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Neural effects of a short-term virtual reality self-training program to reduce social anxiety

Published online by Cambridge University Press:  03 September 2020

Min-Kyeong Kim
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
Hyojung Eom
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
Jun Hee Kwon
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
Sunghyon Kyeong
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
Jae-Jin Kim*
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
Author for correspondence: Jae-Jin Kim, E-mail:



Social anxiety disorder (SAD) is characterized by anxiety regarding social situations, avoidance of external social stimuli, and negative self-beliefs. Virtual reality self-training (VRS) at home may be a good interim modality for reducing social fears before formal treatment. This study aimed to find neurobiological evidence for the therapeutic effect of VRS.


Fifty-two patients with SAD were randomly assigned to a VRS or waiting list (WL) group. The VRS group received an eight-session VRS program for 2 weeks, whereas the WL group received no intervention. Clinical assessments and functional magnetic resonance imaging scanning with the distress and speech evaluation tasks were repeatedly performed at baseline and after 3 weeks.


The post-VRS assessment showed significantly decreased anxiety and avoidance scores, distress index, and negative evaluation index for ‘self’, but no change in the negative evaluation index for ‘other’. Patients showed significant responses to the distress task in various regions, including both sides of the prefrontal regions, occipital regions, insula, and thalamus, and to the speech evaluation task in the bilateral anterior cingulate cortex. Among these, significant neuronal changes after VRS were observed only in the right lingual gyrus and left thalamus.


VRS-induced improvements in the ability to pay attention to social stimuli without avoidance and even positively modulate emotional cues are based on functional changes in the visual cortices and thalamus. Based on these short-term neuronal changes, VRS can be a first intervention option for individuals with SAD who avoid society or are reluctant to receive formal treatment.

Original Article
Copyright © The Author(s), 2020. Published by Cambridge University Press

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