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Antos Z, Zackiewicz K, Tomaszek N, Modzelewski S, Waszkiewicz N. Beyond Pharmacology: A Narrative Review of Alternative Therapies for Anxiety Disorders. Diseases 2024; 12:216. [PMID: 39329885 PMCID: PMC11431799 DOI: 10.3390/diseases12090216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/01/2024] [Accepted: 09/12/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Anxiety disorders significantly reduce patients' quality of life. Current pharmacological treatments, primarily benzodiazepines and antidepressants, are associated with numerous side effects. Consequently, there is a continual search for alternative methods to traditional therapies that are less burdensome for patients and broaden their therapeutic options. Our objective was to determine the role of selected alternative methods in the treatment of anxiety disorders. METHODS In this review, we examined recent evidence on alternative treatments for anxiety disorders, including physical activity, mindfulness, virtual reality (VR) technology, biofeedback, herbal remedies, transcranial magnetic stimulation (TMS), cryotherapy, hyperbaric therapy, vagus nerve stimulation (VNS), 3,4-methylenedioxymethamphetamine (MDMA), electroconvulsive therapy (ECT), and eye movement desensitization and reprocessing (EMDR) therapy. For this purpose we reviewed PubMed and after initial search, we excluded works unrelated to our aim, non-orginal data and animal studies. We conducted second search to cover all minor methods. RESULTS We included 116 studies, which data is presented in Tables. We have investigated which methods can support treatment and which can be used as a stand-alone treatment. We assessed the risks to benefits of using alternative treatments. CONCLUSION Alternative treatments significantly expand the options available to patients and clinicians, with many serving as adjuncts to traditional therapies. Among the methods presented, mindfulness has the most significant therapeutic potential.
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Affiliation(s)
- Zuzanna Antos
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
| | - Klaudia Zackiewicz
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
| | - Natalia Tomaszek
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
| | - Stefan Modzelewski
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, pl. Wołodyjowskiego 2, 15-272 Białystok, Poland
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2
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Banakou D, Johnston T, Beacco A, Senel G, Slater M. Desensitizing Anxiety Through Imperceptible Change: Feasibility Study on a Paradigm for Single-Session Exposure Therapy for Fear of Public Speaking. JMIR Form Res 2024; 8:e52212. [PMID: 39037760 DOI: 10.2196/52212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 04/29/2024] [Accepted: 05/08/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Exposure therapy (ET) for anxiety disorders involves introducing the participant to an anxiety-provoking situation over several treatment sessions. Each time, the participant is exposed to a higher anxiety-provoking stimulus; for example, in the case of fear of heights, the participant would successively experience being at a greater height. ET is effective, and its counterpart, virtual reality (VR) exposure therapy (VRET), where VR substitutes real-world exposure, is equally so. However, ET is time-consuming, requiring several sessions. OBJECTIVE This study aimed to compare the results of single-session exposure with those of traditional VRET with regard to reducing public speaking anxiety. METHODS We introduced a paradigm concerned with public speaking anxiety where the VR exposure occurred in a single session while the participant interacted with a virtual therapist. Over time, the therapist transformed into an entire audience with almost imperceptible changes. We carried out a feasibility study with 45 participants, comparing 3 conditions: single-session exposure (n=16, 36%); conventional multiple-session exposure (n=14, 31%), where the same content was delivered in successive segments over 5 sessions; and a control group (n=15, 33%), who interacted with a single virtual character to talk about everyday matters. A week later, the participants were required to speak on a stage in front of a large audience in VR. RESULTS Across most of the series of conventional public speaking anxiety measures, the single-session exposure was at least as effective in reducing anxiety as the multiple-session exposure, and both these conditions were better than the control condition. The 12-item Personal Report of Confidence as a Speaker was used to measure public speaking anxiety levels, where higher values indicated more anxiety. Using a Bayesian model, the posterior probabilities of improvement compared to a high baseline were at least 1.7 times greater for single- and multiple-session exposures compared to the control group. The State Perceived Index of Competence was used as a measure of anticipatory anxiety for speaking on a stage in front of a large audience, where lower values indicated higher anxiety. The probabilities of improvement were just over 4 times greater for single- and multiple-session exposures compared to the control group for a low baseline and 489 (single) and 53 (multiple) times greater for a middle baseline. CONCLUSIONS Overall, the results of this feasibility study show that for moderate public speaking anxiety, the paradigm of gradual change in a single session is worth following up with further studies with more severe levels of anxiety and a larger sample size, first with a randomized controlled trial with nonpatients and subsequently, if the outcomes follow those that we have found, with a full clinical trial with patients.
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Affiliation(s)
- Domna Banakou
- Event Lab, Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Tania Johnston
- Systems Neuroscience, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Alejandro Beacco
- Event Lab, Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Gizem Senel
- Event Lab, Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Mel Slater
- Event Lab, Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
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Khan K, Hall CL, Babbage C, Dodzo S, Greenhalgh C, Lucassen M, Merry S, Sayal K, Sprange K, Stasiak K, Tench CR, Townsend E, Stallard P, Hollis C. Precision computerised cognitive behavioural therapy (cCBT) for adolescents with depression: a pilot and feasibility randomised controlled trial protocol for SPARX-UK. Pilot Feasibility Stud 2024; 10:53. [PMID: 38532490 DOI: 10.1186/s40814-024-01475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/12/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND A serious game called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts), originally developed in New Zealand and incorporating cognitive behavioural therapy (CBT) principles, has been shown to help reduce symptoms of depression and anxiety in adolescents with mild to moderate depression in studies undertaken in Australasia. However, SPARX has never been trialled in the United Kingdom (UK), and there have been issues relating to low engagement when it has been used in a real-world context. AIMS To conduct the first pilot and feasibility randomised controlled trial (RCT) in England to explore the use of SPARX in different settings. The trial will explore whether SPARX supported by an e-coach (assistant psychologists) improves adherence and engagement compared with self-directed (i.e. self-help) use. The trial results will be used to inform the optimal mode of delivery (SPARX supported vs. SPARX self-directed), to calculate an appropriate sample size for a full RCT, and to decide which setting is most suitable. METHODS Following consultation with young people to ensure study suitability/appropriateness, a total of 120 adolescents (11-19 years) will be recruited for this three-arm study. Adolescents recruited for the study across England will be randomised to receive either SPARX with human support (from an e-coach), self-directed SPARX, or a waitlist control group. Assessments will be conducted online at baseline, week 4, and 8-10-week post-randomisation. The assessments will include measures which capture demographic, depression (Patient Health Questionnaire modified for adolescents [PHQ-A]) and anxiety (Revised Child Anxiety and Depression Scale [RCADS]) symptomatology, and health-related quality-of-life data (EQ-5D-Y and proxy version). Analyses will be primarily descriptive. Qualitative interviews will be undertaken with a proportion of the participants and clinical staff as part of a process evaluation, and the qualitative data gathered will be thematically analysed. Finally, feasibility data will be collected on recruitment details, overall study uptake and engagement with SPARX, participant retention, and youth-reported acceptability of the intervention. DISCUSSION The findings will inform the design of a future definitive RCT of SPARX in the UK. If the subsequent definitive RCT demonstrates that SPARX is effective, then an online serious game utilising CBT principles ultimately has the potential to improve the provision of care within the UK's health services if delivered en masse. TRIAL REGISTRATION ISRCTN: ISRCTN15124804. Registered on 16 January 2023, https://www.isrctn.com/ISRCTN15124804 .
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Affiliation(s)
- K Khan
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK.
| | - C L Hall
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - C Babbage
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK
| | - S Dodzo
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK
| | - C Greenhalgh
- School of Computer Science, University of Nottingham, Nottingham, UK
| | - M Lucassen
- School of Health and Psychological Sciences, University of London, London, UK
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - S Merry
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - K Sayal
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Centre for Mood Disorders, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - K Sprange
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - K Stasiak
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - C R Tench
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Precision Imaging Beacon, Queen's Medical Centre, Nottingham, UK
| | - E Townsend
- School of Psychology, University of Nottingham, Nottingham, UK
| | - P Stallard
- Department for Health, University of Bath, Bath, UK
| | - C Hollis
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, NG7 2TU, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
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Kleinlogel EP, Schmid Mast M, Renier LA. The effect of gender on emotional reactions and perceptions when individuals meet themselves in immersive virtual reality. Sci Rep 2024; 14:6953. [PMID: 38521831 PMCID: PMC10960816 DOI: 10.1038/s41598-024-57662-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 03/20/2024] [Indexed: 03/25/2024] Open
Abstract
Immersive virtual reality-based training and research are becoming more and more popular and are in continuous development. For instance, it is now possible to be trained by one's virtual self (i.e., doppelganger), meaning that a trainee can participate in a training program in which the trainer resembles the trainee. While past research involving doppelgangers showed promising results, findings revealed gender effects such that doppelganger-based training seems to be beneficial only for male trainees. In the present research, we contribute to this literature by investigating the emotional reactions and perceptions that people have when they meet a virtual human in immersive virtual reality. Specifically, we assess the extent to which the appearance of the virtual human (doppelganger vs. unknown avatar) and an individual's gender influence these reactions and perceptions. We found that males felt more positive emotions toward their doppelganger than toward the unknown avatar and that females perceived their doppelganger as less competent and warm than the unknown avatar. Our findings have important practical implications in terms of virtual reality-based training and research design such that the use of a doppelganger (unknown avatar) might be recommended in a training program or research setting involving men (women).
