Biofeedback-Augmented Virtual Reality as a Tool for Treating Arachnophobia

Abstract

Virtual Reality Exposure Therapy (VRET) is a widely used exposure-therapy method that has shown effectiveness in treating phobias such as spider phobia (arachnophobia). However, it is often limited by high equipment costs, restricted accessibility, and a lack of real-time feedback on the user’s emotional state. This research integrates VRET with biofeedback, a technique for capturing a user’s physiological activity to develop a low-cost game aimed at supporting users in overcoming arachnophobia. The game features three difficulty levels, with higher difficulties affecting spider behavior, the virtual environment, and the heart-rate threshold required to complete a level. Fifteen participants played the game across the three difficulties and completed questionnaires assessing usability, presence, and physical comfort. Testing showed a reduction in mean heart rate from 88.01 to 81.25 BPM (t = 5.43, p < 0.001) and an increase in mean heart-rate variability from 30.20 to 51.43 ms (t = 8.75, p < 0.001) between the first and final sessions. A mean System Usability Scale (SUS) score of 74.33 indicates good usability, while a mean presence score of 4.61 out of 7 reflects a moderate sense of immersion. Most participants were comfortable during the experiment, though 46% reported eyestrain. As participants were not screened for clinical arachnophobia and no control group was used, these results are preliminary. Nonetheless, they suggest that integrating adaptive biofeedback into a low-cost VR framework is a promising direction for VRET, associated with reduced physiological arousal across repeated exposure in an engaging environment.