Virtual reality therapy versus cognitive behavior therapy for social phobia: a preliminary controlled study.

Social phobia is one of the most frequent mental disorders and is accessible to two forms of scientifically validated treatments: anti-depressant drugs and cognitive behavior therapies (CBT). In this last case, graded exposure to feared social situations is one of the fundamental therapeutic ingredients. Virtual reality technologies are an interesting alternative to the standard exposure in social phobia, especially since studies have shown its usefulness for the fear of public speaking. This paper reports a preliminary study in which a virtual reality therapy (VRT), based on exposure to virtual environments, was used to treat social phobia. The sample consisted of 36 participants diagnosed with social phobia assigned to either VRT or a group-CBT (control condition). The virtual environments used in the treatment recreate four situations dealing with social anxiety: performance, intimacy, scrutiny, and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors in order to reduce anxiety in the corresponding real situations. Both treatments lasted 12 weeks, and sessions were delivered according to a treatment manual. Results showed statistically and clinically significant improvement in both conditions. The effect-sizes comparing the efficacy of VRT to the control traditional group-CBT revealed that the differences between the two treatments are trivial.     

Assessment of emotional reactivity produced by exposure to virtual environments in patients with eating disorders.

The aim of this study was to assess the usefulness of virtual environments representing situations that are emotionally significant to subjects with eating disorders (ED). These environments may be applied with both evaluative and therapeutic aims and in simulation procedures to carry out a range of experimental studies. This paper is part of a wider research project analyzing the influence of the situation to which subjects are exposed on their performance on body image estimation tasks. Thirty female patients with eating disorders were exposed to six virtual environments: a living-room (neutral situation), a kitchen with high-calorie food, a kitchen with low-calorie food, a restaurant with high-calorie food, a restaurant with low-calorie food, and a swimming-pool. After exposure to each environment the STAI-S (a measurement of state anxiety) and the CDB (a measurement of depression) were administered to all subjects. The results show that virtual reality instruments are particularly useful for simulating everyday situations that may provoke emotional reactions such as anxiety and depression, in patients with ED. Virtual environments in which subjects are obliged to ingest high-calorie food provoke the highest levels of state anxiety and depression.     

Using a virtual reality cricket simulator to explore the effects of pressure,competition anxiety on batting performance in cricket

Virtual reality (VR) has created opportunities to innovatively re-imagine the way we examine the relations between pressure, competition anxiety and performance. This study aimed to determine the efficacy of VR as a means of measuring the effects of competition anxiety when pressure manipulations are applied while participants bat in a cricket batting VR simulator. The twenty-eight male participants who took part in two experiments were divided into a high (14, mean age: 22.94, SD: 5.4) and a low skill group (14; mean age: 23.55, SD: 9.9). The aim of the first experiment was to validate the VR simulator as a tool that could capture differences in batting performance between a high and low skilled group. The results showed that high skill participants not only scored significantly higher run rates than low skill participants, but they outperformed the low skill group in all performance measures including higher incidences of correct foot placements that reflect better anticipatory responses. Having established the VR batting simulator as being a reliable tool for capturing batting dynamics, experiment 2 aimed to explore the effects of a pressure manipulation on competition anxiety and batting performance. All measures of competition anxiety were significantly greater for both groups in the high-pressure condition compared to the two low-pressure conditions (p < 0.001). The magnitude of this effect was greater in the low skill group for cognitive (0.59) and somatic (0.794) anxiety. Despite anxiety levels significantly increasing in the high-pressure condition, no significant negative changes to batting performance were found for either group, with both groups actually demonstrating performance improvements. Overall, the findings show how a cricket batting virtual reality simulator can be used as a tool to measure the effects of pressure on competition anxiety and batting performance in tasks involving dynamic skill execution.     

