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van Rijn MM, de Heer LM, Nieuwenhuis-Wendt J, van der Kaaij NP, Moolenaar EGE, van der Ham DH, van der Plank L, Westland H, Weldam SWM. Use of virtual reality in preoperative education of cardiac surgery patients - A feasibility study. PATIENT EDUCATION AND COUNSELING 2024; 129:108394. [PMID: 39168039 DOI: 10.1016/j.pec.2024.108394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/15/2024] [Accepted: 08/08/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVE A Virtual Patient Tour (VPT) was developed to inform cardiac surgery patients about their hospitalization from the admission to their postoperative stay on the ward. The objective of our study was to assess the feasibility and acceptability of this VPT following the framework of the Virtual Reality Clinical Outcomes Research Experts Committee. METHODS In this single-centre cross-sectional study, adult patients admitted to the hospital for elective cardiac surgery were included. Acceptability, usability, and tolerability were measured by the validated questionnaires Unified Theory of Acceptance and Use of Technology (acceptability), System Usability Scale (usability), and Virtual Reality Sickness Questionnaire (tolerability). Descriptive statistics were used for the analysis. RESULTS Twenty-eight participants used the VPT. Results showed high acceptability (mean 16.7 ± 1.5), acceptable usability (mean 86.7 ± 9.3), and high tolerability (sickness score, median 7.1 % [0-17.1 %]). CONCLUSION The use of the VPT is a feasible and promising technique. The next step is to optimize the content and technique of the VPT based on the suggestions of the participants. PRACTICE IMPLICATIONS We recommend incorporating the VPT into preoperative patient education in addition to the routine information in cardiac surgery patients.
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Affiliation(s)
- Michelle M van Rijn
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Linda M de Heer
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Jenny Nieuwenhuis-Wendt
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Niels P van der Kaaij
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Eveline G E Moolenaar
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Daan Halle van der Ham
- Department Technology Enhanced Learning, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Lars van der Plank
- Department Technology Enhanced Learning, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Heleen Westland
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Saskia W M Weldam
- Department of Cardiothoracic surgery, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Simoncini G, Borghesi F, Mancuso V, Pedroli E, Cipresso P. Assessing alexithymia: the proposal of a psychometric tool based on spheric videos. Front Hum Neurosci 2024; 18:1375342. [PMID: 38562229 PMCID: PMC10982385 DOI: 10.3389/fnhum.2024.1375342] [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: 01/23/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
The present perspective introduces a novel psychometric tool designed to enhance the evaluation of alexithymia. Alexithymia, a condition marked by difficulties in recognizing and expressing emotions, along with a propensity to direct attention outside rather than toward one's own interior experiences, is commonly investigated through self-report questionnaires. These instruments assume that individuals have sufficient self-awareness and abstraction capabilities, which restricts the understanding of the underlying mechanisms of emotional recognition in individuals who do not possess these capacities. To address this lack, emerging technologies like virtual reality (VR) and 360° videos facilitate the recreation of immersive contexts, enabling subjects to engage with scenarios even remotely. Our innovative tool employs spherical video technology to recreate social and non-social scenarios that elicit emotions. Psychophysiological measures are collected during video observation; then, questions are asked to investigate how the subject consciously processes the emotions they experienced. This multimodal approach aims to capture both implicit and explicit emotion processing, providing a comprehensive assessment. Overall, the proposed psychometric tool offers the potential for a more nuanced understanding of alexithymic traits and their real-life impact, empowering clinicians to tailor treatment processes to individual needs based on a richer set of information.
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Affiliation(s)
| | | | | | - Elisa Pedroli
- Faculty of Psychology, eCampus University, Novedrate, Italy
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Javvaji CK, Reddy H, Vagha JD, Taksande A, Kommareddy A, Reddy NS. Immersive Innovations: Exploring the Diverse Applications of Virtual Reality (VR) in Healthcare. Cureus 2024; 16:e56137. [PMID: 38618363 PMCID: PMC11016331 DOI: 10.7759/cureus.56137] [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: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
Virtual reality (VR) has experienced a remarkable evolution over recent decades, evolving from its initial applications in specific military domains to becoming a ubiquitous and easily accessible technology. This thorough review delves into the intricate domain of VR within healthcare, seeking to offer a comprehensive understanding of its historical evolution, theoretical foundations, and current adoption status. The examination explores the advantages of VR in enhancing the educational experience for medical students, with a particular focus on skill acquisition and retention. Within this exploration, the review dissects the applications of VR across diverse medical disciplines, highlighting its role in surgical training and anatomy/physiology education. While navigating the expansive landscape of VR, the review addresses challenges related to technology and pedagogy, providing insights into overcoming technical hurdles and seamlessly integrating VR into healthcare practices. Additionally, the review looks ahead to future directions and emerging trends, examining the potential impact of technological advancements and innovative applications in healthcare. This review illuminates the transformative potential of VR as a tool poised to revolutionize healthcare practices.
