CLINICAL EFFICACY AND SOCIOECONOMIC IMPLICATIONS OF VIRTUAL REALITY EXPOSURE THERAPY (VRET) IN ANXIETY DISORDERS AND POST-TRAUMATIC STRESS DISORDER

Abstract

Anxiety disorders and Post-Traumatic Stress Disorder (PTSD) represent leading contributors to the global burden of non-fatal disease, generating profound psychological distress, functional impairment, and multi-billion-dollar direct and indirect economic costs. While Cognitive Behavioral Therapy (CBT) incorporating exposure principles remains the empirical gold standard, conventional delivery modalities—specifically in vivo and imaginal exposure—suffer from substantial structural limitations, including high patient avoidance, attrition rates up to 30%, prohibitive logistical expenses, and difficulties in achieving controlled emotional engagement. Over the past decade, Virtual Reality Exposure Therapy (VRET) has emerged as an innovative, ecologically valid, and strictly controllable paradigm capable of overcoming these therapeutic bottlenecks. This comprehensive systematic review synthesizes clinical and technological literature published between 2019 and 2026, evaluating the efficacy of VRET across specific phobias, Social Anxiety Disorder (SAD), Panic Disorder with Agoraphobia (PDA), and PTSD. By evaluating translational mechanisms of fear extinction, inhibitory learning, neurobiological markers, and digital phenotyping via integrated biosensors, this review demonstrates the clinical non-inferiority—and in specific logistical domains, superiority—of VRET compared to conventional exposure. Furthermore, we examine the macroeconomic impact, tele-VRET dissemination models, and ethical hurdles such as cybersickness and risk of retraumatization. The review concludes that VRET represents a scalable, cost-effective digital therapeutic platform that aligns high-tech immersive simulation with high-touch clinical guidance.