Discriminating Clinical From Nonclinical Manifestations of Test Anxiety: A Validation Study

Test anxiety, although being a very common, severe, and impairing psychological disorder, is not coded as a separate diagnosis in the DSM or ICD. In the present study we investigated whether the Test Anxiety Inventory can be used to discriminate clinical and subclinical levels of test anxiety by comparing patients who seek treatment for their test anxiety in an outpatient clinic with carefully matched students with normal test anxiety. The data from 47 test-anxious patients as well as 41 healthy university students were examined. Results show that a cutoff score of ≥ 80 in the Test Anxiety Inventory can discriminate the clinical group from the control students. The symptom pattern of test anxiety was very consistent in the clinical group regardless of the principal diagnosis allocated by the treating clinician. Comorbid depression did not affect the severity of test anxiety. The motivation to avoid failure was one of the most important differences between patients who sought help for their test anxiety and students with nonclinical levels of test anxiety.     

Big fish in big ponds: a multilevel analysis of test anxiety and achievement in special gifted classes

This study analyzes the effects of individual achievement and achievement level of student reference group on test anxiety in a national sample of 769 gifted Israeli students (grade levels 4-9), which was previously investigated by Zeidner and Schleyer (1999a). We hypothesized that when controlling for individual achievement, students' experiences of test anxiety should increase with the increasing ability level of their peer reference group. It was assumed that this effect was largely mediated by reference group effects on academic self-concept (big-fish-little-pond effect). Zeidner and Schleyer found that gifted students within a gifted peer reference group showed higher levels of test anxiety than gifted students within a non-gifted peer reference group. Of note, the present study focused exclusively on gifted students attending special gifted classes. The main research question was whether or not the assumed effects of individual and class achievement can be found for gifted students in special gifted classes when taking the variance of achievement level (grades) of the special gifted classes into account. Using hierarchical linear modeling (HLM) methodology, the assumed effects were vindicated for this special group of high ability students. Thus, in line with previous results, the Worry component of test anxiety was more highly reactive to the effects of individual achievement than the Emotionality component. Also, in line with our theoretical assumptions, achievement/anxiety relations were largely mediated by the effects of academic self-concept.     

Big fish in big ponds: A multilevel analysis of test anxiety and achievement in special gifted classes

Abstract

This study analyzes the effects of individual achievement and achievement level of student reference group on test anxiety in a national sample of 769 gifted Israeli students (grade levels 4–9), which was previously investigated by Zeidner and Schleyer (1999a). We hypothesized that when controlling for individual achievement, students’ experiences of test anxiety should increase with the increasing ability level of their peer reference group. It was assumed that this effect was largely mediated by reference group effects on academic self-concept (big-fish-little-pond effect). Zeidner and Schleyer found that gifted students within a gifted peer reference group showed higher levels of test anxiety than gifted students within a non-gifted peer reference group. Of note, the present study focused exclusively on gifted students attending special gifted classes. The main research question was whether or not the assumed effects of individual and class achievement can be found for gifted students in special gifted classes when taking the variance of achievement level (grades) of the special gifted classes into account. Using hierarchical linear modeling (HLM) methodology, the assumed effects were vindicated for this special group of high ability students. Thus, in line with previous results, the Worry component of test anxiety was more highly reactive to the effects of individual achievement than the Emotionality component. Also, in line with our theoretical assumptions, achievement/anxiety relations were largely mediated by the effects of academic self-concept.     

Perfectionism and Test Anxiety among High-School Students: the Moderating Role of Academic Hardiness

Recent evidence suggests that test anxiety is increasing among students; however, relatively little is known regarding the related factors of test anxiety. The purpose of this study was to (1) examine the relationships between two forms of perfectionism, academic hardiness, and test anxiety, and (2) examine the moderating role of academic hardiness on the association between two types of perfectionism and test anxiety. This study included 520 students ranging from 15 to 21 years of age from eight high schools in Tehran, Iran completed the self-administered questionnaires. The results of Structural Equation Modelling (SEM) revealed that students with high levels of personal standards perfectionism and high levels of academic hardiness were less likely to experience test anxiety, while students with high levels of evaluative concerns perfectionism were more likely to experience test anxiety. A multi-group analysis revealed that academic hardiness moderated the relationship between evaluative concerns perfectionism and test anxiety. These findings enhance existing literature by revealing moderating processes that explain how perfectionism effects test anxiety.     

