An Optimized Immersive Virtual Reality System for Exposure Therapy in Treating Amaxophobia

The use of virtual reality (VR) for therapeutic purposes has expanded rapidly; however, few studies have specifically addressed amaxophobia, or driving-related fear, using immersive exposure techniques. This pilot study evaluated the feasibility and preliminary effectiveness of an immersive VR-based exposure intervention for pre-drivers with elevated driving fear. Five participants completed a five-session exposure program within a technically stable VR environment designed to support perceptual continuity and reduce cybersickness risk. Driving fear was assessed before and after the intervention using the Cuestionario para la Evaluación del Miedo a Conducir en Preconductores (CEMICP). Results showed a statistically significant reduction in fear, supported by both a one-tailed paired-samples t-test and the exact Wilcoxon signed-rank test, each revealing a large effect size. Reliable and clinically significant change analyses indicated that all participants experienced meaningful improvement, with 60% achieving clinically significant reduction in driving-related fear. These findings suggest that immersive VR exposure may offer a promising and acceptable approach to mitigate amaxophobia in young adults. Given the small single-group sample, further research is required to establish long-term effects, explore behavioral performance outcomes, and determine the mediating role of presence and emotional engagement. Future controlled trials with larger and more diverse samples are warranted to validate the clinical utility of this VR intervention.