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Affiliation(s)
- Emmanuelle P Kleinlogel
- CEMOI Laboratory, IAE Reunion, University of Reunion Island, 24 Avenue de la Victoire, 97400, Saint Denis, France.
| | - Marianne Schmid Mast
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Laetitia A Renier
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
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5
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Sommer JL, Reynolds K, Hebbard P, Smith MSD, Mota N, Mutch WAC, Maples-Keller J, Roos L, El-Gabalawy R. Preoperative Virtual Reality to Expose Patients With Breast Cancer to the Operating Room Environment: Feasibility and Pilot Case Series Study. JMIR Form Res 2024; 8:e46367. [PMID: 38231570 PMCID: PMC10831694 DOI: 10.2196/46367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Clinically elevated preoperative distress and anxiety are common among patients undergoing cancer surgery. Preoperative interventions have been developed to mitigate this distress and anxiety but are inconsistent in efficacy and feasibility for broad implementation. OBJECTIVE This preliminary pilot study aims to assess the feasibility and utility of a newly developed virtual reality (VR) intervention to expose patients awaiting breast cancer surgery to the operating room environment and a simulation of anesthetic induction. METHODS Patients undergoing breast cancer surgery (N=7) were assigned to the VR intervention or control (treatment as usual) group and completed self-report measures of distress and anxiety before surgery, on the day of surgery, and after surgery (5 and 30 d postoperatively). Those in the intervention group trialed the VR simulation 1 to 2 weeks preoperatively and provided qualitative and quantitative feedback. We assessed the feasibility of recruitment capability and study design and evaluated participants' impressions of the intervention using self-report rating scales and open-ended questions. We also descriptively examined distress and anxiety levels throughout the duration of the study. RESULTS Recruitment occurred between December 2021 and December 2022 and progressed slowly (rate: 1 participant/7 wk on average; some hesitancy because of stress and being overwhelmed). All participants who consented to participate completed the entire study. All participants were female and aged 56 (SD 10.56) years on average. In total, 57% (4/7) of the participants were assigned to the intervention group. On average, intervention participants spent 12 minutes engaged in the VR simulation. In general, the intervention was rated favorably (eg, clear information, enjoyable, and attractive presentation; mean% agreement 95.00-96.25, SD 4.79-10.00) and as helpful (mean% agreement 87.50, SD 25.00). Participants described the intervention as realistic (eg, "It was realistic to my past surgical experiences"), impacting their degree of preparedness and expectations for surgery (eg, "The sounds and sights and procedures give you a test run; they prepare you for the actual day"), and having a calming or relaxing effect (eg, "You feel more relaxed for the surgery"). CONCLUSIONS This preoperative VR intervention demonstrated preliminary feasibility among a sample of patients undergoing breast cancer surgery. Results and participant feedback will inform modifications to the VR intervention and the study design of a large-scale randomized controlled trial to examine the efficacy of this intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT04544618; https://clinicaltrials.gov/study/NCT04544618.
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Affiliation(s)
- Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Hebbard
- Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
| | | | - Natalie Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - W Alan C Mutch
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jessica Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Leslie Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
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Sigurvinsdottir R, Skúladóttir H, Antonsdóttir HF, Cardenas P, Georgsdóttir MT, Írisardóttir Þórisdóttir M, Jónsdóttir EK, Konop M, Valdimarsdóttir HB, Vilhjálmsson HH, Ásgeirsdóttir BB. A Virtual Reality Courtroom for Survivors of Sexual Violence: A Mixed-Method Pilot Study on Application Possibilities. Violence Against Women 2024; 30:249-274. [PMID: 37801610 DOI: 10.1177/10778012231205589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
This mixed-method pilot study examined the application possibilities of a virtual courtroom to support survivors of sexual violence who may experience courtroom-associated distress. Female sexual violence survivors (n = 13) who had testified in court following victimization entered an interactive virtual courtroom replica. Their reactions were measured quantitatively and qualitatively. The virtual courtroom evoked both subjective and physiological stress. Participants perceived the virtual reality environment as similar to the real-life courtroom. Most reported negative experiences from interacting with the criminal justice system. The virtual courtroom is a possible future strategy to support survivors when reporting violence to the justice system.
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Affiliation(s)
| | | | | | - Paola Cardenas
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | | | | | | | - Magdalena Konop
- Department of Psychotherapy, Jagiellonian University Medical College, Krakow, Poland
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Kroczek LOH, Mühlberger A. Public speaking training in front of a supportive audience in Virtual Reality improves performance in real-life. Sci Rep 2023; 13:13968. [PMID: 37633990 PMCID: PMC10460391 DOI: 10.1038/s41598-023-41155-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/22/2023] [Indexed: 08/28/2023] Open
Abstract
Public speaking is a challenging task that requires practice. Virtual Reality allows to present realistic public speaking scenarios in this regard, however, the role of the virtual audience during practice remains unknown. In the present study, 73 participants completed a Virtual Reality practice session while audience was manipulated to be supportive or unsupportive or presentations were practiced without audience. Importantly, following the virtual practice, participants held the presentation during a real university course via Zoom. We measured emotional experience, self-efficacy, and the subjective evaluation of performance at baseline, after VR practice, and after the real presentation. Additionally, participants' performance in the real presentation was evaluated by instructors (blinded to condition). Supportive in contrast to unsupportive audiences led to more positive believes about one's own performance, while there were no changes in beliefs in the group without audience. Importantly, practice in front of a supportive compared to unsupportive audience resulted in a more positive evaluation of speaker confidence in real-life public speaking as rated by the instructors. These results demonstrate an impact of virtual social feedback during public speaking on subsequent subjective performance evaluation. This may increase self-confidence resulting in actual improved public speaking performance in real-life.
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Affiliation(s)
- Leon O H Kroczek
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany.
| | - Andreas Mühlberger
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
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Vicario CM, Martino G. Psychology and technology: how Virtual Reality can boost psychotherapy and neurorehabilitation. AIMS Neurosci 2022; 9:454-459. [PMID: 36660073 PMCID: PMC9826745 DOI: 10.3934/neuroscience.2022025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- C. M. Vicario
- COSPECS Department, University of Messina, 98122 Messina, Italy,* Correspondence:
| | - G. Martino
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy,* Correspondence:
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Abstract
Whereas traditional teaching environments encourage lively and engaged interaction and reward extrovert qualities, introverts, and others with symptoms that make social engagement difficult, such as autism spectrum disorder (ASD), are often disadvantaged. This population is often more engaged in quieter, low-key learning environments and often does not speak up and answer questions in traditional lecture-style classes. These individuals are often passed over in school and later in their careers for not speaking up and are assumed to not be as competent as their gregarious and outgoing colleagues. With the rise of the metaverse and democratization of virtual reality (VR) technology, post-secondary education is especially poised to capitalize on the immersive learning environments social VR provides and prepare students for the future of work, where virtual collaboration will be key. This study seeks to reconsider the role of VR and the metaverse for introverts and those with ASD. The metaverse has the potential to continue the social and workplace changes already accelerated by the pandemic and open new avenues for communication and collaboration for a more inclusive audience and tomorrow.
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10
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Virtual Reality Aided Therapy towards Health 4.0: A Two-Decade Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031525. [PMID: 35162546 PMCID: PMC8834834 DOI: 10.3390/ijerph19031525] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 12/12/2022]
Abstract
Health 4.0 aligns with Industry 4.0 and encourages the application of the latest technologies to healthcare. Virtual reality (VR) is a potentially significant component of the Health 4.0 vision. Though VR in health care is a popular topic, there is little knowledge of VR-aided therapy from a macro perspective. Therefore, this paper was aimed to explore the research of VR in aiding therapy, thus providing a potential guideline for futures application of therapeutic VR in healthcare towards Health 4.0. A mixed research method was adopted for this research, which comprised the use of a bibliometric analysis (a quantitative method) to conduct a macro overview of VR-aided therapy, the identification of significant research structures and topics, and a qualitative review of the literature to reveal deeper insights. Four major research areas of VR-aided therapy were identified and investigated, i.e., post-traumatic stress disorder (PTSD), anxiety and fear related disorder (A&F), diseases of the nervous system (DNS), and pain management, including related medical conditions, therapies, methods, and outcomes. This study is the first to use VOSviewer, a commonly used software tool for constructing and visualizing bibliometric networks and developed by Center for Science and Technology Studies, Leiden University, the Netherlands, to conduct bibliometric analyses on VR-aided therapy from the perspective of Web of Science core collection (WoSc), which objectively and visually shows research structures and topics, therefore offering instructive insights for health care stakeholders (particularly researchers and service providers) such as including integrating more innovative therapies, emphasizing psychological benefits, using game elements, and introducing design research. The results of this paper facilitate with achieving the vision of Health 4.0 and illustrating a two-decade (2000 to year 2020) map of pre-life of the Health Metaverse.
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12
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Lin XB, Lee TS, Man REK, Poon SH, Fenwick E. Rasch analysis reveals multidimensionality in the public speaking anxiety scale. HEALTH SERVICES AND OUTCOMES RESEARCH METHODOLOGY 2021. [DOI: 10.1007/s10742-021-00265-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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13
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Chen J, Xie Z, Or C. Effectiveness of immersive virtual reality-supported interventions for patients with disorders or impairments: a systematic review and meta-analysis. HEALTH AND TECHNOLOGY 2021. [DOI: 10.1007/s12553-021-00561-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee M, Kolkmeier J, Heylen D, IJsselsteijn W. Who Makes Your Heart Beat? What Makes You Sweat? Social Conflict in Virtual Reality for Educators. Front Psychol 2021; 12:628246. [PMID: 34122221 PMCID: PMC8195282 DOI: 10.3389/fpsyg.2021.628246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/29/2021] [Indexed: 01/09/2023] Open
Abstract
Though educators often deal with stressful social conflicts, many face them ad hoc without much training. We studied if and how virtual agents can help University staff manage student-teacher conflicts. We explored educators' verbal, behavioral, and physiological reactions to a virtual agent that brought up a student-teacher conflict and held exit-interviews. Our qualitative analysis revealed that virtual agents for conflict training were positively received, but not for conflict mediation with cross-cultural differences. Those with non-Western backgrounds felt that an agent could help "save face," whereas Westerners preferred to resolve conflicts in person. In line with this, participants with a Western background rated the virtual agent to be less competent compared to those with non-Western backgrounds. While physiological measures only allow for limited conclusions, we found that participants who believed that the agent was controlled by a human had higher normalized hear rate variability (for the entire conversation in total) than people who thought that the agent was autonomous. We discuss implications for implementing virtual agents for training purposes, the impact of physiological signals, and the need to consider cultural and individual differences.
