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Ucero-Lozano R, Pérez-Llanes R, Cuesta-Barriuso R, Donoso-Úbeda E. Immersive visualization of movement in patients with hemophilic ankle arthropathy. Multicenter, single-blind, randomized clinical trial. J Rehabil Med 2024; 56:jrm40775. [PMID: 39347694 DOI: 10.2340/jrm.v56.40775] [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: 05/13/2024] [Accepted: 09/08/2024] [Indexed: 10/01/2024] Open
Abstract
OBJECTIVE To evaluate the efficacy of immersive movement observation in adult patients with haemophilic ankle arthropathy. DESIGN Multicentre, single-blind, randomized clinical trial. SUBJECTS 48 patients with haemophilia. METHODS Patients were randomly allocated to 2 groups (180º immersive video-based visualization of movement and a control group with no intervention). Twenty-eight consecutive 15-min home sessions, 1 per day, of immersive visualization of ankle flexion-extension movement were carried out. Three evaluations were performed: pretreatment (T0), post-intervention (T1), and at 16 weeks' follow-up (T2). The primary variable was joint-pain intensity (visual analogue scale). The secondary variables were conditioned pain modulation (Conditioned Pain Modulation Index), pressure pain threshold (pressure algometer), range of motion (goniometry) and kinesiophobia (Tampa Scale of Kinesiophophia). RESULTS There were intergroup differences in pain intensity (F = 37.14; p < 0.001), conditioned pain modulation (F = 5.40; p = 0.006), and dorsal (F = 19.17; p < 0.001) and plantar (F = 9.27; p<0.001) ankle flexion. More than 50% of experimental group patients exhibited changes exceeding the minimum detectable change in pain intensity (MDC = 0.43), and the pressure pain threshold in the extensor carpi radialis longus muscle (MDC = 1.34) and malleolus (MDC = 4.93). CONCLUSIONS 180º immersive video-based visualization of movement can improve the intensity of pain, conditioned pain modulation, and ankle range of motion in patients with haemophilic ankle arthropathy.
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Affiliation(s)
- Roberto Ucero-Lozano
- Department of Physiotherapy, European University of Madrid, Madrid, Spain; InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain
| | - Raúl Pérez-Llanes
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain; Department of Physiotherapy, University of Murcia, Murcia, Spain
| | - Rubén Cuesta-Barriuso
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain; Department of Surgery and Medical-Surgical Specialties, University of Oviedo, Oviedo, Spain.
| | - Elena Donoso-Úbeda
- InHeFis Research Group, Instituto Asturiano de Investigación Sanitaria (ISPA), Oviedo, Spain; Department of Physiotherapy, Catholic University San Antonio-UCAM, Murcia, Spain
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Bohmeier B, Cybinski LM, Gromer D, Bellinger D, Deckert J, Erhardt-Lehmann A, Deserno L, Mühlberger A, Pauli P, Polak T, Herrmann MJ. Intermittent theta burst stimulation of the left dorsolateral prefrontal cortex has no additional effect on the efficacy of virtual reality exposure therapy for acrophobia. A randomized double-blind placebo-controlled study. Behav Brain Res 2024; 476:115232. [PMID: 39236930 DOI: 10.1016/j.bbr.2024.115232] [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: 03/22/2024] [Revised: 07/19/2024] [Accepted: 08/26/2024] [Indexed: 09/07/2024]
Abstract
Anxiety disorders are among the most common mental disorders. Treatment guidelines recommend pharmacotherapy and cognitive behavioral therapy as standard treatment. Although cognitive behavioral therapy is an effective therapeutic approach, not all patients benefit sufficiently from it. In recent years, non-invasive brain stimulation techniques, such as transcranial magnetic stimulation, have been investigated as promising adjuncts in the treatment of affective disorders. The aim of this study is to investigate whether a combination of intermittent theta burst stimulation (iTBS) and virtual reality exposure therapy leads to a significantly greater reduction in acrophobia than virtual reality exposure with sham stimulation. In this randomized double-blind placebo-controlled study, 43 participants with acrophobia received verum or sham iTBS over the left dorsolateral prefrontal cortex prior to two sessions of virtual reality exposure therapy. Stimulation of the left dorsolateral prefrontal cortex with iTBS was motivated by an experimental study showing a positive effect on extinction memory retention. Acrophobic symptoms were assessed using questionnaires and two behavioral approach tasks one week before, after treatment and six months after the second diagnostic session. The results showed that two sessions of virtual reality exposure therapy led to a significant reduction in acrophobic symptoms, with an overall remission rate of 79 %. However, there was no additional effect of iTBS of the left dorsolateral prefrontal cortex on the therapeutic effects. Further research is needed to determine how exactly a combination of transcranial magnetic stimulation and exposure therapy should be designed to enhance efficacy.
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Affiliation(s)
- Barbara Bohmeier
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Lisa M Cybinski
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Daniel Gromer
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Wuerzburg, Wuerzburg, Germany
| | - Daniel Bellinger
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Jürgen Deckert
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Angelika Erhardt-Lehmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany; Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Lorenz Deserno
- Center of Mental Health, Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Andreas Mühlberger
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany
| | - Paul Pauli
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Wuerzburg, Wuerzburg, Germany
| | - Thomas Polak
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Martin J Herrmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
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Shi Z, Wang Y. Enhancing health communication through virtual reality-based art therapy: an opinion. Front Psychol 2024; 15:1438172. [PMID: 39144595 PMCID: PMC11323116 DOI: 10.3389/fpsyg.2024.1438172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024] Open
Affiliation(s)
| | - Yanyun Wang
- Shanghai Film Academy, Shanghai University, Shanghai, China
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Jansen C, Bäuerle A, Jahre LM, Kocol D, Krakowczyk J, Geiger S, Dörrie N, Skoda EM, Teufel M. Needs and Demands for e-Health Interventions in Patients Attending a Psychosomatic Outpatient Clinic: A Baseline Assessment for a User-Centered Design Approach. Telemed J E Health 2024; 30:e1747-e1756. [PMID: 38436236 DOI: 10.1089/tmj.2023.0360] [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: 03/05/2024] Open
Abstract
Objective: Increased utilization of e-health services can help to meet shortages of psychotherapeutic treatment. e-Health interventions can be effective if tailored according to the individual needs and demands of the target group. To gather comprehensive data for the development of a user-centered e-health intervention, a cross-sectional study was conducted among a heterogeneous cohort of 309 patients seeking treatment or consultation at psychosomatic university hospital in a densely populated region of Germany. Methods: Sociodemographic data, psychometric dimensions of mental burden, as well as needs and demands regarding an e-health intervention were assessed. A descriptive statistical analysis and a cluster analysis were performed to examine distribution of preferences and differences based on level of burden regarding needs and demands for e-health interventions. Results: Two hundred thirty-nine (N = 239) participants were included in the final data analysis. Among this primarily urban target group smartphone availability was favored by 77.8% of the participants. The cluster analysis revealed significant differences dependent on mental burden. 75.2% of participants with a high mental burden preferred longer interventions of 1-4 months compared with 49% in the low burden group, which also considered short interventions of up to 1 month (46%). Differences were also identified for content preferences and daily-life integration and were consistent irrespective of the initial reason for consultation. Conclusion: The findings of this study can provide a foundational framework for developing user-centered psychosomatic interventions. The potential relationship between individual burden and individual needs and demands highlights the crucial role of preliminary research to tailor interventions to effectively address diverse needs and preferences.
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Affiliation(s)
- Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Dilara Kocol
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Julia Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Sheila Geiger
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Nora Dörrie
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
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Chandio Y, Interrante V, Anwar FM. Human Factors at Play: Understanding the Impact of Conditioning on Presence and Reaction Time in Mixed Reality. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2024; 30:2400-2410. [PMID: 38437088 DOI: 10.1109/tvcg.2024.3372120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
A prerequisite to improving the presence of a user in mixed reality (MR) is the ability to measure and quantify presence. Traditionally, subjective questionnaires have been used to assess the level of presence. However, recent studies have shown that presence is correlated with objective and systemic human performance measures such as reaction time. These studies analyze the correlation between presence and reaction time when technical factors such as object realism and plausibility of the object's behavior change. However, additional psychological and physiological human factors can also impact presence. It is unclear if presence can be mapped to and correlated with reaction time when human factors such as conditioning are involved. To answer this question, we conducted an exploratory study ($N=60$) where the relationship between presence and reaction time was assessed under three different conditioning scenarios: control, positive, and negative. We demonstrated that human factors impact presence. We found that presence scores and reaction times are significantly correlated (correlation coefficient of -0.64), suggesting that the impact of human factors on reaction time correlates with its effect on presence. In demonstrating that, our study takes another important step toward using objective and systemic measures like reaction time as a presence measure.
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Su Z, Lei B, Lu D, Lai S, Zhang X. Impact of ecological presence in virtual reality tourism on enhancing tourists' environmentally responsible behavior. Sci Rep 2024; 14:5939. [PMID: 38467806 PMCID: PMC10928231 DOI: 10.1038/s41598-024-56615-z] [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: 12/13/2023] [Accepted: 03/08/2024] [Indexed: 03/13/2024] Open
Abstract
In an era where environmental conservation is increasingly critical, identifying pathways through which technological innovations like virtual reality tourism (VRT) can promote sustainable behaviors is vital. This study investigates the impact of 'ecological presence', a newly proposed sub-dimension of presence in VRT, on tourists' environmentally responsible behavior (TERB). Through structural equation modeling and fuzzy set qualitative comparative analysis of data from 290 participants, we unveil that ecological presence-defined as the authenticity and immersion of tourists in virtual ecological environments-significantly bolsters biospheric values, environmental self-identity, and personal norms. Additionally, our findings indicate that ecological presence in VRT indirectly promotes TERB, predominantly through the mediation of enhanced biospheric values and environmental self-identity. Notably, ecological presence, biospheric values, and environmental self-identity constitutes a sufficient condition for achieving a high level of TERB. This research highlights the potential of VRT as an innovative tool for tourism administrators to foster environmental stewardship, offering a novel approach to leveraging technology for conservation efforts.
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Affiliation(s)
- Zhen Su
- Department of Tourism Management, Business School, Guangxi University, No. 100 East Daxue Road, Nanning, 530004, China
- Guangxi Development Strategy Institute, Nanning, 530004, China
- Key Laboratory of Interdisciplinary Science of Statistics and Management, Nanning, 530004, China
| | - Biman Lei
- Department of Tourism Management, Business School, Guangxi University, No. 100 East Daxue Road, Nanning, 530004, China
| | - Dandan Lu
- Department of Tourism Management, Business School, Guangxi University of Finance and Economics, Nanning, 530008, China.
| | - Shuchen Lai
- Department of Tourism Management, Business School, Guangxi University, No. 100 East Daxue Road, Nanning, 530004, China
| | - Xijing Zhang
- Department of Tourism Management, Business School, Guangxi University, No. 100 East Daxue Road, Nanning, 530004, China
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Jurcik T, Zaremba-Pike S, Kosonogov V, Mohammed AR, Krasavtseva Y, Sawada T, Samarina I, Buranova N, Adu P, Sergeev N, Skuratov A, Demchenko A, Kochetkov Y. The efficacy of augmented reality exposure therapy in the treatment of spider phobia-a randomized controlled trial. Front Psychol 2024; 15:1214125. [PMID: 38440241 PMCID: PMC10911123 DOI: 10.3389/fpsyg.2024.1214125] [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: 04/28/2023] [Accepted: 01/15/2024] [Indexed: 03/06/2024] Open
Abstract
The evidence for the use of Augmented Reality (AR) in treating specific phobias has been growing. However, issues of accessibility persist, especially in developing countries. The current study examined a novel, but relatively simple therapist guided smartphone-based AR Exposure Treatment (ARET) of spider phobia. Participants who reported symptoms of Arachnophobia were randomized into one of three comparison groups: ARET (n = 20), traditional in vivo exposure therapy (IVET; n = 18) and a waitlist control group (n = 17). Behavioral approach, subjective symptom measures, and galvanic skin response were assessed pre- and post-treatment. The study was concluded with a one-month follow up assessment. Results indicated that both treatment groups showed statistically significant and clinically meaningful improvements in behavioral approach at post-test that were maintained at 1 month follow- up, compared to the wait-listed group. Moreover, the treatment groups demonstrated significant improvements in subjective symptom report at 1-month follow up. Given its utility and potential accessibility, our findings suggest that future AR evaluation research could be conducted in therapy settings with minimal resources.
