Marilyn P. Safir

Virtual Reality Cognitive Behavior Therapy for Public Speaking Anxiety: A Randomized Clinical Trial.

Public speaking anxiety (PSA) is a common phobia. Although cognitive behavior therapy (CBT) is preferred, difficulties arise with the exposure component (lack of therapist control, patients inability to imagine, self-flooding, loss of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. This study examined whether VRCBT is an alternative to CBT. Participants with PSA were randomly assigned to VRCBT (28 participants), CBT (30 participants), and wait list control (WLC; 30 participants). VRCBT and CBT were significantly more effective than WLC in anxiety reduction on four of five anxiety measures, and on subjects self-rating of anxiety during a behavioral task. No significant differences were found on observer ratings of the behavioral task. However, twice as many participants dropped out from CBT than from VRCBT. Our results demonstrated that VRCBT is an effective and brief treatment regimen, equal to CBT.

Personality variables and presence

The present study was designed to examine the correlation between five personality traits (empathy, imagination, immersive tendencies, dissociation tendencies and locus of control) and presence. Moreover, this study aimed to identify an optimal virtual reality user’s profile. Eighty-four students (66 women, 18 men) completed personality questionnaires, experienced exposure in a virtual environment and completed a presence questionnaire. Twenty-three women, among them 13 non-Jewish women and no men, neglected to look out the virtual window, and reported lower levels of presence. Presence correlated with immersive tendencies and empathy. However, empathy and internal locus of control were the best predictors for the sense of presence. A correlation between imagination and presence was only found in the group that avoided viewing the virtual window. This study revealed the importance of empathy and internal locus of control in the sense of presence. In addition, our findings suggest that the subject’s imagination has an important role when the virtual environment is restricted and that we must attend to cultural and gender-related factors when investigating therapy using virtual reality technology.

Sex, Ethnic, and Social Differences in Test Anxiety Among Israeli Adolescents

The effects of sex, ethnicity, and social class on levels of test anxiety were examined among a sample of 416 adolescent students in Israel. Significant sex differences in mean levels of test anxiety were found, with girls scoring consistently higher than boys across ethnic, social, and grade categories. Pupils of low socioeconomic status (SES) also scored consistently higher than pupils of high SES across grades. Nevertheless, this study provides little support for the commonly held view that sociocultural or sex group differences in school achievement are due, in any meaningful way, to differences in test anxiety. The group differences, though significant for SES and sex, were of negligible magnitude, and the correlation between test anxiety scores and grade point average was minimal for the group as a whole and nonsignificant for students of Eastern background, who have been purported to be particularly affected by high levels of test anxiety. The findings do support other cross-cultural studies, which have found only a modicum of shared variance between test anxiety and grades. It is concluded that test anxiety is not a particularly valid predictor of achievement or ability.

Virtual Reality Cognitive-Behavior Therapy for Public Speaking Anxiety: One-Year Follow-Up

Public speaking anxiety (PSA) is a common social phobia. Although cognitive-behavior therapy (CBT) is the treatment of choice, difficulties arise with both in vivo and in vitro exposure (lack of therapist control, patient’s inability to imagine, self-flooding, and a lack of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. In a previous publication, the authors reported on their findings that VRCBT (n = 28) and CBT (n = 30) groups were significantly more effective than a wait-list control (WLC; n = 30) group in anxiety reduction on four of five anxiety measures as well as on participant’s self-rating of anxiety during a behavioral task. No significant differences were found between VRCBT and CBT. However, twice as many clients dropped out of CBT (15) than from VRCBT (6). Results demonstrated that VRCBT is an effective and brief treatment regimen, equal to CBT. This brief report examined durability of these changes. They found that both VRCBT (25) and CBT (24) groups maintained their improvement from post treatment to follow-up, on all five measures. In addition, they found that the CBT group continued to improve from post treatment to follow-up on Liebowitz Social Anxiety Scale (LSAS) fear. Thus, treatment gains were maintained at a 1-year follow-up.

