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Williams LA, Tzelios K, Masser B, Thijsen A, van Dongen A, Davison TE. A virtual reality paradigm simulating blood donation serves as a platform to test interventions to promote donation. Sci Rep 2024; 14:10334. [PMID: 38710774 DOI: 10.1038/s41598-024-60578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024] Open
Abstract
Effective interventions that support blood donor retention are needed. Yet, integrating an intervention into the time-pressed and operationally sensitive context of a blood donation center requires justification for disruptions to an optimized process. This research provides evidence that virtual reality (VR) paradigms can serve as a research environment in which interventions can be tested prior to being delivered in blood donation centers. Study 1 (N = 48) demonstrated that 360°-video VR blood donation environments elicit a similar profile of emotional experience to a live donor center. Presence and immersion were high, and cybersickness symptoms low. Study 2 (N = 134) was an experiment deploying the 360°-video VR environments to test the impact of an intervention on emotional experience and intentions to donate. Participants in the intervention condition who engaged in a suite of tasks drawn from the process model of emotion regulation (including attentional deployment, positive reappraisal, and response modulation) reported more positive emotion than participants in a control condition, which in turn increased intentions to donate blood. By showing the promise for benefitting donor experience via a relatively low-cost and low-resource methodology, this research supports the use of VR paradigms to trial interventions prior to deployment in operationally-context field settings.
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Affiliation(s)
| | | | - Barbara Masser
- School of Psychology, The University of Queensland, Brisbane, Australia
- Strategy and Growth, Australian Red Cross Lifeblood, Melbourne, Australia
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Amanda Thijsen
- Strategy and Growth, Australian Red Cross Lifeblood, Melbourne, Australia
| | - Anne van Dongen
- Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands
| | - Tanya E Davison
- Monash Art, Design and Architecture, Monash University, Melbourne, Australia
- Research and Innovation, Silverchain, Melbourne, Australia
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Smith LC, Mateos AC, Due AS, Bergström J, Nordentoft M, Clemmensen L, Glenthøj LB. Immersive virtual reality in the treatment of auditory hallucinations: A PRISMA scoping review. Psychiatry Res 2024; 334:115834. [PMID: 38452499 DOI: 10.1016/j.psychres.2024.115834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND A large group of psychiatric patients suffer from auditory hallucinations (AH) despite relevant treatment regimens. In mental health populations, AH tend to be verbal (AVH) and the content critical or abusive. Trials employing immersive virtual reality (VR) to treat mental health disorders are emerging. OBJECTIVE The aim of this scoping review is to provide an overview of clinical trials utilizing VR in the treatment of AH and to document knowledge gaps in the literature. METHODS PubMed, Cochrane Library, and Embase were searched for studies reporting on the use of VR to target AH. RESULTS 16 papers were included in this PRISMA scoping review (ScR). In most studies VR therapy (VRT) was employed to ameliorate treatment resistant AVH in schizophrenia spectrum disorders. Only two studies included patients with a diagnosis of affective disorders. The VRT was carried out with the use of an avatar to represent the patient's most dominant voice. DISCUSSION The research field employing VR to treat AH is promising but still in its infancy. Results from larger randomized clinical trials are needed to establish substantial evidence of therapy effectiveness. Additionally, the knowledge base would benefit from more profound qualitative data exploring views of patients and therapists.
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Affiliation(s)
- Lisa Charlotte Smith
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; Department of Clinical Medicine (DK), University of Copenhagen, Denmark.
| | - Ana Collados Mateos
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
| | - Anne Sofie Due
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
| | - Joanna Bergström
- Department of Computer Science (DK), University of Copenhagen, Denmark
| | - Merete Nordentoft
- Department of Clinical Medicine (DK), University of Copenhagen, Denmark; Research Unit (CORE), Capital Region (DK), Mental Health Center Copenhagen, Denmark
| | - Lars Clemmensen
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
| | - Louise Birkedal Glenthøj
- VIRTU Research Group, Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; Department of Psychology (DK), University of Copenhagen, Denmark
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Andersson J, Hallin J, Tingström A, Knutsson J. Virtual reality exposure therapy for fear of spiders: an open trial and feasibility study of a new treatment for arachnophobia. Nord J Psychiatry 2024; 78:128-136. [PMID: 38295831 DOI: 10.1080/08039488.2023.2279643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/11/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE This analogue pilot study examined the feasibility (i.e. preliminary results, safety, acceptability) of a new single-session treatment for adults with a fear of spiders. MATERIALS It used state-of-the-art consumer available VR-hardware for therapist-assisted exposure (VRET-AP). The VRET-AP is largely adapted from Öst's one-session treatment for arachnophobia (Öst, 1987), with the aim of addressing shortcomings of previous VRET treatments, such as marked differences in procedures compared to available and evidence based in-vivo treatments. METHOD Participants (N = 12) were screened for fear of spiders using the Spider Phobia Questionnaire (SPQ), Fear Questionnaire (FQ) and the Behavioral Approach Test (BAT), prior to and directly after treatment in a repeated measures quasi-experimental design. In addition, acceptance and completion rates were measured and participants were interviewed about their experience of the treatment. Mean ratings as well as Reliable Change Index (RCI) for individual trajectories were analyzed. RESULTS The results from the preliminary data indicates potential for improvements with large effect sizes (d = 0.90-1,384) in all measurements of spider fear at post-treatment. Reliable Change Index (RCI) analysis showed that spider fear diminished in all twelve participants although the change was certain in only two. None deteriorated. All that responded accepted the treatment and all 11 participants completed all levels in the treatment. No concerns or adverse effects were reported in the interviews which largely confirm the quantitative results. CONCLUSION VRET-AP is a feasible alternative for delivering effective treatment for fear of spiders and the results motivate larger, randomized trials of VRET-AP involving participants diagnosed with arachnophobia.
