Association Between Sensation Seeking and Fear Response: Interventional Study of Personality and Behavior Using a Virtual Reality Heights Simulation

Abstract Background Immersive virtual reality (VR) technology presents digital simulations that create the sense of an actual experience. VR simulations are persuasive enough to elicit physiological reactions that mirror real-world responses. Prior research suggests that fear responses and sensation seeking are inversely correlated, but that work largely relies on self-reported outcomes and hypothetical scenarios. Objective To more closely model real-world phenomena, we tested for inverse associations using an experiential height exposure simulation and a behavioral task for sensation seeking. We tested these associations comprehensively by using multiple methods for convergent evidence. Methods A total of 57 healthy undergraduates participated in an interventional study that included an anxiety-inducing VR simulation, behavioral tasks, and personality inventories. The VR paradigm (Richie’s Plank) prompted users to walk across and step off a plank at the top of a skyscraper. This simulation of extreme height exposure and falling was intended to evoke fear. Physiological recordings and self-reported state anxiety were collected prior to and during the experience. Behavioral sensation seeking was quantified using an olfactory choice task offering a “boring” or “exciting” (risky) option varying in intensity and pleasantness. Evoked fear was calculated as the difference between the calm (pre-plank) and provoked fear state (standing on the plank), with correlations performed between evoked fear and personality and behavioral measures. The false discovery rate was set to q <.05, with analyses conducted in SPSS. Results The VR experience evoked self-reported fear ( P <.001) and physiological arousal ( P <.006 for heart rate and P <.017 for respiration). Acrophobia correlated with self-reported fear in men and women ( P< .01). Behavioral sensation seeking negatively correlated with both self-reported fear ( P =.02) and increased heart rate in men ( P =.02). Behavioral and self-reported sensation seeking were uncorrelated ( P =.89). Self-reported fear was uncorrelated with physiological fear responses ( P >.46). Conclusions VR simulations can produce lifelike responses to scenarios that are impractical to test in reality. Our demonstration of an experiential manipulation negatively correlating with sensation seeking behavior in men increases confidence in other findings from studies using more traditional methods. Our use of VR along with objective measures, for example, behavioral tasks, and subjective measures, for example, self-report, confirm the effectiveness of these tools to investigate behavioral health topics. Our findings further suggest that sex is an important intervening factor for fear and sensation seeking and that additional study is warranted. This study highlights the potential of VR to expand convergent validity more broadly with other traits and paradigms. Finally, VR technology permits presenting highly abstract or improbable scenarios, thus expanding the range of topics for behavioral investigations. Given the ever-wider adoption of immersive therapeutics in the clinic, VR research will continue to facilitate the study of biobehavioral outcomes and interactions with personality factors and advance actionable knowledge for clinical applications.