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Affiliation(s)
- Minha Lee
- Future Everyday, Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Jan Kolkmeier
- Human Media Interaction, University of Twente, Enschede, Netherlands
| | - Dirk Heylen
- Human Media Interaction, University of Twente, Enschede, Netherlands
| | - Wijnand IJsselsteijn
- Human Technology Interaction, Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
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Coelho GLDH, Byrne A, Hourihane J, DunnGalvin A. Development of the Food Allergy Anxiety Scale in an Adult Population: Psychometric Parameters and Convergent Validity. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3452-3458.e1. [PMID: 33895363 DOI: 10.1016/j.jaip.2021.04.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/22/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Food allergy (FA) affects up to 10% of young children and 2% to 3% of adults, and appears to be increasing in prevalence across the world. The adverse and growing impact of FAs warrants that closer attention is needed to the psychological mechanisms underlying FA and quality of life, to provide benefits for both clinicians and patients. One of these psychological mechanisms, frequently present in individuals struggling with FA, is anxiety. OBJECTIVE To provide an FA-specific measure to properly assess the impact of anxiety, the present research proposed the novel Food Allergy Anxiety Scale in an adult population. METHODS Two studies were conducted (n = 412), and the psychometric properties of the measure were extensively assessed through several robust statistical techniques (eg, exploratory factor analysis, confirmatory factor analysis, and item response theory). RESULTS Our findings indicated a reliable 1-factor structure, significantly associated with other constructs such as general anxiety, depression, and FA quality of life. CONCLUSIONS We are confident that the Food Allergy Anxiety Scale is a powerful tool to assess this specific role of FA within anxiety, which might lead to a better comprehension on how this psychological distress works, and consequently, the development of better strategies to reduce its impact.
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Affiliation(s)
| | | | | | - Audrey DunnGalvin
- School of Applied Psychology, University College Cork, Cork, Ireland
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16
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Kleinlogel EP, Curdy M, Rodrigues J, Sandi C, Schmid Mast M. Doppelganger-based training: Imitating our virtual self to accelerate interpersonal skills learning. PLoS One 2021; 16:e0245960. [PMID: 33566838 PMCID: PMC7875421 DOI: 10.1371/journal.pone.0245960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022] Open
Abstract
Interpersonal skills require mastering a wide range of competencies such as communication and adaptation to different situations. Effective training includes the use of videos in which role models perform the desired behaviours such that trainees can learn through behavioural mimicry. However, new technologies allow new ways of designing training. In the present study, given that virtual reality is emerging as a valuable training setting, we compare two different demonstration conditions within virtual reality by investigating the extent to which the use of doppelgangers as role models can boost trainees' interpersonal skills development as compared to a role model that does not resemble the trainees. We also assess trainees' level of self-efficacy and gender as potential moderators in this relationship. Participants delivered a speech in front of a virtual audience twice. Before delivering their second speech, they watched a role model giving a speech in front of the same audience. The role model was either their doppelganger or an avatar of the same gender depending on the condition they were randomly assigned to. Results showed that the doppelganger-based training was the most beneficial for male trainees low in self-efficacy. These findings have important implications for training design, suggesting that doppelganger-based training might be effective only for a specific subset of trainees.
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Affiliation(s)
| | - Marion Curdy
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - João Rodrigues
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Carmen Sandi
- Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Marianne Schmid Mast
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
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17
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Asghar I, Egaji OA, Griffiths M. An overview of the digital solutions for helping people with aphasia through bibliometric analysis. eNeurologicalSci 2021; 22:100311. [PMID: 33490656 PMCID: PMC7807248 DOI: 10.1016/j.ensci.2021.100311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/10/2020] [Accepted: 12/31/2020] [Indexed: 01/02/2023] Open
Abstract
This paper gives insights into recent research developments in the field of digital solutions for people with aphasia and tries to analyse its impact on their rehabilitation. A bibliometric research approach is used for data collection. Relevant studies were extracted from seven major academic databases from years 2000 to 2019 inclusive. The systematic process resulted in 986 studies. The average growth in this field is 4%, which is less compared to other research areas. However, the average citations per paper is 7.27, which represents a medium level of publication quality. Scopus and Web of Science are leading databases for the number of studies (379 and 264) and quality of publications (P-Index: 49.26 and 32.85), respectively. The USA, with 42% of publications, leads this research field, followed by the UK with 15%. Both countries have national aphasia strategies in place through charities (not government level strategies), which potentially contributed to their research leadership. The results show that recent advances in digital solutions have the potential to support people with aphasia. However, further work is needed at both academic and government levels to deliver more research contributions and funding for the rehabilitation of people with aphasia. The countries with clear national aphasia strategies in place lead this research field. Western countries carry most of the research for aphasia; the global view of this research area is still messing. Personal care, in combination with digital solutions, can yield better results. The fully immersive virtual reality solutions offer close to real-life interaction experience for the people with aphasia and their surroundings inside the virtual space.
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18
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Wu J, Sun Y, Zhang G, Zhou Z, Ren Z. Virtual Reality-Assisted Cognitive Behavioral Therapy for Anxiety Disorders: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:575094. [PMID: 34366904 PMCID: PMC8342859 DOI: 10.3389/fpsyt.2021.575094] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 06/10/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: We aim to explore the effectiveness of virtual reality-assisted cognitive behavioral therapy (VRCBT) in the treatment of anxiety and depression in patients with anxiety disorders. We further compare the therapeutic effect of VRCBT with that of standard cognitive behavioral therapy (CBT), as well as investigate the long-term efficacy of VRCBT. Methods: As of March 3, 2020, a total of four databases (Web of Science, PubMed, PsycINFO, and Scopus) were retrieved, and two researchers independently conducted literature retrieval and research selection and performed data extraction. Methodological quality assessment was performed using the Cochrane risk of bias tool and Grading of Recommendation, Assessment, Development, and Evaluation tool (GRADE). Results: A total of 11 studies were included (n = 626; range, 25.3-43.8), and six randomized controlled trials were quantitatively analyzed. The main outcome was anxiety and depression, and the secondary outcome was the withdrawal rate and long-term effects. Meta-analysis showed that the therapeutic effect of VRCBT on anxiety was better than that of the waiting list group (WLG) (SMD = -0.92; 95% CI: -1.34, -0.50; p = 0.005, I 2 = 66%, n = 276), while the therapeutic effect of VRCBT on anxiety was similar to that of standard CBT treatment (SMD = -0.26; 95% CI: -0.50, -0.01; p = 0.77, I 2 = 0%, n = 150). We further found that the therapeutic effect of VRCBT on depression was better than that of the WLG (SMD = -1.29; 95% CI: -2.26, -0.32; p = 0.09, I 2 = 58%, n = 74), while the effect of VRCBT was similar to that of standard CBT (SMD = -0.30; 95% CI: -0.67, -0.07; p = 0.39, I 2 = 1%, n = 116). Of the five studies that reported withdrawal rates of patients during the VRCBT and CBT treatment process, the withdrawal rates of the VRCBT group and CBT group did not reach statistical significance (OR = 0.70, 1.48, p > 0.05); only two studies reported the long-term effectiveness of VRCBT in anxiety and depression on patients with anxiety disorders. Conclusion: VRCBT treatment has a specific positive effect on patients with anxiety disorders (anxiety and depression). Compared with standard CBT, similar therapeutic effects can be achieved in the treatment of anxiety disorders. However, limited randomized controlled trials were included, requiring that these results be treated with caution.
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Affiliation(s)
| | - Yi Sun
- College of Physical Education, Jilin University, Changchun, China
| | - Gongwei Zhang
- Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China
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19
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Sampaio M, Haro MVN, De Sousa B, Melo WV, Hoffman HG. Therapists Make the Switch to Telepsychology to Safely Continue Treating Their Patients During the COVID-19 Pandemic. Virtual Reality Telepsychology May Be Next. FRONTIERS IN VIRTUAL REALITY 2021; 1:576421. [PMID: 33585834 PMCID: PMC7880047 DOI: 10.3389/frvir.2020.576421] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Before COVID-19, most therapists had concerns about telepsychology, and only treated patients in person. During the COVID-19 lockdown, patients still needed therapy, but in-person therapy sessions became unsafe. The current study measured how many therapists are using online therapy before vs. during COVID-19, how much training they have received, and their knowledge about legal restrictions on using telepsychology. A sample of 768 U.S.A. mental health professionals completed a 29-item online survey. Results show that before COVID-19, most therapists only saw their patients in person (e.g., at the therapists office), but during the COVID-19 pandemic, nearly all therapists used a wide range of telecommunication technologies to communicate with their quarantined patients, including texting, telephones, video conferences, and even virtual reality. According to within-subject related samples comparisons, 39% of survey respondents used telepsychology before COVID-19, vs. 98% during COVID-19 (χ2 = 450.02, p< 0.001). Therapists reported high treatment effectiveness using telepsychology (7.45 on 0-10 scale). However, overall, on a 0-10 scale, therapists reported a significant increase in feeling burned out during the COVID-19 pandemic, Mean = 3.93 (SD = 1.93) before vs. 6.22 (SD = 2.27) during the pandemic (Z = -18.57, p < 0.001). Although the APA ethics guidelines encourage therapists to use telepsychology with their patients during the crisis, gaps in respondents' knowledge identify a need for increased specialized training and education. Although the current study showed that virtual reality is rarely used by the therapists surveyed, virtual reality is a promising new telepsychology technology. Billions of dollars are currently being invested in mass producing immersive virtual reality systems. In the future, as networked immersive Virtual Reality becomes more widely available, therapists and patients in physically different locations will be able to "meet" in a shared computer-generated world designed for therapy sessions, potentially including group sessions. Telepsychology and virtual reality have the potential to be increasingly valuable tools to help therapists mitigate the consequences of COVID-19. Research, development and training is recommended.