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Affiliation(s)
| | - Joel Hallin
- Department of Psychiatry, Lund University, Lund, Sweden
| | | | - Jens Knutsson
- Department of Psychology, Lund University, Lund, Sweden
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Stern E, Micoulaud Franchi JA, Dumas G, Moreira J, Mouchabac S, Maruani J, Philip P, Lejoyeux M, Geoffroy PA. How Can Digital Mental Health Enhance Psychiatry? Neuroscientist 2023; 29:681-693. [PMID: 35658666 DOI: 10.1177/10738584221098603] [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: 11/17/2022]
Abstract
The use of digital technologies is constantly growing around the world. The wider-spread adoption of digital technologies and solutions in the daily clinical practice in psychiatry seems to be a question of when, not if. We propose a synthesis of the scientific literature on digital technologies in psychiatry and discuss the main aspects of its possible uses and interests in psychiatry according to three domains of influence that appeared to us: 1) assist and improve current care: digital psychiatry allows for more people to have access to care by simply being more accessible but also by being less stigmatized and more convenient; 2) develop new treatments: digital psychiatry allows for new treatments to be distributed via apps, and practical guidelines can reduce ethical challenges and increase the efficacy of digital tools; and 3) produce scientific and medical knowledge: digital technologies offer larger and more objective data collection, allowing for more detection and prevention of symptoms. Finally, ethical and efficacy issues remain, and some guidelines have been put forth on how to safely use these solutions and prepare for the future.
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Affiliation(s)
- Emilie Stern
- GHU Paris-Psychiatrie & Neurosciences, Paris, France
| | - Jean-Arthur Micoulaud Franchi
- University of Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Guillaume Dumas
- CHU Sainte-Justine Research Center, Department of Psychiatry, University of Montreal, Quebec, Canada
- Mila-Quebec Artificial Intelligence Institute, University of Montreal, Quebec, Canada
| | | | - Stephane Mouchabac
- Department of Psychiatry, Department of Psychiatry Hôpital Saint Antoine-APHP, Sorbonne University, Paris, France
- Infrastructure of Clinical Research in Neurosciences-Psychiatry, Brain and Spine Institute (ICM), Inserm, Sorbonne University, Paris, France
| | - Julia Maruani
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
- Université de Paris, NeuroDiderot, Inserm U1141, F-75019, Paris, France
| | - Pierre Philip
- University of Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Michel Lejoyeux
- GHU Paris-Psychiatrie & Neurosciences, Paris, France
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
- Université de Paris, NeuroDiderot, Inserm U1141, F-75019, Paris, France
| | - Pierre A Geoffroy
- GHU Paris-Psychiatrie & Neurosciences, Paris, France
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
- Université de Paris, NeuroDiderot, Inserm U1141, F-75019, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
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Bond RR, Mulvenna MD, Potts C, O'Neill S, Ennis E, Torous J. Digital transformation of mental health services. NPJ MENTAL HEALTH RESEARCH 2023; 2:13. [PMID: 38609479 PMCID: PMC10955947 DOI: 10.1038/s44184-023-00033-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 07/26/2023] [Indexed: 04/14/2024]
Abstract
This paper makes a case for digital mental health and provides insights into how digital technologies can enhance (but not replace) existing mental health services. We describe digital mental health by presenting a suite of digital technologies (from digital interventions to the application of artificial intelligence). We discuss the benefits of digital mental health, for example, a digital intervention can be an accessible stepping-stone to receiving support. The paper does, however, present less-discussed benefits with new concepts such as 'poly-digital', where many different apps/features (e.g. a sleep app, mood logging app and a mindfulness app, etc.) can each address different factors of wellbeing, perhaps resulting in an aggregation of marginal gains. Another benefit is that digital mental health offers the ability to collect high-resolution real-world client data and provide client monitoring outside of therapy sessions. These data can be collected using digital phenotyping and ecological momentary assessment techniques (i.e. repeated mood or scale measures via an app). This allows digital mental health tools and real-world data to inform therapists and enrich face-to-face sessions. This can be referred to as blended care/adjunctive therapy where service users can engage in 'channel switching' between digital and non-digital (face-to-face) interventions providing a more integrated service. This digital integration can be referred to as a kind of 'digital glue' that helps join up the in-person sessions with the real world. The paper presents the challenges, for example, the majority of mental health apps are maybe of inadequate quality and there is a lack of user retention. There are also ethical challenges, for example, with the perceived 'over-promotion' of screen-time and the perceived reduction in care when replacing humans with 'computers', and the trap of 'technological solutionism' whereby technology can be naively presumed to solve all problems. Finally, we argue for the need to take an evidence-based, systems thinking and co-production approach in the form of stakeholder-centred design when developing digital mental health services based on technologies. The main contribution of this paper is the integration of ideas from many different disciplines as well as the framework for blended care using 'channel switching' to showcase how digital data and technology can enrich physical services. Another contribution is the emergence of 'poly-digital' and a discussion on the challenges of digital mental health, specifically 'digital ethics'.
