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© 2019 IJRAR June 2019, Volume 6, Issue 2 www.ijrar.org (E-ISSN 2348-1269, P- ISSN 2349-5138)

IJRAR19K6945 International Journal of Research and Analytical Reviews (IJRAR) www.ijrar.org 689

“TO STUDY EFFECTIVENESS OF VIRTUAL

REALITY EXPOSURE THERAPY (VRET) WITH

BLACKED-OUT GLASSES AND WITHOUT

BLACKED-OUT GLASSES ON PUBLIC

SPEAKING ANXIETY IN SCHOOL GOING HIGH

SCHOOL STUDENTS”

Pankaj Kumar, Lecturer

Occupational Therapy, Department of Therapeutics

NIEPMD, Chennai, India

Abstract: AIM & OBJECTIVE: To determine which treatment is the most effective in reducing the public-speaking anxiety.

The two treatments being examined include. 1.Virtual Reality Exposure Therapy (VRET) with blacked-out glasses,

2. Virtual Reality Exposure Therapy (VRET) without blacked-out glasses.

To determine whether Virtual Reality Exposure Therapy (VRET) with blacked-out glasses is useful into a real-world

setting in reducing public speaking anxiety.To determine whether Virtual Reality Exposure Therapy (VRET) without

blacked-out glasses is useful into a real-world setting in reducing public speaking anxiety.

METHODOLOGY: Comparative Experimental Group Design, Random Sampling,, A total of 41 participants were

included in my sample that was between the ages of 12 and 15. There were 15 male and 26 female who participated

in this study. All participants were full-time students who had opted either Spanish or French subject as a second

language in high school at Excelsior American School. There were 25 Spanish subject opted students and 16 French

subject opted students who participated. Group-1: Virtual Reality Exposure Therapy (VRET) with blacked-out

glasses consist of 21 students (8 Males and 13 Females), Group- 2: Virtual Reality Exposure Therapy (VRET)

without blacked-out glasses consist of 20 students (7 Males and 13 Females), Variables: The Personal Report of

Communication Apprehension (PRCA), Beck Anxiety Inventory (BAI), Personal Report of Confidence as a Speaker

(PRCS), Subject Self Rating Scale Question, Heart Rate . RESULT: Preliminary analyses were conducted to ensure

no violation of the assumptions of normality, linearity, and homosedasticity. There were two outliers. Specifically,

it was determined that there were two participants that were outliers on multiple measures, which was evidenced by

both z-scores and box plots. There was no significant interaction between intervention type and time of measurement,

Wilks Lambda = .90, F (6, 33) = .569, p= .752, partial eta squared = .094. There was not a substantial main effect for

time, Wilks Lambda= .798, F (6, 33) = 1.39, p<.248, partial eta squared = .202, with both groups showing the lowest

anxiety scores as measured by the PRCA, PRCS, and BAI after the in-class presentation. There was not a statistically

significant difference between the VRET with blacked-out glasses and VRET without blacked-out glasses on the

combined dependent variables, F (3,36) = 1.14, p= .346; Wilks Lambda = .913, partial eta squared= .087 . Also, there

was not a strong relationship between the covariate and the participants’ scores on the BAI, PRCA, and PRCS, as

indicated by the partial eta squared values of 0.015, 0.006, and 0.001 resA post-hoc Tukey’s HSD test showed that

baseline heart rate was significantly lower than all occasions that heart rate was recorded, except for heart rate taken

after the third treatment session. Heart rates taken after the second and third treatment sessions were significantly

lower than heart rate taken in the hallway before and after the in-class presentation. Also, heart rates taken before the

second and third treatment sessions were significantly lower than heart rate taken in the hallway before the in-class

presentationpectively. The relationship between self-reported anxiety (as measured the Subject Self Rating Scale of

Anxiety) and heart rate was investigated using Pearson product-moment correlation coefficient. Preliminary analyses

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were performed to ensure no violation of the assumptions of normality, linearity and homoscedasticity. After

adjusting the p-value by performing a Bonferroni correction, no correlations between heart rate and self-reported

anxiety were determined to be statistically significant. There was a small, positive correlation between heart rate and

self-reported

anxiety taken before the first intervention session, r = .225, n= 41, p< .891. There was a very small, negative

correlation between heart rate and self-reported anxiety taken after the first intervention session, r = - 0.022, n= 41,

p< .892, where higher levels of self-reported anxiety were associated with lower levels heart rate and vice versa. A

negative correlation may exist between the two variables because a slight increase in heart rate can

be distorted in the mind of the participant. For example, a slight increase in heart can be experienced as a significant

increase. As a result, one’s heart rate would be negatively correlated with one’s self-reported anxiety (Slater et al.,

2006).

