Social feedback in the virtual environment is a critical part of successful virtual reality exposure therapy (VRET), and identifying the influences of virtual social feedback on social anxiety patients is necessary.

The present study aimed to explore the influences of ambiguous and negative virtual social feedback on social anxiety patients and a health control group (HCG).

Twenty-six social anxiety patients and 26 healthy participants were recruited. All participants were exposed to a virtual public speaking scenario. The participants were required to make two 3-minute speeches while the virtual audiences gave them either ambiguous feedback or negative feedback. The subjective units of discomfort (SUD) and heart rate were collected during the process.

The results showed that SAD individuals reported higher levels of subjective anxiety than those in the HCG, and the between-group differences were larger in the mild ambiguous condition than in the intense negative condition.

This study indicates that social anxiety patients have an interpretation bias towards ambiguous virtual social feedback. Therefore, it is important for VR-based interventions to take into account not only the valence of the feedback but also the ambiguity aspect.