ObjectiveTo investigate the impact of virtual reality (VR)-based psychotherapy on the negative attentional bias of individuals with depressive symptoms and to compare the effects of VR self-help cognitive restructuring training and VR psychotherapy placebo in improving the negative attentional bias of people with depressive symptoms.MethodsA total of 50 individuals with depressive symptoms were selected as participants and were randomly divided into an intervention group and a control group. The intervention group and control group were given the VR cognitive restructuring training and the VR psychotherapy placebo interventions, respectively. The study employed eye-tracking technology and dot-probe paradigm to measure negative attentional bias, while the 9-item Patient Health Questionnaire (PHQ-9), Hamilton Depression Rating Scale (HAMD), 7-item anxiety scale (GAD-7), and Hamilton Anxiety Rating Scale (HAMA) were used to assess depressive and anxiety symptoms. Changes in negative attentional bias indicators (gaze duration and count) and depressive and anxiety symptoms before and after intervention were compared between the two groups.ResultsThe results showed that both groups exhibited a main effect of time on fixation duration and count (P=0.068, P=0.001), but there was no statistically significant difference between the two groups. After the intervention, depressive and anxiety symptoms in both groups were significantly alleviated, and the VR cognitive restructuring training showed a more pronounced effect in symptom alleviation.ConclusionVR psychotherapy is effective in reducing depressive and anxiety symptoms, but there is no difference in the improvement of negative attentional bias when compared to the placebo control group.