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Braz J Psychiatry. 2018 Feb 15;40(2):192-199. doi: 10.1590/1516-4446-2017-2270. Print 2018 Mar-Apr.

Virtual reality exposure therapy for fear of driving: analysis of clinical characteristics, physiological response, and sense of presence.

Costa RTD1,2,3,4, Carvalho MR1,2,3,4, Ribeiro P1,5, Nardi AE1,2,3.

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Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Instituto Nacional de Ciência e Tecnologia (INCT), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Rio de Janeiro, RJ, Brazil.
Laboratório de Pânico e Respiração (LabPR), Rio de Janeiro, RJ, Brazil.
Núcleo Integrado de Pesquisas em Psicoterapia nas Abordagens Cognitivas e Comportamentais (NIPPACC), Instituto de Psiquiatria (IPUB), UFRJ, Rio de Janeiro, RJ, Brazil.
Escola de Educação Física e Desportos, UFRJ, Rio de Janeiro, RJ, Brazil.



To investigate the reactions of women with driving phobia to a therapeutic program of scheduled virtual reality exposure treatment (VRET) sessions.


The study intervention consisted of a computer game with car-driving scenarios that included several traffic situations. We investigated the participants' sense of presence, subjective distress, and physiological responses during eight virtual-reality exposures. We also evaluated clinical characteristics, driving cognitions, and quality of life in the participants.


Thirteen women were selected. Eight were able to complete the protocol. After VRET, there was a decrease in the frequency of distorted thoughts and state anxiety scores, as well as a slight improvement in quality of life. Subjective discomfort scores, heart rate variation, and sense of presence scores confirmed that there was sense of presence in the virtual reality environment.


All patients showed some degree of improvement and demonstrated different levels of anxiety in subsequent in vivo driving experiences. Our findings suggest that VRET could be used to facilitate in vivo exposure, because it can induce presence/immersion and reduce anxiety in patients with specific phobia. Furthermore, VRET is not associated with any type of risk.

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