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Affiliation(s)
| | | | | | | | - Edel Ennis
- School of Psychology, Ulster University, Coleraine, UK
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Patil S, Awan KH, Licari FW. Breaking barriers: immersive virtual reality for dental treatment in autism spectrum children. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00816-z. [PMID: 37329445 DOI: 10.1007/s40368-023-00816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Affiliation(s)
- S Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA.
| | - K H Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA
| | - F W Licari
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA
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Hernandez R, Wilund K, Solai K, Tamayo D, Fast D, Venkatesan P, Lash JP, Lora CM, Martinez L, Martin Alemañy G, Martinez A, Kwon S, Romero D, Browning MHEM, Moskowitz JT. Positive Psychological Intervention Delivered Using Virtual Reality in Patients on Hemodialysis With Comorbid Depression: Protocol and Design for the Joviality Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e45100. [PMID: 37327026 DOI: 10.2196/45100] [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: 02/10/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Depression is highly prevalent in individuals on hemodialysis, but it is infrequently identified and remains undertreated. In this paper, we present details of the methodology of a randomized controlled trial (RCT) aimed at testing the feasibility and preliminary efficacy of a 5-week positive psychological intervention in individuals on hemodialysis with comorbid depression delivered using immersive virtual reality (VR) technology. OBJECTIVE We aim to describe the protocol and design of the Joviality trial whose main objectives are 2-fold: determine the feasibility of the Joviality VR software through metrics capturing rates of recruitment, refusal, retention, noncompliance, and adherence, as well as end-user feedback; and assess preliminary efficacy for outcomes measures of depressive symptoms, psychological well-being and distress, quality of life, treatment adherence, clinical biomarkers, and all-cause hospitalizations. METHODS This 2-arm RCT is scheduled to enroll 84 individuals on hemodialysis with comorbid depression from multiple outpatient centers in Chicago, Illinois, United States. Enrollees will be randomized to the following groups: VR-based Joviality positive psychological intervention or sham VR (2D wildlife footage and nature-based settings with inert music presented using a head-mounted display). To be eligible, individuals must be on hemodialysis for at least 3 months, have Beck Depression Inventory-II scores of ≥11 (ie, indicative of mild-to-severe depressive symptoms), be aged ≥21 years, and be fluent in English or Spanish. The Joviality VR software was built using agile design principles and incorporates fully immersive content, digital avatars, and multiplex features of interactability. Targeted skills of the intervention include noticing positive events, positive reappraisal, gratitude, acts of kindness, and mindful or nonjudgmental awareness. The primary outcomes include metrics of feasibility and acceptability, along with preliminary efficacy focused on decreasing symptoms of depression. The secondary and tertiary outcomes include quality of life, treatment adherence, clinical biomarkers, and all-cause hospitalization rates. There are 4 assessment time points: baseline, immediately after the intervention, 3 months after the intervention, and 6 months after the intervention. We hypothesize that depressive symptoms and hemodialysis-related markers of disease will substantially improve in participants randomized to the VR-based Joviality positive psychology treatment arm compared with those in the attention control condition. RESULTS This RCT is funded by the National Institute of Diabetes and Digestive and Kidney Diseases and is scheduled to commence participant recruitment in June 2023. CONCLUSIONS This trial will be the first to test custom-built VR software to deliver a positive psychological intervention, chairside, in individuals on hemodialysis to reduce symptoms of depression. Within the context of an RCT using an active control arm, if proven effective, VR technology may become a potent tool to deliver mental health programming in clinical populations during their outpatient treatment sessions. TRIAL REGISTRATION ClinicalTrials.gov NCT05642364; https://clinicaltrials.gov/ct2/show/NCT05642364. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/45100.
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Affiliation(s)
- Rosalba Hernandez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Ken Wilund
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Killivalavan Solai
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - David Tamayo
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Drew Fast
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Prasakthi Venkatesan
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - James P Lash
- Division of Nephrology, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Claudia M Lora
- Division of Nephrology, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Lizet Martinez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Geovana Martin Alemañy
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Angela Martinez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Soonhyung Kwon
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Dana Romero
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Chowdhury N, Khandoker AH. The gold-standard treatment for social anxiety disorder: A roadmap for the future. Front Psychol 2023; 13:1070975. [PMID: 36755980 PMCID: PMC9901528 DOI: 10.3389/fpsyg.2022.1070975] [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: 10/15/2022] [Accepted: 11/30/2022] [Indexed: 01/19/2023] Open
Abstract
Exposure therapy (ET), which follows the Pavlovian extinction model, is regarded as the gold-standard treatment for social anxiety disorder (SAD). The prospect of virtual reality in lieu of a traditional laboratory setting for the treatment of SAD has not been rigorously explored. The aim of the review was to summarize, find gaps in the current literature, and formulate future research direction by identifying two broad research questions: the comparative efficacy between in vivo ET and virtual reality exposure therapy (VRET) and the effectiveness of the Pavlovian extinction model in treating SAD. The criteria for effectiveness were effect size, relapse prevention, attrition rate and ecological validity. A literature search on recent randomized controlled trials yielded a total of 6 original studies (N=358), excluding duplication and overlapping participants. All studies supported that VRET was as effective as in vivo ET. Behavioral therapy that follows classical conditioning principles has a high attrition and relapse rate. Comparisons were drawn between the efficacy of the Pavlovian extinction model and other existing models, including third-wave approaches. The neural markers are suggested to be included as efficacy measures in treating SAD. The gold-standard treatment for SAD requires a paradigm shift through rigorous longitudinal comparative studies.
