Introduction. Anxiety and fear of public speaking are some of the common complaints of students during their studies. The prevalence and consequences for psychological well-being make it possible to discuss the fear of public speaking in the context of pathopsychological changes that contribute to or are a variant of a social anxiety disorder. At the same time, constant anxiety and emotional distress can contribute to the development of other comorbid pathologies such as depressive disorder, other anxiety disorders, or substance abuse as a way of coping anxiety. The development and implementation of effective psychological/psychotherapeutic interventions for self-help and psychological support with using a virtual environment has already proven itself in dealing with specific phobias and other anxiety states and can be applied in preventative measures for social anxiety disorder among students.
Aim. Investigate the impact of psychoeducation based on CBT protocol with a one-session virtual exposure on the level of students' social anxiety before public speaking and the features of social interaction during education.
Methods. Social anxiety assessment using the Social Phobia Inventory (SPIN), and Social Phobia Rating Scale (SPRS), clinical semi-structured interview, observation, and assessment of changes in virtual exposure.
Results. Compared with the control group, there was a statistically significant decrease in all indicators on the SPIN (p <0.001) and SPRS (p <0.001) scales in the experimental group 1 month after virtual exposure. Decreases in social anxiety on the SPIN scale before the intervention and one month after were statistically different depending on belonging to the experimental group (F = 5.06, p = 0.035) and time (F = 5.46, p = 0.029), and significantly from a baseline level of social anxiety (F = 124.8, p = 0.000). The significance of changes in the experimental group as a whole on the SPIN scale is achieved by reducing the indicator in the subgroup with a high level of social anxiety, where statistical significance is significant p <0.001. Differences in changes in the level of social anxiety on the SPRS scale before the intervention and one month after, depending on belonging to the experimental group (F = 9.39, p = 0.006), time (F = 12.33, p = 0.002) and baseline level of social anxiety (F = 12.06, p = 0.000) are also significant. According to the SPRS method, a statistically significant decrease in the rate of exhaustion and overall restriction imposing social anxiety (p <0.001) was found in the experimental group and a statistically significant decrease in the using of part of strategies avoidance behaviors and the influence of typical unproductive beliefs (p <0.05, in accordance).
Conclusion. Using psychoeducation based on CBT protocol with a one-session virtual exposure has proven to be an effective way of reducing the fear of public speaking. After 1 month undergoing a psychoeducational session using virtual exposure, a significant decrease in the intensity of anxious feelings, the impact of unproductive beliefs, and changes in behavior that underpinned them were revealed. It was noted that the most significant effect was achieved in the subgroup of participants with high input levels of social anxiety and manifest traits corresponding to the criteria of social anxiety disorder. Such changes may be explained by the need and timeliness of providing psychological support to this category of participants. Given that our findings are incomplete, they require further research and expansion of the experimental base.
2. Avramchuk, O. Virtual exposure as an instrument to overcome student’s fear of public speaking and social interactions. Psychological journal; 2020: 9-17. https://doi.org/10.31108/1.2020.6.1
3. Allen, M., Hunter, J. E. & Donohue, W. A. Meta‐Analysis of Self‐Report Data on the Effectiveness of Public Speaking Anxiety Treatment Techniques. Communication Education; 1989: 54-77. https://doi.org/10.1080/03634528909378740
4. Anderson, P. L., Price, M., Edwards, S. M., et al. Virtual reality exposure therapy for social anxiety disorder: A randomized controlled trial. Journal of Consulting and Clinical Psychology; 2013: 751–760. https://doi.org/10.1037/a0033559
5. Bayram, N., & Bilgel N. The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Social Psychiatry and Psychiatric Epidemiology; 2008: 667-672. https://doi.org/10.1007/s00127-008-0345-x
6. Bodie, G. D. (2010). A Racing Heart, Rattling Knees, and Ruminative Thoughts: Defining, Explaining, and Treating Public Speaking Anxiety. Communication Education, 59(1), 70-105 https://doi.org/10.1080/03634520903443849
7. Blöte, A. W., Kint, M. J., Miers, A. C., & Westenberg, P. M. The relation between public speaking anxiety and social anxiety: A review. Journal of Anxiety Disorders; 2009: 305–313. https://doi.org/10.1016/j.janxdis.2008.11.007
8. Bögels, S. M., Alden, L., Beidel, D. C., Clark, L. A., Pine, D. S., & Stein, M. B. Social anxiety disorder: Questions and answers for the DSM-V. Depression and Anxiety; 2010: 168-189. http://dx.doi.org/10.1002/da.20670
9. Burnley, M., Cross, P., & Spanos, N. The effects of stress inoculation training and skills training on the treatment of speech anxiety. Imagination, Cognition and Personality; 1993: 355–366. https://doi.org/10.2190/N6TK-AR8Q-L4E9-0RJ0
10. Carl, E. et al. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of anxiety disorders; 2019: 27-36
11. Goberman, A., Hughes, S., & Haydock, T. Acoustic characteristics of public speaking: Anxiety and practice effects. Speech Communication; 2011: 867-876. https://doi.org/10.1016/j.specom.2011.02.005.
