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Kim K, Lee JH. The effect of feedback in attention training on Attention Bias to Threat in individuals with Sluggish Cognitive Tempo. J Behav Ther Exp Psychiatry 2024; 86:101997. [PMID: 39299175 DOI: 10.1016/j.jbtep.2024.101997] [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: 04/26/2023] [Revised: 05/29/2024] [Accepted: 09/14/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND AND OBJECTIVES This study was conducted to identify the characteristics of attentional bias of individuals with Sluggish Cognitive Tempo (SCT) and how Attention Bias to Threat (ABT) changes when feedback was provided in attention training. METHODS First, a dot probe task was conducted to confirm the ABT of the SCT feedback group (N = 27) and SCT no feedback group (N = 25), and healthy control group (N = 30) before intervention. Thereafter, a VR-based attention training was conducted three times with feedback or no feedback. Finally, a dot probe task was executed again. RESULTS The SCT groups showed a higher ABT than the healthy control group. A result of the attention training, the reaction time of disengage was significantly reduced when provided feedback. In addition, it was confirmed that the ABT of the SCT group that received feedback, was significantly reduced. LIMITATIONS First, the only stimulus used to examine the ABT was the angry face, and the reaction time to other threatening facial expressions was not confirmed. Second, attention training was conducted three times, but further studies are needed on the effect of the duration of training on the magnitude of effect. CONCLUSIONS This study identified ABT associated with internalizing symptoms of SCT and suggests that attention training with immediate and continuous feedback is needed to reduce ABT.
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Affiliation(s)
- Kyunghwa Kim
- Department of Psychology, Chung-Ang University, 82 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea
| | - Jang-Han Lee
- Department of Psychology, Chung-Ang University, 82 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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2
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Finotti G, Menicagli D, Migliorati D, Costantini M, Ferri F. Beyond peripersonal boundaries: insights from crossmodal interactions. Cogn Process 2024; 25:121-132. [PMID: 37656270 PMCID: PMC10827818 DOI: 10.1007/s10339-023-01154-0] [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: 08/11/2022] [Accepted: 08/01/2023] [Indexed: 09/02/2023]
Abstract
We experience our self as a body located in space. However, how information about self-location is integrated into multisensory processes underlying the representation of the peripersonal space (PPS), is still unclear. Prior studies showed that the presence of visual information related to oneself modulates the multisensory processes underlying PPS. Here, we used the crossmodal congruency effect (CCE) to test whether this top-down modulation depends on the spatial location of the body-related visual information. Participants responded to tactile events on their bodies while trying to ignore a visual distractor presented on the mirror reflection of their body (Self) either in the peripersonal space (Near) or in the extrapersonal space (Far). We found larger CCE when visual events were presented on the mirror reflection in the peripersonal space, as compared to the extrapersonal space. These results suggest that top-down modulation of the multisensory bodily self is only possible within the PPS.
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Affiliation(s)
- Gianluca Finotti
- Centre for Studies and Research in Cognitive Neuroscience, Department of Psychology, University of Bologna, Via Rasi e Spinelli 176, 47521, Cesena (FC), Italy.
| | - Dario Menicagli
- MOMILab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Daniele Migliorati
- Scuola di Specializzazione in Psicoterapia Cognitiva e Comportamentale, Associazione di Psicologia Cognitiva, Rome, Italy
| | - Marcello Costantini
- TEAM Lab, University G. d'Annunzio, Chieti, Italy
- Institute for Advanced Biomedical Technologies - ITAB, Foundation University G. d'Annunzio, Chieti, Italy
| | - Francesca Ferri
- TEAM Lab, University G. d'Annunzio, Chieti, Italy
- Institute for Advanced Biomedical Technologies - ITAB, Foundation University G. d'Annunzio, Chieti, Italy
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3
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Gloeckler S, Biller-Andorno N. Mental health services in the metaverse: potential and concerns. Swiss Med Wkly 2023; 153:40089. [PMID: 37099742 DOI: 10.57187/smw.2023.40089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
No abstract available.
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Affiliation(s)
- Sophie Gloeckler
- Institute of Biomedical Ethics and History of Medicine, University of Zürich
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4
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Kim K, Lee JH. The effect of feedback in virtual attention training on orienting attention in individuals with sluggish cognitive tempo. J Atten Disord 2022; 26:1640-1652. [PMID: 35491754 DOI: 10.1177/10870547221090664] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study was conducted to assess the effectiveness of feedback in a virtual attention training program to improve the attentional characteristics of sluggish cognitive tempo (SCT). METHOD The SCT group (N = 60) and control group (N = 30) were identified, and the attention network test-revised (ANT-R) was performed to measure attention characteristics. Based on this result, a virtual reality (VR) feedback attention training program was developed to improve the efficiency of engagement and disengagement of attention in SCT. Sixty participants with SCT were recruited and grouped into two conditions: VR feedback (n = 30) and no-feedback (n = 30) conditions. RESULTS The results show that the VR attention training program with feedback significantly improves the attention-orienting network. CONCLUSION This suggests that it is necessary to provide immediate feedback for effective attention training for SCT and continuous intervention may be possible when feedback is provided together.