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Affiliation(s)
- Nayeefa Chowdhury
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, Australia,*Correspondence: Nayeefa Chowdhury, ✉
| | - Ahsan H. Khandoker
- Healthcare Engineering Innovation Center, Department of Biomedical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
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Cuijpers P, Miguel C, Ciharova M, Ebert D, Harrer M, Karyotaki E. Transdiagnostic treatment of depression and anxiety: a meta-analysis. Psychol Med 2023; 53:1-12. [PMID: 36606456 PMCID: PMC10600931 DOI: 10.1017/s0033291722003841] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/26/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND In the past 10 years an increasing number of randomised trials have examined the effects of transdiagnostic treatments of patients with depression or anxiety. We conducted the first comprehensive meta-analysis of the outcomes of this emerging field. METHODS We used the searches in PubMed, PsychINFO, Embase and the Cochrane library of an existing database of randomised trials of psychological interventions for depression to identify studies comparing a transdiagnostic treatment of patients with depression or anxiety with a control group (deadline 1 January 2022). We conducted random-effects meta-analyses and examined the effects on depression and anxiety at the short and longer term. RESULTS We included 45 randomised controlled trials with 51 comparisons between a psychotherapy and a control group and 5530 participants. Thirty-five (78%) studies were conducted in the last 10 years. The overall effect size was g = 0.54 (95% CI 0.40-0.69; NNT = 5.87), with high heterogeneity (I2 = 78; 95% CI 71-83), and a broad PI (-0.31-1.39). The effects remained significant in a series of sensitivity analyses, including exclusion of outliers, adjustment for publication bias, for studies with low risk of bias, and in multilevel analyses. The results were comparable for depression and anxiety separately. At 6 months after randomisation the main effects were still significant, but not at 12 months, although the number of studies was small. CONCLUSIONS Transdiagnostic treatments of patients with depression or anxiety are increasingly examined and are probably effective at the short term.
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Affiliation(s)
- Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David Ebert
- Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany
| | - Mathias Harrer
- Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany
- Clinical Psychology & Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Helou S, Khalil N, Daou M, El Helou E. Virtual reality for healthcare: A scoping review of commercially available applications for head-mounted displays. Digit Health 2023; 9:20552076231178619. [PMID: 37312952 PMCID: PMC10259138 DOI: 10.1177/20552076231178619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 05/11/2023] [Indexed: 06/15/2023] Open
Abstract
Objective This scoping review aimed to describe the scope of commercially available virtual reality (VR) healthcare applications for mainstream head-mounted displays (HMD)s. Methods A search was conducted during late April and early May 2022 over five major VR app stores using "health," "healthcare," "medicine," and "medical" as keywords. Apps were screened based on their title and description sections. Metadata collected included: title, description, release date, price (free or paid), multilingual support, VR app store availability, and HMD support. Results The search yielded 1995 apps, out of which 60 met the inclusion criteria. The analysis showed that the number of healthcare VR apps has been steadily increasing since 2016, but no developer has released more than two apps so far. Most of the reviewed apps can run on HTC Vive, Oculus Quest, and Valve Index. Thirty-four (56.7%) apps had a free version, and 12 (20%) apps were multilingual, i.e., supported languages other than English. The reviewed apps fell into eight major themes: life science education (3D anatomy, physiology and pathology, biochemistry, and genetics); rehabilitation (physical, mental, and phobia therapy); public health training (safety, life-saving skills, and management); medical training (surgical and patient simulators); role-playing as a patient; 3D medical imagery viewing; children's health; and online health communities. Conclusions Although commercial healthcare VR is still in its early phases, end-users can already access a broad range of healthcare VR apps on mainstream HMDs. Further research is needed to assess the usefulness and usability of existing apps.