Psychological androgyny and sexual adequacy

This study investigated the hypothesis that individuals with androgynous personalities would be more competent sexually than individuals with sex-typed personalities. Scores on the Bem Sex-Role Inventory were compared for a patient group and a control group. The data revealed a higher percentage of androgynous subjects in the control group than in the patient group. Even when only one spouse was androgynous, the chances of sexual competence within the couple increased. In addition, there was more sex typing among the longer married patient couples and more stereotyped femininity in both men and women in the patient group. The results were taken to support the view that the androgynous persons flexibility and adaptability is conducive to a satisfactory sexual relationship. Some cultural differences between Israeli and American samples were noted. Findings contradicted the cultural stereotypes of the macho Israeli male and the nonfeminine Israeli woman.

Poster Session Abstracts

A random sample of therapists (N=161) working in the field of trauma were surveyed to study levels of stress. Therapists were assessed on measures of general life stress, burnout, and traumatic stress. Twenty-four percent were experiencing high levels of general life stress, 16% reported high levels of emotional exhaustion, 26% felt ineffective in terms of personal accomplishment at work and 14% were experiencing high levels of traumatic stress similar to clients with post traumatic stress disorder. Relationships between measures and demographic variables were reported, a profile of traumatised therapists was identified, and implications of these findings of therapists were presented.

The effects of nature or of nurture on sex differences in intellectual functioning: Israeli findings

This paper contrasts the results of studies examining sex differences in intellectual functioning in the United States and in Israel. Israeli studies indicate earlier sex differences as well as a different pattern of sex differences than those found in the United States. Within Israel, differences in intellectual functioning have been found between children raised and educated in the kibbutz as compared to those raised in the city. Sex differences in the kibbutz populations are less pronounced. These findings indicating cross-cultural and intracultural influences challenge the validity of theories proposing purely biological bases for sex differences in intellectual abilities.

Workplace worries: a preliminary look at online sexual activities at the office-emerging issues for clinicians and employers.

Concerns about the impact of online sexual activities (OSA) on work-life are drastically increasing. This study examined 3,466 respondents who reported OSA, 18.5% of whom reported engaging in OSA at work. They were compared with the 81.5% who engaged in OSA at home, on average time spent in OSA, workplace policies regarding OSA, and relationship status. Two themes were identified and discussed: opportunity and sexual distress. Our findings indicate that participants are cognizant of issues of opportunity (e.g., the OSA from home group was more likely to indicate their workplace has established policies regarding OSA), and privacy, representing an important aspect of this theme (e.g., participants engaging in OSA at work were found to be twice as likely to have extra-marital affairs, compared with the OSA from home group). Secondly, our data suggests that many participants, especially from the OSA at work group, experience OSA-related distress. Engaging in OSA at the workplace may result in decreased productivity, issues of sexual harassment, and concerns about employee well-being. Clearly stated and consistently enforced policies regulating OSA are likely to mitigate workplace OSA. However, a significant minority of employees may have difficulties curbing OSA. Therefore, more sophisticated strategies to deal with workplace OSA should be established. Additional implications of importance for organizations and mental health professionals who support them are discussed.

Psychopathology associated with sexual dysfunction

The association between sexual disorders and psychological functioning was investigated in this study. Seventy-eight subjects who applied for sex therapy were divided into the following groups: Sexual Desire (SDD) and Erectile Disorder; Orgasm (ORG) and Premature ejaculation (PME) disorders. Fifty-six sexually functional subjects served as matched controls. The MMPI was administered to all subjects. The results indicated that the SDD and Erectile groups produced the most disturbed profiles, while the ORG and PME groups yielded profiles within normal limit (WNL). A good fit of individual to group profiles was found for SDD, but not for PME and ORG; thus, clinical interpretation was possible for the former only.

Attachment and sense of presence in a virtual environment

This study is the first to investigate the connection between attachment categories and presence in Virtual Reality (VR) environments. Participants (99) completed an attachment questionnaire, experienced Virtual Reality Exposure (VRE) in a virtual airplane, and completed a presence questionnaire. Twenty-seven participants neglected to look at the virtual window, and reported lower levels of presence. A significant negative correlation between presence and avoidance was found. The correlation between presence and anxiety was not significant. Ethnicity (Jewish/non-Jewish) was found to be an intervening variable. A significant difference between levels of presence of attachment categories was found for participants who viewed the window: those in the Safe category reported the highest levels of presence, followed by the Anxious-Ambivalent group, the Dismissive-Avoidant group, and finally the Fearful-Avoidant group. Our results suggest there is a connection between one’s avoidance level and his/her attachment type and ability to experience the VRE as real and vivid.