CONCLUSION: This study examined the effectiveness of two treatments on anxiety related to public-speaking.

High School students who were enrolled in foreign language as a subject were randomly assigned to one treatment

condition. The treatment conditions include 1) Virtual Reality Exposure Therapy (VRET) with blacked-out glasses

and 2) VRET without blacked-out glasses. Each participant completed three treatment sessions followed by one in-

class presentation. The PRCA, BAI, and PRCS were measured at pre-intervention, post-intervention and after the in-

class presentation. Each participant’s heart rate and Subject Self Rating Scale of Anxiety scores were measured at

pre-intervention, before and after all three treatment sessions, and in the hallway before and after the in-class

presentation. However, each participant’s Subject Self Rating Scale of Anxiety scores were measured an additional

two times, which include post-intervention and while seated in the classroom immediately following the in-class

presentation. Research suggests that wearing a blindfold forces an individual to engage in a defocused gaze, which

results in decreased feelings of anxiety and increased feelings of safety. Also, relaxation is more easily achieved

when a person closes their eyes. Furthermore, wearing blacked-out glasses limits one’s ability to fully experience the

virtual audience. Therefore, individuals are less likely to avoid the task because the situation appears easier to

overcome. The researcher’s goal was to determine which intervention reduces anxiety more effectively. The

researcher expected VRET with blacked-out glasses condition to be the more effective in terms of anxiety reduction.

Overall, the VRET with blacked-out glasses condition did have lower anxiety levels on more measurement occasions

on all dependent measures, but it was not significantly different from the other condition, even though the effect sizes

ranged from moderate to large. This study demonstrates that blacked-out glasses may reduce public-speaking

anxiety.

KEY WORDS: Anxiety, Fear of public speaking, SAD, VRET, Blacked Out Glasses, Virtual

Audience,

I. Introduction

The famous comedian, Jerry Seinfeld,had this to say: According to most studies, people's

number one fear is public speaking. Number two is death. Death is number two. Does that

sound right? This means to the average person, if you go to a funeral, you're better off in the

casket than doing the eulogy.1

Anxiety disorders are prevalent in the general population2 and can have a damaging influence on

people’s lives. The American Psychiatric Association manual DSM-IV defines a variety of anxiety

disorders including panic disorder, obsessive-compulsive disorder, agoraphobia, specific phobia

and social phobia.3




Generally people who suffer from social phobia have a strong fear of one or more social

performance situations. They fear that they will act in a way that is humiliating or embarrassing

and that others will judge them negatively. Although they recognise that this fear is irrational, they

experience extreme discomfort and anxiety when in the feared situation and will seek to avoid the

social encounter whenever possible. Fear of public speaking is a very common form of social

Phobia,with great social significance. People who fear speaking in public may find their career

choices limited and avenues for promotion closed to them, resulting in considerable personal

distress, frustration and depression.4Although discussed humorously, Seinfeld is referring to a

serious, yet irrational

condition called public-speaking anxiety. Public-speaking anxiety is a widespread phenomenon

across college campuses, to the extent that it can affect two out of three students, where 12.5% of

those students experience severe symptoms and 38% experience apprehension on a weekly basis

(Bowers, Bush, Conway, & Darrow,1986).

Public-speaking anxiety has many aliases including communication apprehension, stage

fright, Social Anxiety Disorder, and speech anxiety (Niemi, 2009). In addition, public-speaking

anxiety may have a different name depending on the discipline in which it is addressed. For

example, communication specialists may call it “communication apprehension,” while

psychologists may call it a “public-speaking phobia.” Regardless of the discrepancy across

multiple disciplines, public-speaking anxiety is both common and normative (Niemi, 2009).

However, if the anxiety or apprehension becomes unreasonable, exaggerated or out of proportion

to the danger level, it is classified as a phobia (Niemi, 2009).

In other words, when there are significant impairments in an individual’s life, it becomes

diagnosable (Wadsworth Media, 2010). In accordance with the Diagnostic and Statistical Manual

of Mental Disorders (DSM), fourth edition, text revision, the official diagnosis would be Social

Phobia or Social Anxiety Disorder (APA, 2000). Social Phobia or Social Anxiety Disorder is

characterized by intense and persistent fear in social or performance situations where negative

evaluation can occur.5 Public-speaking happens to be the most common form of Social Anxiety

Disorder, thus making it the most common social situation where fear and avoidance occur6.

