Public speaking anxiety (PSA) is a prevalent condition which is highly interrelated with social anxiety. PSA can be effectively treated with exposure therapy. Virtual reality exposure therapy (VRET) is increasingly being explored as a novel and cost-effective mode of treatment. No previous randomized controlled trial has examined whether stand-alone 360° video VRET is an effective intervention for treating PSA and interrelated disorder relevant fears. Further, studies have not explored whether 360° video content influences VRET outcomes. Participants with high PSA (n = 51) were randomly allocated to: 360° video VRET incorporating stimuli of audiences (360°Audience) (n = 17), 360° video VRET incorporating stimuli of empty rooms (360°Empty) (n = 16) and no treatment control (n = 18). Outcomes were measured over five time-points. Mixed ANOVA revealed a significant interaction between time and intervention group for PSA, social anxiety and fear of negative evaluation (FNE). Within-group analysis demonstrated there was a significant pre-intervention to post-intervention reduction across measures for both 360° video VRET groups: PSA 360°Audience ($\eta$ _p² = .90, p<.001), 360°Empty ($\eta$ _p² = .71, p < .001); social anxiety 360°Audience ($\eta$ _p² = .49, p=.002), 360°Empty ($\eta$ _p² = .39, p = .009); FNE 360°Audience ($\eta$ _p² = .59, p<.001), 360°Empty ($\eta$ _p² = .43, p = .006). Active intervention participants showed significant improvement from pre-intervention to 10-week follow-up on all measures. Findings illustrate that 360° video VRET is an efficacious way to significantly reduce PSA, social anxiety and FNE.

公共演讲焦虑（PSA）是一种普遍存在的疾病，与社交焦虑密切相关。PSA 可以通过暴露疗法有效治疗。越来越多地探索虚拟现实暴露疗法 (VRET) 作为一种新颖且具有成本效益的治疗模式。之前没有随机对照试验检查过独立 360° 视频 VRET 是否是治疗 PSA 和相关疾病相关恐惧的有效干预措施。此外，研究还没有探讨 360° 视频内容是否会影响 VRET 结果。具有高 PSA 的参与者（n = 51）被随机分配到：包含观众刺激的 360°视频 VRET（360°Audience）（n = 17），包含空房间刺激的 360°视频 VRET（360°Empty）（n = 16) 和无治疗控制 (n = 18)。在五个时间点测量结果。混合方差分析显示时间和干预组在 PSA、社交焦虑和负面评价恐惧 (FNE) 之间存在显着的相互作用。组内分析表明，对于 360° 视频 VRET 组：PSA 360°观众（$\eta$ _p ² = .90, p< .001), 360°Empty ($\eta$ _p ² = .71，p < .001)；社交焦虑360°观众（$\eta$ _p ² = .49，p=。002), 360°空 ($\eta$ _p ² = .39，p = .009)；FNE 360°观众（$\eta$ _p ² = .59, p< .001), 360°Empty ($\eta$ _p ² = .43，p = .006）。积极干预参与者在所有措施上从干预前到 10 周随访都有显着改善。研究结果表明，360° 视频 VRET 是显着减少 PSA、社交焦虑和 FNE 的有效方法。