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Affiliation(s)
- Tomas Jurcik
- School of Psychology, HSE University, Moscow, Russia
| | | | | | - Abdul-Raheem Mohammed
- Department of Social and Behavioral Change, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Yulia Krasavtseva
- Department of Pedagogy and Medical Psychology, Sechenov University, Moscow, Russia
- Department of Psychology, Lomonosov MSU, Moscow, Russia
- Center for Cognitive Therapy, Moscow, Russia
| | - Tadamasa Sawada
- School of Psychology, HSE University, Moscow, Russia
- Department of Psychology, Russian-Armenian (Slavonic) University, Yerevan, Armenia
- Akian College of Science and Engineering, American University of Armenia, Yerevan, Armenia
- European University of Armenia, Yerevan, Armenia
| | - Irina Samarina
- Department of Healthcare, P. B. Gannushkin Moscow Clinical Psychiatric Hospital No. 4, Moscow, Russia
| | | | - Peter Adu
- Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Nikita Sergeev
- Department of Computer Engineering, HSE University, Moscow, Russia
| | - Andrei Skuratov
- Department of Computer Engineering, HSE University, Moscow, Russia
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Thaysen-Petersen D, Hammerum SK, Vissing AC, Oestrich IH, Nordentoft M, Düring SW, Fink-Jensen A. Virtual reality-assisted cognitive behavioral therapy for patients with alcohol use disorder: a randomized feasibility study. Front Psychiatry 2024; 15:1337898. [PMID: 38419905 PMCID: PMC10899342 DOI: 10.3389/fpsyt.2024.1337898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Cognitive behavioral therapy (CBT) is an evidence-based treatment for alcohol use disorder (AUD). Exposure to high-risk situations in virtual reality (VR) has been suggested to have a potential therapeutical benefit, but no previous study has combined VR and CBT for AUD. We aimed to investigate the feasibility of using VR-simulated high-risk environments in CBT-based treatment of AUD. Methods We randomized ten treatment-seeking AUD-diagnosed individuals to three sessions of conventional CBT or VR-assisted CBT performed at two outpatient clinics in Denmark. In each session, patients randomized to VR-CBT were exposed to VR-simulations from a restaurant to induce authentic thoughts, emotions, physiological reactions, and craving for CBT purposes. The primary outcome measure was feasibility: Drop-out rate, psychological reactions, and simulator sickness. Secondary outcomes were assessment of preliminary short-term changes in alcohol consumption and craving from baseline to one-week and one-month follow-up. In addition, the study was conducted for training in operationalization of VR equipment, treatment manuals, and research questionnaires. Results The majority of patients completed all study visits (90%). VR induced authentic high-risk related thoughts, emotions, and physiological reactions that were considered relevant for CBT by patients and therapists. Four of five patients randomized to VR-CBT experienced cravings during VR simulations, and most of these patients (3/5) experienced mild simulator sickness during VR exposure. The preliminary data showed that patients receiving VR-CBT had more reduction in alcohol consumption than patients receiving conventional CBT at one week- (median 94% vs. 72%) and one-month follow-up (median 98% vs. 55%). Similar results were found regarding changes in cravings. Conclusion We demonstrated VR-CBT to be a feasible intervention for patients with AUD which supports continued investigations in a larger randomized clinical trial evaluating the efficacy of VR-CBT. Clinical trial registration https://www.clinicaltrials.gov/study/NCT04990765?cond=addiction%20CRAVR&rank=2, identifier NCT05042180.
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Affiliation(s)
- Daniel Thaysen-Petersen
- Mental Health Centre Copenhagen, Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Sigurd Krogh Hammerum
- Mental Health Centre Copenhagen, Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Anne-Cathrine Vissing
- Mental Health Centre Copenhagen, Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Irene Henriette Oestrich
- Mental Health Centre Sct. Hans, Roskilde, Mental Health Services, Capital Region of Denmark, Roskilde, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Signe Wegmann Düring
- Mental Health Centre Sct. Hans, Roskilde, Mental Health Services, Capital Region of Denmark, Roskilde, Denmark
- Outpatient Clinics, Novavi Foundation, Frederiksberg, Denmark
- Psychiatric Center Amager, Mental Health Services, Capitol Region Hospitals, Amager, Denmark
| | - Anders Fink-Jensen
- Mental Health Centre Copenhagen, Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Brambilla E, Petersen E, Stendal K, Sundling V, MacIntyre TE, Calogiuri G. Effects of immersive virtual nature on nature connectedness: A systematic review and meta-analysis. Digit Health 2024; 10:20552076241234639. [PMID: 38533309 PMCID: PMC10964443 DOI: 10.1177/20552076241234639] [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: 06/07/2023] [Accepted: 01/26/2024] [Indexed: 03/28/2024] Open
Abstract
Objective This study systematically summarizes the extant literature on the impacts of immersive virtual nature (IVN) on nature connectedness in the general population. Methods Papers were considered eligible if peer-reviewed, in English language, comprising experimental or quasi-experimental trials, including at least one outcome relative to nature connectedness in the general population. Database search was conducted on Scopus, Web of Science, Google Scholar, Medline, and GreenFILE (22-28 November 2021). Risk of bias was established by the Cochrane RoB 2 tool. Data synthesis was conducted through meta-analysis according with the Cochrane Consumers and Communication Group guidelines. Results Six eligible papers (9 studies; n = 730) were selected, in which IVN was compared to (i) non-immersive virtual nature, (ii) immersive virtual built environments, (iii) non-immersive virtual built environments, and (iv) actual nature. The risk of bias was predominantly "low" or of "some concerns." Meta-analyses showed a statistically significant overall effect for the first (g = 0.26; 95% CI = 0.06-0.45; I2 = 35%) and fourth group (g = -1.98; 95% CI = -3.21 to -0.75; I2 = 96%), the former in favor of IVN and the latter in favor of actual nature. Subgroup analyses were conducted for the first and second groups of studies to explore possible sources of heterogeneity. The small number of studies available limits the validity of the outcomes of the meta-analyses. Conclusion The findings indicate that IVN may be an effective tool for the promotion of nature connectedness, although the evidence in this field is still limited and largely mixed. Recommendations for future research are discussed.
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Affiliation(s)
- Elena Brambilla
- Centre for Health and Technology, Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Evi Petersen
- Department of Sports, Physical Education and Outdoor Studies, University of South-Eastern Norway, Bø, Norway
- Department of Early Childhood Education, Oslo Metropolitan University, Oslo, Norway
| | - Karen Stendal
- Department of Business, Marketing and Law, University of South-Eastern Norway, Ringerike, Norway
| | - Vibeke Sundling
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Tadhg E MacIntyre
- All Institute, Department of Psychology, Maynooth University, Maynooth, Irlanda
| | - Giovanna Calogiuri
- Centre for Health and Technology, Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
- Section for Public Health, Department of Public Health and Sport Sciences, Inland Norway University of Applied Science, Elverum, Norway
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Ilioudi M, Wallström S, Steingrimsson S, Lindner P, Thunström AO, Ali L. Patient experience of a virtual reality calm room in a psychiatric inpatient care setting in Sweden: a qualitative study with inpatients. BMJ Open 2023; 13:e076285. [PMID: 38101823 PMCID: PMC10729110 DOI: 10.1136/bmjopen-2023-076285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE Calm rooms have been developed and implemented in psychiatric inpatient care settings to offer patients a dedicated space for relaxation in a convenient and safe environment. Recent technology developments have enabled virtual reality (VR) equivalents of calm rooms that can be feasibly deployed in psychiatric care settings. While research has shown VR environments to be efficacious in inducing relaxation, little is known how these virtual calm rooms are perceived by patients. The aim of this study was to elucidate patient experiences of using a VR calm room in a psychiatric inpatient setting. DESIGN Qualitative interview study. Semi-structured interviews were analysed using qualitive inductive content analysis, which focuses on the interpretation of texts for making replicable and valid inferences. SETTING Swedish hospital psychiatric inpatient care setting with a wireless, three degrees-of-freedom VR head-mounted display running a calm room application simulating nature environment. PARTICIPANTS 20 adult patients (12 women) with bipolar disorder (n=18) or unipolar depression (n=2). RESULTS Participants experienced the use of the VR calm room as having a positive impact on them, inducing awareness, calmness and well-being. They were thankful to be offered a non-pharmacological alternative for anxiety relief. Participants also expressed that they had some concerns about how they would react emotionally before using the VR device. However, after use, they highlighted that their overall experience was positive. They also expressed that they could see potential for further development of VR technology in psychiatric care. CONCLUSIONS VR technology has the potential to solve pressing logistic issues in offering calm rooms in psychiatric inpatient care. VR calm rooms appear to be appreciated by psychiatric inpatients, who value their accessibility, convenience and variety of modalities offered. Participants perceived an increase in their well-being after use.
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Affiliation(s)
- Maria Ilioudi
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatric Department, Goteborg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gotheborg, Sweden
| | - Sara Wallström
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatric Department, Goteborg, Sweden
- Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Forensic Psychiatry, Gothenburg, Sweden
- Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden
| | - Steinn Steingrimsson
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatric Department, Goteborg, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Goteborg, Sweden
| | - Philip Lindner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute and Stockholm Health Care Services, Stockholm, Sweden
| | - Almira Osmanovic Thunström
- Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Goteborg, Sweden
| | - Lilas Ali
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatric Department, Goteborg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gotheborg, Sweden
- Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Jingili N, Oyelere SS, Nyström MBT, Anyshchenko L. A systematic review on the efficacy of virtual reality and gamification interventions for managing anxiety and depression. Front Digit Health 2023; 5:1239435. [PMID: 38026832 PMCID: PMC10661329 DOI: 10.3389/fdgth.2023.1239435] [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: 06/16/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
This systematic review aims to assess the effectiveness of virtual reality (VR) and gamification interventions in addressing anxiety and depression. The review also seeks to identify gaps in the current VR treatment landscape and provide guidelines for future research and development. A systematic literature search was conducted using Scopus, Web of Science, and PubMed databases, focusing on studies that utilized VR and gamification technology to address anxiety and depression disorders. A total of 2,664 studies were initially identified, 15 of those studies fulfilled the inclusion criteria for this systematic review. The efficacy of VR in addressing anxiety and depression was evident across all included studies. However, the diversity among VR interventions highlights the need for further investigation. It is advised to incorporate more diverse participant samples and larger cohorts and explore a broader spectrum of therapeutic approaches within VR interventions for addressing anxiety and depression to enhance the credibility of future research. Additionally, conducting studies in varying socioeconomic contexts would contribute to a more comprehensive understanding of their real-world applicability.
