Virtual Reality Exposure in Public Speaking Anxiety: The Impact of Expectancy Violation on Treatment Outcomes and Self-Efficacy

Abstract

Aim: Virtual reality exposure therapy (VRET) has been shown to effectively reduce anxiety symptoms, including fear of public speaking. According to the Inhibitory Learning Model (ILM), expectancy violation, meaning a higher mismatch between the initial expectations about the exposure and the actual outcomes, is associated with better treatment outcomes. In our current study, we aim to investigate how expectancy violation influences treatment outcomes. Additionally, our research aims to investigate the alterations in self-efficacy within the context of VRET and to what extent self-efficacy influences treatment outcomes. Methods: 29 participants with a fear of public speaking were randomly assigned to an experimental or control condition. They reported their expectancies regarding public speaking and underwent 5 presentations in a VR environment across 2 sessions. The experimental group was explicitly informed that the audience could not react to their presentations. Results: Contrary to expectation, fear of public speaking did not decrease and showed no difference over time between treatment conditions. Additionally, the control group did not experience higher expectancy violations. Self-efficacy increased in both conditions but did not predict treatment outcomes. Conclusion: Our findings suggest that VRET’s effectiveness for fear of public speaking cannot be explained by the mechanisms of expectancy violation and self-efficacy. However, there is evidence that VRET can improve self-efficacy levels.