity. International Journal of Neural Systems. 34 (2). https://doi.org/10.1142/S0129065722500137
Rejection sensitivity and its relationship to schizotypy and aggression: current status and future directions
Premkumar, P. and Kumari, V. (2022). Rejection sensitivity and its relationship to schizotypy and aggression: current status and future directions. Current Opinion in Behavioral Sciences. 44. https://doi.org/10.1016/j.cobeha.2022.101110
Editorial: The Use of Virtual-Reality Interventions in Reducing Anxiety
Premkumar, P., Heym, N., Anderson, P. L., Brown, D. and Sumich A. (2022). Editorial: The Use of Virtual-Reality Interventions in Reducing Anxiety. Frontiers in Virtual Reality. 3 (853678). https://doi.org/10.3389/frvir.2022.853678
Cortical and subcortical neuroanatomical signatures of schizotypy in 3004 individuals assessed in a worldwide ENIGMA study
Modinos, G., Kirschner, M., Hodzic-Santor, B., Antoniades, M., Nenadic, I., Kircher, T., Krug, A., Meller, T., Grotegerd, D., Fornito, A., Arnatkeviciute, A., Bellgrove, M., Tiego, J., Dannlowski, U., Dohm, K., Hülsmann, C., Kugel, H., Enneking, V., Klug, M., Leehr, E., Boehnlein, J., Gruber, M., Mehler, D., DeRosse, P., Moyett, A., Baune, B., Green, M., Quidé, Y., Pantelis, C., Strachan, R., Wang, Y., Ettinger, U., Debbané, M., Derome, M., Gaser, C., Besteher, B., Diederen, K., Spencer, T., Fletcher, P., Rössler, W., Smigielski, L., Kumari, V., Premkumar, P., Park, H., Wiebels, K., Lemmers-Jansen, I., Gilleen, J., Allen, P., Kozhuharova, P., Marsman, J-B., Lebedeva, I., Tomyshev, A., Mukhorina, A., Kaiser, S., Fett, A.-K., Sommer, I., Schuite-Koops, S., Paquola, C., Lariviere, S., Bernhardt, B., Dagher, A., Grant, P., van Erp, T., Turner, J. A., Thompson, P. and Aleman, A. (2021). Cortical and subcortical neuroanatomical signatures of schizotypy in 3004 individuals assessed in a worldwide ENIGMA study. Molecular Psychiatry. https://doi.org/10.1038/s41380-021-01359-9
Pituitary volume in people with chronic schizophrenia: Clarifying the roles of serious violence and childhood maltreatment
Premkumar, P., Bipin, M., Das, M., Lau, J. Y. F., Sumich, A. L. and Kumari, V. (2021). Pituitary volume in people with chronic schizophrenia: Clarifying the roles of serious violence and childhood maltreatment. Psychiatry Research: Neuroimaging. 314, p. 111323. https://doi.org/10.1016/j.pscychresns.2021.111323
Mild-to-moderate schizotypal traits relate to physiological arousal from social stress
Premkumar, P., Alahakoon, P., Smith, M., Kumari, V., Babu, D. and Baker, J. (2020). Mild-to-moderate schizotypal traits relate to physiological arousal from social stress. Stress. https://doi.org/10.1080/10253890.2020.1797674
The path from schizotypy to depression and aggression and the role of family stress
Premkumar, P., Kuipers, E. and Kumiar, V. (2020). The path from schizotypy to depression and aggression and the role of family stress. European Psychiatry. 63 (1), p. e79. https://doi.org/10.1192/j.eurpsy.2020.76
Developing and maintaining the teacher-student relationship in one to one alternative provision: the tutor’s experience
Premkumar, P., Fitzsimmons, W. and Trigg, R. Developing and maintaining the teacher-student relationship in one to one alternative provision: the tutor’s experience. Educational Review. https://doi.org/10.1080/00131911.2019.1653265
Neural responses to criticism and praise vary with schizotypy and perceived emotional support
Premkumar, P., Santo, M. G. E., Onwumere, O., Schürmann, M., Kumari, V., Blanco, S., Baker, J. and Kuipers, E. (2019). Neural responses to criticism and praise vary with schizotypy and perceived emotional support. International Journal of Psychophysiology. 145, pp. 109-118. https://doi.org/10.1016/j.ijpsycho.2019.05.008
Sensitivity to criticism and praise predicts schizotypy in the non-clinical population: The role of affect and perceived expressed emotion
Premkumar, P., Dunn, A. K., Onwumere, J. and Kuipers, E. (2019). Sensitivity to criticism and praise predicts schizotypy in the non-clinical population: The role of affect and perceived expressed emotion. European Psychiatry. 55, p. 109–115. https://doi.org/10.1016/j.eurpsy.2018.10.009
Deciphering reward-based decision making in schizophrenia: a meta-analysis and behavioral modelling of the Iowa Gambling Task
Premkumar, P., Betz, Linda T, Brambilla, Paolo, Ilankovic, Andrej, Premkumar, Preethi, Kim, Myung-Sun, Raffard, Stéphane, Bayard, Sophie, Hori, Hikaru, Lee, Kyoung-Uk, Lee, Seung Jae, Koutsouleris, Nikolaos and Kambeitz, Joseph (2019). Deciphering reward-based decision making in schizophrenia: a meta-analysis and behavioral modelling of the Iowa Gambling Task. Schizophrenia Research. 204, pp. 7-15. https://doi.org/10.1016/j.schres.2018.09.009
Pituitary volume reduction in schizophrenia following cognitive behavioural therapy
Premkumar, P., Bream, D., Sapara, A., Fannon, D., Anilkumar, A. P., Kuipers, E. and Kumari.V. (2018). Pituitary volume reduction in schizophrenia following cognitive behavioural therapy. Schizophrenia Research. 192, p. 416–422. https://doi.org/10.1016/j.schres.2017.04.035
Schizotypal traits and their relation to rejection sensitivity in the general population: Their mediation by quality of life, agreeableness and neuroticism
Premkumar, P., Onwumere, J., Betts, L., Kibowski, F. and Kuipers, E. (2018). Schizotypal traits and their relation to rejection sensitivity in the general population: Their mediation by quality of life, agreeableness and neuroticism. Psychiatry Research. 267, pp. 201-209. https://doi.org/10.1016/j.psychres.2018.06.002
Neural changes following cognitive behaviour therapy for psychosis: A longitudinal study
Kumari, V., Fannon, D., Peters, E.R., Ffytche, D.H., Sumich, A.L., Premkumar, P., Anilkumar, A.P., Andrew, C., Phillips, M.L., Williams, S.C.R. and Kuipers, E. (2011). Neural changes following cognitive behaviour therapy for psychosis: A longitudinal study. Brain. 134 (8), p. 2396–2407. https://doi.org/10.1093/brain/awr154