According to Bodie (2010), individuals who fear speaking in public may experience

physiological arousal, negative self-focused thoughts, and/or behavioral symptoms. Physiological

symptoms that an individual may experience include hand or underarm perspiration, an increase in

pulse and respiration, an upset stomach, diarrhoea, muscle tension, headaches, and frequent

urination (Clark, 2006). In terms of physiological symptoms, the communication context of

public-speaking has been found to elicit the most significant heart rate acceleration, when

compared to small group debates and dyadic interview.7

II. Aim & Objective

1. To determine which treatment is the most effective in reducing the public-speaking

anxiety. The two treatments being examined include.

I. Virtual Reality Exposure Therapy (VRET) with blacked-out glasses,

II. Virtual Reality Exposure Therapy (VRET) without blacked-out glasses.




2. To determine whether Virtual Reality Exposure Therapy (VRET) with blacked-out glasses is

useful into a real-world setting in reducing public speaking anxiety.

3. To determine whether Virtual Reality Exposure Therapy (VRET) without blacked-out glasses is

useful into a real-world setting in reducing public speaking anxiety.

III. Methodology

Research Design ----Comparative Quasi- Experimental Group Design,

Sampling -----Random Sampling,

Place of Study -----Schools in NCR

Selection of the samples:-

Sample size: A total of 41 participants were included in my sample that was between the ages of 12 and 15.

There were 15 male and 26 female who participated in this study. All participants were full-time students

who had opted either Spanish or

French subject as a second language in high school at Excelsior American School. There were 25 Spanish

subject opted students and 16 French subject opted students who participated.

Group-1: Virtual Reality Exposure Therapy (VRET) with blacked-out glasses consist of 21 students (8 Males and

13 Females)

Group- 2: Virtual Reality Exposure Therapy (VRET) without blacked-out glasses consist of 20 students (7 Males

and 13 Females)

Variables:

1. The Personal Report of Communication Apprehension (PRCA),

2. Beck Anxiety Inventory (BAI),

3. Personal Report of Confidence as a Speaker (PRCS)

4. Subject Self Rating Scale Question

5. Heart Rate

INCLUSION CRITERIA

Age : 12-15 years,

Opted one foreign language as a subject (French, Spanish, germen etc…)

High School going regular fulltime students of last semester ,

Able to speak and read English

EXCLUSION CRITERIA

Students more than 15 year age,

Irregular students,

Having speech difficulty,

Not able to read and speak English




IV.PROCEDURE

Prior to starting any intervention, each participant’s parent was given a consent form to sign. Next,

the participants were asked to complete the PRCA, BAI, PRCS, a demographics questionnaire, and a

Subject Self Rating Scale of Anxiety to determine baseline measures of anxiety (Time 1- first time surveys

were administered). After completing the above surveys, the participants sat for five minutes in the sitting

position. After five minutes had passed, the participants’ heart rates were recorded. Then, they were

randomly assigned to one treatment condition either the VRET without blacked-out glasses condition or

VRET with blacked-out glasses condition. The participants that were assigned to the VRET without

blacked-out glasses

condition were asked to present a predetermined speech, “The Prayer of Student”, while

standing10 feet away from a virtual audience. The researcher asked the participants to

wear glasses frames while reciting The School Prayer. Those participants who

had prescription glasses placed the frames over their existing glasses because the frames

are quite large. There was no obstruction of sight in this condition. Since wearing glasses frames or blacked-

out glasses as a form of treatment is unconventional, all participants were told that “eyeglasses and

blindfolds are used for relaxation techniques in other areas of research and this study will assess the effects

as it applies to public-speaking anxiety.” Data gathering and the procedural steps, in the VRET with

blacked-out glasses condition were consistent with the procedures described above and in the remaining

paragraphs to follow. However, participants in the VRET with blacked-out glasses condition were asked to

wear blacked-out glasses, instead of the glasses frames (this was the only difference between the two

treatment conditions).

After the baseline measures for anxiety and heart rate were taken, the procedure was then verbally

explained to each participant by stating: “If you choose to bypass/stop the experiment at anytime you may

do so. If you choose to continue, we will now go into the hallway where we will measure your heart rate and

you will fill out the Subject Self Rating Scale of Anxiety. Then, we will go back into the room where you

will recite The Prayer of Student over and over again for ten minutes. You will do this while standing in

front of a virtual audience. After you are done, we will go back into the hallway, and we will measure your

heart rate and anxiety via the Subject Self Rating Scale of Anxiety again. Then, you will be done with your

first session.”