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Affiliation(s)
- Samar Helou
- Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Nour Khalil
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Melissa Daou
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Elie El Helou
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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Uddin MN, Emran TB. Prevention of Progression and Remission in Public Health Sectors: Bangladesh Perspectives. ATLANTIS HIGHLIGHTS IN CHEMISTRY AND PHARMACEUTICAL SCIENCES 2023:131-150. [DOI: 10.2991/978-94-6463-130-2_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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12
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Sadeghi S, Daziano R, Yoon SY, Anderson AK. Affective experience in a virtual crowd regulates perceived travel time. VIRTUAL REALITY 2022; 27:1051-1061. [PMID: 36348940 PMCID: PMC9632586 DOI: 10.1007/s10055-022-00713-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 10/19/2022] [Indexed: 06/05/2023]
Abstract
Time sometimes feels like it is flying by or slowing down. Previous research indicates objective number of items, subjective affect, and heart rate all can influence the experience of time. While these factors are usually tested in isolation with simple stimuli in the laboratory, here we examined them together in the ecological context of a virtual subway ride. We hypothesized that subjective affective experience associated with objective crowding lengthens subjective trip duration. Participants (N = 41) experienced short (1-2 min) immersive virtual reality subway trips with different levels of public crowding. Consistent with the immersive nature of decreased interpersonal virtual space, increased crowding decreased pleasantness and increased the unpleasantness of a trip. Virtual crowding also lengthened perceived trip duration. The presence of one additional person per square meter of the train significantly increased perceived travel time by an average of 1.8 s. Degree of pleasant relative to unpleasant affect mediated why crowded trips felt longer. Independently of crowding and affect, heart rate changes were related to experienced trip time. These results demonstrate socioemotional regulation of the experience of time and that effects of social crowding on perception and affect can be reliably created during a solitary virtual experience. This study demonstrates a novel use of Virtual Reality technology for testing psychological theories in ecologically valid and highly controlled settings. Supplementary Information The online version contains supplementary material available at 10.1007/s10055-022-00713-8.
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Affiliation(s)
- Saeedeh Sadeghi
- Department of Psychology, Cornell University, Ithaca, NY USA
| | - Ricardo Daziano
- School of Civil and Environmental Engineering, Cornell University, Ithaca, NY USA
| | - So-Yeon Yoon
- Department of Design and Environmental Analysis, Cornell University, Ithaca, NY USA
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13
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Vlake JH, van Bommel J, Wils EJ, Korevaar TI, Taccone F, Schut AF, Elderman JH, Labout JA, Raben AM, Dijkstra A, Achterberg S, Jurriens AL, Van Mol MM, Gommers D, Van Genderen ME. Effect of intensive care unit-specific virtual reality (ICU-VR) to improve psychological well-being in ICU survivors: study protocol for an international, multicentre, randomised controlled trial-the HORIZON-IC study. BMJ Open 2022; 12:e061876. [PMID: 36127077 PMCID: PMC9490570 DOI: 10.1136/bmjopen-2022-061876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION A substantial proportion of intensive care unit (ICU) survivors develop psychological impairments after ICU treatment, part of the postintensive care syndrome, resulting in a decreased quality of life. Recent data suggest that an ICU-specific virtual reality intervention (ICU-VR) for post-ICU patients is feasible and safe, improves satisfaction with ICU aftercare, and might improve psychological sequelae. In the present trial, we firstly aim to determine whether ICU-VR is effective in mitigating post-traumatic stress disorder (PTSD)-related symptoms and secondly to determine the optimal timing for initiation with ICU-VR. METHODS AND ANALYSIS This international, multicentre, randomised controlled trial will be conducted in 10 hospitals. Between December 2021 and April 2023, we aim to include 300 patients who have been admitted to the ICU ≥72 hours and were mechanically ventilated ≥24 hours. Patients will be followed for 12 consecutive months. Patients will be randomised in a 1:1:1 ratio to the early ICU-VR group, the late ICU-VR group, or the usual care group. All patients will receive usual care, including a mandatory ICU follow-up clinic visit 3 months after ICU discharge. Patients in the early ICU-VR group will receive ICU-VR within 2 weeks after ICU discharge. Patients in the late VR group will receive ICU-VR during the post-ICU follow-up visit. The primary objective is to assess the effect of ICU-VR on PTSD-related symptoms. Secondary objectives are to determine optimal timing for ICU-VR, to assess the effects on anxiety-related and depression-related symptoms and health-related quality of life, and to assess patient satisfaction with ICU aftercare and perspectives on ICU-VR. ETHICS AND DISSEMINATION The Medical Ethics Committee United, Nieuwegein, the Netherlands, approved this study and local approval was obtained from each participating centre (NL78555.100.21). Our findings will be disseminated by presentation of the results at (inter)national conferences and publication in scientific, peer-reviewed journals. TRIAL REGISTRATION NUMBER NL9812.