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Affiliation(s)
- Kyunghwa Kim
- College of Social Science, Chung-Ang University, Seoul, South Korea
| | - Jang-Han Lee
- College of Social Science, Chung-Ang University, Seoul, South Korea
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5
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Dammen LV, Finseth TT, McCurdy BH, Barnett NP, Conrady RA, Leach AG, Deick AF, Van Steenis AL, Gardner R, Smith BL, Kay A, Shirtcliff EA. Evoking stress reactivity in virtual reality: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 138:104709. [PMID: 35644278 DOI: 10.1016/j.neubiorev.2022.104709] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/08/2022] [Accepted: 05/21/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Virtual reality (VR) research probes stress environments that are infeasible to create in the real world. However, because research simulations are applied to narrow populations, it remains unclear if VR simulations can stimulate a broadly applicable stress-response. This systematic review and meta-analysis was conducted on studies using VR stress tasks and biomarkers. METHODS Included papers (N = 52) measured cortisol, heart rate (HR), galvanic skin response (GSR), systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory sinus arrhythmia (RSA), parasympathetic activity (RMSSD), sympathovagal balance (LF/HF), and/or salivary alpha-amylase (sAA). Effect sizes (ES) and confidence intervals (CI) were calculated based on standardized mean change of baseline-to-peak biomarker levels. RESULTS From baseline-to-peak (ES, CI), analyses showed a statistically significant change in cortisol (0.56, 0.28-0.83), HR (0.68, 0.53-0.82), GSR (0.59, 0.36-0.82), SBP (.55, 0.19-0.90), DBP (.64, 0.23-1.05), RSA (-0.59, -0.88 to -0.30), and sAA (0.27, 0.092-0.45). There was no effect for RMSSD and LF/HF. CONCLUSION VR stress tasks elicited a varied magnitude of physiological stress reactivity. VR may be an effective tool in stress research.
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Affiliation(s)
- Lotte van Dammen
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Tor T Finseth
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA.
| | - Bethany H McCurdy
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Neil P Barnett
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Roselynn A Conrady
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Alexis G Leach
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Andrew F Deick
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | | | - Reece Gardner
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Brandon L Smith
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Anita Kay
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
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6
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Implementation of virtual reality for patient distraction during diagnostic cardiac catheterisation. Cardiol Young 2022; 32:323-327. [PMID: 34304747 DOI: 10.1017/s1047951121002845] [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] [Indexed: 11/05/2022]
Abstract
Until now, the application of virtual reality as a distraction model has been widely described in the medical field, showing different benefits offered on patient's perception, particularly related to pain and anxiety. Previous clinical experience of virtual reality applications on surgical intervention has shown how during procedures with local anaesthesia, this modality improves patients' experience without changing times, costs, and clinical outcomes. Herein, we report our experience with three patients during diagnostic cardiac catheterisation, showing the effect of this technology on patients' perception and metrics during the procedure.
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7
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Minen MT, Busis NA, Friedman S, Campbell M, Sahu A, Maisha K, Hossain Q, Soviero M, Verma D, Yao L, Foo FYA, Bhatt JM, Balcer LJ, Galetta SL, Thawani S. The use of virtual complementary and integrative therapies by neurology outpatients: An exploratory analysis of two cross-sectional studies assessing the use of technology as treatment in an academic neurology department in New York City. Digit Health 2022; 8:20552076221109545. [PMID: 35874862 PMCID: PMC9297463 DOI: 10.1177/20552076221109545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Prior to the COVID-19 pandemic, about half of patients from populations that sought care in neurology tried complementary and integrative therapies (CITs). With the increased utilization of telehealth services, we sought to determine whether patients also increased their use of virtual CITs. Methods We examined datasets from two separate cross-sectional surveys that included cohorts of patients with neurological disorders. One was a dataset from a study that examined patient and provider experiences with teleneurology visits; the other was a study that assessed patients with a history of COVID-19 infection who presented for neurologic evaluation. We assessed and reported the use of virtual (and non-virtual) CITs using descriptive statistics, and determined whether there were clinical characteristics that predicted the use of CITs using logistic regression analyses. Findings Patients who postponed medical treatment for non-COVID-19-related problems during the pandemic were more likely to seek CITs. Virtual exercise, virtual psychotherapy, and relaxation/meditation smartphone applications were the most frequent types of virtual CITs chosen by patients. In both studies, age was a key demographic factor associated with mobile/virtual CIT usage. Interpretations Our investigation demonstrates that virtual CIT-related technologies were utilized in the treatment of neurologic conditions during the pandemic, particularly by those patients who deferred non-COVID-related care.
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Affiliation(s)
- Mia T Minen
- Department of Neurology, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Neil A Busis
- Department of Neurology, NYU Langone Health, New York, NY, USA
| | - Steven Friedman
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Maya Campbell
- Barnard College, Columbia University, New York, NY, USA
| | - Ananya Sahu
- The City College of New York, New York, NY, USA
| | - Kazi Maisha
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Quazi Hossain
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Mia Soviero
- The City College of New York, New York, NY, USA
| | | | - Leslie Yao
- Barnard College, Columbia University, New York, NY, USA
| | | | - Jaydeep M Bhatt
- Department of Neurology, NYU Langone Health, New York, NY, USA
| | - Laura J Balcer
- Department of Neurology, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Langone Health, New York, NY, USA
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Steven L Galetta
- Department of Neurology, NYU Langone Health, New York, NY, USA
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Sujata Thawani
- Department of Neurology, NYU Langone Health, New York, NY, USA
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8
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Lee M, Kolkmeier J, Heylen D, IJsselsteijn W. Who Makes Your Heart Beat? What Makes You Sweat? Social Conflict in Virtual Reality for Educators. Front Psychol 2021; 12:628246. [PMID: 34122221 PMCID: PMC8195282 DOI: 10.3389/fpsyg.2021.628246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/29/2021] [Indexed: 01/09/2023] Open
Abstract
Though educators often deal with stressful social conflicts, many face them ad hoc without much training. We studied if and how virtual agents can help University staff manage student-teacher conflicts. We explored educators' verbal, behavioral, and physiological reactions to a virtual agent that brought up a student-teacher conflict and held exit-interviews. Our qualitative analysis revealed that virtual agents for conflict training were positively received, but not for conflict mediation with cross-cultural differences. Those with non-Western backgrounds felt that an agent could help "save face," whereas Westerners preferred to resolve conflicts in person. In line with this, participants with a Western background rated the virtual agent to be less competent compared to those with non-Western backgrounds. While physiological measures only allow for limited conclusions, we found that participants who believed that the agent was controlled by a human had higher normalized hear rate variability (for the entire conversation in total) than people who thought that the agent was autonomous. We discuss implications for implementing virtual agents for training purposes, the impact of physiological signals, and the need to consider cultural and individual differences.
