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Virtual reality exposure therapy advances and potential for clinical and experimental use

Neuropsychopharmacology volume 50, pages 343–344 (2025)Cite this article

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A Correction to this article was published on 19 March 2025

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Exposure therapy, in which patients are assisted in approaching feared but realistically safe stimuli in a therapeutic manner, is effective at treating posttraumatic stress disorder (PTSD) and other fear and anxiety disorders. Virtual reality (VR) has been utilized for exposure therapy and in activation paradigms for neurobiological assessment. The seminal paper using VR to treat a psychiatric disorder [1] spurred a novel way to present stimuli and has been used successfully to treat PTSD [2] and anxiety disorders. VR has been a novel ingredient to achieve methodological rigor in translational research [3], and to present fear stimuli in a controlled, reproducible manner.

VR’s advantages in clinical treatment and research include control over stimuli; feasibility over in vivo exposure (e.g., virtual flying without going on a real airplane); methodological rigor; increased engagement; and presentation of potent stimuli that users can see, feel, smell, and hear. VR has been shown to modify biological responses, including cortisol, C-reactive protein, skin conductance, heart rate, startle reactivity, and various brain regions depending on the population and task. For example, VR Social Cognition Training for young adults with autism led to significant brain changes in the right posterior superior temporal sulcus, the left inferior frontal gyrus, and the left superior parietal lobule, all regions involved in processing social information [4]. Veterans with PTSD who received 2-mA anodal transcranial Direct Current Stimulation (tDCS) targeted to the ventromedial prefrontal cortex with VR improved more on PTSD symptoms and accelerated psychophysiological habituation to VR events between sessions compared with sham tDCS [5].

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References

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA

    Barbara O. Rothbaum

  2. Division of Chemistry & Chemical Engineering, California Institute of Technology, Pasadena, USA

    Jacob O. Rothbaum

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  1. Barbara O. Rothbaum
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  2. Jacob O. Rothbaum
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Dr. Barbara Rothbaum wrote the first draft of the article and edited the final draft. Dr. Jacob Rothbaum wrote the second draft of the article and formatted it for publication.

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Correspondence to Barbara O. Rothbaum.

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Competing interests

Dr. Barbara Rothbaum has received Research/Grants from Wounded Warrior Project, NIH, Department of Defense, NSF, Bob Woodruff Foundation, MAPS; is a stockholder in Virtually Better; has been paid as a consultant by Otsuka, Psychwire, Senseye, MAPS, Jazz Pharmaceuticals, GoodCap, Transcend, Penumbra; serves on the Scientific Advisory Boards for Anxiety and Depression Association of America (ADAA), National Center for PTSD; serves on the Board of Directors for GratitudeAmerica; receives Royalties from Oxford University Press, APPI, Emory University. Emory Healthcare Veterans Program is supported by a grant from the Wounded Warrior Project. The terms of these arrangements have been reviewed and approved by Emory University in accordance with its conflict of interest policies. Dr. Jacob Rothbaum reports no competing interests.

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Rothbaum, B.O., Rothbaum, J.O. Virtual reality exposure therapy advances and potential for clinical and experimental use. Neuropsychopharmacol. 50, 343–344 (2025). https://doi.org/10.1038/s41386-024-01930-2

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