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Affiliation(s)
- Mariana Sampaio
- Department of Psychology, University of Coimbra, Coimbra, Portugal
- Department of Social Work, Catholic University of Portugal, Lisbon, Portugal
| | - Maria Vicenta Navarro Haro
- Instituto Aragonés de Investigaciones Sanitarias, Universidad de Zaragoza, Zaragoza, Spain
- Department of Psychology and Sociology, Faculty of Economics and Business, University of Zaragoza, Zaragoza, Spain
| | - Bruno De Sousa
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Hunter G. Hoffman
- Department of Mechanical Engineering, Radiology and Psychology, University of Washington, Seattle, WA, United States
- Human Photonics Lab, Virtual Reality Research Center, University of Washington, Seattle, WA, United States
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20
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Brandrick C, Hooper N, Roche B, Kanter J, Tyndall I. A Comparison of Ultra-Brief Cognitive Defusion and Positive Affirmation Interventions on the Reduction of Public Speaking Anxiety. PSYCHOLOGICAL RECORD 2020. [DOI: 10.1007/s40732-020-00432-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Dilgul M, Martinez J, Laxhman N, Priebe S, Bird V. Cognitive behavioural therapy in virtual reality treatments across mental health conditions: a systematic review. CONSORTIUM PSYCHIATRICUM 2020; 1:30-46. [PMID: 38680386 PMCID: PMC11047275 DOI: 10.17650/2712-7672-2020-1-1-30-46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/10/2020] [Indexed: 05/01/2024] Open
Abstract
Background Virtual reality (VR) has been effectively used in the treatment of many mental health disorders.However, significant gaps exist in the literature. There is no treatment framework for researchers to use when developing new VR treatments. One recommended treatment across a range of diagnoses, which may be suitable for use in VR treatments, is Cognitive Behavioural Therapy (CBT). The aim of this systematic review is to investigateCBT treatment methods that utilize VR to treat mental health disorders. Objectives To investigate how CBT has been used in VR to treat mental health disorders and to report onthe treatment characteristics (number of sessions, duration, and frequency) that are linked to effective and ineffective trials. Methods Studies were included if patients had a mental health diagnosis and their treatment included immersiveVR technology and CBT principles. Data were extracted in relation to treatment characteristics and outcomes,and analysed using narrative synthesis. Results Ninety-three studies were analysed. Exposure-based VR treatments were mainly used to treat anxiety related disorders. Treatments generally consisted of eight sessions, once a week for approximately one hour. VR treatments were commonly equal to or more effective than traditional face-to-face methods. No specific treatment characteristics were linked to this effectiveness. Conclusion The number, frequency and duration of the VR treatment sessions identified in this review, could be used as a treatment framework by researchers and clinicians. This could potentially save researchers time and money when developing new interventions.
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Affiliation(s)
- Merve Dilgul
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
| | - Jasmine Martinez
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
| | - Neelam Laxhman
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
| | - Victoria Bird
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
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22
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Murakami H, Yasui‐Furukori N, Otaka H, Nakayama H, Murabayashi M, Mizushiri S, Matsumura K, Tanabe J, Matsuhashi Y, Yanagimachi M, Sugawara N, Shimoda K, Daimon M. Coping styles associated with glucose control in individuals with type 2 diabetes mellitus. J Diabetes Investig 2020; 11:1215-1221. [PMID: 32017452 PMCID: PMC7477505 DOI: 10.1111/jdi.13225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 01/21/2020] [Accepted: 02/02/2020] [Indexed: 01/26/2023] Open
Abstract
AIMS/OBJECTIVES Glycemic control varies according to stress level and the efficacy of control measures, affecting the outcomes of diabetes. Although detailed coping styles have not been well studied in patients with type 2 diabetes mellitus, problem-focused coping strategies are believed to be related to better control of blood glucose. Associations between coping profiles/dimensions and blood glucose control were examined in individuals with type 2 diabetes. MATERIALS AND METHODS The participants included 503 Japanese patients (mean age 63.9 ± 12.6 years) with type 2 diabetes. The average glycated hemoglobin A1c (HbA1c) levels were calculated from HbA1c levels measured more than four times within the 12 months before the assessment. Coping profiles were assessed using the Brief Scale for Coping Profile. Lifestyle factors were also included in the analyses. RESULTS Factors other than age were not associated with HbA1c levels in patients who used insulin. Conversely, habitual alcohol consumption, single status, the adaptive emotion-focused coping dimension, and changing mood and changing one's point of view profiles were associated with HbA1c levels. CONCLUSIONS These findings suggest that adaptive emotion-focused coping supports glycemic control in type 2 diabetes patients who do not use insulin. Additional studies using a longitudinal design are required to further examine the relationships between psychological factors and glycemic control.
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Affiliation(s)
- Hiroshi Murakami
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Norio Yasui‐Furukori
- Department of NeuropsychiatryHirosaki University Graduate School of MedicineHirosakiJapan
- Department of PsychiatryDokkyo Medical University School of MedicineMibuJapan
| | - Hideyuki Otaka
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Hirofumi Nakayama
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Masaya Murabayashi
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Satoru Mizushiri
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Koki Matsumura
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Jutaro Tanabe
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Yuki Matsuhashi
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Miyuki Yanagimachi
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
| | - Norio Sugawara
- Department of PsychiatryDokkyo Medical University School of MedicineMibuJapan
- Department of Clinical EpidemiologyTranslational Medical CenterNational Center of Neurology and PsychiatryKodairaJapan
| | - Kazutaka Shimoda
- Department of PsychiatryDokkyo Medical University School of MedicineMibuJapan
| | - Makoto Daimon
- Department of Endocrinology and MetabolismHirosaki University Graduate School of MedicineHirosakiJapan
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23
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Conversational Therapy through Semi-Immersive Virtual Reality Environments for Language Recovery and Psychological Well-Being in Post Stroke Aphasia. Behav Neurol 2020; 2020:2846046. [PMID: 32831969 PMCID: PMC7428879 DOI: 10.1155/2020/2846046] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 11/18/2022] Open
Abstract
Aphasia is a highly disabling acquired language disorder generally caused by a left-lateralized brain damage. Even if traditional therapies have been shown to induce an adequate clinical improvement, a large percentage of patients are left with some degree of language impairments. Therefore, new approaches to common speech therapies are urgently needed in order to maximize the recovery from aphasia. The recent application of virtual reality (VR) to aphasia rehabilitation has already evidenced its usefulness in promoting a more pragmatically oriented treatment than conventional therapies (CT). In the present study, thirty-six chronic persons with aphasia (PWA) were randomly assigned to two groups. The VR group underwent conversational therapy during VR everyday life setting observation, while the control group was trained in a conventional setting without VR support. All patients were extensively tested through a neuropsychological battery which included not only measures for language skills and communication efficacy but also self-esteem and quality of life questionnairies. All patients were trained through a conversational approach by a speech therapist twice a week for six months (total 48 sessions). After the treatment, no significant differences among groups were found in the different measures. However, the amount of improvement in the different areas was distributed over far more cognitive and psychological aspects in the VR group than in the control group. Indeed, the within-group comparisons showed a significant enhancement in different language tasks (i.e., oral comprehension, repetition, and written language) only in the VR group. Significant gains, after the treatment, were also found, in the VR group, in different psychological dimensions (i.e., self-esteem and emotional and mood state). Given the importance of these aspects for aphasia recovery, we believe that our results add to previous evidence which points to the ecological validity and feasibility of VR treatment for language recovery and psychosocial well-being.
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24
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Hinojo-Lucena FJ, Aznar-Díaz I, Cáceres-Reche MP, Trujillo-Torres JM, Romero-Rodríguez JM. Virtual Reality Treatment for Public Speaking Anxiety in Students. Advancements and Results in Personalized Medicine. J Pers Med 2020; 10:E14. [PMID: 32121589 PMCID: PMC7151627 DOI: 10.3390/jpm10010014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 12/15/2022] Open
Abstract
Public speaking anxiety (PSA) is a common phobia in the student population. Traditionally, exposure therapy has been used as a treatment. However, the use of virtual reality (VR) is increasingly common to treat PSA. The purpose of this paper was to analyze the published scientific literature on VR as a treatment for PSA in students. The articles indexed in two databases (Web of Science and Scopus) were analyzed, with a time period from the beginning of the first publications until 2019 included. The systematic literature review was based on fixed inclusion and exclusion criteria. A total of 13 studies were identified which included 481 students. The results collected indicate that the duration of treatments to have positive effects was at least one week, where the number of sessions was between one and twelve. Furthermore, most VR treatments reported positive effects. Finally, this study showed evidence that VR treatment for PSA is effective while being less invasive than in vivo exposure.
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Affiliation(s)
| | | | | | | | - José-María Romero-Rodríguez
- Department of Didactics and School Organization, University of Granada, 18071 Granada, Spain; (F.-J.H.-L.); (I.A.-D.); (M.-P.C.-R.); (J.-M.T.-T.)
