The influences of virtual social feedback on social anxiety disorders

Background: Social feedback in the virtual environment is a critical part of successful virtual reality exposure therapy (VRET), and identifying the influences of virtual social feedback on social anxiety patients is necessary. Aims: The present study aimed to explore the influences of ambiguous and negative virtual social feedback on social anxiety patients and a health control group (HCG). Method: Twenty-six social anxiety patients and 26 healthy participants were recruited. All participants were exposed to a virtual public speaking scenario. The participants were required to make two 3-minute speeches while the virtual audiences gave them either ambiguous feedback or negative feedback. The subjective units of discomfort (SUD) and heart rate were collected during the process. Results: The results showed that SAD individuals reported higher levels of subjective anxiety than those in the HCG, and the between-group differences were larger in the mild ambiguous condition than in the intense negative condition. Conclusions: This study indicates that social anxiety patients have an interpretation bias towards ambiguous virtual social feedback. Therefore, it is important for VR-based interventions to take into account not only the valence of the feedback but also the ambiguity aspect.