12. Hancock, A.B., Stone, M.D., Brundage, Sh. B. & Zeigler, M.T. Public speaking attitudes: does curriculum make a difference? JVoice; 2010:302-7. doi: 10.1016/j.jvoice.2008.09.007
13. Harris, S. R., Kemmerling, R. L., & North, M. M. Brief Virtual Reality Therapy for Public Speaking Anxiety. CyberPsychology & Behavior; 2002: 543–50. https://doi.org/10.1089/109493102321018187
14. Nordahl, H. & Wells, A. Metacognitive Therapy for Social Anxiety Disorder: An A–B Replication Series Across Social Anxiety Subtypes Frontiers in psychology; 2018: 540 https://doi.org/10.3389/fpsyg.2018.00540
15. Hofmann, S. G., Heinrichs, N., & Moscovitch, D. A. The nature of social phobia: Toward a new classification. Clinical Psychology Review; 2004: 769–797 https://doi.org/10.1016/j.cpr.2004.07.004
16. Hook, J. N., & Valentiner, D. P. Are specific and generalized social phobias qualitatively distinct? Clinical Psychology: Science and Practice; 2002: 379–395 https://doi.org/10.1093/clipsy.9.4.379
17. Kant, L. Public speaking anxiety. Tennessee: University of Tennessee; 2000.
18. Kampmann, I. L., Emmelkamp, P. M. G., Hartanto, D., Brinkman, W.-P., Zijlstra, B. J. H., & Morina, N. Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial. Behaviour Research and Therapy; 2016: 147–156. https://doi.org/10.1016/j.brat.2015.12.016
19. Lindner, P., Miloff, A., Hamilton, W., et al. Creating state of the art, next-generation virtual reality exposure therapies for anxiety disorders using consumer hardware platforms: Design considerations and future directions. Cognitive Behaviour Therapy, 2017: 404–420. https://doi.org/10.1080/16506073.2017.1280843
20. Lindner, P. Therapist-led and self-led one-session virtual reality exposure therapy for public speaking anxiety with consumer hardware and software: A randomized controlled trial. Journal of Anxiety Disorders; 2019: 45–54 https://doi.org/10.1016/j.janxdis.2018.07.003
21. Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., & Cui, L. Lifetime prevalence of mental disorders in U. S. adolescents: Results from the national comorbidity survey replication–adolescent supplement (NCS-A). Journal of the American Academy of Child Adolescent Psychiatry; 2010: 980-989. http://dx.doi.org/10.1016/j.jaac.2010.05.017
22. Miloff, A., Lindner, P., Hamilton, W., Reuterskiöld, L., Andersson, G., & Carlbring, P. Single-session gamified virtual reality exposure therapy for spider phobia vs. Traditional exposure therapy: Study protocol for a randomized controlled non-inferiority trial. Trials; 2016: 60. https://doi.org/10.1186/s13063-016-1171-1.
23. Moldovan, R., & David, D. One session treatment of cognitive and behavioral therapy and virtual reality for social and specific phobias. Preliminary results from a randomized clinical trial. Journal of Cognitive and Behavioral Psychotherapies; 2014: 67–83.
24. Morina, N., Brinkman, W.-P., Hartanto, D., Kampmann, I. L., & Emmelkamp, P. M. G. Social interactions in virtual reality exposure therapy: A proof-of-concept pilot study. Technology and Health Care; 2015: 581–589. https://doi.org/10.3233/ THC-151014.
25. Pertaub, D. P., Slater, M., & Barker, C. An Experiment on Public Speaking Anxiety in Response to Three Different Types of Virtual Audience. Massachusetts Institute of Technology; 2002: 68-78. https://doi.org/10.1162/105474602317343668
26. Shri, R. Anxiety: Causes and Management. The Journal of Behavioral Science; 2010: 100-118.
27. Söyler E., Gunaratne C., & Akbaş M.İ. Towards a comprehensive simulator for public speaking anxiety treatment Advances in Applied Digital Human Modeling and Simulation. Springer, Cham; 2017: 195-205 https://doi.org/10.1007/978-3-319-41627-4_18
28. Spence, S.H. & Rapee, R.M. The etiology of social anxiety disorder: An evidence-based model. BehavResTher; 2016: 50-67. https://doi.org/10.1016/j.brat.2016.06.007
29. Tillfors, M., Carlbring, P., Furmark, T., Lewenhaupt, S., Spak, M., & Eriksson, A. Treating University Students with Social Phobia and Public Speaking Fears. Wiley InterScience; 2008: 708-717. https://doi.org/10.1002/da.20416
30. Westenberg, P.M., Drewes, M.J., Goedhart, A.W., Siebelink, B.M. & Treffers, P.D. A developmental analysis of self-reported fears in late childhood through mid-adolescence: social-evaluative fears on the rise? J Child Psychol Psychiatry; 2004:481-95. https://doi.org/10.1111/j.1469-7610.2004.00239.x