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Affiliation(s)
- Chaitanya Kumar Javvaji
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshitha Reddy
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jayant D Vagha
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amar Taksande
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anirudh Kommareddy
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Naramreddy Sudheesh Reddy
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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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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Wisher I, Pettitt P, Kentridge R. The deep past in the virtual present: developing an interdisciplinary approach towards understanding the psychological foundations of palaeolithic cave art. Sci Rep 2023; 13:19009. [PMID: 37923922 PMCID: PMC10624876 DOI: 10.1038/s41598-023-46320-8] [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: 08/01/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
Virtual Reality (VR) has vast potential for developing systematic, interdisciplinary studies to understand ephemeral behaviours in the archaeological record, such as the emergence and development of visual culture. Upper Palaeolithic cave art forms the most robust record for investigating this and the methods of its production, themes, and temporal and spatial changes have been researched extensively, but without consensus over its functions or meanings. More compelling arguments draw from visual psychology and posit that the immersive, dark conditions of caves elicited particular psychological responses, resulting in the perception-and depiction-of animals on suggestive features of cave walls. Our research developed and piloted a novel VR experiment that allowed participants to perceive 3D models of cave walls, with the Palaeolithic art digitally removed, from El Castillo cave (Cantabria, Spain). Results indicate that modern participants' visual attention corresponded to the same topographic features of cave walls utilised by Palaeolithic artists, and that they perceived such features as resembling animals. Although preliminary, our results support the hypothesis that pareidolia-a product of our cognitive evolution-was a key mechanism in Palaeolithic art making, and demonstrates the potential of interdisciplinary VR research for understanding the evolution of art, and demonstrate the potential efficacy of the methodology.
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Affiliation(s)
- Izzy Wisher
- Department of Linguistics, Cognitive Science and Semiotics, Aarhus University, Aarhus, Denmark.
- Department of Archaeology and Heritage Studies, Aarhus University, Aarhus, Denmark.
| | - Paul Pettitt
- Department of Archaeology, Durham University, Durham, UK
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Zhang Z, Fort JM, Giménez Mateu L. Facial expression recognition in virtual reality environments: challenges and opportunities. Front Psychol 2023; 14:1280136. [PMID: 37885738 PMCID: PMC10598841 DOI: 10.3389/fpsyg.2023.1280136] [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: 08/19/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
This study delved into the realm of facial emotion recognition within virtual reality (VR) environments. Using a novel system with MobileNet V2, a lightweight convolutional neural network, we tested emotion detection on 15 university students. High recognition rates were observed for emotions like "Neutral", "Happiness", "Sadness", and "Surprise". However, the model struggled with 'Anger' and 'Fear', often confusing them with "neutral". These discrepancies might be attributed to overlapping facial indicators, limited training samples, and the precision of the devices used. Nonetheless, our research underscores the viability of using facial emotion recognition technology in VR and recommends model improvements, the adoption of advanced devices, and a more holistic approach to foster the future development of VR emotion recognition.
