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Updated: Jun 12, 2026

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
Published on: November 12, 2009
Virtual reality interoceptive exposure for the treatment of panic disorder and agoraphobia
Maria Angeles Pérez-Ara1, S Quero, C Botella
1Universidad Jaume I, Castellón de Plana, Spain. ara@psb.uji.es
Abstract:
The efficacy of cognitive-behavioral therapy for panic disorder and agoraphobia (PDA) has been widely demonstrated. The exposure technique is the main component of these programs; interoceptive exposure also plays an important role. The virtual reality (VR) program for treating PDA developed by Botella's group can simulate physical sensations in a controlled manner while the user is immersed in the VR environments in the consultation room. These include audible effects, such as rapid heartbeat and panting, as well as visual effects, such as blurry vision, double vision and tunnel vision. This work examines the efficacy of the interoceptive exposure (IE) component in two treatment conditions: 1) VR Interoceptive Exposure Simultaneous Condition (VRIE-sim; N=14), and 2) Interoceptive Exposure Traditional Condition (IET; N=15). Results obtained showed that both treatment conditions significantly reduced the main clinical variables at post-treatment; these results were maintained or even improved at three month follow-up. Simultaneous VR interoceptive and VR external stimuli exposure is a new and effective way to apply PDA treatment.
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