Anxiety Partially Mediates Cybersickness Symptoms in Immersive Virtual Reality Environments

Abstract

The use of virtual reality (VR) in psychological treatment is expected to increase. Cybersickness (CS) is a negative side effect of VR exposure and is associated with treatment dropout. This study aimed to investigate the following: (a) if gender differences in CS can be replicated, (b) if differences in anxiety and CS symptoms between patients and controls can be replicated, and (c) whether the relationship between exposure to VR and CS symptoms is mediated by anxiety. A sample (N = 170) of participants with different levels of psychosis liability was exposed to VR environments. CS and anxiety were assessed with self-report measures before and after the VR experiment. This study replicated gender differences in CS symptoms, most of which were present before exposure to VR. It also replicated findings that a significant correlation between anxiety and CS can be found in healthy individuals, but not in patients. In a VR environment, anxiety partially mediated CS symptoms, specifically nausea and disorientation. A partial explanation for the differences found between patients and controls may lie in a ceiling effect for the symptoms of CS. A second explanation may be the partial overlap between CS symptoms and physiological anxiety responses. CS symptoms reported at baseline cannot be explained by exposure to VR, but are related to anxiety. Caution is required when interpreting studies on both CS and anxiety, until the specificity in measurements has been improved. Since anxiety mediated the CS symptoms, CS is expected to decline during treatment together with the reduction of anxiety.

Immersive Virtual Reality for the Management of Pain in Community-Dwelling Older Adults

“…The nature of immersive VR is known to cause motion sickness due to visual conflict giving rise to adverse reactions such as nausea and dizziness, referred to as cybersickness (Pot-Kolder, Veling, Counotte & Van Der Gaag, 2018). In this study, seven out of 12 participants (58.3 %) stated that they did not experience any symptoms in any of the 12 monitored sessions.…”

“…"), attendance at the senior center (serving ages 55 and over) at least two days per week, and self-reported intact or corrected vision. Participants were excluded if they self-reported a history of vertigo, seizures, and/or epilepsy to prevent exacerbation of those symptoms as potential VR side effects (Pot-Kolder, Veling, Counotte, & Van Der Gaag, 2018). Individuals scoring less than four on the Mini-Cog were excluded to ensure that all participants could demonstrate the mental process skills to understand and attend to the VR programming (Borson, Scanlan, Brush, Vitaliano, & Dokmak, 2000).…”

A paradigm description of virtual reality and its possible applications in psychiatry

“…In another study [62] there was no such difference in the sense of presence. In the study of Veling et al [65], the symptoms of simulatory disease were already higher in the group of people with an episode of early psychosis before their stay in the VE than in the healthy group, and after their stay in the VE these symptoms were comparable in both groups, which may result from a partial overlap of cybersickness symptoms and anxiety [66]. Both patients and healthy persons experienced a similar level of the sense of presence.…”

“…W badaniu Velinga i wsp. [65] objawy choroby symulatorowej były wyższe już przed pobytem w VE w grupie osób z epizodem wczesnej psychozy niż w grupie zdrowych, a po pobycie w VE objawy te były porównywalne w obu grupach, co prawdopodobnie wynika z częściowego zachodzenia na siebie objawów cyberchoroby i lęku [66]. Zarówno pacjenci, jak i osoby zdrowe doświadczali poczucia obecności na podobnym poziomie.…”

“…At the beginning of exposure therapy, patients may experience a high level of anxiety by definition, showing symptoms partially identical to those of cybersickness, which may result in a premature cessation of therapy. It has also been shown that symptoms of cybersickness in the area of nausea and disorientation are partially mediated by anxiety [66]. After exposure to VR, a correlation between the level of anxiety and cybersickness was detected in healthy individuals, but in patients with persecutory delusions it was not confirmed [66].…”