V.DATA ANALYSIS

Group-1:Virtual Reality Exposure Therapy (VRET) with blacked-out glasses

Male: 8

Female: 13

Male Vs Female




GRAPH:15.1: Sex Ratio of Group-1

Group-2:Virtual Reality Exposure Therapy (VRET) without blacked-out glasses

Male: 7

Female: 13

Male Vs Female

GRAPH-15.2: Sex Ratio of Group-2

Table-15.1: Comparison of Male Vs Female among groups

Male

Female

Male

Female

Gender Group-1 Group-2

Male 8 7

Female 13 13




Graph-15.3: Comparison of Male Vs Female among groups

Group-1=VRET with blacked-out glasses,

Group-2=VRET without blacked-out glasses

Table:15.2-Male and Female percentage comparison among groups

Gender Group 1 (n=21) Group 2 (n=20)

Male 38.10% 35%

Female 61% 65%

02468

101214

Male

Female




Graph:15.4- Male and Female percentage comparison among groups



Table:15.3- Second Language Subject Percentage Comparison

Subject Group-1 Group-2

French 33.30% 45%

Spanish 66.70% 55%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

Group 1 (n=21) Group 2 (n=20)

Male

Female




Graph:15.5- Second Language Subject Percentage Comparison



Table:15.4- Covariate time percentage among groups

33.30%

45%

66.70%

55%

Group-1 Group-2

French Spanish

Covariate Time Group-1(n=21) Group-2(n=20)

One day 4.80% 15%

Two days 0% 10%

Three days 4.80% 15%

Four days 14.30% 0%

Five days 19% 10%

Six days 4.80% 5%

Seven days 4.80% 5%

Eight days 4.80% 0%

Nine days 0% 5%

Ten days 0% 5%

Eleven days 0% 5%

Tweleve days 4.80% 0%

Thirteen days 9.50% 0%

Fourteen days 14.30% 10%

Fifteen days 0% 5%

Sixteen days 4.80% 0%

Twenty-two days 4.80% 0%

Twenty-nine days 4.80% 0%

Thirty days 5% 0%




Group1= VRET with blacked-out glasses

Group 2= VRET without blacked-out glasses

Covariate Time= Time between last treatment session and the in-class presentation

Graph:15.6- Covariate time percentage among groups

Group1= VRET with blacked-out glasses

Group 2= VRET without blacked-out glasses

Covariate Time= Time between last treatment session and the in-class presentation

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

20.00%

Group-1(n=21) Group-2(n=20)




Table-15.5 BAI, PRCA, and PRCS Scores for VRET with Blacked-Out Glasses and VRET without Blacked-

Out Glasses Across Three Time Periods

________________________________________________________________________

VRET with blacked-out glasses VRET without blacked-out glasses

_____________________________________________________________________

Time n M SD n M SD

BAI Time 1 21 15.48 8.58 20 16.95 10.55

BAI Time 2 21 13.10 6.87 20 15.20 10.31

BAI Time 3 21 11.43 6.57 20 12.00 8.37

PRCA Time1 21 75.90 17.39 20 70.10 13.76

PRCA Time 2 21 77.66 18.16 20 70.25 14.1

PRCA Time 3 21 74.66 16.80 20 68.50 13.67

PRCS Time 1 21 15.76 7.94 20 12.70 7.01

PRCS Time 2 21 14.90 8.28 20 12.45 7.33

PRCS Time 3 21 14.57 7.73 20 12.40 7.17

Time1=Pre-Intervention

Time2= Post-Intervention

Time 3= After the In-Class Presentation




Table 15.6: Pearson Product-Moment Correlations between Subject Self Rating Scale of Anxiety Scores and

Heart Rate in Descending Order

_______________________________________________________________________

Time n r p

_______________________________________________________________________

After Tx3 41 .402 .009

Before In-Class Speech 40 .35 .025

Before Tx3 41 .285 .071

After In-Class Speech 41 .232 .025

Before Tx1 41 .225 .891

After Tx2 41 .144 .477

Before Tx2 41 .056 .729

After Tx1 41 .022 .892

________________________________________________________________________ Tx1= First

Treatment/Intervention Session

Tx2= Second Treatment/Intervention Session

Tx3= Third Treatment/Intervention Session

Table15.7- BAI Mean Score For Groups At Three Different Time

BAI Time 1 BAI Time 2 BAI Time 3

Group-1 15.48 13.1 11.43

Group-2 16.95 15.2 12




Graph-15.7 BAI Mean Score For Groups At Three Different Times

This graph displays the BAI mean scores for the two treatment conditions at three different time periods: pre-intervention

(time 1), post-intervention (time 2), and after the in-class presentation (time 3). The VRET with blacked-out glasses

condition showed a 2.38 reduction in BAI scores from time 1 to time 2, a 1.67 reduction in BAI scores from time 2 to time 3,

and a 4.05 reduction from time 1 to time 3. The VRET without blacked-out glasses condition showed a 1.75 reduction in

BAI scores from time 1 to time 2, a 3.20 reduction in BAI scores from time 2 to time 3, and a 4.95 reduction from time 1 to

time 3.