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Affiliation(s)
- Nuru Jingili
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Skellefteå, Sweden
| | - Solomon Sunday Oyelere
- Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Skellefteå, Sweden
| | - Markus B. T. Nyström
- Department of Health, Education and Technology Division, Luleå University of Technology, Luleå, Sweden
| | - Lina Anyshchenko
- Department of Health, Education and Technology Division, Luleå University of Technology, Luleå, Sweden
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Donker T, Fehribach J, van Klaveren C, Cornelisz I, Toffolo MBJ, van Straten A, van Gelder JL. Automated mobile virtual reality cognitive behavior therapy for aviophobia in a natural setting: a randomized controlled trial. Psychol Med 2023; 53:6232-6241. [PMID: 36426618 PMCID: PMC10520596 DOI: 10.1017/s0033291722003531] [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: 05/23/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Access to evidence-based psychological treatment is a challenge worldwide. We assessed the effectiveness of a fully automated aviophobia smartphone app treatment delivered in combination with a $5 virtual reality (VR) viewer. METHODS In total, 153 participants from the Dutch general population with aviophobia symptoms and smartphone access were randomized in a single-blind randomized controlled trial to either an automated VR cognitive behavior therapy (VR-CBT) app treatment condition (n = 77) or a wait-list control condition (n = 76). The VR-CBT app was delivered over a 6-week period in the participants' natural environment. Online self-report assessments were completed at baseline, post-treatment, at 3-month and at 12-month follow-up. The primary outcome measure was the Flight Anxiety Situations Questionnaire (FAS). Analyses were based on intent-to-treat. RESULTS A significant reduction of aviophobia symptoms at post-test for the VR-CBT app compared with the control condition [p < 0.001; d = 0. 98 (95% CI 0.65-1.32)] was demonstrated. The dropout rate was 21%. Results were maintained at 3-month follow-up [within-group d = 1.14 (95% CI 0.46-1.81)] and at 12-month follow-up [within-group d = 1.12 (95% CI 0.46-1.79)]. Six participants reported adverse effects of cyber sickness symptoms. CONCLUSIONS This study is the first to show that fully automated mobile VR-CBT therapy delivered in a natural setting can maintain long-term effectiveness in reducing aviophobia symptoms. In doing so, it offers an accessible and scalable evidence-based treatment solution that can be applied globally at a fraction of the cost of current treatment alternatives.
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Affiliation(s)
- T. Donker
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute Amsterdam, Amsterdam, Noord-Holland, The Netherlands
- Department of Biological Psychology, Clinical Psychology and Psychotherapy, Albert Ludwigs-University of Freiburg, Freiburg im Breisgau, Baden-Württenberg, Germany
| | - J.R. Fehribach
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute Amsterdam, Amsterdam, Noord-Holland, The Netherlands
| | - C. van Klaveren
- Department of Education Sciences, Section Methods and Statistics, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
- Amsterdam Center for Learning Analytics (ACLA), Amsterdam, Noord-Holland, The Netherlands
| | - I. Cornelisz
- Department of Education Sciences, Section Methods and Statistics, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, The Netherlands
- Amsterdam Center for Learning Analytics (ACLA), Amsterdam, Noord-Holland, The Netherlands
| | - M. B. J. Toffolo
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute Amsterdam, Amsterdam, Noord-Holland, The Netherlands
| | - A. van Straten
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam and Amsterdam Public Health Research Institute Amsterdam, Amsterdam, Noord-Holland, The Netherlands
| | - J.-L. van Gelder
- Department of Criminology, Max Planck Institute for the Study of Crime, Security and Law, Freiburg im Breisgau, Baden-Württenberg, Germany
- Department of Clinical Neurodevelopmental Sciences, Institute of Education and Child Studies, Leiden University, Leiden, Zuid-Holland, The Netherlands
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Ito A, Hiyoshi F, Kanie A, Maruyama A, Oba MS, Kito S. Feasibility Study of Virtual Reality-Based Cognitive Behavioral Therapy for Patients With Depression: Protocol for an Open Trial and Therapeutic Intervention. JMIR Res Protoc 2023; 12:e49698. [PMID: 37751242 PMCID: PMC10565619 DOI: 10.2196/49698] [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: 06/11/2023] [Revised: 07/26/2023] [Accepted: 08/16/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The clinical usefulness of cognitive behavioral therapy (CBT) for patients with depression who do not remit with pharmacotherapy has been recognized. However, the longer time burden on health care providers associated with conducting CBT and the lack of a system for providing CBT lead to inadequate CBT provision to patients who wish to receive it. OBJECTIVE We aim to evaluate the feasibility of introducing virtual reality (VR) into CBT for patients with depression. METHODS This is a single-center, interventional, exploratory, single-arm, nonrandomized, open, pre-post-comparative feasibility study of an unapproved medical device program to evaluate the acceptability, preliminary efficacy, and safety of the study device. Eligible patients meet the diagnostic criteria of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) for major depressive disorder, have a 17-item Hamilton Depression Rating Scale (HAMD-17) score of ≥12, and are aged 18-65 years. The sample will comprise 12 patients. VR-based CBT (CBT-VR) sessions will be conducted once a week in an outpatient setting. CBT-VR has been developed in accordance with 6 stages and 16 sessions in the current CBT therapist manual. VR contents and other components correspond to the themes of these 16 sessions. The flow of CBT-VR treatment is similar to that of normal CBT; however, this product replaces the in-person portion of CBT. The primary end point will be the change in the HAMD-17 score from baseline up to 16 sessions. Secondary end points will be treatment retention; psychiatrist consultation time; satisfaction with the equipment or program; ease of use; homework compliance; change in the HAMD-17 score from baseline up to 8 sessions; change in Montgomery-Åsberg Depression Rating Scale (MADRS), Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR), EQ-5D-5L, and Clinical Global Impressions (CGI) scores from baseline up to 8 and 16 sessions; and change in remission and response rates and HAMD-17, MADRS, QIDS-SR, and EQ-5D-5L scores from baseline to 3 and 6 months post intervention (or discontinuation). CBT-VR's feasibility will be assessed at baseline, after 8 sessions, after 16 sessions, or treatment discontinuation, by measuring the time required for testing and medical care during each session and with a patient questionnaire. After intervention discontinuation, a follow-up evaluation will be conducted unless the patient withdraws consent or otherwise discontinues participation in the study after 3 and 6 months. RESULTS Participant recruitment started on November 30, 2022, and data collection is ongoing as of September 2023. CONCLUSIONS This study is the first step in testing the acceptability, feasibility, and preliminary efficacy and safety of CBT-VR for patients with depression without controls in an open-label trial. If its feasibility for depression treatment is confirmed, we intend to proceed to a large-scale validation study. TRIAL REGISTRATION Japan Registry of Clinical Trials jRCTs032220481; https://jrct.niph.go.jp/en-latest-detail/jRCTs032220481. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49698.
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Affiliation(s)
- Ai Ito
- Department of Clinical Psychology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira-shi, Japan
| | - Fumikazu Hiyoshi
- Department of Clinical Psychology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira-shi, Japan
- Brain Bioregulatory Science, Cooperative Graduate School, The Jikei University Graduate School of Medicine, Minato-ku, Japan
| | - Ayako Kanie
- Jolly Good Inc, Chuo-ku, Japan
- Department of Child Neropsyhchitatry, The University of Tokyo Hosoital, Bunkyo-ku, Japan
- National Center for Cognitive Behavior Therapy and Research, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira-shi, Japan
| | | | - Mari S Oba
- Department of Clinical Data Science, Clinical Research and Education Premotion Division, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira-shi, Japan
| | - Shinsuke Kito
- Department of Clinical Psychology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira-shi, Japan
- Neuromodulation Therapy and Research Center, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira-shi, Japan
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14
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Hendriks C, Jansen JM, Smit M, Smulders LM, Popma A, Van Der Pol T. VReedom: training for authorized leave of absence through virtual reality - a feasibility study. Front Psychol 2023; 14:1231619. [PMID: 37790227 PMCID: PMC10544993 DOI: 10.3389/fpsyg.2023.1231619] [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: 05/30/2023] [Accepted: 08/28/2023] [Indexed: 10/05/2023] Open
Abstract
This study assessed the feasibility, implementation process and outcomes of the VReedom training; a virtual reality (VR)-based intervention designed to prepare forensic psychiatric patients for their first authorized leave. Clinical forensic mental healthcare organization Inforsa, operating at security level 3, introduced the VReedom training for forensic patients eligible for their first authorized leave, between March 1st and November 13th, 2022. Employing a retrospective observational cohort study design with patient dossier data as the primary source, the study also used participant observation, weekly evaluative questionnaires and focus group discussions as data sources. Five objectives were utilized to evaluate the feasibility: recruitment capacity and resulting sample characteristics, data collection and evaluation procedures, acceptability and suitability of the training and protocol, training management and implementation, and preliminary participant results. Despite the lack of a control group, findings align with literature suggesting VR's potential for enhancing treatment motivation and reducing stress in preparation for first authorized leave. Of 13 patients approached, 10 participated without dropouts, and no incidents occurred during training. Emotion elicitation was successful, supporting VR Exposure therapy's efficacy. Findings align with literature, emphasizing VR's value in forensic psychiatry. Establishing favorable implementation conditions was crucial, with positive reception from treatment providers. Also, the need for personalization and additional locations was identified, and the training seemed most suitable for patients with a tbs-measure. Future research with control groups is recommended to further validate the effectiveness of the VReedom training intervention, and further protocol development is necessary to make it suitable for a broader population. Current findings contribute to the refinement and expansion of evidence-based practices in the field of VR-assisted training and treatment in forensic psychiatry.
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Affiliation(s)
- Cylia Hendriks
- Inforsa, Forensic Mental Healthcare, Amsterdam, Netherlands
- Department of Child and Adolescent Psychiatry and Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jochem Milan Jansen
- Inforsa, Forensic Mental Healthcare, Amsterdam, Netherlands
- Faculty of Law, Institute for Criminal Law and Criminology, Leiden University, Leiden, Netherlands
| | - Merel Smit
- Inforsa, Forensic Mental Healthcare, Amsterdam, Netherlands
| | - Lisanne M. Smulders
- Inforsa, Forensic Mental Healthcare, Amsterdam, Netherlands
- Department of Child and Adolescent Psychiatry and Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry and Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Thimo Van Der Pol
- Inforsa, Forensic Mental Healthcare, Amsterdam, Netherlands
- Department of Child and Adolescent Psychiatry and Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Department of Research and Quality of Care, Arkin, Amsterdam, Netherlands
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15
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Tikka P, Kaipainen M, Salmi J. Narrative simulation of social experiences in naturalistic context - A neurocinematic approach. Neuropsychologia 2023; 188:108654. [PMID: 37507066 DOI: 10.1016/j.neuropsychologia.2023.108654] [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] [Received: 10/15/2022] [Revised: 07/02/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023]
Abstract
Narratives may be regarded as simulations of everyday social situations. They are key to studying the human mind in socio-culturally determined contexts as they allow anchoring to the common ground of embodied and environmentally-engaged cognition. Here we review recent findings from naturalistic neuroscience on neural functions in conditions that mimic lifelike situations. We will focus particularly on neurocinematics, a research field that applies mediated narratives as stimuli for neuroimaging experiments. During the last two decades, this paradigm has contributed to an accumulation of insights about the neural underpinnings of behavior and sense-making in various narratively contextualized situations particularly pertaining to socio-emotional encounters. One of the key questions in neurocinematics is, how do intersubjectively synchronized brain activations relate to subjective experiences? Another question we address is how to bring natural contexts into experimental studies. Seeking to respond to both questions, we suggest neurocinematic studies to examine three manifestations of the same phenomenon side-by-side: subjective experiences of narrative situations, unfolding of narrative stimulus structure, and neural processes that co-constitute the experience. This approach facilitates identifying experientially meaningful activity patterns in the brain and points out what they may mean in relation to shared and communicable contents. Via rich-featured and temporally contextualized narrative stimuli, neurocinematics attempts to contribute to emerging holistic theories of neural dynamics and connectomics explaining typical and atypical interindividual variability.
