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Eur Rev Med Pharmacol Sci. 2013 Jun;17(12):1561-8.

A survey on virtual environment applications to fear of public speaking.

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Perceptual Robotics Laboratory, Scuola Superiore Sant'Anna, Pisa, Italy.



Social Anxiety Disorder (SAD) is one of the most prevalent anxiety disorders in Europe and comprises the fear of public speaking as its typical sub-type. Cognitive-Behavioural Therapy (CBT) is the intervention of choice for SAD, and it includes exposure to anxiety-provoking stimuli to induce systematic desensitization and reduce anxiety. Similarly, exposure therapy per se has been used and found effective, although it is not as specific as CBT for the treatment of SAD. Interestingly, exposure to anxiety-provoking situations can be achieved in Virtual Environments (VEs) through the simulation of social situations allowing individuals with public speaking anxiety to live and develop real exposure-like reactions. The Virtual Reality Exposure Therapy (VRET) is the treatment of anxiety disorders based on such VEs.


This article aims to provide an overview of the scientific literature related to the applications of Virtual Reality to the treatment of fear of public speaking.


We conducted the literature review on PubMed and Google Scholar for studies including the fear-of-public-speaking VEs.


Reviewed studies addressed two main aspects: the design parameters of the VEs for adequate reactions to synthetic social stimuli, and the efficacy of VEs for fear of public speaking treatment. VEs resulted effective for triggering as-if-real reactions in relation to public speaking. VE-based exposures reduced public speaking anxiety measurements, decreased scores and maintained them at 3 month follow-up. Studies comparing VRET to pharmacological therapy are lacking, and there are few randomized controlled trials that compare VRET to CBT, especially on fear of public speaking treatment.

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