Enhancing Generalization of Virtual Reality Exposure for Public Speaking Anxiety
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-70
SponsorPhilipps University Marburg
About this trial
This randomized controlled trial examines whether imagery-based extinction memory updating following a standardized virtual reality (VR) exposure session improves the generalization of exposure effects to novel public speaking contexts. Individuals with elevated public speaking anxiety will complete a single-session VR speech exposure. Participants are randomized to (a) standard mental rehearsal of the exposure experience or (b) mental rehearsal plus guided imagery that updates the extinction memory with novel, non-exposed contexts. Generalization is assessed 7-14 days later using a multi-context behavioral approach test (BAT) in vivo and in VR.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
speech anxiety scale score of ≥ 18 on the Personal Report of Communication Apprehension, Public Speaking Subscale (PRCA-PS)
Self-report of 18 - 70 years of age
Disqualifiers
None
Trial design
Design model
Parallel
Treatments tested in this trial
VR Exposure
Behavioral6 VR speech exposure trials (3 min each; topic: "something you are proud of")
Standard Mental Rehearsal
BehavioralPost-exposure guided imagery: vivid mental rehearsal of the same exposure experience in the same VR contexts (brief, ≤30s each)
Mental Rehearsal With Extinction Memory Updating
BehavioralPost-exposure guided imagery: vivid rehearsal of the exposure experience while updating the extinction memory with novel, non-exposed contexts (e.g., speaking to three real listeners; speaking in a new VR context with a larger audience). Brief, ≤30s each
Treatment groups
48 Participants
are divided into 2 treatment groupsGroup A: VR Exposure + Standard Mental RehearsalActive comparator 2 interventions
Group B: VR Exposure + Mental Rehearsal With Extinction Memory UpdatingExperimental treatment 2 interventions
Trial outcomes
Primary outcomes
1
Public Speaking Anxiety
Assessed using the Personal Report of Communication Apprehension, Public Speaking Subscale (PRCA-PS). Scores range from 6 to 30, with higher scores associated with higher public speaking anxiety.
Time frame
From enrollment to one-week follow-up assessment2
Subjective Fear During Behavioral Approach Tests
Self-reported fear during oral presentations, rated on a scale from 0 (no fear) to 100 (severe fear) during each behavioral approach test. Participants were instructed to speak for up to three minutes and could terminate the task at any time. BAT 1: Oral presentation in vivo in front of 3 real listeners BAT 2: Oral presentation in a simulated videoconference with a large audience (30 listeners) BAT 3: Oral presentation in virtual reality (exposure context 1; familiar) BAT 4: Oral presentation in virtual reality (exposure context 2; familiar) BAT 5: Oral presentation in virtual reality (novel context with \~50 virtual listeners) BAT 6: Oral presentation in virtual reality (novel context with \~100 virtual listeners)
Time frame
one-week follow-up assessmentSecondary outcomes
1
Social Anxiety Severity
Severity of social anxiety symptoms assessed using the Social Phobia Inventory (SPIN). Scores range from 0-68, with higher scores indicating greater social phobia.
Time frame
From enrollment to one-week follow-up assessment2
Anticipatory Anxiety Before BATs
Self-reported anticipatory anxiety assessed immediately before each behavioral approach test on a scale from 0 (no fear) to 100 (severe fear).
Time frame
One-week follow-up assessment3
Behavioral Performance During BATs (Duration of oral presentation during BATs)
Duration of oral presentation during each behavioral approach test, measured in seconds. Participants were instructed to speak for up to three minutes and could terminate the task at any time.
Time frame
One-week follow-up assessment4
Valence of Public Speaking
Self-report measure assessing how participants feel about having to give a speech. Valence is rated on a 7-point Likert scale ranging from extremely unpleasant to extremely pleasant (-3 = extremely unpleasant, -2 = moderately unpleasant, -1= slightly unpleasant, 0 = neutral, 1= slightly pleasant, 2= moderately pleasant, 3=extremely pleasant). Higher scores indicate more pronounced pleasantness.
Time frame
From enrollment to immediately post-treatment assessment and one-week follow-up assessmentSponsors and contacts
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Source ClinicalTrials.gov