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Affiliation(s)
- Minha Lee
- Future Everyday, Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Jan Kolkmeier
- Human Media Interaction, University of Twente, Enschede, Netherlands
| | - Dirk Heylen
- Human Media Interaction, University of Twente, Enschede, Netherlands
| | - Wijnand IJsselsteijn
- Human Technology Interaction, Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
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9
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Weiss TL, Bailenson JN, Bullock K, Greenleaf W. Reality, from virtual to augmented. Digit Health 2021. [DOI: 10.1016/b978-0-12-818914-6.00018-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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10
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Gainsford K, Fitzgibbon B, Fitzgerald PB, Hoy KE. Transforming treatments for schizophrenia: Virtual reality, brain stimulation and social cognition. Psychiatry Res 2020; 288:112974. [PMID: 32353694 DOI: 10.1016/j.psychres.2020.112974] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/16/2020] [Accepted: 03/29/2020] [Indexed: 12/13/2022]
Abstract
Schizophrenia is characterised by delusions, hallucinations, anhedonia and apathy; while impairments in social cognition are often less recognised. Poor social cognition can lead to difficulties in obtaining and maintaining employment, academic progression, interpersonal relationships, and community functioning. Current interventions are highly intensive, require significant resources and have only modest effects on functional outcomes. Virtual reality (VR) and non-invasive brain stimulation (NIBS) may have a role in addressing these limitations. VR allows treatments that are potentially more accessible, less delivery intensive, and have higher ecological validity. While NIBS is able to directly modulate activity in social brain areas in order to promote neuroplasticity, strengthen neural connections and enhance brain function related to social cognitive behaviours. Therefore, the combination of VR and NIBS may allow for more efficient and transferrable interventions than those currently available. This review will explore the potential role of these technologies in the treatment of social cognitive impairment.
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Affiliation(s)
- Kirsten Gainsford
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Bernadette Fitzgibbon
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Kate E Hoy
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
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11
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The role of EEG and EMG combined virtual reality gaming system in facial palsy rehabilitation - A case report. J Bodyw Mov Ther 2019; 23:425-431. [PMID: 31103130 DOI: 10.1016/j.jbmt.2019.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND The recovery rates for facial palsy are usually excellent; however, regularly patients present with problems with their fine facial movements that affect their emotional expressions. OBJECTIVE To discover the viability and ease of using an Electroencephalogram (EEG) and Electromyography (EMG) combined Virtual Reality (VR) gaming system - the 'Oculus Rift' device in the evaluation and rehabilitation of facial palsy. DESIGN Single case study. PATIENT INFORMATION A young 23-year-old female with facial palsy. CLINICAL FINDINGS Most of the patient's facial features were re-established within the recovery time frame, except for her right forehead and eyebrow movements. INTERVENTION A 10 day exercise program (Day 2-11) with an immersive virtual reality device, which randomly shoots virtually animated white balls in an unpredictable and testing pattern. OUTCOME MEASURES EEG and EMG patterns corresponding to the facial upper quadrant were taken at baseline, post-intervention, and at follow up. RESULTS EMG and EEG investigation revealed a progressive improvement in the muscle activation in response to the impulsive and unpredictable activities in the virtual environment provided through the immersive VR device. CONCLUSION The case report found a positive relationship between VR, facial upper quadrant EMG activation and EEG pattern changes following the intervention.
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12
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A Phenomenological Framework of Architectural Paradigms for the User-Centered Design of Virtual Environments. MULTIMODAL TECHNOLOGIES AND INTERACTION 2018. [DOI: 10.3390/mti2040080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In some circumstances, immersion in virtual environments with the aid of virtual reality (VR) equipment can create feelings of anxiety in users and be experienced as something “frightening”, “oppressive”, “alienating”, “dehumanizing”, or “dystopian”. Sometimes (e.g., in exposure therapy or VR gaming), a virtual environment is intended to have such psychological impacts on users; however, such effects can also arise unintentionally due to the environment’s poor architectural design. Designers of virtual environments may employ user-centered design (UCD) to incrementally improve a design and generate a user experience more closely resembling the type desired; however, UCD can yield suboptimal results if an initial design relied on an inappropriate architectural approach. This study developed a framework that can facilitate the purposeful selection of the most appropriate architectural approach by drawing on Norberg-Schulz’s established phenomenological account of real-world architectural modes. By considering the unique possibilities for structuring and experiencing space within virtual environments and reinterpreting Norberg-Schulz’s schemas in the context of virtual environment design, a novel framework was formulated that explicates six fundamental “architectural paradigms” available to designers of virtual environments. It was shown that the application of this framework could easily be incorporated as an additional step within the UCD process.