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Affiliation(s)
- Pia Tikka
- Enactive Virtuality Lab, Baltic School of Film, Media and Arts, Tallinn University, Estonia.
| | | | - Juha Salmi
- Translational Cognitive Neuroscience Lab, Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
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16
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Abstract
PURPOSE OF REVIEW This examines significant trends and developments in the utilization of virtual reality (VR) and augmented reality (AR) simulations in the field of mental health and education. The objective is to gain insights into the emerging applications of VR/AR in mental health interventions and their potential impact on patient outcomes. The review also includes personal observations on the effectiveness and challenges associated with VR/AR simulations and the rise of exciting, disruptive artificial intelligence large language models. The findings of this review contribute to the understanding of the current state of VR/AR technology in mental health and highlight potential future directions in this rapidly evolving field. RECENT FINDINGS Recent studies have shown that VR/AR simulation is an effective and promising approach for treating various anxiety disorders, including specific phobias, social anxiety disorder, and post-traumatic stress disorder (PTSD). Simulated environments can be tailored to induce provoking situations, allowing individuals to learn from and gradually confront and grow in controlled and safe environments. Recent findings in the field of virtual reality simulations in mental health indicate that VR/AR exposure therapy is effective for treating anxiety disorders, while interventions show promise in improving social skills in individuals working with patients. In a broader sense, the use of VR/AR as an educational tool shows enormous potential now that functional generative artificial intelligence (AI) is recently available.
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Affiliation(s)
- Clint G Carlson
- Fitzsimons Building, University of Colorado, School of Medicine, 13001 East 17Th Place, Room E1354, Campus Box C290, CO, 80045, Aurora, USA.
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17
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Kako N, Waugh CE, McRae K. The Future of Immersive Mood Induction in Affective Science: Using Virtual Reality to Test Effects of Mood Context on Task Performance. AFFECTIVE SCIENCE 2023; 4:570-579. [PMID: 37744975 PMCID: PMC10514247 DOI: 10.1007/s42761-023-00213-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/30/2023] [Indexed: 09/26/2023]
Abstract
A fundamental premise of affective and clinical science is that fluctuations in mood drive meaningful changes in cognition and behavior. These theories are often tested via laboratory mood induction procedures followed by performing an established task. Despite advances in understanding the temporal dynamics of emotions, it is still unclear whether it is the enduring mood that impacts subsequent task performance. Additionally, this design requires task switching, which may limit the impact of mood and affect task performance. We suggest that virtual reality (VR) offers a more powerful, immersive alternative to traditional mood induction methods and effectively addresses these limitations because it can be used to create mood contexts that occur simultaneously with task performance. VR creates an immersive, real-world experience while benefiting from a well-controlled laboratory setting (Diniz Bernardo et al., 2021). We first summarize the literature on mood induction methodologies, including evidence that VR creates a more immersive environment, leading to mood inductions that are greater in magnitude than other methods. We then report a novel empirical study on the feasibility of utilizing VR to create a mood context that occurs simultaneously with a gold-standard emotion regulation task. Our results indicate that VR was a powerful and enduring positive mood induction tool, resulting in immediate changes in mood and greater trial-by-trial positivity ratings during the concurrent task. Portions of this study were pre-registered on August 3, 2020, on the Clinical Trials website (project citation: https://clinicaltrials.gov/ct2/show/NCT04496258). Supplementary Information The online version contains supplementary material available at 10.1007/s42761-023-00213-1.
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Affiliation(s)
- Nadia Kako
- Department of Psychology, University of Denver, 2155 S Race St, Denver, CO 80210 USA
| | - Christian E. Waugh
- Department of Psychology, Wake Forest University, 1834 Wake Forest Rd, Winston-Salem, NC 27109 USA
| | - Kateri McRae
- Department of Psychology, University of Denver, 2155 S Race St, Denver, CO 80210 USA
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18
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Palombi T, Galli F, Giancamilli F, D'Amico M, Alivernini F, Gallo L, Neroni P, Predazzi M, De Pietro G, Lucidi F, Giordano A, Chirico A. The role of sense of presence in expressing cognitive abilities in a virtual reality task: an initial validation study. Sci Rep 2023; 13:13396. [PMID: 37591908 PMCID: PMC10435488 DOI: 10.1038/s41598-023-40510-0] [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: 02/17/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023] Open
Abstract
There is a raised interest in literature to use Virtual Reality (VR) technology as an assessment tool for cognitive domains. One of the essential advantages of transforming tests in an immersive virtual environment is the possibility of automatically calculating the test's score, a time-consuming process under natural conditions. Although the characteristics of VR can deliver different degrees of immersion in a virtual environment, the sense of presence could jeopardize the evolution of these practices. The sense of presence results from a complex interaction between human, contextual factors, and the VR environment. The present study has two aims: firstly, it contributes to the validation of a virtual version of the naturalistic action test (i.e., virtual reality action test); second, it aims to evaluate the role of sense of presence as a critical booster of the expression of cognitive abilities during virtual reality tasks. The study relies on healthy adults tested in virtual and real conditions in a cross-over research design. The study's results support the validity of the virtual reality action test. Furthermore, two structural equation models are tested to comprehend the role of sense of presence as a moderator in the relationship between cognitive abilities and virtual task performance.
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Affiliation(s)
- Tommaso Palombi
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Federica Galli
- Department of Movement, Human and Health Sciences, University of Rome, Foro Italico, Rome, Italy
| | - Francesco Giancamilli
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Monica D'Amico
- Department of Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Fabio Alivernini
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Luigi Gallo
- Institute for High-Performance Computing and Networking, National Research Council, Naples, Italy
| | - Pietro Neroni
- Institute for High-Performance Computing and Networking, National Research Council, Naples, Italy
| | | | - Giuseppe De Pietro
- Institute for High-Performance Computing and Networking, National Research Council, Naples, Italy
| | - Fabio Lucidi
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, USA
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Andrea Chirico
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy.
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Ezawa ID, Hollon SD, Robinson N. Examining Predictors of Depression and Anxiety Symptom Change in Cognitive Behavioral Immersion: Observational Study. JMIR Ment Health 2023; 10:e42377. [PMID: 37450322 PMCID: PMC10382949 DOI: 10.2196/42377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 03/20/2023] [Accepted: 04/26/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Depressive and anxiety disorders are the most common mental disorders, and there is a critical need for effective, affordable, and accessible interventions. Cognitive Behavioral Immersion (CBI) is a novel group-based cognitive behavioral skills training program delivered by lay coaches in the metaverse that can be accessed through various modalities including virtual reality (VR) head-mounted displays or flat-screen devices. Combining its ability to offer empirically supported therapy skills in a digital setting that can still facilitate interpersonal variables (eg, working alliance and sense of social support) with the aid of lay coaches, CBI has the potential to help fill this critical need. OBJECTIVE This study had 2 primary aims. First, we aimed to examine changes in depression and anxiety symptoms in a sample of individuals who participated in CBI. Second, we aimed to examine 2 interpersonal process variables (working alliance and web-based social support) as predictors of symptom changes. We predicted CBI participants would experience depression and anxiety symptom improvements and that such improvements would be associated with an increase in both interpersonal process variables. METHODS The study sample consists of 127 participants who endorsed clinical levels of depression or anxiety symptoms during their first CBI session and attended at least 2 sessions. Participants were asked to complete self-report measures of depression symptoms, anxiety symptoms, alliance, and web-based social support throughout their participation in CBI. RESULTS Repeated measures ANOVAs determined that depression and anxiety symptom scores differed significantly across sessions (Ps<.01). We also found participants' web-based social support predicted improvement in depression symptoms (P=.01), but neither the alliance nor web-based social support predicted change in anxiety symptoms (Ps>.05). We also observed a significant difference in anxiety symptoms between participants who used a VR head-mounted display to access CBI and those who did not, such that participants who used VR head-mounted displays endorsed lower anxiety symptoms than those who did not at nearly every session (P=.04). CONCLUSIONS Participation in CBI is associated with both depression and anxiety symptom improvement. Web-based social support may play an important role in fostering changes in depression symptoms. Future studies are encouraged to continue examining the process of change in CBI with special attention paid to methods that can elucidate causal mechanisms of change.
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Affiliation(s)
- Iony D Ezawa
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Steven D Hollon
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
| | - Noah Robinson
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
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20
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Aliwi I, Schot V, Carrabba M, Duong P, Shievano S, Caputo M, Wray J, de Vecchi A, Biglino G. The Role of Immersive Virtual Reality and Augmented Reality in Medical Communication: A Scoping Review. J Patient Exp 2023; 10:23743735231171562. [PMID: 37441275 PMCID: PMC10333997 DOI: 10.1177/23743735231171562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Communication between clinicians and patients and communication within clinical teams is widely recognized as a tool through which improved patient outcomes can be achieved. As emerging technologies, there is a notable lack of commentary on the role of immersive virtual reality (VR) and augmented reality (AR) in enhancing medical communication. This scoping review aims to map the current landscape of literature on this topic and highlights gaps in the evidence to inform future endeavors. A comprehensive search strategy was conducted across 3 databases (PubMed, Web of Science, and Embase), yielding 1000 articles, of which 623 were individually screened for relevance. Ultimately, 22 articles were selected for inclusion and review. Similarities across the cohort of studies included small sample sizes, observational study design, use of questionnaires, and more VR studies than AR. The majority of studies found these technologies to improve medical communication, although user tolerability limitations were identified. More studies are required, presenting more robust findings, in order to draw more definitive conclusions and stronger recommendations for use of immersive VR/AR in clinical environments.
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Affiliation(s)
| | - Vico Schot
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Phuoc Duong
- Alder Hey Children's Hospital,
Liverpool, UK
| | | | - Massimo Caputo
- Bristol Medical School, University of Bristol, Bristol, UK
- University Hospitals Bristol &
Weston NHS Foundation Trust, Bristol, UK
| | - Jo Wray
- UCL Institute of Cardiovascular
Science, UCL, London, UK
- Great Ormond Street Hospital for Children
NHS Foundation Trust, London, UK
| | | | - Giovanni Biglino
- Bristol Medical School, University of Bristol, Bristol, UK
- National Heart and Lung Institute,
Imperial College London, London, UK
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21
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Bouraghi H, Mohammadpour A, Khodaveisi T, Ghazisaeedi M, Saeedi S, Familgarosian S. Virtual Reality and Cardiac Diseases: A Systematic Review of Applications and Effects. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:8171057. [PMID: 37287540 PMCID: PMC10243949 DOI: 10.1155/2023/8171057] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/22/2023] [Accepted: 03/04/2023] [Indexed: 06/09/2023]
Abstract
Introduction Cardiac diseases have grown significantly in recent years, causing many deaths globally. Cardiac diseases can impose a significant economic burden on societies. The development of virtual reality technology has attracted the attention of many researchers in recent years. This study aimed to investigate the applications and effects of virtual reality (VR) technology on cardiac diseases. Methods A comprehensive search was carried out in four databases, including Scopus, Medline (through PubMed), Web of Science, and IEEE Xplore to identify related articles published until May 25, 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guideline for systematic reviews was followed. All randomized trials that investigated the effects of virtual reality on cardiac diseases were included in this systematic review. Results Twenty-six studies were included in this systematic review. The results illustrated that virtual reality applications in cardiac diseases can be classified in three categories of physical rehabilitation, psychological rehabilitation, and education/training. This study revealed that the use of virtual reality in psychological and physical rehabilitation can reduce stress, emotional tension, Hospital Anxiety and Depression Scale (HADS) total score, anxiety, depression, pain, systolic blood pressure, and length of hospitalization. Finally, the use of virtual reality in education/training can enhance technical performance, increase the speed of procedures, and improve the user's skills, level of knowledge, and self-confidence as well as facilitate learning. Also, the most limitations mentioned in the studies included small sample size and lack of or short duration of follow-up. Conclusions The results showed that the positive effects of using virtual reality in cardiac diseases are much more than its negative effects. Considering that the most limitations mentioned in the studies were the small sample size and short duration of follow-up, it is necessary to conduct studies with adequate methodological quality to report their effects in the short term and long term.
