The purpose of this study was to examine the effects of virtual reality exposure therapy on public speaking anxiety among female university students. Forty-eight female university students with public speaking anxiety were recruited and randomly assigned to either an experimental group (n=24) or a waitlist control group (n=24). The experimental group completed 4 sessions of virtual reality exposure therapy over a period of 2 weeks, in which the participants were exposed to public speaking scenes in virtual reality. Both groups completed a questionnaire during the pre-treatment, post-treatment, and at three-weeks after the treatment period. The speech anxiety scale, the speech anxiety thoughts inventory and subjective anxiety ratings were used to collect self-report outcome data. The timed behavior checklist for performance anxiety and a fingertip pulse oximeter were used to collect objective outcome data. The results revealed that the experimental group’s speech anxiety, speech anxiety thoughts, subjective anxiety, observer evaluation of anxiety behaviors, and heart rate decreased significantly compared to the waitlist control group. These effects were maintained at the 3-week follow-up assessment period. These results demonstrated that virtual reality exposure therapy is effective at easing public speaking anxiety. The implications of this study and suggestions for future research are also discussed.
이정윤, 최정훈 (1996). 사회불안증에 대한 인지행동치료와 노출치료의 효과연구. 한국심리학회 학술대회 자료집, 1996(1), 583-598.
이창현, 조용래, 오은혜 (2016). 발표불안에 대한 마음챙김 기반 노출치료의 효능 및 조절변인으로서의 기저선 우울증상 심각도. 한국심리학회지: 임상, 35(2), 335-363.
이혜경, 권정혜 (1998). 사회공포증에서 나타나는 인지적 특성이 수행불안에 미치는 영향. 한국심리학회 학술대회 자료집, 1998(1), 143-156.
조용래 (2001a). 불안장애에 대한 노출치료 : 비판적 분석, 작용기제 및 개선방안. 한국심리학회지: 일반, 20(1), 229-257.
조용래 (2001b). 발표불안에 대한 인지행동집단치료의효과. 한국심리학회지: 임상, 20(3), 399-411.
조용래 (2004). 한국판 발표불안 사고 검사의 신뢰도와타당도. 한국심리학회지: 임상, 23(4), 1109-1125.
조용래, 원호택 (1997). 대인불안에 대한 인지적 평가:사회적 상호작용에 대한 자기 효능감 척도의 개발과 타당도에 관한 연구. 심리학의 연구문제, 1997(4), 397-434.
조용래, 원호택, 표경식 (2000). 사회공포증에 대한 집단인지치료의 효과. 한국심리학회지: 임상, 19(2), 181-206.
조용래, 이민규, 박상학 (1999). 한국판 발표불안척도의신뢰도와 타당도에 대한 연구. 한국심리학회지: 임상, 18(2), 165-178.
Bar-Zvi, M. (2011). Virtual reality exposure versus cognitive restructuring for treatment of public speaking anxiety: A pilot study. The Israel Journal of Psychiatry and Related Studies, 48(2), 91-97.
Beck, A. T., Emery, G., & Greenberg, R. L. (1985). Anxiety disorders and phobias: A Cognitive Perspective. New York: Basic Books.
Bloom, R. W. (1997). Psychiatric Therapeutic Applications of Virtual Reality Technology (VRT):Research Prospectus and Phenomenological Critique. Medicine Meets Virtual Reality: Global Healthcare Grid. San Diego, CA: IOS Press.
Cho, Y., Smits, J. A. J., & Telch, M. J. (2004). The Speech Anxiety Thoughts Inventory: scale development and preliminary psychometric data. Behaviour Research and Therapy, 42(1), 13-25.
Clark, D. M. (2001). A cognitive perspective on social phobia. In W. R. Crozier & L. E. Alden (Eds.), International Handbook of Social Anxiety (pp. 405–430). Chichester, UK: Wiley.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. Social phobia: diagnosis, assessment, and treatment. New York: The Guilford Press.