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Affiliation(s)
- Johan Hendrik Vlake
- Intensive Care, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
- Intensive Care, Franciscus Gasthuis en Vlietland, Rotterdam, Zuid-Holland, Netherlands
| | | | - Evert-Jan Wils
- Intensive Care, Franciscus Gasthuis en Vlietland, Rotterdam, Zuid-Holland, Netherlands
| | - Tim Im Korevaar
- Internal Medicine, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
- Academic Centre for Thyroid Diseases, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
| | - Fabio Taccone
- Intensive Care, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Anna Fc Schut
- Intensive Care, Ikazia Hospital, Rotterdam, Zuid-Holland, Netherlands
| | - Jan H Elderman
- Intensive Care, IJsselland Hospital, Capelle aan den IJssel, Zuid-Holland, Netherlands
| | - Joost Am Labout
- Intensive Care, Maasstad Hospital, Rotterdam, Zuid-Holland, Netherlands
| | - Adrienne Mtj Raben
- Intensive Care, Groene Hart Ziekenhuis, Gouda, Zuid-Holland, Netherlands
| | - Annemieke Dijkstra
- Intensive Care, Van Weel-Bethesda Hospital, Middelharnis, Goeree-Overflakkee, Netherlands
| | | | - Amber L Jurriens
- Intensive Care, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
| | - Margo Mc Van Mol
- Intensive Care, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
| | - Diederik Gommers
- Intensive Care, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
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14
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Preston AM, Brown L, Padala KP, Padala PR. Veterans Affairs Health Care Provider Perceptions of Virtual Reality: Brief Exploratory Survey. Interact J Med Res 2022; 11:e38490. [PMID: 36053568 PMCID: PMC9482067 DOI: 10.2196/38490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/01/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022] Open
Abstract
Background Virtual reality (VR), a simulated experience that can be similar to or completely different from the real world, has become increasingly useful within the psychiatric and medical fields. This VR technology has been applied in medical school trainings, exposure therapy for individuals with posttraumatic stress disorder (PTSD), and reminiscence therapy associated with mood disorders for older adults. Perceptions of VR through the lens of the health care provider require further exploration. VR has grown in popularity; however, this modality continues to be underused in most Veterans Affairs (VA) hospitals. Objective A web-based survey was used to explore health care provider perceptions of immersive VR availability and use for older adults and identify potential barriers for immersive VR use in older adults with cognitive impairment. Methods An 8-item web-based survey was developed to obtain health care provider feedback. This survey was disseminated throughout a single Veterans Integrated Services Network (VISN). The VR survey was developed via the Survey Monkey platform and distributed through the secure VA email network. Providers were asked to voluntarily participate in the brief, anonymous survey and offer their perceptions of immersive VR use within their patient population. Survey data were reviewed and interpreted using descriptive statistics. Results A total of 49 respondents completed the survey over a 15-day period. Of them, 36 respondents (73%) had heard of a VR device, though the majority (n=44, 90%) had never used or prescribed a VR device. Respondents identified several potential barriers to immersive VR use in older adults with cognitive impairment (eg, hearing difficulties, perceptions of technology, cognitive concerns, access to resources, and visual impairment). Despite the barriers identified, providers (n=48, 98%) still reported that they would feel comfortable prescribing immersive VR as an intervention for their patient population. Conclusions Survey findings revealed that health care providers within this VISN for VAs have heard of VR, although they may not have actively engaged in its use. Most of the providers reported that they would prescribe the use of an immersive VR intervention for their older adult patients. This key point highlights the desire to implement VR strategies for patient use by their providers. If underlying barriers can be addressed and relatively resolved, this technological intervention has the potential to create substantial breakthroughs in clinical care.
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Affiliation(s)
- A'mie M Preston
- Geriatric Research Education and Clinical Center, Eugene J Towbin Veterans Affairs Healthcare Center, North Little Rock, AR, United States
| | - Lana Brown
- Geriatric Research Education and Clinical Center, Eugene J Towbin Veterans Affairs Healthcare Center, North Little Rock, AR, United States.,College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kalpana P Padala
- Geriatric Research Education and Clinical Center, Eugene J Towbin Veterans Affairs Healthcare Center, North Little Rock, AR, United States.,Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Prasad R Padala
- Geriatric Research Education and Clinical Center, Eugene J Towbin Veterans Affairs Healthcare Center, North Little Rock, AR, United States.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,University of Arkansas for Medical Sciences Graduate Medical Education, Baptist Health, North Little Rock, AR, United States
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15
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Schmidt F, Schürmann L, Haberkamp A. Animal eMotion, or the emotional evaluation of moving animals. Cogn Emot 2022; 36:1132-1148. [PMID: 35749075 DOI: 10.1080/02699931.2022.2087600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Responding adequately to the behaviour of human and non-human animals in our environment has been crucial for our survival. This is also reflected in our exceptional capacity to detect and interpret biological motion signals. However, even though our emotions have specifically emerged as automatic adaptive responses to such vital stimuli, few studies investigated the influence of biological motion on emotional evaluations. Here, we test how the motion of animals affects emotional judgements by contrasting static animal images and videos. We investigated this question (1) in non-fearful observers across many different animals, and (2) in observers afraid of particular animals across four types of animals, including the feared ones. In line with previous studies, we find an idiosyncratic pattern of evoked emotions across different types of animals. These emotions can be explained to different extents by regression models based on relevant predictor variables (e.g. familiarity, dangerousness). Additionally, our findings show a boosting effect of motion on emotional evaluations across all animals, with an additional increase in (negative) emotions for moving feared animals (except snakes). We discuss implications of our results for experimental and clinical research and applications, highlighting the importance of experiments with dynamic and ecologically valid stimuli.
