Slide
Centre Interdisciplinaire
de Recherche et d’Innovation
en Cybersécurité et Société
de Recherche et d’Innovation
en Cybersécurité et Société
1.
Ørskov, P. T.; Runge, E.; Sainte-Marie, T. T. H.; Ernst, M. T.; Clemmensen, L.; Dalsgaard, C. H.; Lichtenstein, M. B.; Bouchard, S.
In: Frontiers in Virtual Reality, vol. 6, 2025, ISSN: 26734192 (ISSN), (Publisher: Frontiers Media SA).
Abstract | Links | BibTeX | Tags: 360° video, cognitive behavioral therapy, exposure, randomized controlled trial, social anxiety disorder, virtual reality
@article{orskov_virtual_2025,
title = {Virtual reality-based exposure with 360° video as part of cognitive behavioral therapy for social anxiety disorder: a three-arm randomized controlled trial},
author = {P. T. Ørskov and E. Runge and T. T. H. Sainte-Marie and M. T. Ernst and L. Clemmensen and C. H. Dalsgaard and M. B. Lichtenstein and S. Bouchard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105009844371&doi=10.3389%2Ffrvir.2025.1588181&partnerID=40&md5=eb28bc502f030b1af4bff5592815253b},
doi = {10.3389/frvir.2025.1588181},
issn = {26734192 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Frontiers in Virtual Reality},
volume = {6},
abstract = {Background: Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective: To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods: This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013)},
note = {Publisher: Frontiers Media SA},
keywords = {360° video, cognitive behavioral therapy, exposure, randomized controlled trial, social anxiety disorder, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Background: Social anxiety disorder (SAD) has a high prevalence and an early onset. It often persists well into adulthood, turning into a chronic disorder. Cognitive behavioral therapy (CBT) is effective in treating SAD, but real-life exposure conducted as part of CBT is often costly and time-consuming, and imaginary exposure might lack realism and intensity. Virtual reality (VR)-based exposure using 360° video offers a promising way to deliver exposure therapy. Objective: To develop a complete psychotherapeutic treatment program including CBT with VR-based exposure using 360° videos (CBT-ExpVR) for adult patients with SAD and to test the treatment effect using the Social Interaction Anxiety Scale (SIAS) as the primary outcome. Methods: This three-arm randomized controlled trial involved 51 participants who were recruited through self-referral. The interventions took place at Center for Digital Psychiatry in Denmark. Participants were randomized via computer program to CBT-ExpVR, CBT with in vivo exposure (CBT-Exp), or an active control group offered VR relaxation (RlxVR). Afterwards, participants assigned to RlxVR were re-randomized to one of the two CBT interventions. Allocation was not blinded. Results: Intention-to-treat analysis showed that participants receiving CBT-ExpVR reported significantly fewer symptoms of social anxiety at post-treatment compared to pre-treatment, β = −14.89, 95% CI (−18.64, −11.14), p < 0.0001. At post-treatment, no difference in treatment effect was found between CBT-ExpVR and CBT-Exp, β = 3.643, 95% CI (−1.727, 9.013)
2.
Bouchard, S.; Forget, H.
Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs Journal Article
In: Annual Review of CyberTherapy and Telemedicine, vol. 23, pp. 258–264, 2025, ISSN: 15548716 (ISSN).
Abstract | Links | BibTeX | Tags: adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality
@article{bouchard_conducting_2025,
title = {Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs},
author = {S. Bouchard and H. Forget},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105023856314&partnerID=40&md5=db4c4e86d7c32b544fe28c7fb6f9172b},
issn = {15548716 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {23},
pages = {258–264},
abstract = {This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.},
keywords = {adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality},
pubstate = {published},
tppubtype = {article}
}
This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.
3.
Ernst, M.; Bouchard, S.; Andersen, T.; Orskov, P. T.; Tarp, K.; Lichtenstein, M. B.
Virtual Reality–Based Exposure With 360° Environments for Social Anxiety Disorder: Usability and Feasibility Study Journal Article
In: JMIR Formative Research, vol. 8, 2024, ISSN: 2561326X (ISSN), (Publisher: JMIR Publications Inc.).