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Affiliation(s)
- Hamid Bouraghi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Mohammadpour
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Taleb Khodaveisi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marjan Ghazisaeedi
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Saeedi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
- Clinical Research Development Unit of Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
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22
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Arroyo-Cruz G, Orozco-Varo A, Domínguez-Cardoso P, Árbol-Carrero AB, Jiménez-Castellanos E. FitJaw Mobile, a virtual reality device applied to dentistry: An analysis based on two patient treatments. J Prosthet Dent 2023:S0022-3913(23)00274-3. [PMID: 37236885 DOI: 10.1016/j.prosdent.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
STATEMENT OF PROBLEM Virtual reality (VR) has improved significantly in the last decade and has been applied to different fields, including medicine, dentistry, and physiotherapy. VR has been used for the innovative treatment of painful conditions, especially when traditional exercise therapies were unsuccessful because of patient noncompliance. PURPOSE The purpose of this study was to analyze the use of VR as an aid when using exercises to manage temporomandibular disorders (TMDs). MATERIAL AND METHODS Two White women diagnosed with TMDs of muscular origin (one with muscular pain and the other with reduced mouth opening) were referred to the Department of Prosthodontics of the University of Seville, where they were enrolled in an exercise program using the VR software program FitJaw Mobile. Both had been treated the previous year with an occlusal device for TMD of muscular origin, but their symptoms had not improved. RESULTS For both patients, the functional movement limitation and the chronic pain improved noticeably. CONCLUSIONS The use of VR when doing jaw exercises can improve outcomes and compliance.
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Affiliation(s)
- Gema Arroyo-Cruz
- Assistant Professor, Department of Stomatology, School of Dentistry, University of Seville, Seville, Spain
| | - Ana Orozco-Varo
- Assistant Professor, Department of Stomatology, School of Dentistry, University of Seville, Seville, Spain.
| | - Pablo Domínguez-Cardoso
- Assistant Professor, Department of Stomatology, School of Dentistry, University of Seville, Seville, Spain
| | - Ana Belén Árbol-Carrero
- Graduate student, Graduate Physiotherapy, School of Physiotherapy, University of Seville, Seville, Spain; Private practice, Seville, Spain
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23
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Thaysen-Petersen D, Hammerum SK, Vissing AC, Arnfred BT, Nordahl R, Adjorlu A, Nordentoft M, Oestrich IH, Düring SW, Fink-Jensen A. Virtual reality-assisted cognitive behavioural therapy for outpatients with alcohol use disorder (CRAVR): a protocol for a randomised controlled trial. BMJ Open 2023; 13:e068658. [PMID: 36990475 PMCID: PMC10069573 DOI: 10.1136/bmjopen-2022-068658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Alcohol use disorder (AUD) is a brain disorder linked to over 200 health conditions. Cognitive behavioural therapy (CBT) is considered the best practice in the treatment of AUD, but more than 60% of patients relapse within the first year after treatment. Psychotherapy combined with virtual reality (VR) has received increasing interest in the treatment of AUD. However, existing studies have primarily investigated the use of VR for cue reactivity. We therefore aimed to investigate the effect of VR-assisted CBT (VR-CBT). METHODS AND ANALYSIS This study is an assessor-blinded, randomised clinical trial being conducted at three outpatient clinics in Denmark. We will randomise 102 patients to 14 individual sessions of either manualised VR-CBT or CBT. The VR-CBT group will receive exposure to immersive high-risk VR situations from a pub, bar/party, restaurant, supermarket and at-home (30 videos) to activate high-risk-related beliefs and cravings for subsequent modification using CBT techniques. The treatment period is 6 months, and follow-up visits will be performed 3, 6, 9 and 12 months after inclusion. The primary outcome measure is the change in total alcohol consumption from baseline to 6 months after inclusion, measured with the Timeline Followback Method. Key secondary outcome measures include changes in the number of heavy drinking days, alcohol cravings, cognition, and symptoms of depression and anxiety. ETHICS AND DISSEMINATION Approval has been obtained by the research ethics committee in the Capital Region of Denmark (H-20082136) and the Danish Data Protection Agency (P-2021-217). All patients will receive both oral and written information about the trial and written informed consent will be obtained from each patient before inclusion. The study results will be disseminated in peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ClinicalTrial.gov, NCT05042180.
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Affiliation(s)
- Daniel Thaysen-Petersen
- Psychiatric Centre Copenhagen, Department of Neuroscience and Pharmacology, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark
| | - Sigurd Krogh Hammerum
- Psychiatric Centre Copenhagen, Department of Neuroscience and Pharmacology, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark
| | - Anne-Cathrine Vissing
- Psychiatric Centre Copenhagen, Department of Neuroscience and Pharmacology, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark
| | - Benjamin Thorup Arnfred
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark
| | - Rolf Nordahl
- Multisensory Experience Lab, Department of Architecture and Media Technology, Aalborg Universitet, Copenhagen, Denmark
| | - Ali Adjorlu
- Multisensory Experience Lab, Department of Architecture and Media Technology, Aalborg Universitet, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark
| | - Irene Henriette Oestrich
- Psychiatric Center Sct. Hans, Mental Health Services, Capitol Region Hospitals, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark
| | - Signe Wegmann Düring
- Psychiatric Center Sct. Hans, Mental Health Services, Capitol Region Hospitals, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark
| | - Anders Fink-Jensen
- Psychiatric Center Copenhagen, Rigshospitalet, Mental Health Services, Capitol Region Hospitals, Capital Region of Denmark Mental Health Services, Kobenhavn, Hovedstaden, Denmark
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Liu H, Cheng Z, Wang S, Jia Y. Effects of virtual reality-based intervention on depression in stroke patients: a meta-analysis. Sci Rep 2023; 13:4381. [PMID: 36928345 PMCID: PMC10020160 DOI: 10.1038/s41598-023-31477-z] [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: 10/16/2021] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
As one of the most common neuropsychiatric complications after stroke, post-stroke depression can significantly affect the initiative of rehabilitation exercise and the rehabilitation of neurological function of patients. Virtual reality (VR) has been widely used in health-related fields in recent years. There is some evidence that VR-based interventions have benefits for depression. The aim of this study was to assess the effectiveness of VR-based intervention on depression in stroke patients. A total of 752 patients with stroke from 11 randomized controlled trials (RCTs) studies were included in this meta-analysis and the studies derived from seven electronic databases searched from database inception to August 2021. Different tools were used to measure depression. For continuous results, the standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated to synthesize the effects. We assessed the risk of bias by using the Cochrane Collaboration criteria. The results showed that compared to the control group, VR-based interventions significantly decreased the depression scale score (SMD = - 0.75, 95% CI - 1.35, - 0.15). The meta-analysis indicated that VR-based intervention had a moderate effect on depression in stroke patients compared to control group. There was no evidence of potential publication bias as assessed by visual inspection of funnel plots in Egger and Begg tests. Substantial heterogeneity between studies was observed, meta-regression analysis showed that mean age might be the source of heterogeneity.
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Affiliation(s)
- Hebing Liu
- The Second Hospital, Jilin University, No. 218 Ziqiang Street, Changchun, 130021, Jilin, China
| | - Zhaohua Cheng
- The Second Hospital, Jilin University, No. 218 Ziqiang Street, Changchun, 130021, Jilin, China
| | - Shuo Wang
- School of Nursing, Xuzhou Medical University, Tongshan Road, Xuzhou, 221004, Jiangsu, China
| | - Yong Jia
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun, 130021, Jilin, China.
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Tychkov AY, Chernyshov DS, Bofonova NS, Churakov PP, Yuldashev ZM, Gorbunov VN, Zolotarev RV, Alimuradov AK. Spectral Analysis of the EEG of Subjects with Anxious-Phobic Disorders in a Virtual Reality Environment. BIOMEDICAL ENGINEERING 2023. [DOI: 10.1007/s10527-023-10250-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Jan Pawlik R, Aulenkamp J, Elsenbruch S. Wenn aus einem Bauchgefühl viszerale Schmerzen werden:
Placebo- und Nocebo-Mechanismen entlang der Darm-Hirn-Achse. AKTUELLE ERNÄHRUNGSMEDIZIN 2023. [DOI: 10.1055/a-1976-9382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
ZusammenfassungDas Erleben von Schmerz ist nach heutigem Verständnis durch eine Vielzahl
biologischer, psychologischer und sozialer Faktoren geprägt und somit
eine komplexe, von der Nozizeption abzugrenzende, psychologische Erfahrung.
Entsprechend ist das Schmerzerleben durch psychologische Faktoren modulierbar
und chronische Schmerzen werden als biopsychosoziale Erkrankungen verstanden.
Dies gilt auch für den Viszeralschmerz, dem spezifische
psychophysiologische Prinzipien und neurobiologische Mechanismen zugrunde
liegen, was eine interdisziplinäre Betrachtung unter Einbeziehung der
Psychologie und der Neurowissenschaften erforderlich macht. Ausgehend von den
bidirektionalen Verbindungen zwischen Darm und Hirn und aufbauend auf einem
biopsychosozialen Krankheitsmodell beschreibt dieser Übersichtsbeitrag
psychologische Mechanismen, die bei der Entstehung, Aufrechterhaltung und
Therapie viszeraler Schmerzen wichtig sind. Dabei liegt der Fokus auf positiven
und negativen Erwartungseffekten im psychosozialen Behandlungskontext.
Therapieerwartungen können Krankheitssymptome sowohl positiv als auch
negativ beeinflussen. Diese gemeinhin als Placebo- und Noceboeffekte bekannten
Phänomene, die durch die Arzt-Patient Kommunikation, Lernprozesse,
Stress und Furcht vermittelt werden, sind auch für den Viszeralschmerz
bei gastrointestinalen Erkrankungen zunehmend anerkannt und Gegenstand aktueller
grundlagenwissenschaftlicher und klinischer Forschungsaktivitäten. Neue
interdisziplinäre und translationale Forschungsansätze aus der
Forschung zu Placebo- und Noceboeffekten liefern spannende Einblicke in die
zahlreichen Verbindungen und Wechselbeziehungen zwischen Darm und Gehirn bei
normalen wie auch pathologischen Darm-Hirn Interaktionen und können dazu
beitragen, die Pathophysiologie von Erkrankungen, die mit viszeralen Schmerzen
einhergehen, besser zu verstehen und wichtige Erkenntnisse für neue
Therapieansätze zu gewinnen.
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Affiliation(s)
- Robert Jan Pawlik
- Abteilung für Medizinische Psychologie und Medizinische
Soziologie, Ruhr-Universität Bochum Medizinische Fakultät,
Bochum, Germany
| | - JanaLuisa Aulenkamp
- Klinik für Anästhesiologie und Intensivmedizin,
Universitätsklinikum Essen, Essen, Germany
- Klinik für Neurologie, Zentrum für Translationale
Neuro- und Verhaltenswissenschaften, Universitätsklinikum Essen, Essen,
Germany
| | - Sigrid Elsenbruch
- Abteilung für Medizinische Psychologie und Medizinische
Soziologie, Ruhr-Universität Bochum Medizinische Fakultät,
Bochum, Germany
- Klinik für Neurologie, Zentrum für Translationale
Neuro- und Verhaltenswissenschaften, Universitätsklinikum Essen, Essen,
Germany
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Flujas-Contreras JM, García-Palacios A, Gómez I. Technology in psychology: a bibliometric analysis of technology-based interventions in clinical and health psychology. Inform Health Soc Care 2023; 48:47-67. [PMID: 35353661 DOI: 10.1080/17538157.2022.2054343] [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: 11/05/2022]
Abstract
This study aimed to identify, synthesize, and evaluate the current state of research on the use of technology-based interventions in clinical psychology through 2017 as a recent innovative area of study. It was intended to provide a critical overview of trends in different tools and populations and identify future areas of interest. This paper focuses on studies published in psychological interventions in childhood, adolescents, adults, and geriatric populations using new technologies, including web-based intervention, virtual reality, augmented reality, mobile applications, and robotics, with particular attention to methodology. To achieve this aim, a systematic search was made in the ISI Web of Science for intervention, psychology, and the technological tools previously mentioned. The results of the study show that the use of information and communication technologies in psychology has been an innovative and growing field of study for the last 10 years. In total, 743 were included in this study. A growing trend has been observed in publications related to psychology and the use of technologies since 2007. Resea0rch topics were focused mainly on interventions on specific problems or disorders such as depression. The largest number of publications were found for the web-based intervention, in randomized clinical trials and applied to adults.