Craske, M. G., Niles, A. N., Burklund, L. J., Wolitzky-Taylor, K. B., Vilardaga, J. C. P., Arch, J. J., ... Lieberman, M. D. (2014). Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators. Journal of Consulting and Clinical Psychology, 82(6), 1034-1048.
Feske, U., & Chambless, D. L. (1995). Cognitive behavioral versus exposure only treatment for social phobia: A meta-analysis. Behavior Therapy, 26(4), 695-720.
Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: exposure to corrective information. Psychological Bulletin, 99(1), 20-35.
Fremouw, W. J., & Breitenstein, J. L. (1990). Speech anxiety. In H. Leitenberg (Ed.), Handbook of Social and Evaluation Anxiety (pp. 455-474). New York: Plenum Press.
Garcia-Palacios, A., Botella, C., Hoffman, H., & Fabregat, S. (2007). Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias. Cyberpsychology & Behavior, 10(5), 722-724.
Gould, R. A., Otto, M. W., Pollack, M. H., & Yap, L. (1997). Cognitive bahavioral and pharmacological treatment of generalized anxiety disorder: A preliminary mate-analysis. Behavior Therapy, 28(2), 285-305.
Harris, S. R., Kemmerling, R. L., & North, M. M. (2002). Brief virtual reality therapy for public speaking anxiety. Cyberpsychology & Behavior, 5(6), 543-550.
Krijn, M., Emmelkamp, P. M., Olafsson, R. P., & Biemond, R. (2004). Virtual reality exposure therapy of anxiety disorders: A review. Clinical Psychology Review, 24(3), 259–281.
Mahone, E. M., Bruch, M. A., & Heimberg, R. G. (1993). Focus of attention and social anxiety: The role of negative self-thoughts and perceived positive attributes of the other. Cognitive Therapy and Research, 17(3), 209-224.
McCann, R. A., Armstrong, C. M., Skopp, N. A., Edwards-Stewart, A., Smolenski, D. J., June, J. D., ... Reger, G. M. (2014). Virtual reality exposure therapy for the treatment of anxiety disorders: An evaluation of research quality. Journal of Anxiety Disorders, 28(6), 624-631.
Nunnally, J. C. (1978). Psychometric methods. New York: McGraw Hill.
Parsons, T. D., & Rizzo, A. A. (2008). Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: A meta-analysis. Journal of Behavior Therapy & Experimental Psychiatry, 39(3), 250−261.
Paul, G. L. (1966). Insight vs. desensitization in psychotherapy: An experiment in anxiety reduction. Stanford, CA: Stanford University Press.
Powers, M. B., & Emmelkamp, P. M. G. (2008). Virtual reality exposure therapy for anxiety disorders: A meta-analysis. Journal of Anxiety Disorders, 22(3), 561−569.
Pupim, D., Iwaki Filho, L., Takeshita, W. M., & Iwaki, L. C. V. (2013). Evaluation of accuracy of portable fingertip pulse oximeter, as compared to that of a hospital oximeter with digital sensor. Indian Journal of Dental Research, 24(5), 542-546.
Ruscio, A. M., Brown, T. A., Chiu, W. T., Sareen, J., Stein, M. B., & Kessler, R. C. (2008). Social fears and social phobia in the USA: Results from the National Comorbidity Survey Replication. Psychological Medicine, 38(1), 15-28.
Salkovskis, P. M., Clark, D. M., Hackmann, A., Wells, A., & Gelder, M. G. (1999). An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia. Behaviour Research and Therapy, 37(6), 559-574.
Sheehan, D. V. (1986). Tricyclic antidepressants in the treatment of panic and anxiety disorders. Psychosomatics, 27(11), 10-16.
Taylor, S. (1996). Meta-analysis of cognitivebehavioral treatments for social phobia. Journal of Behavior Therapy and Experimental Psychiatry, 27(1), 1-9.
Wallach, H. S., Safir, M. P., & Bar-Zvi, M. (2009). Virtual reality cognitive behavior therapy for public speaking anxiety: A randomized clinical trial. Behavior Modification, 33(3), 314-338.