Behavioral analysis of computer-administered vicarious exposure in agoraphobic subjects: The effect of personality on in-session treatment process

Pretreatment measures of personality and symptom levels in agoraphobic subj ects (N = 18) were correlated with their behavior on an interactive compute r simulation that provided vicarious exposure to a phobia of elevators. Beh avior during treatment sessions was assessed via human-computer interaction s (HCIs), Automated programs analyzed these interactions to provide detaile d behavioral descriptions. All subjects engaged in vicarious exposure, but the extent of this varied eightfold. Vicarious exposure increased across tr eatment sessions, with a qualitative shift to a high-exposure routine of st aying in the simulated elevator and repeatedly traveling the maximum number of floors. The amount of activity spent on traveling in the elevator incre ased from 43% to 62% across three treatment sessions, Correlations were obs erved between vicarious exposure behaviors and a number of subject characte ristics including neuroticism and conscientiousness. We conclude that HCIs provide a detailed record of behavior during computer-administered treatmen t. Subjects demonstrate learning of exposure strategies across treatment se ssions. Interindividual differences in behavior correlate with a number of pretreatment subject personality characteristics. Copyright (C) 1999 by W.B . Saunders Company.