Multisite Virtual Reality Intervention for Speech Anxiety (ETC2)

Exposure-based cognitive behavior therapy is an efficacious treatment for speech anxiety and has been delivered effectively in a virtual reality (VR) environment. The present multicenter study (conducted through the Exposure Therapy Consortium) is designed to evaluate whether trait versus state positive affectivity is a more effective predictor of exposure therapy outcomes. Further, the investigators will examine whether the predictive significance of trait positive affectivity can be accounted for by examination of baseline levels of self-efficacy, hope, and optimism.

Study Overview

• Status: Completed
• Conditions: Public Speaking; Speech Anxiety
• Intervention / Treatment: Behavioral: Single-session VR exposure intervention

Detailed Description

The goal of this multicenter clinical trial is to examine predictors of VR exposure therapy outcomes for college students with public speaking anxiety following a positive or negative mood induction. The overarching aim of the present study is to evaluate whether trait versus state positive affectivity is a more effective predictor of exposure therapy outcomes. Further, the investigators will examine whether the predictive significance of trait positive affectivity can be accounted for by examination of baseline levels of self-efficacy, hope, and optimism. State affect is manipulated at an experimental level with affect induction procedures; trait positive affectivity is measured at baseline.

The study involves three phases: (1) initial screening, (2) in-person assessment and brief exposure intervention for a subset of participants with elevated public speaking anxiety, and (3) a one-week follow-up assessment conducted online. Students who choose to participate and screen high on a public speaking anxiety scale will be assigned to a positive or negative mood induction condition prior to undergoing VR-based exposure therapy. Public speaking and social anxiety outcomes are measured immediately post-intervention and one week later. The one-week follow-up assessment represents the primary outcome.

• Study Type: Interventional
• Enrollment (Actual): 1542
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Australia
  • New South Wales
    • Penrith, New South Wales, Australia, 2751
      • Western Sydney University
    • Sydney, New South Wales, Australia, 2052
      • University of New South Wales
  • Western Australia
    • Bently, Western Australia, Australia, 6102
      • Curtin University
• China
  • Hong Kong
    • Pokfulam, Hong Kong, China
      • University of Hong Kong
• Germany
  • Hesse
    • Marburg, Hesse, Germany, 35037
      • Philipps-Universität Marburg
• Netherlands
  • Utrecht, Netherlands, 3584 CS
    • Utrecht University
  • South Holland
    • Rotterdam, South Holland, Netherlands, 3062 PA
      • Erasmus University
• United States
  • Arizona
    • Tucson, Arizona, United States, 85721
      • University of Arizona
  • Illinois
    • Carbondale, Illinois, United States, 62901
      • Southern Illinois University
  • Massachusetts
    • Boston, Massachusetts, United States, 02215
      • Boston University
    • Boston, Massachusetts, United States, 02155
      • Tufts University
  • Pennsylvania
    • Reading, Pennsylvania, United States, 19604
      • Albright College
  • Texas
    • Austin, Texas, United States, 78712
      • University of Texas at Austin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Self-report of 18 - 70 years of age
• Current student at a participating University
• Ability to read English to provide informed consent
• Familiarity with a computer keyboard and mouse or a touch screen device (e.g. phone, tablet).
• For Phase 2: speech anxiety scale score of ≥ 18 on the Personal Report of Communication Apprehension, Public Speaking Subscale (PRCA-PS)

Exclusion Criteria:

• Previous participation (i.e., no participant may take the survey more than once).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Positive or Negative Mood Induction via film clips; VR exposure is the only intervention, but the VR intervention is conducted following either positive or negative mood induction.	Behavioral: Single-session VR exposure intervention; VR exposure is the only intervention, but the VR intervention is conducted following either positive or negative mood induction.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	One week follow-up assessment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Valence	Self-report measure of how participant feels about having to give a speech	One week follow-up assessment
Assessed using the Social Phobia Inventory (SPIN)	Assessed using the Social Phobia Inventory (SPIN). Scores range from 0-68, with higher scores indicating greater social phobia.	One week follow-up assessment
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.	Post-treatment assessment immediately after the intervention

Collaborators and Investigators

• Sponsor: Boston University Charles River Campus
• Collaborators: The University of Hong Kong; Tufts University; University of Arizona; University of Texas at Austin; The University of New South Wales; Southern Illinois University; Utrecht University; Curtin University; Erasmus University Rotterdam; University of Western Sydney; Philipps Universität Marburg; National University of Singapore; Albright College
• Investigators: Principal Investigator: Michael Otto, PhD, Boston University

Publications and helpful links

Helpful Links

• Exposure Therapy Consortium

Study record dates

Study Major Dates

• Study Start (Actual): October 8, 2024
• Primary Completion (Actual): July 23, 2025
• Study Completion (Actual): July 23, 2025

Study Registration Dates

• First Submitted: September 3, 2024
• First Submitted That Met QC Criteria: September 9, 2024
• First Posted (Actual): September 19, 2024

Study Record Updates

• Last Update Posted (Actual): December 18, 2025
• Last Update Submitted That Met QC Criteria: December 11, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Communication; Verbal Behavior; Speech; Glossophobia
• Other Study ID Numbers: 7565E

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data will be posted on the Open Science Foundation site.
• IPD Sharing Time Frame: Within one year of study completion.
• IPD Sharing Access Criteria: Via request to the Exposure Therapy Consortium
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No