Enhancing Generalization of Virtual Reality Exposure for Public Speaking Anxiety

NCT07323498 | Recruiting

• 1 other identifier: VREX2.0
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial examines whether imagery-based extinction memory updating following a standardized virtual reality (VR) exposure session improves the generalization of exposure effects to novel public speaking contexts. Individuals with elevated public speaking anxiety will complete a single-session VR speech exposure. Participants are randomized to (a) standard mental rehearsal of the exposure experience or (b) mental rehearsal plus guided imagery that updates the extinction memory with novel, non-exposed contexts. Generalization is assessed 7-14 days later using a multi-context behavioral approach test (BAT) in vivo and in VR.

Conditions

Public Speaking Anxiety; Public Speaking Fear

Keywords

virtual reality exposure; extinction generalization; fear extinction; exposure therapy

Outcome Measures

Primary Outcomes (2)

• Public Speaking Anxiety

  Assessed using the Personal Report of Communication Apprehension, Public Speaking Subscale (PRCA-PS). Scores range from 6 to 30, with higher scores associated with higher public speaking anxiety.

  From enrollment to one-week follow-up assessment

• Subjective Fear During Behavioral Approach Tests

  Self-reported fear during oral presentations, rated on a scale from 0 (no fear) to 100 (severe fear) during each behavioral approach test. Participants were instructed to speak for up to three minutes and could terminate the task at any time. BAT 1: Oral presentation in vivo in front of 3 real listeners BAT 2: Oral presentation in a simulated videoconference with a large audience (30 listeners) BAT 3: Oral presentation in virtual reality (exposure context 1; familiar) BAT 4: Oral presentation in virtual reality (exposure context 2; familiar) BAT 5: Oral presentation in virtual reality (novel context with \~50 virtual listeners) BAT 6: Oral presentation in virtual reality (novel context with \~100 virtual listeners)

  one-week follow-up assessment

Secondary Outcomes (5)

• Social Anxiety Severity

  From enrollment to one-week follow-up assessment

• Anticipatory Anxiety Before BATs

  One-week follow-up assessment

• Behavioral Performance During BATs (Duration of oral presentation during BATs)

  One-week follow-up assessment

• Valence of Public Speaking

  From enrollment to immediately post-treatment assessment and one-week follow-up assessment

• Anticipated Fear of Public Speaking

  From enrollment to immediately post-intervention and 1-week follow-up

Study Arms (2)

VR Exposure + Standard Mental Rehearsal

ACTIVE COMPARATOR

Single-session VR exposure intervention: 6 VR speech exposure trials \& Post-exposure standard mental rehearsal

Behavioral: VR Exposure; Behavioral: Standard Mental Rehearsal

VR Exposure + Mental Rehearsal With Extinction Memory Updating

EXPERIMENTAL

Single-session VR exposure intervention: 6 VR speech exposure trials \& Post-exposure mental rehearsal with updating the extinction memory with novel, non-exposed contexts

Behavioral: VR Exposure; Behavioral: Mental Rehearsal With Extinction Memory Updating

Interventions

VR Exposure BEHAVIORAL

6 VR speech exposure trials (3 min each; topic: "something you are proud of")

VR Exposure + Mental Rehearsal With Extinction Memory Updating; VR Exposure + Standard Mental Rehearsal

Standard Mental Rehearsal BEHAVIORAL

Post-exposure guided imagery: vivid mental rehearsal of the same exposure experience in the same VR contexts (brief, ≤30s each)

VR Exposure + Standard Mental Rehearsal

Mental Rehearsal With Extinction Memory Updating BEHAVIORAL

Post-exposure guided imagery: vivid rehearsal of the exposure experience while updating the extinction memory with novel, non-exposed contexts (e.g., speaking to three real listeners; speaking in a new VR context with a larger audience). Brief, ≤30s each

VR Exposure + Mental Rehearsal With Extinction Memory Updating

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• speech anxiety scale score of ≥ 18 on the Personal Report of Communication Apprehension, Public Speaking Subscale (PRCA-PS)
• Self-report of 18 - 70 years of age

Sponsors & Collaborators

• Philipps University Marburg: lead

Study Sites (1)

Department of Psychology, Philipps-University of Marburg

Marburg, Hesse, 35037, Germany

RECRUITING

MeSH Terms

Conditions

Glossophobia

Study Officials

• Christoph Benke, Ph.D.

  Philiips-University of Marburg

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Christoph Benke, Ph.D.

CONTACT

+49 6421 28-24091; christoph.benke@uni-marburg.de

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 22, 2025
• First Posted: January 7, 2026
• Study Start: November 26, 2025
• Primary Completion (Estimated): November 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: January 9, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

DE (1)