Effectiveness of a participatory and interactive virtual reality intervention in patients with social anxiety disorder: Longitudinal questionnaire study

Hyun Jin Kim, Seulki Lee, Dooyoung Jung, Ji Won Hur, Heon Jeong Lee, Sungkil Lee, Gerard J. Kim, Chung Yean Cho, Seungmoon Choi, Seung Moo Lee, Chul Hyun Cho

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


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.

Original languageEnglish
Article numbere23024
JournalJournal of medical Internet research
Issue number10
Publication statusPublished - 2020 Oct

Bibliographical note

Funding Information:
This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Government of Korea (MSIT) (NRF-2020R1C1C1007463), and the ICT & Future Planning for Convergent Research in the Development Program for R&D Convergence over Science and Technology Liberal Arts (NRF-2017M3C1B6070978).

Publisher Copyright:
© 2020 Journal of Medical Internet Research. All rights reserved.


  • Anxiety
  • Effectiveness
  • Intervention
  • Questionnaires
  • Social anxiety disorder
  • Virtual reality

ASJC Scopus subject areas

  • Health Informatics


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