Students' perceptions of constructivist Internet learning environments by a physics virtual laboratory: the gap between ideal and reality and gender differences.

The purpose of this study was to investigate the perceptions of Internet users of a physics virtual laboratory, Demolab, in Taiwan. Learners' perceptions of Internet-based learning environments were explored and the role of gender was examined by using preferred and actual forms of a revised Constructivist Internet-based Learning Environment Survey (CILES). The students expressed a clear gap between ideal and reality, and they showed higher preferences for many features of constructivist Internet-based learning environments than for features they had actually learned in Demolab. The results further suggested that male users prefer to be involved in the process of discussion and to show critical judgments. In addition, male users indicated they enjoyed the process of negotiation and discussion with others and were able to engage in reflective thoughts while learning in Demolab. In light of these findings, male users seemed to demonstrate better adaptability to the constructivist Internet-based learning approach than female users did. Although this study indicated certain differences between males and females in their responses to Internet-based learning environments, they also shared numerous similarities. A well-established constructivist Internet-based learning environment may encourage more female learners to participate in the science community.     

Sex, ethnic, and social differences in test anxiety among Israeli adolescents

The effects of sex, ethnicity, and social class on levels of test anxiety were examined among a sample of 416 adolescent students in Israel. Significant sex differences in mean levels of test anxiety were found, with girls scoring consistently higher than boys across ethnic, social, and grade categories. Pupils of low socioeconomic status (SES) also scored consistently higher than pupils of high SES across grades. Nevertheless, this study provides little support for the commonly held view that sociocultural or sex group differences in school achievement are due, in any meaningful way, to differences in test anxiety. The group differences, though significant for SES and sex, were of negligible magnitude, and the correlation between test anxiety scores and grade point average was minimal for the group as a whole and nonsignificant for students of Eastern background, who have been purported to be particularly affected by high levels of test anxiety. The findings do support other cross-cultural studies, which have found only a modicum of shared variance between test anxiety and grades. It is concluded that test anxiety is not a particularly valid predictor of achievement or ability.     

Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia

The aim of the present study was to evaluate the effectiveness of low-budget virtual reality (VR) exposure versus exposure in vivo in a between-group design in 33 patients suffering from acrophobia. The virtual environments used in treatment were exactly copied from the real environments used in the exposure in vivo program. VR exposure was found to be as effective as exposure in vivo on anxiety and avoidance as measured with the Acrophobia Questionnaire (AQ), the Attitude Towards Heights Questionnaire (ATHQ) and the Behavioral Avoidance Test (BAT). Results were maintained up to six months follow-up. The present study shows that VR exposure can be effective with relatively cheap hardware and software on stand-alone computers currently on the market. Further studies into the effectiveness of VR exposure are recommended in other clinical groups as agoraphobics and social phobics and studies in which VR exposure is compared with more emerging virtual worlds as presented in CAVE-type systems.     

团体箱庭疗法干预初中生考试焦虑的效果

以19名考试焦虑初中生为被试,运用等组前后测实验方法,考察团体箱庭疗法干预考试焦虑的效果,并与放松训练进行比较。结果表明：团体箱庭疗法与放松训练一样能够有效地干预初中生的考试焦虑情绪,团体箱庭疗法干预效果的保持性优于放松训练。     

Repeated exposure of flight phobics to flights in virtual reality

The present study examined the effects of repeated exposure of flight phobics to flights in virtual reality (VR). Flight phobics were randomly assigned either to complete one VR test flight followed by four VR exposure flights (VR group; N=15) in one lengthy session or to complete one VR test flight followed by a lengthy relaxation training session (relaxation group; N=15). All participants completed a second VR test flight at the end of the session. Fear reports and physiological fear reactions (heart rate, skin conductance level) during VR exposures were registered, and fear of flying was assessed psychometrically from 3 weeks before to 3 months after exposure. Exposure to VR flights elicited subjective and physiological fear responses in flight phobics, and these responses attenuated within and across VR flights. Fear reduction associated with repeated VR exposure was greater than fear reduction caused by relaxation training. Fear of flying improved in both treatment groups, but several outcome measures indicated greater effects in the VR treated group than in the relaxation group. These findings indicate that exposure in virtual reality may offer a new and promising approach for the treatment of fear of flying.     

