Can you escape the virtual room? A novel paradigm to assess avoidance behaviour

Anxiety patients often experience conflicts between approaching (pass barking dog) and avoiding (take detour) feared situations. In most experimental avoidance paradigms, response options are limited or forced, making it difficult to generalize the results to daily life situations. The aim of the present study was twofold: 1) to develop a more ecologically valid avoidance paradigm; 2) to examine the influence of individual characteristics (trait anxiety; distress tolerance) on approach-avoidance behaviour. To encourage free exploration behaviour, a virtual reality (VR) escape room was developed. In this room, participants searched for cues to decipher a code-locked door. Opening a marked vase (conditioned stimulus, CS) was followed by a jump scare, a rat jumping out of the vase (unconditioned stimulus, US). Avoidance was measured via questionnaires and relative manipulation time of CS-marked (EXPgen) or nonmarked (CONT) objects in the room; questionnaires measured trait anxiety and distress tolerance. EXPgen participants reported higher US expectancies and more avoidance of the (marked) vase compared to the CONT participants, yet behavioural data did not support these ratings. Additionally, higher trait anxiety scores coincided with higher US expectancies before the jump scare. The current flexible free-exploratory paradigm provides multiple opportunities to examine avoidance behaviour in different populations and settings.