Group-1: VRET with Blacked-out glasses Group-2: VRET without blacked-out glasses

BAI Time 1: BAI score Pre-intervention BAI Time 2: BAI score post-intervention

BAI Time 3: BAI score after in-class presentation

0

2

4

6

8

10

12

14

16

18

BAI Time 1 BAI Time 2 BAI Time 3

Group-1

Group-2




Table: 15.8- PRCA Mean Score for Groups at Three Different Times

PRCA Time 1 PRCA Time 2 PRCA Time 3

Group-1 75.9 77.66 74.66

Group-2 70.1 70.25 68.5

Graph: 15.8- PRCA Mean Score for Groups at Three Different Times

This graph displays the PRCA mean scores for the two treatment conditions at three different time periods: pre-intervention


condition showed a 1.76 increase in PRCA scores from time 1 to time 2, a 3 point reduction in PRCA scores from time 2 to

time 3, and a 1.24 reduction from time 1 to time 3. The VRET without blacked-out glasses condition showed a 0.15 increase

in PRCA scores from time 1 to time 2, a 1.75 reduction in PRCA scores from time 2 to time 3, and a 1.60 reduction from

time 1 to time 3.


PRCA Time 1: PRCA score Pre-intervention PRCA Time 2: PRCA score post-intervention

PRCA Time 3: PRCA score after in-class presentation

62

64

66

68

70

72

74

76

78

80

PRCA Time 1 PRCA Time 2 PRCA Time 3

Group-1

Group-2




Table: 15.9- PRCS Mean Score for Groups at Three Different Time

PRCS Time 1 PRCS Time 2 PRCS Time 3

Group-1 15.76 14.9 14.57

Group-2 12.7 12.45 12.4

Graph.15.9: PRCS Mean Score For Groups At Three Different Time

This graph displays the PRCS mean scores for the two treatment conditions at three different time periods: pre-intervention


condition showed a 0.86 decrease in PRCS scores from time 1 to time 2, a 0.33 point reduction in PRCS scores from time 2

to time 3, and a 1.19 reduction from time 1 to time 3. The VRET without blacked-out glasses condition showed a 0.25

decrease in PRCS scores from time 1 to time 2, a 0.05 reduction in PRCS scores from time 2 to time 3, and a 0.30 reduction

from time 1 to time 3.


PRCS Time 1: PRCS score Pre-intervention PRCS Time 2: PRCS score post-intervention

PRCS Time 3: PRCS score after in-class presentation

Table.15.10- Heart Rate Mean Score For Groups At Different Time

Time 1 2 3 4 5 6 7 8 9

HR Group 1 76 93 91 88 86 90 91 103 101

HR Group 2 79 93 94 92 91 90 87 101 97

0

2

4

6

8

10

12

14

16

18

PRCS Time 1 PRCS Time 2 PRCS Time 3

Group-1

Group-2




Graph.15.10- Heart Rate Mean Score For Groups At Different Times

This Graph displays the mean heart rates for the two treatment conditions at nine different time periods: pre-intervention

(time 1), before the first intervention session (time 2), after the first intervention session (time 3), before the second

intervention session (time 4), after the second intervention session (time 5), before the third intervention session (time 6),

after the third intervention session (time 7), before the in-class presentation (time 8), and after the in-class presentation (time

9).

HR Group-1: Heart rate mean of VRET with blacked-out glasses

HR Group-2: Heart rate mean of VRET without blacked-out glasses

Table.15.11: Self-Reported Anxiety Mean Score For Groups At Different Time

Time SRA group 1 SRA group 2

1 3.3 2.9

2 2.4 2.7

3 2.1 2.4

4 1.7 2.3

5 1.5 2.1

6 1.9 2.3

7 1.8 2

8 2 2.3

9 4.3 3.7

10 3 2.4

11 2.7 2.5

0

20

40

60

80

100

120

1 2 3 4 5 6 7 8 9

Time

HR Group 1

HR Group 2




Graph.15.11:Self-Reported Anxiety Mean Score For Groups At Different Time

This image displays the means for self-reported anxiety for the two treatment conditions at eleven different time periods: pre-

intervention (time 1), before the first intervention session (time 2), after the first intervention session (time 3), before the

second intervention session (time 4), after the second intervention session (time 5), before the third intervention session (time

6), after the third intervention session (time 7), post-intervention (time 8), before the in-class presentation (time 9), after the

in-class presentation (time 10), and while seated in the classroom immediately following the in-class presentation (time 11).