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13
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Shin YB, Kim JJ, Kim MK, Kyeong S, Jung YH, Eom H, Kim E. Development of an effective virtual environment in eliciting craving in adolescents and young adults with internet gaming disorder. PLoS One 2018; 13:e0195677. [PMID: 29672530 PMCID: PMC5908156 DOI: 10.1371/journal.pone.0195677] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 03/27/2018] [Indexed: 12/13/2022] Open
Abstract
Internet gaming disorder (IGD) is a new disorder that warrants further investigation, as recently noted in the research criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Offering controlled environments that increase cue-induced craving, virtual reality cue-exposure therapy has been shown to be effective for some addiction disorders. To assess the feasibility of virtual reality for patients with IGD, this study aimed to develop virtual environments that represent risk situations for inducing craving, and assess the effect of virtual reality in cue reactivity. A total of 64 male adolescents and young adults (34 with IGD and 30 without) were recruited for participation. We developed a virtual internet café environment and the participants were exposed to four different tasks. As the primary feasibility outcome, cravings were measured with a visual analogue scale measuring current urge to play a game after exposure to each task. The virtual internet café induced significantly greater cravings in patients with IGD compared to controls. Additionally, patients exhibited a significantly higher acceptance rate of an avatar's invitation to play a game together than that of controls. In IGD, craving response to the tasks was positively associated with the symptom severity score as measured by Young's Internet Addiction Test. These findings reveal that virtual reality laden with complex game-related cues could evoke game craving in patients with IGD and could be used in the treatment of IGD as a cue-exposure therapy tool for eliciting craving.
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Affiliation(s)
- Yu-Bin Shin
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Jin Kim
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Min-Kyeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Sunghyon Kyeong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Hoon Jung
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyojung Eom
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunjoo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea
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14
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Metcalf M, Rossie K, Stokes K, Tallman C, Tanner B. Virtual Reality Cue Refusal Video Game for Alcohol and Cigarette Recovery Support: Summative Study. JMIR Serious Games 2018; 6:e7. [PMID: 29661748 PMCID: PMC5928331 DOI: 10.2196/games.9231] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/23/2018] [Accepted: 03/13/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND New technologies such as virtual reality, augmented reality, and video games hold promise to support and enhance individuals in addiction treatment and recovery. Quitting or decreasing cigarette or alcohol use can lead to significant health improvements for individuals, decreasing heart disease risk and cancer risks (for both nicotine and alcohol use), among others. However, remaining in recovery from use is a significant challenge for most individuals. OBJECTIVE We developed and assessed the Take Control game, a partially immersive Kinect for Windows platform game that allows users to counter substance cues through active movements (hitting, kicking, etc). METHODS Formative analysis during phase I and phase II guided development. We conducted a small wait-list control trial using a quasi-random sampling technique (systematic) with 61 participants in recovery from addiction to alcohol or tobacco. Participants used the game 3 times and reported on substance use, cravings, satisfaction with the game experience, self-efficacy related to recovery, and side effects from exposure to a virtual reality intervention and substance cues. RESULTS Participants found the game engaging and fun and felt playing the game would support recovery efforts. On average, reported substance use decreased for participants during the intervention period. Participants in recovery for alcohol use saw more benefit than those in recovery for tobacco use, with a statistically significant increase in self-efficacy, attitude, and behavior during the intervention. Side effects from the use of a virtual reality intervention were minor and decreased over time; cravings and side effects also decreased during the study. CONCLUSIONS The preliminary results suggest the intervention holds promise as an adjunct to standard treatment for those in recovery, particularly from alcohol use.
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Affiliation(s)
- Mary Metcalf
- Clinical Tools, Inc, Chapel Hill, NC, United States
| | - Karen Rossie
- Clinical Tools, Inc, Chapel Hill, NC, United States
| | - Katie Stokes
- Clinical Tools, Inc, Chapel Hill, NC, United States
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15
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Philip P, Micoulaud-Franchi JA, Sagaspe P, Sevin ED, Olive J, Bioulac S, Sauteraud A. Virtual human as a new diagnostic tool, a proof of concept study in the field of major depressive disorders. Sci Rep 2017; 7:42656. [PMID: 28205601 PMCID: PMC5311989 DOI: 10.1038/srep42656] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 01/12/2017] [Indexed: 11/23/2022] Open
Abstract
Embodied Conversational Agents (ECAs) are promising software to communicate with patients but no study has tested them in the diagnostic field of mental disorders. The aim of this study was 1) to test the performance of a diagnostic system for major depressive disorders (MDD), based on the identification by an ECA of specific symptoms (the MDD DSM 5 criteria) in outpatients; 2) to evaluate the acceptability of such an ECA. Patients completed two clinical interviews in a randomized order (ECA versus psychiatrist) and filled in the Acceptability E-scale (AES) to quantify the acceptability of the ECA. 179 outpatients were included in this study (mean age 46.5 ± 12.9 years, 57.5% females). Among the 35 patients diagnosed with MDD by the psychiatrist, 14 (40%) patients exhibited mild, 12 (34.3%) moderate and 9 (25.7%) severe depressive symptoms. Sensitivity increased across the severity level of depressive symptoms and reached 73% for patients with severe depressive symptoms, while specificity remained above 95% for all three severity levels. The acceptability of the ECA evaluated by the AES was very good (25.4). We demonstrate here the validity and acceptability of an ECA to diagnose major depressive disorders. ECAs are promising tools to conduct standardized and well-accepted clinical interviews.
