A novel virtual reality paradigm: Predictors for stress-related intrusions and avoidance behavior

• Published in: Journal of behavior therapy and experimental psychiatry 2020-06, Vol.67, p.101449-101449, Article 101449
• Main Author: Dibbets, Pauline
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Avoidance; Avoidance behavior; Avoidance Learning; Behavior; Clinical research; Coping strategies; Emotions; Female; Heart rate; Humans; Induction; Intrusions; Life threatening; Male; Negative emotions; Paradigms; Positive emotions; Risk behavior; Risk Factors; Stress; Stress Disorders, Post-Traumatic - psychology; Stress-related disorders; Surveys and Questionnaires; Trait anxiety; Virtual Reality; Young Adult
• ISSN: 0005-7916; 1873-7943
• DOI: 10.1016/j.jbtep.2019.01.001

Most people are exposed to a violent or life-threatening situation during their lives, but only a minority develops a stress-related disorder. To examine risk factors for the development of stress-related symptoms, such as intrusions and avoidance, analogue trauma studies are necessary. The often-used trauma film paradigm has proven to be valuable to examine intrusions, but inherently to its technique is less suitable for assessing behavioral avoidance, a core symptom of stress-related disorders. The aim of the present study was twofold, first to further develop an analogue that explicitly addresses behavioral avoidance and second, to link previously-established risk factors for the development of stress-related symptoms. Eighty-two healthy participants were subjected to a trauma induction using virtual reality (VR). At follow-up, participants were placed in a similar VR environment and could approach or avoid the trauma-scene, a trauma-related scene or a neutral, unrelated scene. Several pre- and peri-trauma risk factors were measured. The VR paradigm increased negative mood and heart rate, decreased positive mood and heart rate variability, and resulted in stress-related symptoms as trauma-related thoughts and beliefs, intrusions and avoidance behavior. The most prominent risk factors that contributed to the stress-related symptoms were negative emotions during the trauma induction, trait anxiety, and avoidant coping strategies. The stress-related symptoms were mild, resulting in a vast amount of participants without intrusions and limited avoidance behavior. The current VR paradigm can elicit stress-related symptoms, including avoidance; risk factors contributing to these symptoms were similar to those observed in clinical research, indicating the potential of the general set up. •Intrusions and avoidance are core symptoms of stress-related disorders.•Virtual reality can induce stress-related symptoms.•Virtual trauma induction resulted in intrusions and avoidance.•Negative emotions, trait anxiety and coping style predicted stress-related symptoms.