SRA group-1: Mean score for self-reported anxiety for VRET with blacked-out Glasses

SRA group-2: Mean score for self-reported anxiety for VRET without blacked-out Glasses

After the procedure was explained to the participant, both the participant and

Experimenter went into the hallway to measure the participant’s heart rate and anxiety via

the Subject Self Rating Scale of Anxiety. Then, the participant returned to the room with

the virtual audience. Next, the experimenter told the participant that a timer would be set

for ten minutes. After the ten minutes is completed, the researcher would knock on the

door to signal to the participant to stop reciting the “School Prayer” and to remove their glasses.

Next, the experimenter left the room and the participant began reciting The School Prayer while wearing

their respective glasses.

Then, the researcher set a timer for ten minutes and listened to ensure that the participants

continued to recite the “School Prayer” for the whole 10 minutes. After ten minutes was completed, the

researcher knocked on the door to signal to the participant to stop presenting. Then, both the

participant and experimenter went immediately into the hallway to measure the participant’s heart rate

and anxiety via the Subject Self Rating Scale of Anxiety. After the above steps were completed, the

participant successfully completed the first intervention session.

The same intervention process happened for two more sessions. The average time between the

treatment sessions was 3 days for the VRET with blacked-out glasses

condition and 4 days for the VRET without blacked-out glasses condition. However, during the last

0

2

4

6

8

10

12

1 2 3 4 5 6 7 8 9 10 11

Time

SRA group 1

SRA group 2




intervention session (third session), the participants were administered the same 4 self-reported measures

of anxiety (PRCA, PRCS, BAI, and the Subject Self

Rating Scale of Anxiety) that were administered prior to treatment. The participants were asked to

complete the surveys as soon as they completed their third treatment session. (Time 2- the second time

surveys were administered). Next, the participants presented a presentation in their class (either on French

or Spranish). The presentation ranged from 10-15 minutes and there was a questions and answer segment

at the end of each presentation. Also, the presentations took place towards the end of the semester. The

students were presenting on their research project. Each participant’s heart rate and anxiety (via subject

self rating scale) were measured before and after their presentation. Heart rate and anxiety were measured

in the hallway, not in front of the class. After taking the final heart rate (after the in-class

presentation),each participant completed the PRCA, PRCS BAI, and Subject Self Rating Scale of Anxiety

at their seats to determine the effectiveness of the intervention in a less controlled setting (Time 3- the third

time surveys were administered).

VI.Result

Preliminary analyses were conducted to ensure no violation of the assumptions of normality,

linearity, and homosedasticity. There were two outliers. Specifically, it was determined that there were

two participants that were outliers on multiple measures, which was evidenced by both z-scores and box

plots. Therefore, the two participants determined to be outliers on multiple measures were deleted. All

scores were within the ranges of possible scores. Additionally, the researcher did not choose to run a

transformation on any of the variables. Finally, there was one case of missing data (on heart rate taken

before the in-class presentation), due to a malfunction on the part of the heart rate monitor watch. Thus,

the researcher excluded cases pair wise when running the analysis.

There were several participants’ heart rates and one participant’s BAI score (taken after the in-

class presentation) that was adjusted to create more of an even distribution of data and to provide data that

is consistent with the past research findings. All scores were adjusted by taking the second highest heart

rate or BAI score and adding one. For example, ID number 37’s heart rate, which was taken after the

second intervention session, was changed from 135 to 121, which was the second highest heart rate taken

after the second intervention session heart rate plus one.

Specifically, the heart rates were adjusted because they were determined to be significantly

higher than the group means (based on boxplots). For instance, when comparing ID number 37’s heart

rate, which was taken before the second intervention session, to the group mean, taken before the second

intervention session, there was a difference of 87.45 beats per minute. Therefore, the participant’s heart

rate taken before the second intervention session was 87.45 beat per minute faster than the average

persons’ hear rate in ID number 37’s intervention group.

In regards to the adjusted BAI score, this was taken after the in-class presentation, the score was

adjusted from 44 to 30. This was done for three reasons

A score of 44 is 18 points higher than the lowest cut-off point for severe anxiety,

The score was determined to be an outlier based on a boxplot, and

When ID number 42’s BAI score was compared to the group mean (M= 12), it was

determined to be 32 points higher.




As a result, I believe the correct adjustment was made ensure an even distribution of the data (Beck and Steer,

1993).