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25
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Wechsler TF, Kümpers F, Mühlberger A. Inferiority or Even Superiority of Virtual Reality Exposure Therapy in Phobias?-A Systematic Review and Quantitative Meta-Analysis on Randomized Controlled Trials Specifically Comparing the Efficacy of Virtual Reality Exposure to Gold Standard in vivo Exposure in Agoraphobia, Specific Phobia, and Social Phobia. Front Psychol 2019; 10:1758. [PMID: 31551840 PMCID: PMC6746888 DOI: 10.3389/fpsyg.2019.01758] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 07/15/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Convincing evidence on Virtual Reality (VR) exposure for phobic anxiety disorders has been reported, however, the benchmark and golden standard for phobia treatment is in vivo exposure. For direct treatment comparisons, the control of confounding variables is essential. Therefore, the comparison of VR and in vivo exposure in studies applying an equivalent amount of exposure in both treatments is necessary. Methods: We conducted a systematic search of reports published until June 2019. Inclusion criteria covered the diagnosis of Specific Phobia, Social Phobia, or Agoraphobia, and a randomized-controlled design with an equivalent amount of exposure in VR and in vivo. We qualitatively reviewed participants' characteristics, materials, and the treatment procedures of all included studies. For quantitative synthesis, we calculated Hedges' g effect sizes for the treatment effects of VR exposure, in vivo exposure, and the comparison of VR to in vivo exposure in all studies and separately for studies on each diagnosis. Results: Nine studies (n = 371) were included, four on Specific Phobia, three on Social Phobia, and two on Agoraphobia. VR and in vivo exposure both showed large, significant effect sizes. The comparison of VR to in vivo exposure revealed a small, but non-significant effect size favoring in vivo (g = -0.20). Specifically, effect sizes for Specific Phobia (g = -0.15) and Agoraphobia (g = -0.01) were non-significant, only for Social Phobia we found a significant effect size favoring in vivo (g = -0.50). Except for Agoraphobia, effect sizes varied across studies from favoring VR to favoring in vivo exposure. Conclusions: We found no evidence that VR exposure is significantly less efficacious than in vivo exposure in Specific Phobia and Agoraphobia. The wide range of study specific effect sizes, especially in Social Phobia, indicates a high potential of VR, but also points to the need for a deeper investigation and empirical examination of relevant working mechanisms. In Social Phobia, a combination of VR exposure with cognitive interventions and the realization of virtual social interactions targeting central fears might be advantageous. Considering the advantages of VR exposure, its dissemination should be emphasized. Improvements in technology and procedures might even yield superior effects in the future.
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Affiliation(s)
- Theresa F. Wechsler
- Department for Clinical Psychology and Psychotherapy, Institute of Psychology, University of Regensburg, Regensburg, Germany
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26
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Gavarkovs AG. Behavioral Counseling Training for Primary Care Providers: Immersive Virtual Simulation as a Training Tool. Front Public Health 2019; 7:116. [PMID: 31143761 PMCID: PMC6521729 DOI: 10.3389/fpubh.2019.00116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/25/2019] [Indexed: 11/13/2022] Open
Abstract
Behavioral counseling represents an efficacious approach for improving health behaviors on a population level, and the primary care setting is an appropriate context in which to implement this approach. However, evidence suggests that the utilization of behavioral counseling techniques in primary care, including those informed by motivational interviewing, is sub-optimal. Insufficient training has been cited as a barrier to utilizing counseling in the primary care setting. Recent work has evaluated the effectiveness of virtual simulations that can provide access to "virtual" patients while retaining the scalability inherent to a digital medium. However, these educational interventions have been limited to simulations delivered through a two-dimensional screen. More immersive simulations delivered through a head-mounted display can create a realistic practice environment that encompasses a learner's entire field of view, which may confer additional benefits with respect to training outcomes. The purpose of this short article is to briefly review the relevant literature across disciplines to conceptualize the potential effectiveness of this technology as a training tool for behavioral counseling. Immersive virtual simulations are designed to induce a psychological phenomenon referred to as presence, whereby a learner perceives themselves as existing within the virtual environment. As such, immersive virtual simulations can provide opportunities for practice, coaching, and feedback in an environment that closely approximates the clinical setting in which counseling will be delivered. Through its effects on presence, this technology may be particularly useful for developing empathy, which is an important component of counseling. Recommendations for future research are also provided.
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Affiliation(s)
- Adam G Gavarkovs
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
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27
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Raber J, Arzy S, Bertolus JB, Depue B, Haas HE, Hofmann SG, Kangas M, Kensinger E, Lowry CA, Marusak HA, Minnier J, Mouly AM, Mühlberger A, Norrholm SD, Peltonen K, Pinna G, Rabinak C, Shiban Y, Soreq H, van der Kooij MA, Lowe L, Weingast LT, Yamashita P, Boutros SW. Current understanding of fear learning and memory in humans and animal models and the value of a linguistic approach for analyzing fear learning and memory in humans. Neurosci Biobehav Rev 2019; 105:136-177. [PMID: 30970272 DOI: 10.1016/j.neubiorev.2019.03.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/30/2019] [Accepted: 03/18/2019] [Indexed: 01/04/2023]
Abstract
Fear is an emotion that serves as a driving factor in how organisms move through the world. In this review, we discuss the current understandings of the subjective experience of fear and the related biological processes involved in fear learning and memory. We first provide an overview of fear learning and memory in humans and animal models, encompassing the neurocircuitry and molecular mechanisms, the influence of genetic and environmental factors, and how fear learning paradigms have contributed to treatments for fear-related disorders, such as posttraumatic stress disorder. Current treatments as well as novel strategies, such as targeting the perisynaptic environment and use of virtual reality, are addressed. We review research on the subjective experience of fear and the role of autobiographical memory in fear-related disorders. We also discuss the gaps in our understanding of fear learning and memory, and the degree of consensus in the field. Lastly, the development of linguistic tools for assessments and treatment of fear learning and memory disorders is discussed.
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Affiliation(s)
- Jacob Raber
- Department of Behavioral Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA; Departments of Neurology and Radiation Medicine, and Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA.
| | - Shahar Arzy
- Department of Medical Neurobiology, Hebrew University, Jerusalem 91904, Israel
| | | | - Brendan Depue
- Departments of Psychological and Brain Sciences and Anatomical Sciences and Neurobiology, University of Louisville, Louisville, KY, USA
| | - Haley E Haas
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - Stefan G Hofmann
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Maria Kangas
- Department of Psychology, Macquarie University, Sydney, Australia
| | | | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Hilary A Marusak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
| | - Jessica Minnier
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Anne-Marie Mouly
- Lyon Neuroscience Research Center, CNRS-UMR 5292, INSERM U1028, Université Lyon, Lyon, France
| | - Andreas Mühlberger
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany; PFH - Private University of Applied Sciences, Department of Psychology (Clinical Psychology and Psychotherapy Research), Göttingen, Germany
| | - Seth Davin Norrholm
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - Kirsi Peltonen
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Christine Rabinak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
| | - Youssef Shiban
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany; PFH - Private University of Applied Sciences, Department of Psychology (Clinical Psychology and Psychotherapy Research), Göttingen, Germany
| | - Hermona Soreq
- Department of Biological Chemistry, Edmond and Lily Safra Center of Brain Science and The Institute of Life Sciences, Hebrew University, Jerusalem 91904, Israel
| | - Michael A van der Kooij
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Universitatsmedizin der Johannes Guttenberg University Medical Center, Mainz, Germany
| | | | - Leah T Weingast
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - Paula Yamashita
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Sydney Weber Boutros
- Department of Behavioral Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA
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Latu IM, Mast MS, Bombari D, Lammers J, Hoyt CL. Empowering Mimicry: Female Leader Role Models Empower Women in Leadership Tasks Through Body Posture Mimicry. SEX ROLES 2019; 80:11-24. [PMID: 30651662 PMCID: PMC6318345 DOI: 10.1007/s11199-018-0911-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In two studies we investigated the behavioral process through which visible female leader role models empower women in leadership tasks. We proposed that women tend to mimic the powerful (open) body postures of successful female role models, thus leading to more empowered behavior and better performance on a challenging leadership task, a process we called empowering mimicry. In Study 1, we experimentally manipulated the body posture of the male and female role models and showed that 86 Swiss college women mimicked the body posture of the female (ingroup) but not the male (outgroup) role model, thus leading to more empowered behavior and better performance on a public speaking task. In Study 2, we investigated the boundary conditions of this process and showed that empowering mimicry does not extend to exposures to non-famous female models among 50 Swiss college women. These findings suggest that nonverbal mimicry is one important mechanism through which female leader role models inspire women performing a challenging leadership task. From a practice perspective, our research underscores the importance of female leaders' visibility because visibility can drive other women's advancement in leadership by affording women the opportunity to mimic and be empowered by successful female role models.
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Affiliation(s)
- Ioana M Latu
- 1Center for Identity and Intergroup Relations, Queen's University Belfast, 18-30 Malone Road, Belfast, BT9 5BN UK
| | - Marianne Schmid Mast
- 2Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Dario Bombari
- 2Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Joris Lammers
- 3Social Cognition Center Cologne, University of Cologne, Cologne, Germany
| | - Crystal L Hoyt
- 4Jepson School of Leadership Studies, University of Richmond, Richmond, VA USA
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Virtual Reality and Anxiety Disorders Treatment: Evolution and Future Perspectives. VIRTUAL REALITY FOR PSYCHOLOGICAL AND NEUROCOGNITIVE INTERVENTIONS 2019. [DOI: 10.1007/978-1-4939-9482-3_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Benbow AA, Anderson PL. A meta-analytic examination of attrition in virtual reality exposure therapy for anxiety disorders. J Anxiety Disord 2019; 61:18-26. [PMID: 30646997 DOI: 10.1016/j.janxdis.2018.06.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/12/2018] [Accepted: 06/18/2018] [Indexed: 11/24/2022]
Abstract
A proposed advantage of virtual reality exposure therapy for anxiety disorders is that people will be less likely to drop out of treatment prematurely if the treatment involves facing one's fear in a virtual world rather than the real world, but this has yet to be empirically tested. The present meta-analyses assess the odds of dropout from virtual reality exposure therapy compared to in vivo exposure therapy, estimate the overall rate of dropout from virtual reality exposure treatment, and test potential moderating variables. The odds ratio meta-analysis indicated that there was no significant difference in the likelihood of attrition from virtual reality exposure therapy relative to in vivo exposure therapy. The overall attrition rate for virtual reality exposure therapy across 46 studies with a combined sample size of 1057 participants was 16%. This rate is slightly lower than other estimates of dropout from in vivo therapy and from cognitive-behavioral therapy for anxiety disorders. Incorporation of between-session intervention (i.e., homework) was identified as a moderator; specifically, inclusion of between-session interventions in the treatment was associated with better retention. Overall, the findings of the present study indicate that virtual reality exposure and in vivo exposure therapy show similar rates of attrition.