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Affiliation(s)
- Juan M Flujas-Contreras
- Department of Psychology University of Almeria, Almería, Spain.,Health Research Centre of University of Almeria (CEINSA/ual), Almería, Spain
| | - Azucena García-Palacios
- Department of Psychology, University Jaume I, Castellon, Spain.,CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Instituto de Salud Carlos III, Spain
| | - Inmaculada Gómez
- Department of Psychology University of Almeria, Almería, Spain.,Health Research Centre of University of Almeria (CEINSA/ual), Almería, Spain
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Ford T, Buchanan DM, Azeez A, Benrimoh DA, Kaloiani I, Bandeira ID, Hunegnaw S, Lan L, Gholmieh M, Buch V, Williams NR. Taking modern psychiatry into the metaverse: Integrating augmented, virtual, and mixed reality technologies into psychiatric care. Front Digit Health 2023; 5:1146806. [PMID: 37035477 PMCID: PMC10080019 DOI: 10.3389/fdgth.2023.1146806] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
The landscape of psychiatry is ever evolving and has recently begun to be influenced more heavily by new technologies. One novel technology which may have particular application to psychiatry is the metaverse, a three-dimensional digital social platform accessed via augmented, virtual, and mixed reality (AR/VR/MR). The metaverse allows the interaction of users in a virtual world which can be measured and manipulated, posing at once exciting new possibilities and significant potential challenges and risks. While the final form of the nascent metaverse is not yet clear, the immersive simulation and holographic mixed reality-based worlds made possible by the metaverse have the potential to redefine neuropsychiatric care for both patients and their providers. While a number of applications for this technology can be envisioned, this article will focus on leveraging the metaverse in three specific domains: medical education, brain stimulation, and biofeedback. Within medical education, the metaverse could allow for more precise feedback to students performing patient interviews as well as the ability to more easily disseminate highly specialized technical skills, such as those used in advanced neurostimulation paradigms. Examples of potential applications in brain stimulation and biofeedback range from using AR to improve precision targeting of non-invasive neuromodulation modalities to more innovative practices, such as using physiological and behavioral measures derived from interactions in VR environments to directly inform and personalize treatment parameters for patients. Along with promising future applications, we also discuss ethical implications and data security concerns that arise when considering the introduction of the metaverse and related AR/VR technologies to psychiatric research and care.
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Affiliation(s)
- T.J. Ford
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - Derrick M. Buchanan
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
- Correspondence: Derrick M. Buchanan
| | - Azeezat Azeez
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - David A. Benrimoh
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Irakli Kaloiani
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - Igor D. Bandeira
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - Saron Hunegnaw
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - Lucy Lan
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - Mia Gholmieh
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - Vivek Buch
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
- Neurosurgery, Stanford University, Palo Alto, CA, United States
| | - Nolan R. Williams
- Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
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Luong T, Lecuyer A, Martin N, Argelaguet F. A Survey on Affective and Cognitive VR. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2022; 28:5154-5171. [PMID: 34495833 DOI: 10.1109/tvcg.2021.3110459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In Virtual Reality (VR), users can be immersed in emotionally intense and cognitively engaging experiences. Yet, despite strong interest from scholars and a large amount of work associating VR and Affective and Cognitive States (ACS), there is a clear lack of structured and systematic form in which this research can be classified. We define "Affective and Cognitive VR" to relate to works which (1) induce ACS, (2) recognize ACS, or (3) exploit ACS by adapting virtual environments based on ACS measures. This survey clarifies the different models of ACS, presents the methods for measuring them with their respective advantages and drawbacks in VR, and showcases Affective and Cognitive VR studies done in an Immersive Virtual Environment (IVE) in a non-clinical context. Our article covers the main research lines in Affective and Cognitive VR. We provide a comprehensive list of references with the analysis of 63 research articles and summarize future works directions.
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Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, Blumenthal N, Li M, Asché L, Jonas S, Bey K, Schulze M, Steffens M, Pensel MC, Guth M, Rohlfsen F, Ekhlas M, Lügering H, Fileccia H, Pakos J, Lux S, Philipsen A, Braun N. Virtual reality in the diagnostic and therapy for mental disorders: A systematic review. Clin Psychol Rev 2022; 98:102213. [PMID: 36356351 DOI: 10.1016/j.cpr.2022.102213] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/21/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Virtual reality (VR) technologies are playing an increasingly important role in the diagnostics and treatment of mental disorders. OBJECTIVE To systematically review the current evidence regarding the use of VR in the diagnostics and treatment of mental disorders. DATA SOURCE Systematic literature searches via PubMed (last literature update: 9th of May 2022) were conducted for the following areas of psychopathology: Specific phobias, panic disorder and agoraphobia, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, eating disorders, dementia disorders, attention-deficit/hyperactivity disorder, depression, autism spectrum disorder, schizophrenia spectrum disorders, and addiction disorders. ELIGIBILITY CRITERIA To be eligible, studies had to be published in English, to be peer-reviewed, to report original research data, to be VR-related, and to deal with one of the above-mentioned areas of psychopathology. STUDY EVALUATION For each study included, various study characteristics (including interventions and conditions, comparators, major outcomes and study designs) were retrieved and a risk of bias score was calculated based on predefined study quality criteria. RESULTS Across all areas of psychopathology, k = 9315 studies were inspected, of which k = 721 studies met the eligibility criteria. From these studies, 43.97% were considered assessment-related, 55.48% therapy-related, and 0.55% were mixed. The highest research activity was found for VR exposure therapy in anxiety disorders, PTSD and addiction disorders, where the most convincing evidence was found, as well as for cognitive trainings in dementia and social skill trainings in autism spectrum disorder. CONCLUSION While VR exposure therapy will likely find its way successively into regular patient care, there are also many other promising approaches, but most are not yet mature enough for clinical application. REVIEW REGISTRATION PROSPERO register CRD42020188436. FUNDING The review was funded by budgets from the University of Bonn. No third party funding was involved.
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Affiliation(s)
- Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ann-Kathrin Thöne
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Pramme
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Nike Blumenthal
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mengtong Li
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Asché
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Stephan Jonas
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Marcel Schulze
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Maria Steffens
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Max Christian Pensel
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Matthias Guth
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Felicia Rohlfsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mogda Ekhlas
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Lügering
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Fileccia
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Julian Pakos
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
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31
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Therapeutic Alliance and Treatment Expectations: Predicting Outcomes in Exposure Treatments for Specific Phobia. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10343-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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32
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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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Tan J, Kannis-Dymand L, Jones C. Examining the potential of VR program Tilt Brush in reducing anxiety. VIRTUAL REALITY 2022; 27:1-13. [PMID: 36405877 PMCID: PMC9647245 DOI: 10.1007/s10055-022-00711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Recent advancement in technology has made virtual reality (VR) more accessible and immersive than ever before, resulting in its increasing utility in various industries. Despite this, VR has remained an underutilised tool within clinical psychology. This study aimed to explore the potential of using VR for therapeutic benefits through examining the level of flow and anxiety-reducing effects of freeform drawing in real life (on paper) versus drawing in VR (using Tilt Brush) via a randomised-controlled trial with 40 participants. State and trait anxiety was measured using the State-Trait Anxiety Inventory, level of flow was measured using the Long Flow State Scale, and level of presence was measured using the iGroup Presence Questionnaire. Overall level of flow was not significantly different between both groups, implying drawing in VR induces as much flow as drawing in real life. Level of flow was positively correlated to level of presence experienced in the VR group (p < .01). Although there was no significant interaction effect, both groups experienced an overall decrease in state anxiety, with the VR group experiencing a significant reduction of state anxiety from pre- to post-test (p < .01).
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Affiliation(s)
- Janice Tan
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD Australia
| | - Lee Kannis-Dymand
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD Australia
| | - Christian Jones
- School of Law and Society, University of the Sunshine Coast, Maroochydore, QLD Australia
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Kiss BL, Birkás B, Zilahi L, Zsidó AN. The role of fear, disgust, and relevant experience in the assessment of stimuli associated with blood-injury-injection phobia. Heliyon 2022; 8:e11839. [DOI: 10.1016/j.heliyon.2022.e11839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 11/28/2022] Open
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Zolfaghari E, Ridout B, Medlow S, Campbell A, Coggins A, Murphy M, Jani S, Thosar D, Wiederhold BK, Wiederhold M, Steinbeck K. Exploring the use of virtual reality to manage distress in adolescent patients in emergency departments: A feasibility study. Emerg Med Australas 2022; 34:687-693. [PMID: 35238143 PMCID: PMC9790434 DOI: 10.1111/1742-6723.13945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The present study aimed to explore the feasibility and potential benefits of deploying virtual reality (VR) for adolescents in the ED. METHODS This multi-centre study was undertaken in paediatric and adult EDs in two university teaching hospitals. Twenty-six participants who had voluntarily attended the ED received the VR intervention. Pre- and post-measures assessing changes in state anxiety, stress and affect, and physical biomarkers were obtained. RESULTS The use of VR intervention was associated with significant reductions in distress (Short State Stress Questionnaire - Distress Subscale; t = 4.55, P < 0.001) and negative affect (the International Positive and Negative Affect Scale - Short Form version; t = 4.99, P < 0.001). Most participants chose 'Netflix' as their content of choice. The technology was well received by the participants with subjective reports indicating that receiving VR intervention was 'insanely cool', 'takes you away from what's actually happening' and some participants felt 'privileged to get this experience in a hospital'. CONCLUSIONS VR technology can effectively be used in EDs to assist adolescents and young adults better manage their distress and take steps towards activating more self-control mechanisms that will in turn allow for more meaningful engagements to be established with health clinicians. This technology has broad implications for reducing distress in adolescents in a variety of clinical contexts.
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Affiliation(s)
- Elham Zolfaghari
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Brad Ridout
- Discipline of Biomedical Informatics and Digital HealthCyberpsychology Research Group, Faculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia
| | - Sharon Medlow
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Andrew Campbell
- Discipline of Biomedical Informatics and Digital HealthCyberpsychology Research Group, Faculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia
| | - Andrew Coggins
- Department of Emergency Medicine, Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia,Discipline of Emergency MedicineSydney Medical School, The University of SydneySydneyNew South WalesAustralia
| | - Margaret Murphy
- Department of Emergency Medicine, Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia,Discipline of Emergency MedicineSydney Medical School, The University of SydneySydneyNew South WalesAustralia
| | - Shefali Jani
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Department of Emergency MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Deepali Thosar
- Department of Emergency MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Brenda K Wiederhold
- Virtual Reality Medical CenterScripps Memorial HospitalLa JollaCaliforniaUSA
| | - Mark Wiederhold
- Virtual Reality Medical CenterScripps Memorial HospitalLa JollaCaliforniaUSA
| | - Katharine Steinbeck
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
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Preliminary Study of Efficacy and Safety of Self-Administered Virtual Exposure Therapy for Social Anxiety Disorder vs. Cognitive-Behavioral Therapy. Brain Sci 2022; 12:brainsci12091236. [PMID: 36138972 PMCID: PMC9496986 DOI: 10.3390/brainsci12091236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/05/2022] [Accepted: 09/05/2022] [Indexed: 12/02/2022] Open
Abstract
Social anxiety disorder (SAD) is one of the most frequent mental disorders. Exposure to virtual reality can be a solution complementing standard CBT (cognitive-behavioral therapy) or can be used as an independent therapeutic tool. The study’s objective was to assess the safety and efficacy of using self-administered virtual reality exposure vs. CBT and CBT with virtual exposure. We assessed the efficacy of the applied intervention with the Leibowitz Social Anxiety Scale (LSAS). We compared three groups: CBT (n = 25), CBT + VR (n = 29), and self-administered therapy without aid of a therapist (n = 19). The results indicated that all three groups showed changes on the LSAS. The simple effect analysis showed that there were no differences between experimental conditions at T0 (session 1) and T1 (session 9) and that the only significant difference occurred at T2 (session 14). The pairwise comparisons showed that the participants in the VR condition scored higher on the LSAS score during the measurement at T2 than participants in CBT condition. Our study has several limitations. The presented initial study shows that the methods of CBT for social anxiety used so far are also effective, while the VR tool for self-therapy requires further research.