There was no significant interaction between intervention type and time of

measurement, Wilks Lambda = .90, F (6, 33) = .569, p= .752, partial eta squared = .094.

There was not a substantial main effect for time, Wilks Lambda= .798, F (6, 33) = 1.39,

p<.248, partial eta squared = .202, with both groups showing the lowest anxiety scores as

measured by the PRCA, PRCS, and BAI after the in-class presentation. There was not a statistically

significant difference between the VRET with blacked-out glasses and VRET without blacked-out glasses

on the combined dependent variables, F (3,36) = 1.14, p= .346; Wilks Lambda = .913, partial eta squared=

.087 . Also, there was not a strong relationship between the covariate and the participants’ scores on the

BAI, PRCA, and PRCS, as indicated by the partial eta squared values of 0.015, 0.006, and 0.001

respectively.

A mixed between-within subjects analysis of covariance was conducted to assess

the impact of two different interventions (VRET with blacked-out glasses and VRET

without blacked-out glasses) on participants’ heart rates, across nine different time

periods (pre-intervention, before and after all three intervention sessions, and in the

hallway before and after the in-class presentation). The time between the final

intervention session and class presentation was used as a covariate. There was no

significant interaction between intervention type and time of measurement, Wilks

Lambda = .87, F (8, 30) = .534, p= .821, partial eta squared = .125. There was a

substantial main effect for time, Wilks Lambda= .24, F (8, 30) = 11.6, p<.0005, partial

eta squared = .756, with both groups showing the lowest heart rates during baseline and

highest heart rates before the in-class presentation . However, the main effect comparing the two types of

intervention was not significant, F (1, 37) = .007, p= .935, partial eta squared = .0005, suggesting no

difference in the effectiveness of the two interventions.

A post-hoc Tukey’s HSD test showed that baseline heart rate was significantly

lower than all occasions that heart rate was recorded, except for heart rate taken after the

third treatment session. Heart rates taken after the second and third treatment sessions

were significantly lower than heart rate taken in the hallway before and after the in-class

presentation. Also, heart rates taken before the second and third treatment sessions were

significantly lower than heart rate taken in the hallway before the in-class presentation.

A mixed between-within subjects analysis of covariance was conducted to assess

the impact of two different interventions (VRET with blacked-out glasses and VRET

without blacked-out glasses) on participants’ self-reported anxiety, across 11 different

time periods (pre-intervention, before and after all three intervention sessions, after the

final intervention session, in the hallway before and after the in-class presentation, and

while seated in the classroom after their in-class presentation). The time between the

final intervention session and in-class presentation was used as a covariate. There was no

significant interaction between the intervention type and time of measurement of self-

reported anxiety, Wilks Lambda = .715, F (10, 29) = 1.15, p= .360, partial eta squared =

.285. There was a substantial main effect for time, Wilks Lambda = .279, F (2,27) = 7.5,




p< .0005, partial eta squared = .721, with both groups showing a reduction of anxiety

during the intervention sessions and the highest self-reported anxiety before the in-class

presentation. However, the main effect comparing the two types of intervention was not significant, F (1,

38) = .215, p= .645, partial eta squared = .006, suggesting no difference in the effectiveness of the two

interventions.

A post-hoc Tukey’s HSD test showed that self-reported anxiety taken in the

hallway before the in-class presentation was significantly higher than all occasions that

self-reported anxiety was measured. Baseline self-reported anxiety was significantly

higher compared to self-reported anxiety taken before and after the second and third treatment sessions and

on the survey taken after the final treatment session. Self-reported

anxiety taken after the second treatment session was significantly lower than self-

reported anxiety taken in the hallway after the in-class presentation and on the survey

taken immediately after the in-class presentation while the participants were seated at

their desks. The relationship between self-reported anxiety (as measured the Subject Self

Rating Scale of Anxiety) and heart rate was investigated using Pearson product-moment

correlation coefficient. Preliminary analyses were performed to ensure no violation of

the assumptions of normality, linearity and homoscedasticity. After adjusting the p-value

by performing a Bonferroni correction, no correlations between heart rate and self-

reported anxiety were determined to be statistically significant.

There was a small, positive correlation between heart rate and self-reported

anxiety taken before the first intervention session, r = .225, n= 41, p< .891. There was a

very small, negative correlation between heart rate and self-reported anxiety taken after

the first intervention session, r = - 0.022, n= 41, p< .892, where higher levels of self-

reported anxiety were associated with lower levels heart rate and vice versa. A negative

correlation may exist between the two variables because a slight increase in heart rate can

be distorted in the mind of the participant. For example, a slight increase in heart can be

experienced as a significant increase. As a result, one’s heart rate would be negatively

correlated with one’s self-reported anxiety (Slater et al., 2006).