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Affiliation(s)
- Zhihui Zhang
- Escola Tècnica Superior d'Arquitectura de Barcelona, Universitat Politècnica de Catalunya, Barcelona, Spain
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Bargeri S, Scalea S, Agosta F, Banfi G, Corbetta D, Filippi M, Sarasso E, Turolla A, Castellini G, Gianola S. Effectiveness and safety of virtual reality rehabilitation after stroke: an overview of systematic reviews. EClinicalMedicine 2023; 64:102220. [PMID: 37745019 PMCID: PMC10514431 DOI: 10.1016/j.eclinm.2023.102220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023] Open
Abstract
Background Virtual reality (VR) is an innovative neurorehabilitation modality that has been variously examined in systematic reviews. We assessed VR effectiveness and safety after cerebral stroke. Methods In this overview of systematic reviews, we searched eleven databases (Cochrane Database of Systematic Reviews, EMBASE, MEDLINE, SCOPUS, ISI Web of Science, CINAHL, PsycINFO, Pedro, Otseeker, Healthevidence.org, Epistemonikos) and grey literature from inception to January 17, 2023. Studies eligible for inclusion were systematic reviews published in English that included adult patients with a clinical diagnosis of stroke (acute to chronic phase) undergoing any kind of immersive, semi-immersive or non-immersive VR intervention with or without conventional therapy versus conventional therapy alone. The primary outcome was motor upper limb function and activity. The secondary outcomes were gait and balance, cognitive and mental function, limitation of activities, participation, and adverse events. We calculated the degree of overlap between reviews based on the corrected covered area (CCA). Methodological quality was assessed using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) and the Certainty of Evidence (CoE) using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Discordances between results were examined using a conceptual framework based on the Jadad algorithm. This overview is registered with PROSPERO, CRD42022329263. Findings Of the 58 reviews included (n = 345 unique primary studies), 42 (72.4%) had conducted meta-analysis. More than half of the reviews (58.6%) were published between 2020 and 2022 and many (77.6%) were judged critically low in quality by AMSTAR 2. Most reported the Fugl Meyer Assessment scale (FMA-UE) to measure upper limb function and activity. For the primary outcome, there was a moderate overlap of primary studies (CCA 9.0%) with discordant findings. Focusing on upper limb function (FMA-UE), VR with or without conventional therapy seems to be more effective than conventional therapy alone, with low to moderate CoE and probable to definite clinical relevance. For secondary outcomes there was uncertainty about the superiority or no difference between groups due to substantial heterogeneity of measurement scales (eg, methodological choices). A few reviews (n = 6) reported the occurrence of mild adverse events. Interpretation Current evidence suggests that multiple meta-analyses agreed on the superiority of VR with or without conventional therapy over conventional therapy on FME-UE for upper limb. Clinicians may consider embedding VR technologies into their practice as appropriate with patient's goals, abilities, and preferences. However, caution is needed given the poor methodological quality of reviews. Funding Italian Ministry of Health.
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Affiliation(s)
- Silvia Bargeri
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
| | | | - Federica Agosta
- Vita-Salute San Raffaele University, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giuseppe Banfi
- Vita-Salute San Raffaele University, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Davide Corbetta
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Massimo Filippi
- Vita-Salute San Raffaele University, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Sarasso
- Vita-Salute San Raffaele University, Milan, Italy
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences – DIBINEM, Alma Mater Università di Bologna, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Greta Castellini
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
| | - Silvia Gianola
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
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Buselli R, Corsi M, Veltri A, Marino R, Caldi F, Del Guerra P, Guglielmi G, Tanca C, Paoli M, Calabretta VM, Perretta S, Foddis R, Carrozzino MA. Comparison between Standard Expository Cognitive Behavioral Therapy (CBT-E) and Immersive Virtual Reality CBT (CBT-VR) for Rehabilitation of Patients Affected by Occupational Stress Disorders: Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095735. [PMID: 37174252 PMCID: PMC10178175 DOI: 10.3390/ijerph20095735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
Work-related stress presents a significant impact on work performance and physical health. It has been associated with the onset of a multitude of symptoms that can lead to occupational stress diseases, namely Adjustment Disorder and Post-Traumatic Stress Disorder. The literature has evidenced that "exposure therapy" of cognitive-behavioral training (CBT-E) seems to be the most effective technique to manage stress symptoms, including work stress diseases, and several studies have considered Virtual Reality (VR) as an adjuvant tool to exposure-based psychotherapy (CBT-VR) for the treatment of multiple psychiatric disorders. The aim of this study is to evaluate the effectiveness of CBT with exposure to stressful work scenarios in imaginative (CBT-E) and in immersive virtual reality (CBT-VR) scenarios in a group of workers affected by work-related stress disorders and compare the clinical and physiological outcomes between the two exposure techniques. A long-term goal would be to develop an evidence-based rehabilitation program as a treatment for the reintegration into work of patients affected by these psychiatric disorders.
