The Impact of Adding Multisensory Stimulation to a Fear of Heights Virtual Reality Experience

The sense of presence (SP) is a critical factor in eliciting emotional responses during virtual reality exposure therapy (VRET) for treating anxiety disorders. Multisensory stimulation has been suggested as an effective method to enhance the SP in VR environments.

This study aims to investigate the relationship between SP and anxiety in a VR environment designed to simulate fear of heights (FoH). Specifically, it compares the levels of SP and anxiety experienced in multisensory (i.e., visual, auditory and tactile stimulation) versus bisensory (i.e., visual and auditory stimulation) virtual environments and examines the associations between SP and individual characteristics.

A total of 162 participants were randomly assigned to one of two experimental conditions: bisensory virtual reality exposure (B-VRE; n = 85) and multisensory virtual reality exposure (M-VRE; n = 77). Differences in anxiety and SP between the two conditions were assessed using Student's t-tests. In addition, correlation, mediation and moderation analyses were conducted to explore the relationships between SP, anxiety, technological features and individual characteristics.

Correlation analyses revealed statistically significant relationships between SP and anxiety during VR exposure, as well as between SP and participants' demographic and personality characteristics. Furthermore, SP partially mediated the relationship between participants' baseline FoH and the anxiety they experienced in the VR environment. Finally, the addition of multisensory cues increased the SP experienced in the virtual scenario but did not significantly impact reported anxiety levels.

Incorporating multisensory feedback to enhance SP during VRET should be considered when designing VR systems for therapeutic use.

Adding multisensory cues enhances users' sense of presence in virtual environments. Sense of presence partially mediates the link between fear of heights and anxiety during VR exposure. Incorporating multisensory elements can improve the effectiveness of VR-based therapy.