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Affiliation(s)
- Pierre Philip
- Clinique du Sommeil, Service d’Explorations Fonctionnelles du Système Nerveux, CHU de Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux, France
- Univ. Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Clinique du Sommeil, Service d’Explorations Fonctionnelles du Système Nerveux, CHU de Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux, France
- Univ. Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
| | - Patricia Sagaspe
- Clinique du Sommeil, Service d’Explorations Fonctionnelles du Système Nerveux, CHU de Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux, France
- Univ. Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
| | - Etienne De Sevin
- Univ. Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
| | - Jérôme Olive
- Univ. Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
| | - Stéphanie Bioulac
- Univ. Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
- Pôle Universitaire Psychiatrie Enfants et Adolescents, Centre Hospitalier Charles Perrens, 121, rue de la Béchade, 33076 Bordeaux, France
| | - Alain Sauteraud
- Univ. Bordeaux, SANPSY, USR 3413, F-33000 Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France
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Rizzo A“S, Buckwalter JG, Forbell E, Reist C, Difede J, Rothbaum BO, Lange B, Koenig S, Talbot T. Virtual Reality Applications to Address the Wounds of War. Psychiatr Ann 2013. [DOI: 10.3928/00485713-20130306-08] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lange B, Koenig S, Chang CY, McConnell E, Suma E, Bolas M, Rizzo A. Designing informed game-based rehabilitation tasks leveraging advances in virtual reality. Disabil Rehabil 2012; 34:1863-70. [PMID: 22494437 DOI: 10.3109/09638288.2012.670029] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This paper details a brief history and rationale for the use of virtual reality (VR) technology for clinical research and intervention, and then focuses on game-based VR applications in the area of rehabilitation. An analysis of the match between rehabilitation task requirements and the assets available with VR technology is presented. KEY MESSAGES AND IMPLICATIONS Low-cost camera-based systems capable of tracking user behavior at sufficient levels for game-based virtual rehabilitation activities are currently available for in-home use. Authoring software is now being developed that aims to provide clinicians with a usable toolkit for leveraging this technology. This will facilitate informed professional input on software design, development and application to ensure safe and effective use in the rehabilitation context. CONCLUSION The field of rehabilitation generally stands to benefit from the continual advances in VR technology, concomitant system cost reductions and an expanding clinical research literature and knowledge base. Home-based activity within VR systems that are low-cost, easy to deploy and maintain, and meet the requirements for "good" interactive rehabilitation tasks could radically improve users' access to care, adherence to prescribed training and subsequently enhance functional activity in everyday life in clinical populations.
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Affiliation(s)
- Belinda Lange
- University of Southern California, Institute for Creative Technologies, Los Angeles, California, USA
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The use of virtual reality in the study, assessment, and treatment of body image in eating disorders and nonclinical samples: a review of the literature. Body Image 2012; 9:1-11. [PMID: 22119329 DOI: 10.1016/j.bodyim.2011.10.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 10/13/2011] [Accepted: 10/13/2011] [Indexed: 11/20/2022]
Abstract
This article reviews research into the use of virtual reality in the study, assessment, and treatment of body image disturbances in eating disorders and nonclinical samples. During the last decade, virtual reality has emerged as a technology that is especially suitable not only for the assessment of body image disturbances but also for its treatment. Indeed, several virtual environment-based software systems have been developed for this purpose. Furthermore, virtual reality seems to be a good alternative to guided imagery and in vivo exposure, and is therefore very useful for studies that require exposure to life-like situations but which are difficult to conduct in the real world. Nevertheless, review highlights the lack of published controlled studies and the presence of methodological drawbacks that should be considered in future studies. This article also discusses the implications of the results obtained and proposes directions for future research.
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Using Virtual Reality and Other Computer Technologies to Implement Cognitive-Behavior Therapy for the Treatment of Anxiety Disorders in Youth. INTENSIVE ONE-SESSION TREATMENT OF SPECIFIC PHOBIAS 2012. [DOI: 10.1007/978-1-4614-3253-1_12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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20
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Clough BA, Casey LM. Technological adjuncts to enhance current psychotherapy practices: A review. Clin Psychol Rev 2011; 31:279-92. [DOI: 10.1016/j.cpr.2010.12.008] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 12/17/2010] [Accepted: 12/21/2010] [Indexed: 11/28/2022]
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21
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Repetto C, Riva G. From virtual reality to interreality in the treatment of anxiety disorders. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/npy.11.5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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22
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Malloy KM, Milling LS. The effectiveness of virtual reality distraction for pain reduction: A systematic review. Clin Psychol Rev 2010; 30:1011-8. [DOI: 10.1016/j.cpr.2010.07.001] [Citation(s) in RCA: 349] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 06/30/2010] [Accepted: 07/07/2010] [Indexed: 11/25/2022]
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23
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Rizzo AS, Difede J, Rothbaum BO, Reger G, Spitalnick J, Cukor J, McLay R. Development and early evaluation of the Virtual Iraq/Afghanistan exposure therapy system for combat-related PTSD. Ann N Y Acad Sci 2010; 1208:114-25. [PMID: 20955333 DOI: 10.1111/j.1749-6632.2010.05755.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Numerous reports indicate that the growing incidence of posttraumatic stress disorder (PTSD) in returning Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) military personnel is creating a significant health care and economic challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. Virtual reality-delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. The current paper will detail the development and early results from use of the Virtual Iraq/Afghanistan exposure therapy system. The system consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern contexts for exposure therapy, including a city and desert road convoy environment. The process for gathering user-centered design feedback from returning OEF/OIF military personnel and from a system deployed in Iraq (as was needed to iteratively evolve the system) will be discussed, along with a brief summary of results from an open clinical trial using Virtual Iraq with 20 treatment completers, which indicated that 16 no longer met PTSD checklist-military criteria for PTSD after treatment.
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Affiliation(s)
- Albert Skip Rizzo
- Institute for Creative Technologies, Department of Psychiatry and School of Gerontology, University of Southern California, Playa Vista, California 90094, USA.