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Gong Z, Wang Z, Jiang L, Wang X, Zhang B, Vashisth MK, Zhou Q. Neuronal activity in the dorsal dentate gyrus during extinction regulates fear memory extinction and renewal. Exp Neurol 2022; 358:114224. [PMID: 36089058 DOI: 10.1016/j.expneurol.2022.114224] [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] [Received: 04/29/2022] [Revised: 07/16/2022] [Accepted: 09/05/2022] [Indexed: 11/19/2022]
Abstract
Memory extinction and renewal are major factors that limits the efficacy of exposure therapy. The dorsal dentate gyrus (dDG) plays a crucial role in spatial memory, and epigenetic modifications in the dDG play an important role in fear memory renewal. However, whether dDG activity regulates fear memory extinction and renewal remains unclear. In this study, we showed that an extinction procedure that prevents fear memory renewal (extinction within the reconsolidation window) leads to increased c-fos expression in the dDG. Chemicogenetic activation of dDG excitatory neurons during extinction training elevated fear memory extinction and prevented renewal, whereas inhibition of dDG excitatory neurons inhibited fear memory extinction. We also demonstrated that inhibiting fear engram cells (neurons active during fear acquisition) during extinction training inhibits fear memory extinction. Therefore, dDG activity during fear extinction plays an important role in fear memory extinction and renewal.
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Affiliation(s)
- Zhiting Gong
- Department of Anatomy, College of Preclinical Medicine, Dali University, Dali, China
| | - Zongliang Wang
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Le Jiang
- Department of Anatomy, College of Preclinical Medicine, Dali University, Dali, China
| | - Xiaobing Wang
- Department of Anatomy, College of Preclinical Medicine, Dali University, Dali, China
| | - Bensi Zhang
- Department of Anatomy, College of Preclinical Medicine, Dali University, Dali, China
| | - Manoj Kumar Vashisth
- Department of Anatomy, College of Preclinical Medicine, Dali University, Dali, China
| | - Qiang Zhou
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China.
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Iloudi M, Lindner P, Ali L, Wallström S, Thunström AO, Ioannou M, Anving N, Johansson V, Hamilton W, Falk Ö, Steingrimsson S. Physical Versus Virtual Reality-based Calm Rooms for Psychiatric Inpatients: a Quasi-randomized Trial (Preprint). J Med Internet Res 2022; 25:e42365. [DOI: 10.2196/42365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/18/2023] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
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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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40
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Miegel F, Bücker L, Kühn S, Mostajeran F, Moritz S, Baumeister A, Lohse L, Blömer J, Grzella K, Jelinek L. Exposure and Response Prevention in Virtual Reality for Patients with Contamination-Related Obsessive-Compulsive Disorder: a Case Series. Psychiatr Q 2022; 93:861-882. [PMID: 35779165 DOI: 10.1007/s11126-022-09992-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 11/27/2022]
Abstract
Exposure therapy in virtual reality is successful in treating anxiety disorders. Studies on exposure and response prevention in virtual reality (VERP) in obsessive-compulsive disorder (OCD) are rare, and it is unclear whether distress associated with other emotions than anxiety (e.g., disgust) can be evoked. The present study aimed to investigate whether distress can be induced during VERP in patients with contamination-related OCD (C-OCD) and a primary feeling of disgust. We treated eight female patients with C-OCD with the primary emotion of disgust over six weeks with VERP and assessed their OC symptoms before and after the intervention period with the Y-BOCS. We measured subjective units of distress (SUD), heart rate and skin conductivity (arousal), sense of presence, and simulator sickness during four consecutive exposure sessions. VERP was able to induce distress and arousal. The qualitative feedback was heterogeneous and sense of presence moderate. Patients' OC symptoms reduced over the treatment period with medium to large effect sizes, but only two patients were considered responders; two patients discontinued treatment due to lack of treatment success. Although VERP was able to induce distress and arousal associated with disgust and evoked a moderate sense of presence, the low rate of symptom reduction diminishes the positive results. Possible reasons for the heterogeneous results and implications are discussed. Trial registration: German Registry for Clinical Studies (DRKS00016929), 10.04.2019.
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Affiliation(s)
- Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Lara Bücker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Lentzeallee 94, 14195, Berlin, Germany
| | - Fariba Mostajeran
- Department of Informatics, University of Hamburg, Vogt-Kölln-Strasse 30, 22527, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Anna Baumeister
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Luzie Lohse
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Jannik Blömer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Karsten Grzella
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Toffolo MBJ, Fehribach JR, van Klaveren CPBJ, Cornelisz I, van Straten A, van Gelder JL, Donker T. Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial. PLoS One 2022; 17:e0271175. [PMID: 35830423 PMCID: PMC9278761 DOI: 10.1371/journal.pone.0271175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background Fear of spiders, or Arachnophobia, is one of the most common specific phobias. The gold standard treatment, in vivo exposure therapy, is effective, but comes with significant limitations, including restricted availability, high costs, and high refusal rates. Novel technologies, such as augmented reality, may help to overcome these limitations and make Exposure Therapy more accessible by using mobile devices. Objective This study will use a Randomized Controlled Trial design to investigate whether ZeroPhobia: Arachnophobia, a 6-week Augmented Reality Exposure Therapy smartphone self-help application, can effectively reduce spider phobia symptoms. Additionally, we will examine user-friendliness of the application and the effect of usage intensity and presence on treatment outcome. Methods This study is registered in the Netherlands Trial Registry under NL70238.029.19 (Trial NL9221). Ethical approval was received on October 11, 2019. One-hundred-twelve participants (age 18–64, score ≥ 59) on the Fear of Spiders Questionnaire [FSQ] will be recruited from the general Dutch population and randomly assigned to a treatment or waitlist control group. The ZeroPhobia application can be accessed on users’ smartphone. Baseline, post-test (i.e., at six weeks), 3- and 12-month follow-up assessments will be done, each including the Fear of Spiders Questionnaire as the main outcome measure as well as additional measures of anxiety, depression, user-friendliness, and presence as secondary measures and covariates. Results The study was funded on September 25, 2018. Data collection started in September 2021 and the study is expected to run until September 2022. Conclusions Our study will improve our understanding of the efficacy and feasibility of providing Exposure Therapy for spider phobia using an Augmented Reality self-help application, with the intention of making mental health care more accessible.
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Affiliation(s)
- Marieke B. J. Toffolo
- Department of Clinical, Neuro-, and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Jamie R. Fehribach
- Department of Clinical, Neuro-, and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Chris P. B. J. van Klaveren
- Department of Education Sciences, Section Methods and Statistics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Center for Learning Analytics (ACLA), Amsterdam, The Netherlands
| | - Ilja Cornelisz
- Department of Education Sciences, Section Methods and Statistics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Center for Learning Analytics (ACLA), Amsterdam, The Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro-, and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute Amsterdam, Amsterdam, The Netherlands
| | - Jean-Louis van Gelder
- Max Planck Institute for the Study of Crime, Security and Law, Freiburg im Breisgau, Germany
- Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands
| | - Tara Donker
- Department of Clinical, Neuro-, and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute Amsterdam, Amsterdam, The Netherlands
- Department of Psychology, Laboratory of Biological and Personality Psychology, Albert Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany
- * E-mail:
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Leal Santos S, Chen BK, Pereira GR, Pham V, Denny CA. Propranolol Administration Modulates Neural Activity in the Hippocampal Hilus During Fear Retrieval. Front Behav Neurosci 2022; 16:919831. [PMID: 35874651 PMCID: PMC9301278 DOI: 10.3389/fnbeh.2022.919831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022] Open
Abstract
Altered fear learning is a strong behavioral component of anxiety disorders such as post-traumatic stress disorder (PTSD). Recent efforts have attempted to combine exposure therapies with drugs that target fear memory retrieval and memory reconsolidation, in order to improve treatment efficacy. The noradrenergic (NA) signaling system is of particular interest, due to its role in regulating the stress response and its involvement in fear and learning processes. Importantly, propranolol (P), a non-selective β-adrenergic antagonist, has shown the potential in decreasing exaggerated fear in both humans and animal models. In a previous study, we utilized an activity-dependent tagging murine model to determine the neural mechanisms by which propranolol attenuates learned fear. We found that propranolol acutely decreased memory trace reactivation specifically in the dorsal dentate gyrus (dDG), but not in CA3 or CA1. Here, we extended our previous study by investigating whether propranolol additionally altered activity in the hilus, a polymorphic layer that consists of neurons, mossy cells, and GABAergic interneurons. We found that propranolol acutely reduced overall hilar activity in both the dorsal and ventral hilus. Moreover, we report that propranolol significantly altered the activity of parvalbumin (PV)+ cells in the ventral (vDG), but not dorsal DG (dDG). Together, these results suggest that a β-adrenergic blockade may affect the activity of excitatory and inhibitory cell types in the hilar layer of the DG, and that these alterations may contribute to manipulating fear memory traces.
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Affiliation(s)
- Sofia Leal Santos
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
- Division of Systems Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH)/New York State Psychiatric Institute (NYSPI), New York, NY, United States
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- Instituto de Investigação em Ciências da Vida e da Saúde (ICVS)/3Bs - PT Government Associate Laboratory, Guimarães, Portugal
| | - Briana K. Chen
- Neurobiology and Behavior (NB&B) Graduate Program, Columbia University, New York, NY, United States
| | - Guilherme R. Pereira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- Instituto de Investigação em Ciências da Vida e da Saúde (ICVS)/3Bs - PT Government Associate Laboratory, Guimarães, Portugal
| | - Vananh Pham
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
- Division of Systems Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH)/New York State Psychiatric Institute (NYSPI), New York, NY, United States
| | - Christine A. Denny
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
- Division of Systems Neuroscience, Research Foundation for Mental Hygiene, Inc. (RFMH)/New York State Psychiatric Institute (NYSPI), New York, NY, United States
- *Correspondence: Christine A. Denny,
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Litleskare S, Fröhlich F, Flaten OE, Haile A, Kjøs Johnsen SÅ, Calogiuri G. Taking real steps in virtual nature: a randomized blinded trial. VIRTUAL REALITY 2022; 26:1777-1793. [PMID: 35818369 PMCID: PMC9261150 DOI: 10.1007/s10055-022-00670-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Studies show that green exercise (i.e., physical activity in the presence of nature) can provide the synergistic psychophysiological benefits of both physical exercise and nature exposure. The present study aimed to investigate the extent to which virtual green exercise may extend these benefits to people that are unable to engage in active visits to natural environments, as well as to promote enhanced exercise behavior. After watching a video validated to elicit sadness, participants either performed a treadmill walk while exposed to one of two virtual conditions, which were created using different techniques (360° video or 3D model), or walked on a treadmill while facing a blank wall (control). Quantitative and qualitative data were collected in relation to three overarching themes: "Experience," "Physical engagement" and "Psychophysiological recovery." Compared to control, greater enjoyment was found in the 3D model, while lower walking speed was found in the 360° video. No significant differences among conditions were found with respect to heart rate, perceived exertion, or changes in blood pressure and affect. The analysis of qualitative data provided further understanding on the participants' perceptions and experiences. These findings indicate that 3D model-based virtual green exercise can provide some additional benefits compared to indoor exercise, while 360° video-based virtual green exercise may result in lower physical engagement.