The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder

Individuals with social anxiety are prone to engage in post event processing (PEP), a post mortem review of a social interaction that focuses on negative elements. The extent that PEP is impacted by cognitive behavioral therapy (CBT) and the relation between PEP and change during treatment has yet to be evaluated in a controlled study. The current study used multilevel modeling to determine if PEP decreased as a result of treatment and if PEP limits treatment response for two types of cognitive behavioral treatments, a group-based cognitive behavioral intervention and individually based virtual reality exposure. These hypotheses were evaluated using 91 participants diagnosed with social anxiety disorder. The findings suggested that PEP decreased as a result of treatment, and that social anxiety symptoms for individuals reporting greater levels of PEP improved at a slower rate than those with lower levels of PEP. Further research is needed to understand why PEP attenuates response to treatment.     

计算机虚拟技术训练辅助盲人构建空间表征之研究

摘要 由于视觉经验的缺乏,盲人的空间认知存在一定的缺陷,尤其表现在对现实环境的空间布局认识存在困难。本研究欲探究计算机虚拟技术手段辅助盲人建构表征的成效,并在此基础上探究盲人定向行走的效果。本研究是一个现场实验,采用随机分配的方式将全盲被试分为三组,之后让被试接受三种不同的实验处理,即计算机虚拟技术、触觉地图和人导处理,最后接受空间任务测试,测试不仅考察被试对环境空间布局的认识,而且还测量了被试在现实环境的行走探路效率。结果发现,虚拟技术组的被试不仅能够对整个实验环境形成清晰整体的认识,而且还能借助形成的空间表征在测验场地有效地实施定向行走。从研究结果得知,计算机虚拟技术这一手段对应用于改善盲人空间表征系统及提高盲人定向行走训练效率具有一定的积极意义。     

A randomised placebo-controlled trial of a self-help Internet-based intervention for test anxiety

Test anxiety is widespread and associated with poor performance in academic examinations. The Internet, not well-proven for the treatment of anxiety, should be able to deliver highly accessible Cognitive Behavior Therapy (CBT). This study sought to test the hypothesis that CBT, available on the Internet, could reduce test anxiety. Ninety university students were randomly allocated to CBT or a control program, both on the Internet. Before and after treatment, the participants completed the Test Anxiety Inventory (TAI), an Anxiety Hierarchy Questionnaire (AHQ), the Exam Problem-Solving Inventory (EPSI), the General Self-Efficacy Scale (GSES) and the Heim reasoning tests (AH) as a measure of test performance. Of the CBT and control groups 28% and 35%, respectively, withdrew. According to the TAI, 53% of the CBT group showed a reliable and clinically significant improvement with treatment but only 29% of the control group exhibited such a change. On the AHQ, 67% of the CBT group and 36% of the control group showed a clinically significant improvement, more than two standard deviations above the mean of the baseline, a change in favour of CBT. Both groups improved on the GSES, in state anxiety during exams retrospectively assessed, and on the AH tests. The improvement on the AH tests was probably a practice effect and not a reflection of a change in capacity for academic testing. This study thus supports use of CBT on the Internet for the treatment of test anxiety.     

Group preprogrammed systematic desensitization without the simultaneous presentation of aversive scenes with relaxation training

This study investigated the assumption that it is necessary to simultaneously present muscle relaxation and aversive scenes in order for decrements in anxiety to occur. Utilizing 70 high test anxious students, the following treatment groups were delineated: (a) preprogrammed systematic desensitization, (b) non-simultaneous (scenes presented prior to muscle relaxation), (c) relaxation, and (d) no-treatment control. Self-report measures of test and general anxiety as well as college grades constituted the dependent measures. The results indicated that there tended to be no significant differences between the preprogrammed systematic desensitization and non-simultaneous groups on the dependent measures and that the latter group tended to show significant decrements in anxiety and obtain better grades than the relaxation and no-treatment control groups. These findings question the necessity of simultaneously pairing muscle relaxation and aversive scenes in treating anxiety by this method.     

