Into the spiderverse: validation of a behavioral avoidance test in virtual reality for assessing spider phobia

Abstract Specific phobias are characterized by excessive fear of an object or situation and its avoidance. In research, avoidance behavior is often assessed via the behavioral avoidance test (BAT) which employs real fear-eliciting stimuli. While its feasibility and standardization can be improved by using virtual reality, these two setups have not been compared yet. This study aims to validate a BAT in virtual reality, regarding fear and avoidance, and compare different approach behaviors, utilized in BATs. Individuals with spider phobia ( N = 25) completed four BATs, two in virtuo and two in vivo in a randomized order. The BATs involved approaching a (virtual) spider by either walking towards it or sliding it towards oneself. The final distance between the patient and the spider in each BAT indicated the avoidance behavior. The study was preregistered with the Open Science Framework (osf.io/xmf62). The results showed large associations between the BATs in virtuo and the BATs in vivo, but also between the two approach behaviors. Correlations with a psychometric measure of spider phobia revealed large associations. Overall, the BAT in virtuo offers a feasible and reliable alternative to traditional BAT procedures and provides valuable insights into the manifestations of avoidance behavior in a controlled virtual environment.