THE INFLUENCE OF VIRTUAL REALITY EXPOSURE ON SOCIAL AND PHOBIC BEHAVIOURS THEODORE CHIH-KUANG OING SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS OF THE UNIVERSITY OF BOLTON FOR THE DEGREE OF DOCTOR OF PHILOSOPHY ON THE BASIS OF THESIS THE UNIVERSITY OF BOLTON SCHOOL OF EDUCATION AND PSYCHOLOGY December 2019 1 Table of Contents Table of Contents .......................................................................................................................................... 1 Abbreviations ................................................................................................................................................ 5 Abstract ......................................................................................................................................................... 7 Acknowledgements ....................................................................................................................................... 9 Chapter 1: Introduction .............................................................................................................................. 10 1.1: An Introduction to Virtual Reality .................................................................................................... 12 1.2: A Brief History of Virtual Reality ...................................................................................................... 13 1.3: Thesis Objectives and Contribution to Knowledge .......................................................................... 16 1.3.1: Thesis Objectives....................................................................................................................... 16 1.3.2: Contribution to Knowledge ....................................................................................................... 18 Chapter 2: Research Methodology ............................................................................................................. 20 2.1: An Introduction to Qualitative, Quantitative, and Mixed Research Methodologies ....................... 20 2.1.1: Qualitative vs. Quantitative: An Argument of Subjectivity and Objectivity ............................. 20 2.1.2: The Growth of Mixed Methods................................................................................................. 23 2.1.3: Rationale for the Methodologies Employed for the Current Thesis ......................................... 25 Chapter 3: A Systematic Review of VR Research ........................................................................................ 26 Databases Searched ................................................................................................................................ 27 Search Terms ........................................................................................................................................... 27 Inclusion and Exclusion Criteria .............................................................................................................. 27 Quality Assessment Outcomes ............................................................................................................... 37 3.1: Summary of Papers: Implementing VR for Therapeutic Use ........................................................... 37 3.1.1: Phobias ...................................................................................................................................... 41 3.1.1.1: Acrophobia ......................................................................................................................... 41 3.1.1.2: Aviophobia ......................................................................................................................... 43 3.1.1.3: Arachnophobia ................................................................................................................... 44 3.1.1.4: Claustrophobia ................................................................................................................... 45 3.1.1.5: Agoraphobia ....................................................................................................................... 45 3.1.1.6: Section Conclusions ........................................................................................................... 46 3.1.2: Anxiety ...................................................................................................................................... 47 3.1.2.1: Social Anxiety Disorders ..................................................................................................... 47 3.1.2.2: Posttraumatic Stress Disorder ........................................................................................... 48 3.1.2.3: Paranoia ............................................................................................................................. 50 3.1.2.4: Section Conclusions ........................................................................................................... 52 3.1.3: Pain Analgesia ........................................................................................................................... 52 2 3.2: Summary of Papers: Perception ...................................................................................................... 55 3.2.1: Realism and Presence ............................................................................................................... 55 3.2.2: Distance Estimation and Spatial Knowledge Acquisition .......................................................... 57 3.2.2.1: Distance Estimation ........................................................................................................... 57 3.2.2.2: Distance Perception ........................................................................................................... 58 3.2.2.3: Spatial Knowledge and Training ......................................................................................... 59 3.2.2.4: Section Conclusions ........................................................................................................... 60 3.3: Summary of Papers: Applications of VR in Social and Cross-Cultural Studies ................................. 60 3.3.1: Social Psychology ...................................................................................................................... 61 3.3.1.1: Cooperation within a Shared VE ........................................................................................ 62 3.3.1.2: Attraction ........................................................................................................................... 63 3.3.1.3: Sexual and Physical Violence ............................................................................................. 64 3.3.1.4: Prosocial Behaviour ........................................................................................................... 64 3.3.1.5: Moral Dilemma: The Trolley Problem ................................................................................ 65 3.3.2: Cross-Cultural Psychology ......................................................................................................... 65 3.3.3: Section Conclusions .................................................................................................................. 66 3.4: Summary of Papers: Utilization of VR as a Protective Measure for Dangerous Situations ............. 67 3.5: General Conclusions ........................................................................................................................ 68 3.5.1: Moving Towards a Self-Directed Approach towards VRET ....................................................... 68 3.5.2: Evaluation of VR Systems .......................................................................................................... 71 Chapter 4: Automating VRET: A Case for Self-Directed or Minimally Guided VR Therapy (Study 1) ......... 72 4.1: An Evaluation of Self-Directed Interventions .................................................................................. 75 4.1.1: Evidence from Meta-Analyses .................................................................................................. 75 4.1.2: Evidence from Controlled Studies for Specific Phobias ........................................................... 77 4.2: Study Overview ................................................................................................................................ 79 4.2.1: Methodology ............................................................................................................................. 81 4.2.1.1: Design................................................................................................................................. 81 4.2.1.2: Participants ........................................................................................................................ 81 4.2.1.3: Instruments/Apparatus...................................................................................................... 82 4.2.1.4: Procedure ........................................................................................................................... 86 4.2.2: Case Summaries ........................................................................................................................ 87 4.2.2.1: The Case of Christina ......................................................................................................... 87 4.2.2.2: The Case of Freddy ............................................................................................................