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Affiliation(s)
- Filipp Schmidt
- Experimental Psychology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Lisa Schürmann
- Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Anke Haberkamp
- Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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16
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Elphinston RA, Vaezipour A, Fowler JA, Russell TG, Sterling M. Psychological therapy using virtual reality for treatment of driving phobia: a systematic review. Disabil Rehabil 2022; 45:1582-1594. [PMID: 35532316 DOI: 10.1080/09638288.2022.2069293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Driving phobia is prevalent in injured individuals following motor vehicle crashes (MVCs). The evidence for virtual reality (VR) based psychological treatments for driving phobia is unknown. This systematic review synthesized the available evidence on the effectiveness, feasibility, and user experience of psychological treatments for driving phobia using VR. METHODS Three databases (PsycINFO, SCOPUS, and PubMed) were searched. Eligibility criteria included adults with clinical or sub-clinical levels of driving phobia manifesting as part of an anxiety disorder or post-traumatic stress disorder (PTSD). Primary outcomes were driving-related anxiety/fear or avoidance, PTSD symptoms and driving frequency/intensity, as well as treatment feasibility including recruitment, treatment completion and retention rates, user experience and immersion/presence in the VR program. Secondary outcomes were other health outcomes (e.g., depression) and VR technological features. RESULTS The 14 included studies were of low methodological quality. Clinical and methodological heterogeneity prevented quantitative pooling of data. The evidence provided in this review is limited by trials with small sample sizes, and lack of diagnostic clarity, controlled designs, and long-term assessment. The evidence did suggest that VR-based psychological interventions could be feasible and acceptable in this population. CONCLUSIONS For VR-based psychological interventions to be recommended for driving phobia, more high-quality trials are needed. Implications for rehabilitationVirtual reality (VR) based psychological treatments may be feasible and acceptable to patients with driving phobia.There is potential to increase accessibility to psychological therapies in patients with driving phobia following motor vehicle crashes through the use of digital psychiatry such as VR.
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Affiliation(s)
- Rachel A Elphinston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.,National Health and Medical Research Council Centre for Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Brisbane, Australia.,School of Psychology, The University of Queensland, Brisbane, Australia
| | - Atiyeh Vaezipour
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - James A Fowler
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Trevor G Russell
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.,National Health and Medical Research Council Centre for Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Brisbane, Australia
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An Exploratory Study on the Effectiveness of Virtual Reality Analgesia for Children and Adolescents with Kidney Diseases Undergoing Venipuncture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042291. [PMID: 35206481 PMCID: PMC8872518 DOI: 10.3390/ijerph19042291] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/02/2022] [Accepted: 02/10/2022] [Indexed: 02/01/2023]
Abstract
The current study evaluated the effectiveness of VR analgesia among pediatric and adolescent patients with kidney disease undergoing venipuncture. Patients at an Italian Children’s hospital (N = 82, age range 7–17 years) undergoing venipuncture were randomly assigned to a No VR group (non-medical conversation) vs. a Yes VR group (VR analgesia). After the procedure, patients gave 0–10 Verbal Numeric Pain Scale ratings. Compared with patients in the No VR Group, patients in the Yes VR group reported significantly lower “Pain intensity”(No VR mean = 2.74, SD = 2.76 vs. Yes VR mean = 1.56, SD = 1.83) and the VR group also rated “Pain unpleasantness” significantly lower than the No VR group (No VR mean = 2.41, SD = 0.94 vs. Yes VR mean = 1.17, SD = 1.80). Patients distracted with VR also reported having significantly more fun during the venipuncture procedure. No side effects emerged. In addition to reducing pain intensity, VR has the potential to make venipuncture a more fun and less unpleasant experience for children with CKD, as measured in the present study for the first time. Finally, in exploratory analyses, children aged 7–11 in the VR group reported 55% lower worst pain than control subjects in the same age range, whereas children aged 12 to 17 in the VR group only reported 35% lower worst pain than control subjects. Additional research and development using more immersive VR is recommended.
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18
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Phobia Exposure Therapy Using Virtual and Augmented Reality: A Systematic Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A specific phobia is a common anxiety-related disorder that can be treated efficiently using different therapies including exposure therapy or cognitive therapy. One of the most famous methods to treat a specific phobia is exposure therapy. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger. One promising track of research lies in VR exposure therapy (VRET) and/or AR exposure therapy (ARET), where gradual exposure to a negative stimulus is used to reduce anxiety. In order to review existing works in this field, a systematic search was completed using the following databases: PubMed, ProQuest, Scopus, Web of Science, and Google Scholar. All studies that present VRET and/or ARET solutions were selected. By reviewing the article, each author then applied the inclusion and exclusion criteria, and 18 articles were selected. This systematic review aims to investigate the previous studies that used either VR and/or AR to treat any type of specific phobia in the last five years. The results demonstrated a positive outcome of virtual reality exposure treatment in the treatment of most phobias. In contrast, some of these treatments did not work for a few specific phobias in which the standard procedures were more effective. Besides, the study will also discuss the best of both technologies to treat a specific phobia. Furthermore, this review will present the limitations and future enhancements in this field.
