title: Social interactions in virtual reality exposure therapy: A proof-of-concept pilot study.
abstract: OBJECTIVE
  Research on virtual reality exposure therapy (VRET) has demonstrated good treatment efficacy with regards to several anxiety disorders. Yet, there is lack of knowledge about the value of integrating interaction between clients and virtual humans in VRET. Such interaction might prove effective in treating psychological complaints that involve social interactions, such as social anxiety.
  
  
  METHODS
  A VRET system specifically designed to expose clients with social anxiety disorder to anxiety provoking social situations was applied to 16 and 18 individuals with high and low levels of social anxiety, respectively. Participants engaged in two exposure sessions in several free speech dialogues with virtual humans while being monitored by a therapist.
  
  
  RESULTS
  Participants with high levels of social anxiety reported significantly lower levels of social anxiety three months after exposure to two virtual reality interaction sessions than before treatment (p < 0.01). In the group with low levels of social anxiety, no significant change of social anxiety was reported between pre-treatment and follow-up. Additionally, participants in both groups reported higher self-efficacy three months after treatment than before treatment (ps ≤ 0.001).
  
  
  CONCLUSIONS
  These findings indicate that virtual reality technology that incorporates social interactions may be successfully applied for therapeutic purposes.
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.|Amsterdam Brain and Cognition Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Nexhmedin
authors.initials: N
authors.lastname: Morina
authors.affiliation: Interactive Intelligence Group, Delft University of Technology, The Netherlands.
authors.forename: Willem-Paul
authors.initials: WP
authors.lastname: Brinkman
authors.affiliation: Interactive Intelligence Group, Delft University of Technology, The Netherlands.
authors.forename: Dwi
authors.initials: D
authors.lastname: Hartanto
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Isabel L
authors.initials: IL
authors.lastname: Kampmann
authors.affiliation: Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.|Center for Social and Humanities Research, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Paul M G
authors.initials: PM
authors.lastname: Emmelkamp
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010698:Phobic Disorders / Q000628:therapy; D010865:Pilot Projects; D020377:Self Efficacy; D014584:User-Computer Interface; D063367:Virtual Reality Exposure Therapy / Q000379:methods*; D055815:Young Adult
keywords: Virtual reality; exposure; social anxiety; social phobia