VR-Counseling to Reduce Public Speaking Anxiety

Change from baseline to post-treatment in public speaking anxiety as assessed by the Personal Report of Public Speaking Anxiety (PRPSA), comparing the experimental arm with the control arm.

The PRPSA is a self-report questionnaire designed to measure anxiety specifically related to speaking in front of an audience. It assesses cognitive, physiological, and behavioral components of public speaking anxiety, capturing both anticipatory anxiety and anxiety experienced during performance. The scale consists of 34 items rated on a 5-point Likert scale, with response options ranging from 1 = strongly disagree to 5 = strongly agree. Items reflect feelings of tension and nervousness, physiological arousal, negative self-appraisal, and fear of audience evaluation. Total scores range from 34 to 170, with higher scores indicating greater levels of public speaking anx

Heart rate is continuously recorded during each intervention session to assess physiological arousal and recovery and to examine whether VR-supported counseling is associated with different within-session heart rate responses compared with counseling alone.

Heart rate variability is continuously recorded during each intervention session as an index of autonomic regulation and physiological recovery, and to compare within-session variability between VR-supported counseling and counseling alone.

Electrodermal activity is continuously recorded during each intervention session to assess sympathetic nervous system activation and physiological arousal during counseling, and to compare responses between treatment arms.

Skin temperature is continuously recorded during each intervention session as an indicator of peripheral physiological responses associated with stress and recovery, and to evaluate differences between VR-supported counseling and counseling alone.

Movement and activity levels are continuously recorded during each intervention session to quantify physical activity and motion-related physiological responses and to compare within-session patterns between treatment arms.

Change from baseline in anxiety assessed with the State-Trait Anxiety Inventory (STAI), Form Y, a widely used self-report questionnaire designed to measure two distinct dimensions of anxiety:

(i) State Anxiety, a temporary emotional condition characterized by feelings of tension, apprehension, and heightened autonomic nervous system activity, reflecting how the respondent feels "right now, at this moment"; and (ii) Trait Anxiety, a relatively stable disposition to perceive situations as threatening and to respond with anxiety across time and contexts.

Each subscale consists of 20 items rated on a 4-point Likert scale. Response options range from 1 = not at all to 4 = very much so for the State Anxiety subscale, and from 1 = almost never to 4 = almost always for the Trait Anxiety subscale. Total scores for each subscale range from 20 to 80, with higher scores indicating greater levels of anxiety.

Change from baseline (T0) to the 3-month follow-up (T2) in public speaking anxiety (PSA). The experimental arm (VR intervention sessions) is expected to show greater sustained improvements at T2 compared with the control arm (brief standard counseling only).