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Lindner P, Miloff A, Fagernäs S, Andersen J, Sigeman M, Andersson G, Furmark T, Carlbring P. Therapist-led and self-led one-session virtual reality exposure therapy for public speaking anxiety with consumer hardware and software: A randomized controlled trial. J Anxiety Disord 2019; 61:45-54. [PMID: 30054173 DOI: 10.1016/j.janxdis.2018.07.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 06/29/2018] [Accepted: 07/04/2018] [Indexed: 01/10/2023]
Abstract
Public speaking anxiety (PSA) is a common condition which can be treated effectively with exposure therapy. However, inherent difficulties in stimuli presentation and control limits dissemination and the therapeutic potential. Virtual Reality (VR) technology has the potential to resolve these issues and provide a scalable platform for self-help interventions. No previous study has examined whether this can be achieved using the first generation of consumer VR hardware and software. In the current trial, n = 25 + 25 participants were randomized to either one-session therapist-led VR exposure therapy for PSA followed by a four-week internet-administered VR to in-vivo transition program, or a waiting-list. Linear mixed effects modeling revealed significant, large (within Cohen's d = 1.67) decreases in self-reported PSA. The waiting-list was then given access to an internet-administered, self-led version of the same VR exposure therapy to be conducted at home, followed by the same transition program. Dual-slope mixed effects modeling revealed significant, large (d = 1.35) decreases in self-reported PSA. Results were maintained or improved at six- and twelve-month follow-ups. We show for the first time that low-cost, off-the-shelf consumer VR hardware and software can be used to conduct exposure therapy for PSA, both in the traditional, previously impractical one-session format, and in a novel self-led, at-home format.
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Affiliation(s)
- Philip Lindner
- Department of Psychology, Stockholm University, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Alexander Miloff
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Simon Fagernäs
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Joel Andersen
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Martin Sigeman
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Psychology, University of Southern Denmark, Odense, Denmark
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Abstract
BACKGROUND Although the ABC model proposed by cognitive behavioral theory has strong empirical support for a wide range of psychological problems, little is known about the role of irrational beliefs (IBs), a central concept of the ABC model, in the aetiology of paranoid thoughts, one of the most common psychotic symptoms. AIMS The present study aimed to investigate the impact of IBs on paranoid thoughts and people's perceptions of others. METHOD Eighty-one non-clinical participants (m age = 21.21 years, SD = 2.72, range 18-33; 83.95% female) recruited for this study were randomly assigned to one of the two conditions: IBs or rational beliefs (RBs). In a role-play paradigm, subjects were asked to imagine holding a list of IBs or RBs, respectively, while being exposed to a neutral social context in a virtual reality environment. RESULTS In line with the ABC model, results indicate that IBs lead to significantly higher levels of state paranoid thoughts and more negative perceptions of others than RBs, even after controlling for participants' baseline irrationality and trait paranoia [F (5,68) = 11.23, p < .001, Wilk's λ = .54, partial η2 = .45]. CONCLUSIONS The findings of this paper suggest that IBs might play an aetiological role in the occurrence of paranoid thoughts. Practical and theoretical implications of these results are also considered.
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Benbow AA, Anderson PL. Long-Term Improvements in Probability and Cost Biases Following Brief Cognitive Behavioral Therapy for Social Anxiety Disorder. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9947-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Kumar M, Kalakbandi V, Prashar S, Neelu, Parashar A. Overcoming the effect of low self-esteem on public speaking anxiety with mindfulness-based interventions. DECISION 2017. [DOI: 10.1007/s40622-017-0166-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Galliers J, Wilson S, Marshall J, Talbot R, Devane N, Booth T, Woolf C, Greenwood H. Experiencing EVA Park, a Multi-User Virtual World for People with Aphasia. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2017. [DOI: 10.1145/3134227] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Virtual worlds are used in wide-ranging ways by many people with long-term health conditions, but their use by people with aphasia (PWA) has been limited. In contrast, this article reports the use of EVA Park, a multi-user virtual world designed for PWA to practice conversations, focusing on people's emotional, social, and conversational experiences. An analysis of observation and interview data collected from 20 people with aphasia who participated in a 5-week therapy intervention revealed key themes related to user experience. The themes offer a rich insight into aspects of the virtual world experience for PWA that go beyond therapeutic outcomes. They are as follows: affect (positive and negative); types of conversation, miscommunication, and misunderstanding; immersion in the virtual world; social presence and initiative and flow. Overall, the study showed that participants experienced positive emotional and social outcomes. We argue that this was achieved as a consequence of EVA Park being not only accessible but also a varied and entertaining environment within which PWA experienced both the realistic and the quirky while engaging with others and having fun.
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Reichenberger J, Diemer J, Zwanzger P, Notzon S, Mühlberger A. Soziales Kompetenztraining in Virtueller Realität bei sozialer Angst. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2017. [DOI: 10.1026/1616-3443/a000444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Soziale Kompetenztrainings sind wichtige Werkzeuge bei der Psychotherapie der Sozialen Angststörung. Die Durchführung in Virtueller Realität (VR) könnte die Verfügbarkeit und Effektivität erhöhen, allerdings besteht ein Bedarf an validierten VR-Szenarien. Fragestellung: Geprüft wird die Validität von zwei in Anlehnung an das Gruppentraining sozialer Kompetenzen von Hinsch und Pfingsten (2015) entwickelten VR-Szenarien. Es wird angenommen, dass die durch das Szenario ausgelösten Komponenten sozialer Angst auf subjektiver, psychophysiologischer und kognitiver Ebene signifikant zwischen höher (HSA) und niedriger (NSA) sozial ängstlichen Personen differenzieren. Methode: Insgesamt durchliefen N = 55 HSA und NSA Studierende zwei VR-Szenarien vom Typ „Recht durchsetzen“. Zusätzlich wurde experimentell die Blickkontaktdauer des virtuellen Gesprächspartners variiert. Hauptoutcome war die erlebte Angst in den Rollenspielen. Zusätzlich wurden Herzschlagfrequenz, Hautleitfähigkeit sowie die Einschätzung der eigenen Kompetenz erfasst. Ergebnisse: HSA im Vergleich zu NSA berichteten für beide Szenarien signifikant höhere Angst sowie negative Verzerrungen in Bezug auf die Einschätzung der eigenen Kompetenz. Zusätzlich zeigte sich eine physiologische Aktivierung während der Rollenspiele, aber keine Differenzierung zwischen beiden Gruppen. Beide VR-Szenarien wurden als realistisch empfunden. Schlussfolgerungen: Virtuelle Interaktionsszenarien können zu Trainingszwecken genutzt werden und Soziale Kompetenztrainings in VR haben ein großes Potential für den Einsatz als psychotherapeutisches Verfahren bei Sozialer Angststörung.
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Affiliation(s)
- Jonas Reichenberger
- Institut für Psychologie, Lehrstuhl für Klinische Psychologie und Psychotherapie, Universität Regensburg
| | - Julia Diemer
- Institut für Psychologie, Lehrstuhl für Klinische Psychologie und Psychotherapie, Universität Regensburg
- kbo-Inn-Salzach-Klinikum, Wasserburg am Inn
| | - Peter Zwanzger
- kbo-Inn-Salzach-Klinikum, Wasserburg am Inn
- Lehrstuhl für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
| | - Swantje Notzon
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster
| | - Andreas Mühlberger
- Institut für Psychologie, Lehrstuhl für Klinische Psychologie und Psychotherapie, Universität Regensburg
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Silva MLD, Frère AF, Oliveira HJQD, Martucci Neto H, Scardovelli TA. Computer tool to evaluate the cue reactivity of chemically dependent individuals. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2017; 140:139-149. [PMID: 28254070 DOI: 10.1016/j.cmpb.2016.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 10/31/2016] [Accepted: 11/23/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Anxiety is one of the major influences on the dropout of relapse and treatment of substance abuse treatment. Chemically dependent individuals need (CDI) to be aware of their emotional state in situations of risk during their treatment. Many patients do not agree with the diagnosis of the therapist when considering them vulnerable to environmental stimuli related to drugs. This research presents a cue reactivity detection tool based on a device acquiring physiological signals connected to personal computer. Depending on the variations of the emotional state of the drug addict, alteration of the physiological signals will be detected by the computer tool (CT) which will modify the displayed virtual sets without intervention of the therapist. METHODS Developed in 3ds Max® software, the CT is composed of scenarios and objects that are in the habit of marijuana and cocaine dependent individual's daily life. The interaction with the environment is accomplished using a Human-Computer Interface (HCI) that converts incoming physiological signals indicating anxiety state into commands that change the scenes. Anxiety was characterized by the average variability from cardiac and respiratory rate of 30 volunteers submitted stress environment situations. To evaluate the effectiveness of cue reactivity a total of 50 volunteers who were marijuana, cocaine or both dependent were accompanied. RESULTS Prior to CT, the results demonstrated a poor correlation between the therapists' predictions and those of the chemically dependent individuals. After exposure to the CT, there was a significant increase of 73% in awareness of the risks of relapse. CONCLUSION We confirmed the hypothesis that the CT, controlled only by physiological signals, increases the perception of vulnerability to risk situations of individuals with dependence on marijuana, cocaine or both.