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19
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Caponnetto P, Triscari S, Maglia M, Quattropani MC. The Simulation Game-Virtual Reality Therapy for the Treatment of Social Anxiety Disorder: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413209. [PMID: 34948817 PMCID: PMC8701873 DOI: 10.3390/ijerph182413209] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: With the term Virtual reality (VR) we refer to a three-dimensional environment generated by the computer, in which subjects interact with the environment as if they were really inside it. The most used VR tools are the so-called HMD (head-mounted display) which make it possible to achieve what theorists define "direct mediated action". The aim of our systematic review is specifically to investigate the applications of virtual reality therapy for the treatment of social anxiety disorder, also known as social phobia. The most common treatment for social anxiety disorder is represented by "in vivo exposure therapy" (iVET). This method consists of exposing the participant, in a gradual and controlled way, to anxious stimuli, with the goal to change the subject's response to the object or situation that is causing the fear. However, the main flaw of "in Vivo therapies" is represented by both the huge costs involved and the possible disturbance variables that can hinder the execution of the therapeutic treatment. Virtual reality exposure therapy could therefore, if confirmed in its effectiveness, constitute a solution to eliminate these two defects demonstrated by "in vivo exposure therapy". The goal is to use VR as a means for the clinician to build a tailor-made path for the participant in order to make him acquire "in virtual" those skills necessary for a good adaptation in the "real" world. (2) Methods: From February 2021 until the date of submission of the article (September 2021), we conducted a systematic review aiming to verify the effectiveness of virtual reality exposure therapy (VRET) for the treatment of SAD. (3) Results: We identified a total of 205 unique articles. Among these, 20 full-text articles were assessed for eligibility and 5 of these met the eligibility criteria and were, therefore, included in the final systematic review. (4) Conclusions: Virtual reality therapies proved to be a valid alternative to the acquisition of social skills suitable for improving the symptoms of SAD. Although there has not been a significant difference between VRET and iVET, the low costs and flexibility of VRET open up new scenarios for achieving greater psychophysical well-being.
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Affiliation(s)
- Pasquale Caponnetto
- Department of Educational Sciences, Section of Psychology, University of Catania, 95124 Catania, Italy; (S.T.); (M.C.Q.)
- Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, 95123 Catania, Italy
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, 95030 Mascalucia, Italy
- Correspondence: (P.C.); (M.M.)
| | - Sergio Triscari
- Department of Educational Sciences, Section of Psychology, University of Catania, 95124 Catania, Italy; (S.T.); (M.C.Q.)
| | - Marilena Maglia
- Department of Educational Sciences, Section of Psychology, University of Catania, 95124 Catania, Italy; (S.T.); (M.C.Q.)
- Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, 95123 Catania, Italy
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, 95030 Mascalucia, Italy
- Correspondence: (P.C.); (M.M.)
| | - Maria C. Quattropani
- Department of Educational Sciences, Section of Psychology, University of Catania, 95124 Catania, Italy; (S.T.); (M.C.Q.)
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20
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Sommer C. ["COVID-19" and "Anxiety and Virtual Reality"]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 89:605-606. [PMID: 34872129 DOI: 10.1055/a-1653-8400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Das Thema COVID-19 und neurologische Erkrankungen lässt uns so schnell nicht los. Nach unserem Themenheft im Juni dieses Jahres greifen Gülke und Gerloff das Thema im aktuellen Heft noch einmal auf, mit einem instruktiven Fallbeispiel, und setzten den Fokus auf die Auswirkungen einer COVID-19 Erkrankung bei Patienten mit neurologischen Vorerkrankungen 1. Die neurologischen Symptome bei COVID-19 Erkrankung werden derzeit durch verschiedene Pathomechanismen erklärt: a) Direkte Bindung an ACE2-Rezeptoren und somit Funktionsstörung von Neuronen, die solche Rezeptoren exprimieren, b) Hyperkoagulabilität und c) der Zytokinsturm, der auch für die schwere Lungenbeteiligung verantwortlich gemacht wird 2. Anosmie und Ageusie, Schlaganfälle und Enzephalopathie sind somit pathophysiologisch plausible und inzwischen in der internationalen Literatur gut beschriebene Komplikationen der COVID-19 Erkrankung. Im peripheren Nervensystem kommen noch einige Erkrankungen dazu. Eine Critical-illness Neuropathie ist eine häufige Komplikation bei allen intensivmedizinisch behandelten Patienten, insbesondere, wenn auch eine Sepsis vorliegt 3, und somit auch bei COVID-19 erkrankten Intensivpatienten. Ob das Guillain-Barré-Syndrom (GBS, oder akute inflammatorische demyelinisierende Polyradikuloneuropathie (AIDP)) im Zusammenhang mit COVID-19 Erkrankungen häufiger vorkommt als sonst, wird in der Literatur kontrovers diskutiert, während z. B. der Anstieg von GBS-Fällen in endemischen Gebieten der ZIKA-Erkrankung vor einigen Jahren eindeutig war 4. Im Zusammenhang mit COVID-19 Erkrankung wurde in Großbritannien sogar ein Rückgang der GBS-Fälle beobachtet 5, während eine rezente Metaanalyse ein erhöhtes GBS-Risiko nach COVID-19 Erkrankung fand 6. Auch Fälle von neuaufgetretenen neuropathisch oder myogen verursachten Schmerzen nach COVID-19 Erkrankung sind beschrieben worden 7. Ein interessantes Phänomen ist die vorübergehende Hyp- oder Analgesie unter und nach COVID-19 Erkrankung, für die man einen ähnlichen Mechanismus annimmt wie für die Anosmie. Hierzu wurde kürzlich eine Fallserie publiziert 8, und auch wir konnten einen solchen Fall beobachten 9. Aus den vielfältigen Wirkungen von SARS-CoV-2 und der COVID-19 Erkrankung auf das Nervensystem werden wir also noch viele pathophysiologische Erkenntnisse ziehen können. Ein großes Rätsel sind weiterhin die Symptome des Post-COVID-19-Syndroms, insbesondere Fatigue und die kognitiven Störungen 1.
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