Virtual Reality and Anxiety Disorders Treatment: Evolution and Future Perspectives

Using 360-degree immersive videos to assess multiple transdiagnostic symptoms: A study focusing on fear of negative evaluation, paranoid thoughts, negative automatic thoughts, and craving

Over the last 20 years, virtual reality (VR) has gained a great interest for both assessment and treatment of various psychopathologies. However, due to high costs and material specificity, VR remains disadvantageous for clinicians. Adopting a multiple transdiagnostic approach, this study aims at testing the validity of a 360-degree immersive video (360IV) for the assessment of five common psychological symptoms (fear of negative evaluation, paranoid thoughts, negative automatic thoughts, craving for alcohol and for nicotine). A 360IV was constructed in the Darius Café and included actors behaving naturally. One hundred and fifty-eight adults from the general population were assessed in terms of their proneness towards the five symptoms, were then exposed to the 360IV and completed measures for the five state symptoms, four dimensions of presence (place, plausibility, copresence and social presence illusions) and cybersickness. Results revealed that the five symptoms occurred during the immersion and were predicted by the participants' proneness towards these symptoms. The 360IV was also able to elicit various levels of the four dimensions of presence while producing few cybersickness. The present study provides evidence supporting the use of the 360IV as a new accessible, ecological, and standardized tool to assess multiple transdiagnostic symptoms.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10055-023-00779-y.

Adults with Animal Phobia: Systematic Replication of Clinical Cases

Animal phobia is common in children, but it is also frequent in adults who maintain the problem throughout their lives. Eleven cases of animal phobia that were treated with progressive multimedia exposure are presented. The participants were two men and nine women (aged 19–27 years), with anxiety and avoidance problems in relation to various animals. A single-case A-B-Follow-up design was carried out, with concurrent control of several baselines; and a systematic between-subjects replication, with the same treatment repeated across different participants and types of phobias. A behavioural interview, phobia questionnaires, and Multimedia Behavioural Avoidance Test (M-BAT) with pictures and videos of animals, as well as heart rate, were used for assessment purposes. The intervention was the progressive multimedia exposure in four phases (photographs, videos, simulated animals, and live exposure), in addition to diaphragmatic breathing, and homework assignments. The results replicate the same efficacy in each of the participants, with statistically significant and clinical changes in their daily lives. Also, the data as a group show this success with a high Cohen's d effect size (between −1.63 and −30.03). We conclude with an appraisal of the usefulness of the procedure for adults with phobias who do not tolerate direct exposure.

A Decade in Review: A Systematic Review of Virtual Reality Interventions for Emotional Disorders

Research is increasingly demonstrating the therapeutic benefits of virtual reality interventions for various mental health conditions, though these rarely translate from research to application in clinical settings. This systematic review aims to examine the efficacy of current virtual reality interventions for emotional disorders, with a focus on clinical and technological features that influence translation of treatments from research to clinical practice. A comprehensive systematic literature search was conducted following PRISMA guidelines, for studies including the application of a virtual reality intervention to a clinical population of adults with an emotional disorder. Thirty-seven eligible studies were identified, appraised, and assessed for bias. Treatment effects were typically large across studies, with virtual reality being considered an efficacious treatment modality for various anxiety disorders and post-traumatic stress disorder. Virtual reality interventions were typically used for delivering exposure in cognitive behavioural therapy approaches. Considerable variability was seen in cost, technological specifications, degree of therapist involvement, delivery format, dosage, duration, and frequency of treatment. Suboptimal methodological rigour was identified in some studies. Remote use of virtual reality was rare, despite increasing options for in home use. Virtual reality interventions have the potential to overcome barriers to care and better meet the needs of consumers. Future research should examine the efficacy of virtual reality for treatment of depressive disorders and obsesive compulsive disorder. Improved methodological reporting and development of transdiagnostic and remotely delivered virtual reality interventions, will likely increase the translation of this treatment modality.

Effectiveness of virtual reality as a distraction on anxiety and pain during impacted mandibular third molar surgery under local Anesthesia

OBJECTIVE

The aim of this study was to assess the effectiveness of Virtual Reality (VR) in reducing anxiety and pain during impacted mandibular third molar extraction under local anesthesia.

METHODS

The study was designed as a prospective clinical study covering 74 respondents over 20 years of age. Surgical extraction of both impacted mandibular third molars was performed in two phases, two weeks apart. In the first phase, surgical extraction of the tooth was performed following the standard procedure (Non VR), and in the second phase (VR), we used VR goggles as an auxiliary tool for distraction during the procedure. Face scale was used to assess the level of pain. Heart rate values were recorded by means of wristbands. After both procedures, the patients filled out a modified post-clinical satisfaction questionnaire.

RESULTS

During the procedure with VR goggles, the respondents had significantly lower pain values during the application of anesthesia, as well as during the surgical extraction of the third molar. There was no statistically significant difference in the level of pain during both surgical procedures with regard to the gender and age. Heart rate values in both phases of the study were not significantly different before the application of anesthesia. When VR goggles were used, the respondents had significantly lower heart rate values before the procedure, as well as during the procedure. Analysis of answers to the post-clinical questionnaire measuring satisfaction with VR technology shows that over 90% of respondents did not experience any VR-related discomfort during the surgery.

CONCLUSIONS

The VR distraction concept applied during impacted third molar surgery under local anesthesia can help reduce the patients' anxiety and acute pain levels.