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24
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Segal R, Bhatia M, Drapeau M. Therapists' perception of benefits and costs of using virtual reality treatments. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2010; 14:29-34. [PMID: 21329440 DOI: 10.1089/cyber.2009.0398] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Research indicates that virtual reality is effective in the treatment of many psychological difficulties and is being used more frequently. However, little is known about therapists' perception of the benefits and costs related to the use of virtual therapy in treatment delivery. In the present study, 271 therapists completed an online questionnaire that assessed their perceptions about the potential benefits and costs of using virtual reality in psychotherapy. Results indicated that therapists perceived the potential benefits as outweighing the potential costs. Therapists' self-reported knowledge of virtual reality, theoretical orientation, and interest in using virtual reality were found to be associated with perceptual measures. These findings contribute to the current knowledge of the perception of virtual reality amongst psychotherapists.
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Abstract
Virtual reality (VR) is as effective in inducing emotional responses as reality and its application is extremely valuable in exposure treatment. In virtual environments, the patients experience similar physiological symptoms and fear as they do in real life situations, thereby facilitating the habituation process. Our goal is to offer an overview of the current panorama of VR and psychotherapy, underlining the (virtual) exposure technique and the studies that focus on panic disorder treatment through the use of VR. The literature was revised through consultation to the ISI and PubMed databases. Virtual exposure treatment offers good results and great patient acceptability. However, despite the importance of this data for the evaluation of treatment efficacy, only a few studies measure physiological responses during exposure. Lack of controlled studies and standardized treatment protocols were observed. Despite the great advance of VR use in psychotherapy, a great deal of its potential is still unknown, therefore requiring the creation of new virtual environments so that controlled studies regarding its clinical application can be conducted. Throughout the process of elaboration and investigation, clinical experiences in virtual environments must be related to real experiences in a flexible context that combines relevant cultural, physical and cognitive aspects.
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Affiliation(s)
- Marcele Regine de Carvalho
- Laboratory of Panic and Respiration, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro (RJ), Brazil.
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26
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Cukor J, Spitalnick J, Difede J, Rizzo A, Rothbaum BO. Emerging treatments for PTSD. Clin Psychol Rev 2009; 29:715-26. [DOI: 10.1016/j.cpr.2009.09.001] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2009] [Revised: 09/01/2009] [Accepted: 09/02/2009] [Indexed: 11/16/2022]
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Abstract
OBJECTIVE To provide a narrative review of studies regarding the outcomes of Virtual Reality (VR)-based treatment and rehabilitation programmes within the paediatric population. METHODS Studies related to the use of VR across a number of paediatric areas (e.g. cerebral palsy, autism, foetal alcohol syndrome and attention deficits) were identified and summarized. RESULTS Outcomes from the studies reviewed provide preliminary support for the use of VR. CONCLUSION VR may be an effective treatment method for specific disorders, although the generalizability of this literature is hindered by several methodological limitations, such as small samples and the absence of appropriate control participants.
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Affiliation(s)
- Thomas D Parsons
- Institute for Creative Technologies, University of Southern California, CA 90292-4019, USA.
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28
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Rutter CE, Dahlquist LM, Weiss KE. Sustained efficacy of virtual reality distraction. THE JOURNAL OF PAIN 2009; 10:391-7. [PMID: 19231295 DOI: 10.1016/j.jpain.2008.09.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 09/10/2008] [Accepted: 09/23/2008] [Indexed: 11/30/2022]
Abstract
UNLABELLED The current study tested whether the effectiveness of distraction using virtual reality (VR) technology in reducing cold pressor pain would maintain over the course of 8 weekly exposures. Twenty-eight adults, 18 to 23 years of age, underwent 1 baseline cold pressor trial and 1 VR distraction trial in randomized order each week. VR distraction led to significant increases in pain threshold and pain tolerance and significant decreases in pain intensity, time spent thinking about pain, and self-reported anxiety, relative to baseline. Repeated exposure did not appear to affect the benefits of VR. Implications for the long-term use of VR distraction as a nonpharmacological analgesic are discussed. PERSPECTIVE This article addresses the concern that the efficacy of virtual reality-assisted distraction from pain could potentially decrease with repeated exposure. The current finding that efficacy did not diminish over several repeated exposures provides support for the use of virtual reality as an adjuvant treatment of pain.
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Affiliation(s)
- Charles E Rutter
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD 21250, USA
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Parsons TD, Rizzo AA. Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: a meta-analysis. J Behav Ther Exp Psychiatry 2008; 39:250-61. [PMID: 17720136 DOI: 10.1016/j.jbtep.2007.07.007] [Citation(s) in RCA: 340] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2006] [Revised: 07/06/2007] [Accepted: 07/18/2007] [Indexed: 11/25/2022]
Abstract
Virtual reality exposure therapy (VRET) is an increasingly common treatment for anxiety and specific phobias. Lacking is a quantitative meta-analysis that enhances understanding of the variability and clinical significance of anxiety reduction outcomes after VRET. Searches of electronic databases yielded 52 studies, and of these, 21 studies (300 subjects) met inclusion criteria. Although meta-analysis revealed large declines in anxiety symptoms following VRET, moderator analyses were limited due to inconsistent reporting in the VRET literature. This highlights the need for future research studies that report uniform and detailed information regarding presence, immersion, anxiety and/or phobia duration, and demographics.
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Affiliation(s)
- Thomas D Parsons
- Institute for Creative Technologies, University of Southern California, 13274 Fiji Way, Office 301, Marina del Rey, CA 90292-4019, USA.
