Treatment of acrophobia in virtual reality: the role of immersion and presence

Behav Res Ther. 2004 Feb;42(2):229-39. doi: 10.1016/S0005-7967(03)00139-6.


In this study the effects of virtual reality exposure therapy (VRET) were investigated in patients with acrophobia. Feelings of presence in VRET were systematically varied by using either a head-mounted display (HMD) (low presence) or a computer automatic virtual environment (CAVE) (high presence). VRET in general was found to be more effective than no treatment. No differences were found in effectiveness between VRET using an HMD or CAVE. Results were maintained at 6 months follow-up. Results of VRET were comparable with those of exposure in vivo (Cyberpsychology and Behavior 4 (2001) 335). In treatment completers no relationship was found between presence and anxiety. Early drop-outs experienced less acrophobic complaints and psychopathology in general at pre-test. They also experienced less presence and anxiety in the virtual environment used in session one as compared to patients that completed VRET.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Analysis of Variance
  • Computer Simulation*
  • Conditioning, Psychological
  • Female
  • Humans
  • Implosive Therapy / methods*
  • Male
  • Middle Aged
  • Phobic Disorders / psychology
  • Phobic Disorders / therapy*
  • Psychiatric Status Rating Scales
  • Therapy, Computer-Assisted / methods*
  • Treatment Outcome