虚拟现实暴露疗法在社交焦虑中的应用:效果、机制及展望

由于传统干预方法的诸多局限,虚拟现实暴露疗法(virtual reality exposure therapy,VRET)逐渐应用于对社交焦虑的干预,VRET是将虚拟现实技术与传统行为暴露治疗相结合而形成的一种新的干预方法。文章总结了VRET的三个发展阶段及其研究范式,述评了在VRET过程中的作用机制。未来研究可致力于设计更加自然的人机交互技术,实现技术与社交焦虑治疗的深度融合以及关注第三人称视角应用的作用及机制。     

Performance on creativity measures with examination‐taking instructions intended to induce high or low levels of test anxiety

The major purpose of this investigation was to ascertain whether differential levels of performance on three tests of creativity portraying divergent production of verbal (semantic), figural (visual), and mathematical (symbolic) responses would be associated with two sets of test‐taking instructions: (a) one intended to induce a relatively high level of anxiety or stress and (b) the other designed to minimize the degree of anxiety or stress in the testing experience. Participants were 132 private secondary school students (82 females and 50 males) in a college preparatory program who were divided into experimental and control groups. On the basis of three univariate four‐way factorial designs at each of two levels per variable (treatment x sex x test anxiety x mathematics anxiety) with the pretest serving as a covariate, it was observed that only in the instance of a mathematics fluency test did the experimental group exposed to anxiety‐inducing test‐taking instructions achieve a significantly lower mean score on the posttest than did the control group that had been administered instructions intended to minimize anxiety (p < .001). A marginally significant interaction occurred between gender and mathematics anxiety on the mathematics fluency test with highly‐anxious males showing a greater decrement in performance than highly‐anxious females when exposed to anxiety‐inducing instructions. The results were interpreted primarily within a conceptual framework developed by Tobias (1985), who proposed an integration of cognitive capacity and interference as explanatory constructs for decrements in the performance of tasks involving anxiety.     

A standardized set of 3-D objects for virtual reality research and applications

The use of immersive virtual reality as a research tool is rapidly increasing in numerous scientific disciplines. By combining ecological validity with strict experimental control, immersive virtual reality provides the potential to develop and test scientific theories in rich environments that closely resemble everyday settings. This article introduces the first standardized database of colored three-dimensional (3-D) objects that can be used in virtual reality and augmented reality research and applications. The 147 objects have been normed for name agreement, image agreement, familiarity, visual complexity, and corresponding lexical characteristics of the modal object names. The availability of standardized 3-D objects for virtual reality research is important, because reaching valid theoretical conclusions hinges critically on the use of well-controlled experimental stimuli. Sharing standardized 3-D objects across different virtual reality labs will allow for science to move forward more quickly.     

Future-Oriented Positive Mental Imagery Reduces Anxiety for Exposure to Public Speaking

Exposure therapy is the recommended treatment for anxiety disorders, but many anxious individuals are unwilling to expose themselves to feared situations. Episodic simulation of future situations contributes to adaptive emotion regulation and motivates behavior. This study investigated whether future-oriented positive mental imagery reduces anticipatory anxiety and distress during exposure, and increases exposure willingness and duration. Forty-three individuals with moderate public speaking anxiety were randomized to a standardized positive mental imagery exercise about future public speaking or no-task. All participants were then asked to present in a virtual reality environment. Anticipatory anxiety reduced in the positive mental imagery group, but not in the control group. Additionally, the positive mental imagery group reported lower distress during exposure than the control group, but groups did not differ in exposure willingness. Due to limited variance, effects on exposure duration could not be tested. Future-oriented positive mental imagery is promising to prepare individuals for exposure to previously avoided situations.