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30
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Adams R, Finn P, Moes E, Flannery K, Rizzo AS. Distractibility in Attention/Deficit/ Hyperactivity Disorder (ADHD): the virtual reality classroom. Child Neuropsychol 2008; 15:120-35. [PMID: 18608217 DOI: 10.1080/09297040802169077] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Nineteen boys aged 8 to 14 with a diagnosis of ADHD and 16 age-matched controls were compared in a virtual reality (VR) classroom version of a continuous performance task (CPT), with a second standard CPT presentation using the same projection display dome system. The Virtual Classroom included simulated "real-world" auditory and visual distracters. Parent ratings of attention, hyperactivity, internalizing problems, and adaptive skills on the Behavior Assessment System for Children (BASC) Monitor for ADHD confirmed that the ADHD children had more problems in these areas than controls. The difference between the ADHD group (who performed worse) and the control group approached significance (p = .05; adjusted p = .02) in the Virtual Classroom presentation, and the classification rate of the Virtual Classroom was better than when the standard CPT was used (87.5% versus 68.8%). Children with ADHD were more affected by distractions in the VR classroom than those without ADHD. Results are discussed in relation to distractibility in ADHD.
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Affiliation(s)
- Rebecca Adams
- Suffolk University, Psychology, Boston, Massachusetts 02108-2770, USA
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31
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Gorini A, Riva G. Virtual reality in anxiety disorders: the past and the future. Expert Rev Neurother 2008; 8:215-33. [PMID: 18271709 DOI: 10.1586/14737175.8.2.215] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One of the most effective treatments of anxiety is exposure therapy: a person is exposed to specific feared situations or objects that trigger anxiety. This exposure process may be done through actual exposure, with visualization, by imagination or using virtual reality (VR), that provides users with computer simulated environments with and within which they can interact. VR is made possible by the capability of computers to synthesize a 3D graphical environment from numerical data. Furthermore, because input devices sense the subject's reactions and motions, the computer can modify the synthetic environment accordingly, creating the illusion of interacting with, and thus being immersed within the environment. Starting from 1995, different experimental studies have been conducted in order to investigate the effect of VR exposure in the treatment of subclinical fears and anxiety disorders. This review will discuss their outcome and provide guidelines for the use of VR exposure for the treatment of anxious patients.
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Affiliation(s)
- Alessandra Gorini
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Via Pelizza da Volpedo, 41. 20149 Milan, Italy
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32
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Abstract
OBJECTIVE To investigate whether virtual humans produce social facilitation effects. BACKGROUND When people do an easy task and another person is nearby, they tend to do that task better than when they are alone. Conversely, when people do a hard task and another person is nearby, they tend to do that task less well than when they are alone. This phenomenon is referred to in the social psychology literature as social facilitation. The present study investigated whether virtual humans can evoke a social facilitation response. METHOD Participants were given different tasks to do that varied in difficulty. The tasks involved anagrams, mazes, and modular arithmetic. They did the tasks alone, in the company of another person, or in the company of a virtual human on a computer screen. RESULTS For easy tasks, performance in the virtual human condition was better than in the alone condition, and for difficult tasks, performance in the virtual human condition was worse than in the alone condition. CONCLUSION As with a human, virtual humans can produce social facilitation. APPLICATION The results suggest that designers of virtual humans should be mindful about the social nature of virtual humans; a design decision as to when and how to present a virtual human should be a deliberate and informed decision. An ever-present virtual human might make learning and performance difficult for challenging tasks.
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Affiliation(s)
- Sung Park
- School of Psychology, Georgia Institute of Technology, Atlanta 30332-0170, USA.
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Gregg L, Tarrier N. Virtual reality in mental health : a review of the literature. Soc Psychiatry Psychiatr Epidemiol 2007; 42:343-54. [PMID: 17431528 DOI: 10.1007/s00127-007-0173-4] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several virtual reality (VR) applications for the understanding, assessment and treatment of mental health problems have been developed in the last 10 years. The purpose of this review is to outline the current state of virtual reality research in the treatment of mental health problems. METHODS PubMed and PsycINFO were searched for all articles containing the words "virtual reality". In addition a manual search of the references contained in the papers resulting from this search was conducted and relevant periodicals were searched. Studies reporting the results of treatment utilizing VR in the mental health field and involving at least one patient were identified. RESULTS More than 50 studies using VR were identified, the majority of which were case studies. Seventeen employed a between groups design: 4 involved patients with fear of flying; 3 involved patients with fear of heights; 3 involved patients with social phobia/public speaking anxiety; 2 involved people with spider phobia; 2 involved patients with agoraphobia; 2 involved patients with body image disturbance and 1 involved obese patients. There are both advantages in terms of delivery and disadvantages in terms of side effects to using VR. Although virtual reality based therapy appears to be superior to no treatment the effectiveness of VR therapy over traditional therapeutic approaches is not supported by the research currently available. CONCLUSIONS There is a lack of good quality research on the effectiveness of VR therapy. Before clinicians will be able to make effective use of this emerging technology greater emphasis must be placed on controlled trials with clinically identified populations.
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Affiliation(s)
- Lynsey Gregg
- Academic Division of Clinical Psychology, University of Manchester, Manchester, UK.
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Rizzo AA, Bowerly T, Buckwalter JG, Klimchuk D, Mitura R, Parsons TD. A virtual reality scenario for all seasons: the virtual classroom. CNS Spectr 2006; 11:35-44. [PMID: 16400254 DOI: 10.1017/s1092852900024196] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Treatment and rehabilitation of the cognitive, psychological, and motor sequelae of central nervous system dysfunction often relies on assessment instruments to inform diagnosis and to track changes in clinical status. Typically, these assessments employ paper-and-pencil psychometrics, hands-on analog/computer tests, and rating of behavior within the context of real-world functional environments. Virtual reality offers the option to produce and distribute identical "standard" simulation environments in which performance can be measured and rehabilitated. Within such digital scenarios, normative data can be accumulated for performance comparisons needed for assessment/diagnosis and for treatment/rehabilitation purposes. In this manner, reusable archetypic virtual environments constructed for one purpose can also be applied for applications addressing other clinical targets. This article will provide a review of such a retooling approach using a virtual classroom simulation that was originally developed as a controlled stimulus environment in which attention processes could be systematically assessed in children with attention-deficit/hyperactivity disorder. This system is now being applied to other clinical targets including the development of tests that address other cognitive functions, eye movement under distraction conditions, social anxiety disorder, and the creation of an earthquake safety training application for children with developmental and learning disabilities.