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Affiliation(s)
- Sigbjørn Litleskare
- Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Fred Fröhlich
- Game School–Department of Game Development, Inland Norway University of Applied Sciences, Hamar, Norway
| | - Ole Einar Flaten
- Game School–Department of Game Development, Inland Norway University of Applied Sciences, Hamar, Norway
| | - Amelia Haile
- Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Svein Åge Kjøs Johnsen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Giovanna Calogiuri
- Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Nursing and Health Sciences, Centre for Health and Technology, University of South-Eastern Norway, Drammen, Norway
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Parmigiani G, Tortora L, Meynen G, Mandarelli G, Ferracuti S. Virtual reality interventions for victims of crime: A systematic review. J Trauma Stress 2022; 35:804-812. [PMID: 35229354 PMCID: PMC9306974 DOI: 10.1002/jts.22810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 12/02/2022]
Abstract
In the forensic field, most studies employing virtual reality (VR) interventions have focused on offenders. The validity and safety of VR applications for victims of crime are still unclear. Following PRISMA guidelines, a systematic review on VR interventions for crime victims was performed to assess the efficacy, acceptability by patients, and cost-effectiveness of these interventions compared to in-person care. We identified 34 potentially eligible studies from 188 records obtained from database searches (Medline/Pubmed, CINAHL, PsycINFO, Web of Science, and Scopus); four additional articles were identified via alternative sources. In total, nine articles were included for the qualitative synthesis. Patient satisfaction with VR interventions was found to be equivalent to face-to-face interventions. Both VR exposure and control groups found relief from posttraumatic symptoms, with differences either statistically insignificant or in favor of VR. Despite the increased costs linked to the technology required, VR appears to be a promising alternative to in vivo exposure, but further research is needed. Limitations of the review include the varied experimental protocols, which did not allow us to conduct a quantitative analysis and comparison of findings across different studies, and the generally poor quality of the studies included. Further research, preferably in larger groups, is needed to shed more light on the effectiveness of VR interventions for traumatized victims of crime.
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Affiliation(s)
| | - Leda Tortora
- School of Nursing and MidwiferyTrinity College DublinDublinIreland
| | - Gerben Meynen
- Willem Pompe Institute for Criminal Law and CriminologyUtrecht UniversityUtrechtThe Netherlands
- Faculty of HumanitiesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Gabriele Mandarelli
- Section of Criminology and Forensic PsychiatryDepartment of Interdisciplinary MedicineUniversity of BariBariItaly
| | - Stefano Ferracuti
- Department of Human Neurosciences“Sapienza” University of RomeRomeItaly
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Taveira MC, Sá JD, Rosa MGD. Virtual Reality-Induced Dissociative Symptoms: A Retrospective Study. Games Health J 2022; 11:262-267. [PMID: 35648035 DOI: 10.1089/g4h.2022.0009] [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: 11/12/2022] Open
Abstract
Objective: The use of virtual reality (VR) has been increasing worldwide, as devices are becoming more sophisticated and provide an escape from reality during the COVID-19 lockdown. This recent rise in the use of VR leads to new side effects being reported, such as dissociative symptoms that may or may not constitute a mental health concern. This retrospective study investigated the prevalence and intensity of dissociative symptoms in VR users, as well as some potential predisposing conditions that may trigger them, and their impact on the subjects' wellbeing. Materials and Methods: We conducted a survey (n = 358) that was posted on VR Facebook groups. This survey was approved by the University of Lisbon Medical Faculty's IRB, and comprised a modified version of the Clinician-Administered Dissociative State Scale (CADSS) and questions regarding potential risk factors known to induce dissociative disorders or experiences. Results: Data analysis revealed that 83.9% participants reported dissociative symptoms, with varying intensity according to CADSS (X̄=7.62;s=7.89). Significant correlations were found between CADSS score and the time spent playing, the use of software applications (apps) that involve virtual hands or hand tracking, history of previous dissociative experiences, traumatic childhood events, avoidant coping strategies, and psychiatric disorders. Nonetheless, most participants categorized the symptoms as nonanxiogenic (85.8%) and minute lasting (77.4%). Conclusion: In conclusion, this study revealed that although VR can induce dissociative experiences, they seem to be short lasting and nonthreatening to the individual's wellbeing and might be predicted or attenuated by managing other known risk factors for dissociative phenomena.
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Affiliation(s)
| | - João de Sá
- Department of Neurology, Hospital de Santa Maria, Lisboa, Portugal
| | - Michele Gomes da Rosa
- Department of Physiology, Centro Cardiovascular da Universidade de Lisboa, Lisboa, Portugal
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Philippe TJ, Sikder N, Jackson A, Koblanski ME, Liow E, Pilarinos A, Vasarhelyi K. Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review. JMIR Ment Health 2022; 9:e35159. [PMID: 35551058 PMCID: PMC9109782 DOI: 10.2196/35159] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions.
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Affiliation(s)
- Tristan J Philippe
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | | | - Anna Jackson
- School of Social Work, The University of British Columbia, Vancouver, BC, Canada
| | - Maya E Koblanski
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Eric Liow
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Andreas Pilarinos
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Krisztina Vasarhelyi
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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Quantifying virtual reality pain modulation in healthy volunteers: A randomized, crossover study. J Clin Anesth 2022; 80:110876. [PMID: 35525050 DOI: 10.1016/j.jclinane.2022.110876] [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: 12/22/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVE Virtual reality (VR) is an emerging tool to reduce pain and anxiety during procedures. Although VR's clinical benefits are reported, biometric data quantifying VR's effect on pain tolerance is lacking. We used time-lapse, subjective, and biometric data to evaluate VR's effect on modulating pain. DESIGN Randomized, controlled crossover within-subject clinical trial. SETTING This study was conducted in the Chariot Lab at Lucile Packard Children's Hospital and outdoors at Stanford University School of Medicine. PATIENTS 156 healthy volunteers were included. INTERVENTIONS Participants underwent pain-inducing ice immersions while connected to biometric sensors. Participants were randomized to immerse their dominant or non-dominant hand with VR or control (no VR) for one immersion, and then crossed-over to the other hand for the second immersion. We instructed participants to submerge their hand until they reached their pain tolerance or until four minutes elapsed. MEASUREMENTS Outcomes included ice immersion duration, perceived pain scores, and skin conductance response density (SCRD), a marker of sympathetic arousal. We used survival analysis and mixed effects models to compare measurements with and without VR. MAIN RESULTS 153 participants were included in the analysis. Participants with VR were 64% less likely to remove their hands from the ice bath throughout the immersion's duration compared to control (P < 0.001). Participants with VR reported significantly lower pain scores after controlling for dominant hand treatment assignment, VR vs. no VR treatment order, and gender (P < 0.001). SCRD increased as time progressed for both VR and control groups (P = 0.047 combined), with no significant mean group differences. CONCLUSIONS Participants with VR were more likely to survive the 4-min ice bath challenge longer and with lower levels of pain perception, supporting VR's effectiveness as a distraction tool during painful procedures. We observed no differences in sympathetic response when comparing VR to no VR.
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Bazzari AH, Bazzari FH. Advances in targeting central sensitization and brain plasticity in chronic pain. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00472-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
AbstractMaladaptation in sensory neural plasticity of nociceptive pathways is associated with various types of chronic pain through central sensitization and remodeling of brain connectivity. Within this context, extensive research has been conducted to evaluate the mechanisms and efficacy of certain non-pharmacological pain treatment modalities. These include neurostimulation, virtual reality, cognitive therapy and rehabilitation. Here, we summarize the involved mechanisms and review novel findings in relation to nociceptive desensitization and modulation of plasticity for the management of intractable chronic pain and prevention of acute-to-chronic pain transition.
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Sarauskyte L, Monciunskaite R, Griksiene R. The role of sex and emotion on emotion perception in artificial faces: An ERP study. Brain Cogn 2022; 159:105860. [PMID: 35339916 DOI: 10.1016/j.bandc.2022.105860] [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: 11/10/2021] [Revised: 02/08/2022] [Accepted: 03/10/2022] [Indexed: 11/17/2022]
Abstract
Sex has a significant impact on the perception of emotional expressions. However, it remains unclear whether sex influences the perception of emotions in artificial faces, which are becoming popular in emotion research. We used an emotion recognition task with FaceGen faces portraying six basic emotions aiming to investigate the effect of sex and emotion on behavioural and electrophysiological parameters. 71 participants performed the task while EEG was recorded. The recognition of sadness was the poorest, however, females recognized sadness better than males. ERP results indicated that fear, disgust, and anger evoked higher amplitudes of late positive potential over the left parietal region compared to neutral expression. Females demonstrated higher values of global field power as compared to males. The interaction between sex and emotion on ERPs was not significant. The results of our study may be valuable for future therapies and research, as it emphasizes possibly distinct processing of emotions and potential sex differences in the recognition of emotional expressions in FaceGen faces.
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Affiliation(s)
- Livija Sarauskyte
- Vilnius University, Life Sciences Center, Institute of Biosciences, Vilnius, Lithuania.
| | - Rasa Monciunskaite
- Vilnius University, Life Sciences Center, Institute of Biosciences, Vilnius, Lithuania
| | - Ramune Griksiene
- Vilnius University, Life Sciences Center, Institute of Biosciences, Vilnius, Lithuania
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Garrido LE, Frías-Hiciano M, Moreno-Jiménez M, Cruz GN, García-Batista ZE, Guerra-Peña K, Medrano LA. Focusing on cybersickness: pervasiveness, latent trajectories, susceptibility, and effects on the virtual reality experience. VIRTUAL REALITY 2022; 26:1347-1371. [PMID: 35250349 PMCID: PMC8886867 DOI: 10.1007/s10055-022-00636-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
UNLABELLED Although virtual reality (VR) usage has become widespread in the last decade, its adoption has been hampered by experiences of user discomfort known as cybersickness. The present study, in line with the "2020 cybersickness R&D agenda", sought to provide a broad examination of the cybersickness phenomenon, assessing its pervasiveness, latent trajectories, impacts on the VR experience, and predictor variables. The study was composed of 92 participants living in the Dominican Republic with ages ranging from 18 to 52 years (M = 26.22), who experienced a 10-min VR immersion in two environments designed for psychotherapy. The results indicated that cybersickness was pervasive, with 65.2% of the participants experiencing it, and 23.9% severely. Additionally, the latent trajectories of cybersickness were positive and curvilinear, with large heterogeneity across individuals. Cybersickness also had a substantive negative impact on the user experience and the intentions to adopt the VR technology. Finally, motion sickness susceptibility, cognitive stress, and recent headaches uniquely predicted greater severity of cybersickness, while age was negatively related. These combined results highlight the critical role that cybersickness plays on the VR experience and underscore the importance of finding solutions to the problems, such as technological advancements or special usage protocols for the more susceptible individuals. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10055-022-00636-4.
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Affiliation(s)
- Luis Eduardo Garrido
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Maite Frías-Hiciano
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Mariano Moreno-Jiménez
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Gabriella Nicole Cruz
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Zoilo Emilio García-Batista
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Kiero Guerra-Peña
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Leonardo Adrián Medrano
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
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