Abstract | Links | BibTeX | Tags: 360°, Anxiety, Exposure therapy, interactive, Mixed methods, social anxiety disorder, virtual reality
@article{ernst_virtual_2024,
title = {Virtual Reality–Based Exposure With 360° Environments for Social Anxiety Disorder: Usability and Feasibility Study},
author = {M. Ernst and S. Bouchard and T. Andersen and P. T. Orskov and K. Tarp and M. B. Lichtenstein},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85207452707&doi=10.2196%2f55679&partnerID=40&md5=603ff828b152a1cdbc241ab7601a43e5},
doi = {10.2196/55679},
issn = {2561326X (ISSN)},
year = {2024},
date = {2024-01-01},
journal = {JMIR Formative Research},
volume = {8},
publisher = {JMIR Publications Inc.},
abstract = {Background: Social anxiety disorder (SAD) is a long-term and overwhelming fear of social situations that can affect work, school, and other daily activities. Although cognitive behavioral therapy is effective, few seek treatment, and many who do start often drop out. This may be due to the component of exposure inherent to cognitive behavioral therapy, where the patient confronts feared stimuli outside the therapist’s office, which they otherwise try to avoid. As an alternative, research has explored the effectiveness of virtual reality (VR)–based exposure therapy with promising results. However, few studies have investigated the feasibility of VR tools using mixed methodologies before assessing their efficacy. Objective: This study aims to assess the usability, feasibility, and presence of four 360° virtual environments and whether these were able to evoke anxiety in patients with SAD. Methods: A total of 10 adult participants with SAD and 10 healthy controls were recruited for 1 experimental session (age range 21-32 y; 12/20, 60% male participants). Questionnaire and interview data were collected and analyzed. A mixed methods triangulation design was applied to analyze and compare the data. Results: Participants with SAD experienced increased anxiety when exposed to VR, and environments were considered relevant and useful as an exposure tool. Participants with SAD reported significantly higher average anxiety levels (P=.01) and peak anxiety levels (P=.01) compared with controls during exposure; however, significant differences in anxiety when accounting for baseline anxiety levels were only found in 2 of 4 environments (P=.01},
note = {Publisher: JMIR Publications Inc.},
keywords = {360°, Anxiety, Exposure therapy, interactive, Mixed methods, social anxiety disorder, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Background: Social anxiety disorder (SAD) is a long-term and overwhelming fear of social situations that can affect work, school, and other daily activities. Although cognitive behavioral therapy is effective, few seek treatment, and many who do start often drop out. This may be due to the component of exposure inherent to cognitive behavioral therapy, where the patient confronts feared stimuli outside the therapist’s office, which they otherwise try to avoid. As an alternative, research has explored the effectiveness of virtual reality (VR)–based exposure therapy with promising results. However, few studies have investigated the feasibility of VR tools using mixed methodologies before assessing their efficacy. Objective: This study aims to assess the usability, feasibility, and presence of four 360° virtual environments and whether these were able to evoke anxiety in patients with SAD. Methods: A total of 10 adult participants with SAD and 10 healthy controls were recruited for 1 experimental session (age range 21-32 y; 12/20, 60% male participants). Questionnaire and interview data were collected and analyzed. A mixed methods triangulation design was applied to analyze and compare the data. Results: Participants with SAD experienced increased anxiety when exposed to VR, and environments were considered relevant and useful as an exposure tool. Participants with SAD reported significantly higher average anxiety levels (P=.01) and peak anxiety levels (P=.01) compared with controls during exposure; however, significant differences in anxiety when accounting for baseline anxiety levels were only found in 2 of 4 environments (P=.01
4.
Katzman, M. A.; Bleau, P.; Blier, P.; Chokka, P.; Kjernisted, K.; Ameringen, M. Van; Antony, M. M.; Bouchard, S.; Brunet, A.; Flament, M.; Rabheru, K.; Grigoriadis, S.; Richter, P. M. A.; Mendlowitz, S.; O'Connor, K.; Robichaud, M.; Walker, J. R.; Asmundson, G.; Klassen, L. R.; Lam, R. W.; McIntyre, R. S.; Szpindel, I.
Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders Journal Article
In: BMC Psychiatry, vol. 14, no. SUPPL.1, 2014, ISSN: 1471244X (ISSN), (Publisher: BioMed Central Ltd.).
Abstract | Links | BibTeX | Tags: agoraphobia, Anxiety disorder, Anxiety Disorders, benzodiazepine derivative, buspirone, Canada, clinical trial, clomipramine, comorbidity, duloxetine, escitalopram, fluoxetine, fluvoxamine, fluvoxamine maleate, GAD, generalized anxiety disorder, guidelines, human, Humans, obsessive compulsive disorder, Obsessive-Compulsive Disorder, OCD, panic, Panic Disorder, paroxetine, periodic medical examination, pharmacotherapy, Post-Traumatic, posttraumatic stress disorder, practice guideline, Practice Guidelines as Topic, psychotherapy, PTSD, recommendations, review, sertraline, social anxiety disorder, social phobia, special populations, Specific phobia, Stress Disorders, venlafaxine
@article{katzman_canadian_2014,
title = {Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders},
author = {M. A. Katzman and P. Bleau and P. Blier and P. Chokka and K. Kjernisted and M. Van Ameringen and M. M. Antony and S. Bouchard and A. Brunet and M. Flament and K. Rabheru and S. Grigoriadis and P. M. A. Richter and S. Mendlowitz and K. O'Connor and M. Robichaud and J. R. Walker and G. Asmundson and L. R. Klassen and R. W. Lam and R. S. McIntyre and I. Szpindel},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84903778611&doi=10.1186%2f1471-244X-14-S1-S1&partnerID=40&md5=4787fc6f97c204c1428770a5e4a57a00},
doi = {10.1186/1471-244X-14-S1-S1},
issn = {1471244X (ISSN)},
year = {2014},
date = {2014-01-01},
journal = {BMC Psychiatry},
volume = {14},
number = {SUPPL.1},
publisher = {BioMed Central Ltd.},
abstract = {Background: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.Methods: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.Results: These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Conclusions: Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. © 2014 Katzman et al.},
note = {Publisher: BioMed Central Ltd.},
keywords = {agoraphobia, Anxiety disorder, Anxiety Disorders, benzodiazepine derivative, buspirone, Canada, clinical trial, clomipramine, comorbidity, duloxetine, escitalopram, fluoxetine, fluvoxamine, fluvoxamine maleate, GAD, generalized anxiety disorder, guidelines, human, Humans, obsessive compulsive disorder, Obsessive-Compulsive Disorder, OCD, panic, Panic Disorder, paroxetine, periodic medical examination, pharmacotherapy, Post-Traumatic, posttraumatic stress disorder, practice guideline, Practice Guidelines as Topic, psychotherapy, PTSD, recommendations, review, sertraline, social anxiety disorder, social phobia, special populations, Specific phobia, Stress Disorders, venlafaxine},
pubstate = {published},
tppubtype = {article}
}
Background: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.Methods: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.Results: These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Conclusions: Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. © 2014 Katzman et al.