Efficacy of three virtual reality interventions for social anxiety disorder: A meta-analysis.

Objective

To evaluate the efficacy of virtual reality exposure therapy (VRET), virtual reality cognitive behavioral therapy (VR-CBT), and virtual reality exposure combined with biofeedback (VRE + Biofeedback) for social anxiety disorder (SAD) through meta-analysis, and to explore variations according to outcome measures, hardware type, population, region, and control conditions.

Method

Randomized controlled trials (RCTs) of virtual reality interventions for SAD were retrieved from Web of Science, PubMed, Scopus, ScienceDirect, ProQuest, CINAHL, SpringerLink, PsycINFO, and Embase. A total of 17 studies were included, and meta-analysis was conducted using Comprehensive Meta-Analysis V3.

Results

VR interventions were effective for SAD (SMD = 0.477, p < 0.001). VRET had a moderate effect (SMD = 0.521, p < 0.001), VR-CBT had a substantial effect (SMD = 0.618, p = 0.042), whereas VRE + Biofeedback did not show a significant pooled effect (SMD = 0.110, p > 0.05). Subgroup analyses indicated that VRET had comparable effects on global and dimension-specific social anxiety (SMD = 0.528 and 0.527, respectively), with significant effects across Eastern (SMD = 0.606) and Western regions (SMD = 0.441), immersive-device settings (SMD = 0.585), and non-student populations (SMD = 0.600). VR-CBT showed significant effects for global social anxiety measures, immersive-device settings, non-student populations, and Western regions (SMD = 0.618); however, VR-CBT has not been tested in the East.

Conclusion

VR interventions alleviate SAD. VRET and VR-CBT performed well in immersive settings and non-student populations, with VRET showing comparable global and dimension-specific effects across regions, while VR-CBT affected Western regions and global measures. VRE + Biofeedback showed no significant effect.