Cognitive mechanisms underlying virtual reality exposure.

Many studies have assessed virtual reality exposures efficacy, but very few examined its treatment processes. The addition of objective measures of arousal and information processing mechanisms would be a valuable contribution in order to provide a more complete and detailed picture. The goal of this study was to better document the cognitive mechanisms associated with therapeutic change after an in virtuo exposure treatment. Twenty-eight adults suffering from arachnophobia were assessed and received an exposure-based treatment using virtual reality. General outcome and specific processes measures included a battery of standardized questionnaires, a pictorial emotional Stroop task, a Behavioral Avoidance Test, and a measure of participants' cardiac response while they looked at a live tarantula. The analyses showed that changes in perceived self-efficacy and dysfunctional beliefs were the best predictors of change in general outcome and cardiac response; change in dysfunctional beliefs were the best predictor of change in behavioral avoidance. These innovative results provide a very detailed and organized picture of the complex cognitive mechanisms involved in therapeutic change following in virtuo exposure for arachnophobia.