Virtual reality exposure therapy for social anxiety disorder: a systematic review and meta-analysis. Issue 15 (19th November 2020)

• Record Type: Journal Article
• Authors: Horigome, Toshiro; Kurokawa, Shunya; Sawada, Kyosuke; Kudo, Shun; Shiga, Kiko; Mimura, Masaru; Kishimoto, Taishiro
• Is Part Of: Psychological medicine. Volume 50:Issue 15(2020)
• Page Start: 2487
• Page End: 2497
• Publication Date: 2020-11-19
• Subjects: Dropout rate, -- in vivo exposure, -- long-term efficacy, -- social anxiety disorder, -- virtual reality exposure; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291720003785
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract: Background: 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. Methods: 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. Results: 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. Conclusion: 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.