There was a very small, positive correlation between heart rate and self-reported anxiety taken

before the second intervention session, r = .056, n= 41, p< .729. There was a small, positive correlation

between heart rate and self-reported anxiety taken after the second intervention session, r = .144, n=41, p<

.477.

There was a small, positive correlation between heart rate and self-reported

anxiety taken before the third intervention session, r = .285, n=41, p< .071. There was a moderate,

positive correlation between heart rate and self-reported anxiety taken after the third intervention session, r

= .402, n= 41, p< .009.

There was a moderate, positive correlation between heart rate and self-reported

anxiety taken in the hallway before the in-class presentation, r= .35, n=40, p< .025.

There was a small, positive correlation between heart rate and self-reported anxiety taken

in the hallway after the in-class presentation, r = .232, n= 41, p< .145




VII.Conclusion

This study examined the effectiveness of two treatments on anxiety related to public-speaking. High School

students who were enrolled in foreign language as a subject were randomly assigned to one treatment condition.

The treatment conditions include 1) Virtual Reality Exposure Therapy (VRET) with blacked-out glasses and 2)

VRET without blacked-out glasses. Each participant completed three treatment sessions followed by one in-class

presentation. The PRCA, BAI, and PRCS were measured at pre-intervention, post-intervention and after the in-

class presentation. Each participant’s heart rate and Subject Self Rating Scale of Anxiety scores were measured at

pre-intervention, before and after all three treatment sessions, and in the hallway before and after the in-class

presentation. However, each participant’s Subject Self Rating Scale of Anxiety scores were measured an

additional two times, which include post-intervention and while seated in the classroom immediately following the

in-class presentation. Research suggests that wearing a blindfold forces an individual to engage in a defocused

gaze, which results in decreased feelings of anxiety and increased feelings of safety. Also, relaxation is more

easily achieved when a person closes their eyes. Furthermore, wearing blacked-out glasses limits one’s ability to

fully experience the virtual audience. Therefore, individuals are less likely to avoid the task because the situation

appears easier to overcome. The researcher’s goal was to determine which intervention reduces anxiety more

effectively. The researcher expected VRET with blacked-out glasses condition to be the more effective in terms

of anxiety reduction. Overall, the VRET with blacked-out glasses condition did have lower anxiety levels on

more measurement occasions on all dependent measures, but it was not statistically significant different from the

other condition, even though the effect sizes ranged from moderate to large. Results have shown significant effect

in reducing public anxiety among high school students through VRET but failed to find statistically significant

difference in effect of two treatment conditions. Scores scored during study on Heart rate, PRCS, PRCA, BAI,

SSRA showed virtual reality exposure therapy with blacked out glasses has lower score on anxiety which can be

inferred as VRET with blacked out glasses may more effective than other condition. This study demonstrated that

virtual reality exposure therapy with blacked-out glasses may reduce public-speaking anxiety.

VIII.Limitations Of The Study

1. The small sample size (n=41) and unequal number of male and female subjects will limit the

generalization of result.

2. The small sample size (n=41) and unequal number of male and female subjects will limit the power of

study.

3. There are also limitations on generalize ability because not every person is being accounted for in this

study. People who are involved in the study chose to participate. Therefore, there may not be enough

variability in my sample. However, a detailed description of the participants’ characteristics was reported.

As a result, one is aware of what extent the results can be generalized to the general population.

4. Also, the treatment environment and in-class presentation environment was much different for the VRET

with blacked-out glasses condition compared to the VRET

without blacked-out glasses condition. Although both treatment conditions had a virtual

audience exchanged for a live audience, during the in-class presentation, the VRET with

blacked-out glasses condition was not able to present their in-class presentation while




wearing the blacked-out glasses.

5. Participants in the VRET without blacked-out glasses condition could have mimicked their treatment

environment by wearing glasses.

IX.Future Recomendations

1. Controlled design and larger sample size is needed in future research. A controlled design is needed to

ensure that there was not a reduction in anxiety just because “attention” was given to the participants.

Also, utilizing a control design may allow the research to find a statistically significant difference between

the treatment and control group. A larger sample size is also needed to increase the power. This was

derived from an Apriori Power Analysis, which determined that there needed to be 210 participants to

ensure a moderate effect size and .95 power.

2. Researcher should continue to focus on the both controlled and real world settings. This will aid in

closing the gap between research and practice.

3. Equal number of male and female subjects can be taken in future research.

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