Using Virtual Reality in Exposure-Based Treatment for Social Anxiety in Youth

Clinical Trial Details

Anxiety disorders are the most common mental health diagnosis in the US and are associated with avoidance that causes functional impairments and decreases quality of life. Social anxiety disorder is among the most prevalent anxiety disorders, with most common age of onset being in adolescence. The frontline treatment for social anxiety disorder is cognitive behavioral therapy with exposure. However, a significant number of adolescent patients do not get better after completing cognitive behavioral therapy or experience relapse. Providing realistic learning contexts for exposure could be the key to enhancing treatment effects in adolescents. This is often challenging for a variety of reasons, including difficulty realistically mimicking anxiety-provoking social situations due to limited resources, clinician training, time, or motivation. Virtual reality environments could provide contextual exposures for social anxiety.

The aims of this study are threefold: to assess feasibility of using virtual reality in treatment of social anxiety in youth, to examine whether virtual reality invokes arousal similar to anxiety and test the physiological assessment protocol, and to evaluate whether exposure using virtual reality environments reduces symptoms of social anxiety and related functional impairment.

Key Eligibility:

Inclusion Criteria

Ages 13-23 with a primary diagnosis of social anxiety disorder
Anxiety Disorders Interview Schedule-5 Clinician Severity Rating greater than 4
IQ estimate of 70 or higher
Comorbid disorder (e.g., Attention Deficit Hyperactivity Disorder, Obsessive Compulsive Disorder, Oppositional Defiant Disorder) will be allowed provided that the anxiety symptoms are of primary concern to parents and comorbid symptoms are not of sufficient severity to require immediate treatment other than that provided by the current study
Sufficient command of the English language to comply with study protocol
Participants on psychiatric medication must be on a stable dose for at least 2 months prior to study participation and remain symptomatic to the level identified for study inclusion (Anxiety Disorders Interview Schedule-5 less than or equal to 4). Family agrees to refrain from med changes over the course of the study if at all possible.

Exclusion Criteria

Unable to consent
A prior or present diagnosis of receptive and expressive language disorder and/or pervasive developmental disorder or severe mental retardation
Current substance use disorder or dependence as primary diagnosis
Recent suicide behavior (last month) or any other psychiatric condition that requires more intensive care (e.g., psychotic episode, manic episode)

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