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Affiliation(s)
- Meire Luci da Silva
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Filosofia e Ciências, Av. Hygino Muzzi Filho 737, Marília, São Paulo, Brazil.
| | - Annie France Frère
- Universidade Braz Cubas, Av. Francisco Rodrigues Filho 1233, Mogi das Cruzes, São Paulo, Brazil.
| | - Henrique Jesus Quintino de Oliveira
- Universidade de Mogi das Cruzes, Núcleo de Pesquisas Tecnológicas, Av. Dr. Cândido Xavier de Almeida e Souza 200, Mogi das Cruzes, São Paulo, Brazil.
| | - Helio Martucci Neto
- Universidade de Mogi das Cruzes, Núcleo de Pesquisas Tecnológicas, Av. Dr. Cândido Xavier de Almeida e Souza 200, Mogi das Cruzes, São Paulo, Brazil.
| | - Terigi Augusto Scardovelli
- Universidade de Mogi das Cruzes, Núcleo de Pesquisas Tecnológicas, Av. Dr. Cândido Xavier de Almeida e Souza 200, Mogi das Cruzes, São Paulo, Brazil.
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Jackson B, Compton J, Thornton AL, Dimmock JA. Re-Thinking Anxiety: Using Inoculation Messages to Reduce and Reinterpret Public Speaking Fears. PLoS One 2017; 12:e0169972. [PMID: 28125618 PMCID: PMC5268460 DOI: 10.1371/journal.pone.0169972] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/24/2016] [Indexed: 11/19/2022] Open
Abstract
Inoculation theory offers a framework for protecting individuals against challenges to an existing attitude, belief, or state. Despite the prevalence and damaging effects of public speaking anxiety, inoculation strategies have yet to be used to help individuals remain calm before and during public speaking. We aimed to test the effectiveness of an inoculation message for reducing the onset of public speaking anxiety, and helping presenters interpret their speech-related anxiety more positively. Participants (Mage = 20.14, SD = 2.72) received either an inoculation (n = 102) or control (n = 128) message prior to engaging a public speaking task and reported a range of anxiety-related perceptions. Accounting for personality characteristics and perceptions of task importance, and relative to control participants, those who received the inoculation message reported significantly lower pre-task anxiety, and following the task, reported that they had experienced lower somatic anxiety, and that the inoculation message had caused them to view their nerves in a less debilitating light. Inoculation messages may be an effective strategy for helping participants reframe and reduce their apprehension about public speaking, and investigating their efficacy in other stress-inducing contexts may be worthwhile.
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Affiliation(s)
- Ben Jackson
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
- * E-mail:
| | - Josh Compton
- Institute for Writing and Rhetoric, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Ashleigh L. Thornton
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
| | - James A. Dimmock
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
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Rizzo A‘S, Shilling R. Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD. Eur J Psychotraumatol 2017; 8:1414560. [PMID: 29372007 PMCID: PMC5774399 DOI: 10.1080/20008198.2017.1414560] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/22/2017] [Indexed: 12/13/2022] Open
Abstract
Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) military personnel has created a significant behavioural healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. The current article presents the use of Virtual Reality (VR) as a clinical tool to address the assessment, prevention, and treatment of PTSD, based on the VR projects that were evolved at the University of Southern California Institute for Creative Technologies since 2004. A brief discussion of the definition and rationale for the clinical use of VR is followed by a description of a VR application designed for the delivery of prolonged exposure (PE) for treating Service Members (SMs) and Veterans with combat- and sexual assault-related PTSD. The expansion of the virtual treatment simulations of Iraq and Afghanistan for PTSD assessment and prevention is then presented. This is followed by a forward-looking discussion that details early efforts to develop virtual human agent systems that serve the role of virtual patients for training the next generation of clinical providers, as healthcare guides that can be used to support anonymous access to trauma-relevant behavioural healthcare information, and as clinical interviewers capable of automated behaviour analysis of users to infer psychological state. The paper will conclude with a discussion of VR as a tool for breaking down barriers to care in addition to its direct application in assessment and intervention.
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Affiliation(s)
- Albert ‘Skip’ Rizzo
- Institute for Creative Technologies, University of Southern California, Los Angeles, CA, USA
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Virtual Reality and Exposure Group Therapy for Social Anxiety Disorder: Results from a 4–6 Year Follow-Up. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9820-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Marshall J, Booth T, Devane N, Galliers J, Greenwood H, Hilari K, Talbot R, Wilson S, Woolf C. Evaluating the Benefits of Aphasia Intervention Delivered in Virtual Reality: Results of a Quasi-Randomised Study. PLoS One 2016; 11:e0160381. [PMID: 27518188 PMCID: PMC4982664 DOI: 10.1371/journal.pone.0160381] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 07/17/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION This study evaluated an intervention for people with aphasia delivered in a novel virtual reality platform called EVA Park. EVA Park contains a number of functional and fantastic locations and allows for interactive communication between multiple users. Twenty people with aphasia had 5 weeks' intervention, during which they received daily language stimulation sessions in EVA Park from a support worker. The study employed a quasi randomised design, which compared a group that received immediate intervention with a waitlist control group. Outcome measures explored the effects of intervention on communication and language skills, communicative confidence and feelings of social isolation. Compliance with the intervention was also explored through attrition and usage data. RESULTS There was excellent compliance with the intervention, with no participants lost to follow up and most (18/20) receiving at least 88% of the intended treatment dose. Intervention brought about significant gains on a measure of functional communication. Gains were achieved by both groups of participants, once intervention was received, and were well maintained. Changes on the measures of communicative confidence and feelings of social isolation were not achieved. Results are discussed with reference to previous aphasia therapy findings.
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Affiliation(s)
- Jane Marshall
- Division of Language and Communication Science, City University London, London, United Kingdom
| | - Tracey Booth
- Centre for Human Computer Interaction Design, City University London, London, United Kingdom
| | - Niamh Devane
- Division of Language and Communication Science, City University London, London, United Kingdom
| | - Julia Galliers
- Centre for Human Computer Interaction Design, City University London, London, United Kingdom
| | - Helen Greenwood
- Division of Language and Communication Science, City University London, London, United Kingdom
| | - Katerina Hilari
- Division of Language and Communication Science, City University London, London, United Kingdom
| | - Richard Talbot
- Division of Language and Communication Science, City University London, London, United Kingdom
| | - Stephanie Wilson
- Centre for Human Computer Interaction Design, City University London, London, United Kingdom
| | - Celia Woolf
- Division of Language and Communication Science, City University London, London, United Kingdom
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Laforest M, Bouchard S, Bossé J, Mesly O. Effectiveness of In Virtuo Exposure and Response Prevention Treatment Using Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Study Based on a Single-Case Study Protocol. Front Psychiatry 2016; 7:99. [PMID: 27378951 PMCID: PMC4904031 DOI: 10.3389/fpsyt.2016.00099] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/25/2016] [Indexed: 11/23/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is characterized by the presence of distressing, recurrent and intrusive thoughts, impulses, or doubts as well as behavioral or mental rituals. OCD has various subtypes, including the fear of contamination in which individuals fear bacteria, germs, disease, or bodily secretions, and engage in clinically significant cleaning and avoidance rituals. Cognitive-behavioral therapy (CBT) is an effective treatment for OCD and involves, among other therapeutic strategies, exposing patients to feared stimuli while preventing them to engage in compulsive behaviors. In recent years, virtual reality (VR) has shown the potential of in virtuo exposure with people suffering from anxiety disorders and OCD. The objective of this pilot study is to examine the effectiveness of a CBT program where exposure in conducted in virtuo. Three adults suffering from OCD with a dominant subtype of contamination were enrolled in a single-case design with multiple baselines across participants. The presence and intensity of obsessions and compulsions were assessed daily during baselines of 3-, 4-, or 5-week, and a 12-session treatment. Follow-up information was gathered after 4 and 8 months. Treatment outcome is assessed with visual inspection of the graphs and ARMA time-series analyses. Clinical information, self-reports, and details of the treatment are provided for each patient. Statistical analyses for the time-series data revealed a statistically significant improvement in all three participants, but global improvement is considered positive for only two. This study innovates in proving preliminary support for the usefulness of VR in the CBT of OCD with contamination features.
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Affiliation(s)
| | - Stéphane Bouchard
- University of Ottawa, Ottawa, ON, Canada; Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Jessie Bossé
- Université du Québec en Outaouais , Gatineau, QC , Canada
| | - Olivier Mesly
- Université du Québec en Outaouais, Gatineau, QC, Canada; Université Sainte-Anne, Pointe-de-l'Église, NS, Canada
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Kampmann IL, Emmelkamp PMG, Hartanto D, Brinkman WP, Zijlstra BJH, Morina N. Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial. Behav Res Ther 2015; 77:147-56. [PMID: 26752328 DOI: 10.1016/j.brat.2015.12.016] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 12/19/2015] [Accepted: 12/23/2015] [Indexed: 12/01/2022]
Abstract
This randomized controlled trial investigated the efficacy of a stand-alone virtual reality exposure intervention comprising verbal interaction with virtual humans to target heterogeneous social fears in participants with social anxiety disorder. Sixty participants (Mage = 36.9 years; 63.3% women) diagnosed with social anxiety disorder were randomly assigned to individual virtual reality exposure therapy (VRET), individual in vivo exposure therapy (iVET), or waiting-list. Multilevel regression analyses revealed that both treatment groups improved from pre-to postassessment on social anxiety symptoms, speech duration, perceived stress, and avoidant personality disorder related beliefs when compared to the waiting-list. Participants receiving iVET, but not VRET, improved on fear of negative evaluation, speech performance, general anxiety, depression, and quality of life relative to those on waiting-list. The iVET condition was further superior to the VRET condition regarding decreases in social anxiety symptoms at post- and follow-up assessments, and avoidant personality disorder related beliefs at follow-up. At follow-up, all improvements were significant for iVET. For VRET, only the effect for perceived stress was significant. VRET containing extensive verbal interaction without any cognitive components can effectively reduce complaints of generalized social anxiety disorder. Future technological and psychological improvements of virtual social interactions might further enhance the efficacy of VRET for social anxiety disorder.
