Comparing the Effectiveness of Virtual Reality Therapy, Relaxation, and Cognitive-Emotional Regulation Strategies on Students' Social Anxiety Disorder Symptoms

Abstract</span></span></span></span></span></span>
Background &

</span> Anxiety, as an integral part of people's lives, is an unpleasant and widespread feeling and state of concern with an unknown source and is accompanied by physiological and physical symptoms. It becomes a disorder when experienced abstractly and continuously and affects a person's daily functioning. One of the most common anxiety disorders is social anxiety disorder. About 7% of people experience social anxiety disorder during one year, which makes it one of the most common mental disorders. This disorder limits the quality and lifestyle of a person with social anxiety. It affects essential decisions in the person's life and, in most cases, causes the loss of many vital opportunities, especially for students. The purpose of this study was to compare the effectiveness of virtual reality therapy, relaxation, and cognitive–emotional regulation strategies on social anxiety and its symptoms among university students with social anxiety.</span></span>

</span> This quasi–experimental study employed a pretest–posttest design with a control group. The independent variable in this study was treatment with three methods (virtual reality therapy, relaxation, cognitive–emotional regulation), and the dependent variable was the symptoms of social anxiety disorder. The statistical population of the present study included all undergraduate students of Mazandaran University, Iran, in the academic year of 2019–20. Of these students, 48 samples were selected and randomly divided into four groups: virtual reality therapy (12 people), relaxation (12 people), cognitive–emotional regulation strategies (12 people), and control (12 people). The inclusion criteria were as follows: being a student at the undergraduate level of Mazandaran University, having social anxiety based on DSM–5 diagnostic criteria found on a structured diagnostic interview, and providing informed consent to participate in the research. Non–cooperation during the experiment and absence in the treatment sessions were considered the exclusion criteria. We used the Structured Clinical Interview (</span>Mennin et al., 2002</span>) and the Social Anxiety Scale (Liebowitz, 1987) to collect the study data. For data analysis, multivariate analysis of covariance (MANCOVA) and univariate covariance (ANCOVA) were used</span> in SPSS software version 21. The hypotheses were tested at the significance level of 0.05.</span></span>

</span> The findings showed that virtual reality, relaxation, and cognitive strategies of emotional regulation therapies were effective in reducing social anxiety and its symptoms (anxiety and avoidance) in students with social anxiety (p<0.001). Also, virtual reality therapy and emotional regulation cognitive strategies therapy were more effective than relaxation therapy in reducing social anxiety subscales (p<0.05).</span></span>

</span> Virtual reality therapy, relaxation therapy, and emotional regulation cognitive strategies are effective treatments to reduce the symptoms of social anxiety disorder. Among them, virtual reality therapy and cognitive–emotional regulation strategies are more effective and can be used more. </span></span></span></span>