Journal Article

Virtual reality exposure therapy for social anxiety disorder: a systematic review and meta-analysis

Sawada, Kyosuke, Kudo, Shun, Mimura, Masaru, Kishimoto, Taishiro, Horigome, Toshiro, Shiga, Kiko, Kurokawa, Shunya

2020

Overview

Virtual reality exposure therapy (VRET) is currently being used to treat social anxiety disorder (SAD); however, VRET's magnitude of efficacy, duration of efficacy, and impact on treatment discontinuation are still unclear. We conducted a meta-analysis of studies that investigated the efficacy of VRET for SAD. The search strategy and analysis method are registered at PROSPERO (#CRD42019121097). Inclusion criteria were: (1) studies that targeted patients with SAD or related phobias; (2) studies where VRET was conducted for at least three sessions; (3) studies that included at least 10 participants. The primary outcome was social anxiety evaluation score change. Hedges' g and its 95% confidence intervals were calculated using random-effect models. The secondary outcome was the risk ratio for treatment discontinuation. Twenty-two studies (n = 703) met the inclusion criteria and were analyzed. The efficacy of VRET for SAD was significant and continued over a long-term follow-up period: Hedges' g for effect size at post-intervention, -0.86 (-1.04 to -0.68); three months post-intervention, -1.03 (-1.35 to -0.72); 6 months post-intervention, -1.14 (-1.39 to -0.89); and 12 months post-intervention, -0.74 (-1.05 to -0.43). When compared to in vivo exposure, the efficacy of VRET was similar at post-intervention but became inferior at later follow-up points. Participant dropout rates showed no significant difference compared to in vivo exposure. VRET is an acceptable treatment for SAD patients that has significant, long-lasting efficacy, although it is possible that during long-term follow-up, VRET efficacy lessens as compared to in vivo exposure.

• Publisher: Cambridge University Press,Cambridge University Press (CUP)
• Subject: Anxiety / Anxiety disorders / Computer applications / Criteria / Discontinued / Dropping out / Efficacy / Exposure therapy / Fear & phobias / Hedges / Humans / Intervention / Long term / Medical treatment / Meta-analysis / Patient Dropouts / Patient Dropouts - statistics & numerical data / Patients / Phobia, Social / Phobia, Social - therapy / Psychotherapy / Public speaking / Randomized Controlled Trials as Topic / School dropouts / Sensitivity analysis / Social anxiety / Social interactions / Systematic review / Therapy / Virtual reality / Virtual Reality Exposure Therapy