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Affiliation(s)
- Isabel L Kampmann
- Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA, Amsterdam, The Netherlands.
| | - Paul M G Emmelkamp
- Netherlands Institute for Advanced Study, Meijboomlaan 1, 2242 PR, Wassenaar, The Netherlands; King Abdulaziz University, Abdullah Sulayman, 22254, Jeddah, Saudi Arabia
| | - Dwi Hartanto
- Interactive Intelligence Group, Delft University of Technology, Mekelweg 4, 2628 CD, Delft, The Netherlands
| | - Willem-Paul Brinkman
- Interactive Intelligence Group, Delft University of Technology, Mekelweg 4, 2628 CD, Delft, The Netherlands
| | - Bonne J H Zijlstra
- Department of Educational Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands
| | - Nexhmedin Morina
- Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA, Amsterdam, The Netherlands
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Loerinc AG, Meuret AE, Twohig MP, Rosenfield D, Bluett EJ, Craske MG. Response rates for CBT for anxiety disorders: Need for standardized criteria. Clin Psychol Rev 2015; 42:72-82. [DOI: 10.1016/j.cpr.2015.08.004] [Citation(s) in RCA: 290] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 07/17/2015] [Accepted: 08/12/2015] [Indexed: 11/26/2022]
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Shiban Y, Wittmann J, Weißinger M, Mühlberger A. Gradual extinction reduces reinstatement. Front Behav Neurosci 2015; 9:254. [PMID: 26441581 PMCID: PMC4569966 DOI: 10.3389/fnbeh.2015.00254] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/31/2015] [Indexed: 11/13/2022] Open
Abstract
The current study investigated whether gradually reducing the frequency of aversive stimuli during extinction can prevent the return of fear. Thirty-one participants of a three-stage procedure (acquisition, extinction and a reinstatement test on day 2) were randomly assigned to a standard extinction (SE) and gradual extinction (GE) procedure. The two groups differed only in the extinction procedure. While the SE group ran through a regular extinction process without any negative events, the frequency of the aversive stimuli during the extinction phase was gradually reduced for the GE group. The unconditioned stimulus (US) was an air blast (5 bar, 10 ms). A spider and a scorpion were used as conditioned stimuli (CS). The outcome variables were contingency ratings and physiological measures (skin conductance response, SCR and startle response). There were no differences found between the two groups for the acquisition and extinction phases concerning contingency ratings, SCR, or startle response. GE compared to SE significantly reduced the return of fear in the reinstatement test for the startle response but not for SCR or contingency ratings. This study was successful in translating the findings in rodent to humans. The results suggest that the GE process is suitable for increasing the efficacy of fear extinction.
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Affiliation(s)
- Youssef Shiban
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of RegensburgRegensburg, Germany
| | - Jasmin Wittmann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of RegensburgRegensburg, Germany
| | - Mara Weißinger
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of RegensburgRegensburg, Germany
| | - Andreas Mühlberger
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of RegensburgRegensburg, Germany
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Calamaras MR, Tully EC, Tone EB, Price M, Anderson PL. Evaluating changes in judgmental biases as mechanisms of cognitive-behavioral therapy for social anxiety disorder. Behav Res Ther 2015; 71:139-49. [PMID: 26140823 DOI: 10.1016/j.brat.2015.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 05/25/2015] [Accepted: 06/15/2015] [Indexed: 11/29/2022]
Abstract
Reductions in judgmental biases concerning the cost and probability of negative social events are presumed to be mechanisms of treatment for SAD. Methodological limitations of extant studies, however, leave open the possibility that, instead of causing symptom relief, reductions in judgmental biases are correlates or consequences of it. The present study evaluated changes in judgmental biases as mechanisms explaining the efficacy of CBT for SAD. Participants were 86 individuals who met DSM-IV-TR criteria for a primary diagnosis of SAD, participated in one of two treatment outcome studies of CBT for SAD, and completed measures of judgmental (i.e., cost and probability) biases and social anxiety at pre-, mid-, and posttreatment. Treated participants had significantly greater reductions in judgmental biases than not-treated participants; pre-to-post changes in cost and probability biases statistically mediated treatment outcome; and probability bias at midtreatment was a significant predictor of treatment outcome, even when modeled with a plausible rival mediator, working alliance. Contrary to hypotheses, cost bias at midtreatment was not a significant predictor of treatment outcome. Results suggest that reduction in probability bias is a mechanism by which CBT for SAD exerts its effects.
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Affiliation(s)
- Martha R Calamaras
- Georgia State University, Department of Psychology, P.O. Box 5010, Atlanta, GA, 30302-5010, USA; Emory University, Department of Psychiatry and Behavioral Sciences, Grady Health System, 80 Jesse Hill Jr. Drive SE, Atlanta, GA, 30303, USA
| | - Erin C Tully
- Georgia State University, Department of Psychology, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Erin B Tone
- Georgia State University, Department of Psychology, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Matthew Price
- Georgia State University, Department of Psychology, P.O. Box 5010, Atlanta, GA, 30302-5010, USA; University of Vermont, Department of Psychology, 2 Colchester Ave, Burlington, VT, 05405, USA
| | - Page L Anderson
- Georgia State University, Department of Psychology, P.O. Box 5010, Atlanta, GA, 30302-5010, USA.
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Abstract
A rather large body of literature now exists on the use of telemental health services in the diagnosis and management of various psychiatric conditions. This review aims to provide an up-to-date assessment of telemental health, focusing on four main areas: computerized CBT (cCBT), Internet-based CBT (iCBT), virtual reality exposure therapy (VRET), and mobile therapy (mTherapy). Four scientific databases were searched and, where possible, larger, better-designed meta-analyses and controlled trials were highlighted. Taken together, published studies support an expanded role for telepsychiatry tools, with advantages that include increased care access, enhanced efficiency, reduced stigma associated with visiting mental health clinics, and the ability to bypass diagnosis-specific obstacles to treatment, such as when social anxiety prevents a patient from leaving the house. Of technology-mediated therapies, cCBT and iCBT possess the most efficacy evidence, with VRET and mTherapy representing promising but less researched options that have grown in parallel with virtual reality and mobile technology advances. Nonetheless, telepsychiatry remains challenging because of the need for specific computer skills, the difficulty in providing patients with a deep understanding or support, concerns about the "therapeutic alliance", privacy fears, and the well documented problem of patient attrition. Future studies should further test the efficacy, advantages and limitations of technology-enabled CBT, as well as explore the online delivery of other psychotherapeutic and psychopharmacological modalities.
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Affiliation(s)
- Elias Aboujaoude
- OCD Clinic, Stanford University School of MedicineStanford, CA, USA
| | - Wael Salame
- Department of Psychiatry, Lebanese American UniversityBeirut, Lebanon
| | - Lama Naim
- Department of Psychiatry, Lebanese American UniversityBeirut, Lebanon
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Brundage SB, Hancock AB. Real enough: using virtual public speaking environments to evoke feelings and behaviors targeted in stuttering assessment and treatment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2015; 24:139-149. [PMID: 25569429 DOI: 10.1044/2014_ajslp-14-0087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 10/20/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE Virtual reality environments (VREs) are computer-generated, 3-dimensional worlds that allow users to experience situations similar to those encountered in the real world. The purpose of this study was to investigate VREs for potential use in assessing and treating persons who stutter (PWS) by determining the extent to which PWS's affective, behavioral, and cognitive measures in a VRE correlate with those same measures in a similar live environment. METHOD Ten PWS delivered speeches-first to a live audience and, on another day, to 2 virtual audiences (neutral and challenging audiences). Participants completed standard tests of communication apprehension and confidence prior to each condition, and frequency of stuttering was measured during each speech. RESULTS Correlational analyses revealed significant, positive correlations between virtual and live conditions for affective and cognitive measures as well as for frequency of stuttering. CONCLUSIONS These findings suggest that virtual public speaking environments engender affective, behavioral, and cognitive reactions in PWS that correspond to those experienced in the real world. Therefore, the authentic, safe, and controlled environments provided by VREs may be useful for stuttering assessment and treatment.
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Salanitri D, Hare C, Borsci S, Lawson G, Sharples S, Waterfield B. Relationship Between Trust and Usability in Virtual Environments: An Ongoing Study. HUMAN-COMPUTER INTERACTION: DESIGN AND EVALUATION 2015. [DOI: 10.1007/978-3-319-20901-2_5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Aymerich-Franch L, Kizilcec RF, Bailenson JN. The Relationship between Virtual Self Similarity and Social Anxiety. Front Hum Neurosci 2014; 8:944. [PMID: 25477810 PMCID: PMC4237051 DOI: 10.3389/fnhum.2014.00944] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 11/05/2014] [Indexed: 01/04/2023] Open
Abstract
In virtual reality (VR), it is possible to embody avatars that are dissimilar to the physical self. We examined whether embodying a dissimilar self in VR would decrease anxiety in a public speaking situation. We report the results of an observational pilot study and two laboratory experiments. In the pilot study (N = 252), participants chose an avatar to use in a public speaking task. Trait public speaking anxiety correlated with avatar preference, such that anxious individuals preferred dissimilar self-representations. In Study 1 (N = 82), differences in anxiety during a speech in front of a virtual audience were compared among participants embodying an assigned avatar whose face was identical to their real self, an assigned avatar whose face was other than their real face, or embodied an avatar of their choice. Anxiety differences were not significant, but there was a trend for lower anxiety with the assigned dissimilar avatar compared to the avatar looking like the real self. Study 2 (N = 105) was designed to explicate that trend, and further investigated anxiety differences with an assigned self or dissimilar avatar. The assigned dissimilar avatar reduced anxiety relative to the assigned self avatar for one measure of anxiety. We discuss implications for theories of self-representation as well as for applied uses of VR to treat social anxiety.
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Affiliation(s)
- Laura Aymerich-Franch
- Virtual Human Interaction Lab, Department of Communication, Stanford University, Stanford, CA, USA
| | - René F. Kizilcec
- Virtual Human Interaction Lab, Department of Communication, Stanford University, Stanford, CA, USA
| | - Jeremy N. Bailenson
- Virtual Human Interaction Lab, Department of Communication, Stanford University, Stanford, CA, USA
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