Virtually renovating the Trauma Film Paradigm: Comparing virtual reality with on-screen presentation of an analogue trauma

Due to the unpredictable nature of traumatic events, prospective research into trauma relies upon laboratory methods utilising distressing film scenes to act as a trauma analogue measuring vulnerability factors and testing interventions applied to posttraumatic stress disorder (PTSD). This is the first study to test whether Virtual Reality (VR) provides a more effective trauma analogue than traditional on-screen presentation by direct comparison of the same real-life trauma film. Participants viewed footage of a staged car accident either presented in VR (N = 31) or on-screen (OS) (N = 30). Both groups recorded sense of presence, pre- and post-film mood and state anxiety. After the film, some participants (VR: n = 18; OS: n = 12) reported involuntary intrusions of the film and recorded the emotionality of these. VR presentation evoked a greater sense of presence, yet both VR and OS presentation elicited negative mood and involuntary intrusions. Although intrusions were more vivid in the VR condition, there were no significant differences in frequency or distress. However, a greater sense of presence, regardless of medium, was predictive of increased emotional reaction to the film and greater intrusion frequency and distress. Therefore, implementing a VR paradigm could be directly beneficial for TFP research concerning sense of presence or vividness of intrusions. The association between enhanced sense of presence and stress response suggests that an effective trauma analogue should be immersive, and VR presentation is a useful medium to elicit a greater sense of immersion.