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Affiliation(s)
- Albert A Rizzo
- Institute for Creative Technologies, School of Gerontology, University of Southern California, Los Angeles, CA 90292, USA.
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35
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Brundage SB, Graap K, Gibbons KF, Ferrer M, Brooks J. Frequency of stuttering during challenging and supportive virtual reality job interviews. JOURNAL OF FLUENCY DISORDERS 2006; 31:325-39. [PMID: 16999990 DOI: 10.1016/j.jfludis.2006.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2005] [Revised: 07/22/2006] [Accepted: 08/20/2006] [Indexed: 05/12/2023]
Abstract
UNLABELLED This paper seeks to demonstrate the possibility of manipulating the frequency of stuttering using virtual reality environments (VREs). If stuttering manifests itself in VREs similarly to the way it manifests itself in real world interactions, then VREs can provide a controlled, safe, and confidential method for treatment practice and generalization. Though many researchers and clinicians recognize the need for generalization activities in the treatment of stuttering, achieving generalization in a clinical setting poses challenges to client confidentiality, safety, and the efficient use of a professionals' time. Virtual reality (VR) technology may allow professionals the opportunity to enhance and assess treatment generalization while protecting the safety and confidentiality of their clients. In this study, we developed a VR job interview environment which allowed experimental control over communication style and gender of interviewers. In this first trial, persons who stutter (PWS) experienced both challenging and supportive VR job interview conditions. The percentage of stuttered syllables was calculated for both interviews for each participant. Self-reported ratings of communication apprehension and confidence were also obtained, and were not significantly correlated with stuttering severity. Results indicated that interviewer communication style affected the amount of stuttering produced by participants, with more stuttering observed during challenging virtual interviews. Additionally, the amount of stuttering observed during the VR job interviews was significantly, positively correlated with the amount of stuttering observed during an interview with the investigator prior to VR exposure. Participants' subjective reports of the VR experience indicate reactions similar to those they report experiencing in the real world. Possible implications for the use of VR in the assessment and treatment of stuttering are discussed. EDUCATIONAL OBJECTIVES After reading this article, the reader will be able to-(1) list some of the challenges to treatment generalization; (2) describe how virtual reality technology can assist in alleviating some of these challenges; (3) describe how the frequency of stuttering varies across two different virtual environments.
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Affiliation(s)
- Shelley B Brundage
- The George Washington University, Speech and Hearing Science Department, 1922 F Street NW, Suite 400, Washington, DC 20052, United States.
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Morie JF, Iyer K, Luigi DP, Williams J, Dozois A, Rizzo AS. Development of a data management tool for investigating multivariate space and free will experiences in virtual reality. Appl Psychophysiol Biofeedback 2005; 30:319-31. [PMID: 16167194 DOI: 10.1007/s10484-005-6386-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Virtual reality (VR) has become mature enough to be successfully used in clinical applications such as exposure therapy, pain distraction, and neuropsychological assessment. However, we now need to go beyond the outcome data from this research and conduct the detailed scientific investigations required to better understand what factors influence why VR works (or doesn't) in these types of clinical applications. This knowledge is required to guide the development of VR applications in the key areas of education, training, and rehabilitation and to further evolve existing VR approaches. One of the primary assets obtained with the use of VR is the ability to simulate the complexity of real world environments, within which human performance can be tested and trained. But this asset comes with a price in terms of the capture, quantification and analysis of large, multivariate and concurrent data sources that reflect the naturalistic behavioral interaction that is afforded in a virtual world. As well, while achieving realism has been a main goal in making convincing VR environments, just what constitutes realism and how much is needed is still an open question situated firmly in the research domain. Just as in real "reality," such factors in virtual reality are complex and multivariate, and the understanding of this complexity presents exceptional challenges to the VR researcher. For certain research questions, good behavioral science often requires consistent delivery of stimuli within tightly controlled lab-based experimental conditions. However, for other important research questions we do not want to constrain naturalistic behavior and limit VR's ability to replicate real world conditions, simply because it is easier to study human performance with traditional lab-based methodologies. By doing so we may compromise the very qualities that comprise VR's unique capacity to mimic the experiences and challenges that exist in everyday life. What is really needed to address scientific questions that require natural exploration of a simulated environment are more usable and robust tools to instrument, organize, and visualize the complex data generated by measurements of participant behaviors within a virtual world. This paper briefly describes the rationale and methodology of an initial study in an ongoing research program that aims to investigate human performance within a virtual environment where unconstrained "free will" exploratory behavior is essential to research questions that involve the relationships between physiology, emotion, and memory. After a discussion of the research protocol and the types of data that were collected, we describe a novel tool that was borne from our need to more efficiently capture, manage, and explore the complex data that was generated in this research. An example of a research participant's annotated display from this data management and visualization tool is then presented. It is our view that this tool provides the capacity to better visualize and understand the complex data relationships that may arise in VR research that investigates naturalistic free will behavior and its impact on other human performance variables.
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Affiliation(s)
- Jacquelyn Ford Morie
- University of Southern California Institute for Creative Technologies (ICT), 13274 Fiji Way, Marina Del Rey, California 90292, USA.
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