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Affiliation(s)
- Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Center for Work-Related Stress and Occupational Mental Disorders, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Martina Corsi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Center for Work-Related Stress and Occupational Mental Disorders, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Antonello Veltri
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Center for Work-Related Stress and Occupational Mental Disorders, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Riccardo Marino
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Center for Work-Related Stress and Occupational Mental Disorders, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Fabrizio Caldi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Paolo Del Guerra
- Department of Public Health, Azienda USL Toscana Centro, 50053 Empoli, Italy
| | - Giovanni Guglielmi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Camilla Tanca
- Scuola Superiore Sant'Anna, Institute of Communication, Information and Perception Technologies TECIP, 56100 Pisa, Italy
| | - Massimo Paoli
- Department of Public Health, Sovrintendenza Sanitaria Regionale Inail Toscana, 50144 Firenze, Italy
| | | | - Salvio Perretta
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Rudy Foddis
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Marcello Antonio Carrozzino
- Scuola Superiore Sant'Anna, Institute of Communication, Information and Perception Technologies TECIP, 56100 Pisa, Italy
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Finnegan SL, Dearlove DJ, Morris P, Freeman D, Sergeant M, Taylor S, Pattinson KTS. Breathlessness in a virtual world: An experimental paradigm testing how discrepancy between VR visual gradients and pedal resistance during stationary cycling affects breathlessness perception. PLoS One 2023; 18:e0270721. [PMID: 37083693 PMCID: PMC10120935 DOI: 10.1371/journal.pone.0270721] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 03/09/2023] [Indexed: 04/22/2023] Open
Abstract
INTRODUCTION The sensation of breathlessness is often attributed to perturbations in cardio-pulmonary physiology, leading to changes in afferent signals. New evidence suggests that these signals are interpreted in the light of prior "expectations". A misalignment between afferent signals and expectations may underly unexplained breathlessness. Using a novel immersive virtual reality (VR) exercise paradigm, we investigated whether manipulating an individual's expectation of effort (determined by a virtual hill gradient) may alter their perception of breathlessness, independent from actual effort (the physical effort of cycling). METHODS Nineteen healthy volunteers completed a single experimental session where they exercised on a cycle ergometer while wearing a VR headset. We created an immersive virtual cycle ride where participants climbed up 100 m hills with virtual gradients of 4%, 6%, 8%, 10% and 12%. Each virtual hill gradient was completed twice: once with a 4% cycling ergometer resistance and once with a 6% resistance, allowing us to dissociate expected effort (virtual hill gradient) from actual effort (power). At the end of each hill, participants reported their perceived breathlessness. Linear mixed effects models were used to examine the independent contribution of actual effort and expected effort to ratings of breathlessness (0-10 scale). RESULTS Expectation of effort (effect estimate ± std. error, 0.63 ± 0.11, P < 0.001) and actual effort (0.81 ± 0.21, P < 0.001) independently explained subjective ratings of breathlessness, with comparable contributions of 19% and 18%, respectively. Additionally, we found that effort expectation accounted for 6% of participants' power and was a significant, independent predictor (0.09 ± 0.03; P = 0.001). CONCLUSIONS An individuals' expectation of effort is equally important for forming perceptions of breathlessness as the actual effort required to cycle. A new VR paradigm enables this to be experimentally studied and could be used to re-align breathlessness and enhance training programmes.
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Affiliation(s)
- Sarah L. Finnegan
- Wellcome Centre for Integrative Neuroimaging and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - David J. Dearlove
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Peter Morris
- Wellcome Centre for Integrative Neuroimaging and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Martin Sergeant
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Stephen Taylor
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Kyle T. S. Pattinson
- Wellcome Centre for Integrative Neuroimaging and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Abbas JR, O'Connor A, Ganapathy E, Isba R, Payton A, McGrath B, Tolley N, Bruce IA. What is Virtual Reality? A healthcare-focused systematic review of definitions. HEALTH POLICY AND TECHNOLOGY 2023. [DOI: 10.1016/j.hlpt.2023.100741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Manchanda N, Aggarwal A, Setya S, Talegaonkar S. Digital Intervention For The Management Of Alzheimer's Disease. Curr Alzheimer Res 2023; 19:CAR-EPUB-129308. [PMID: 36744687 DOI: 10.2174/1567205020666230206124155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease (AD) is a progressive, multifactorial, chronic, neurodegenerative disease with high prevalence and limited therapeutic options, making it a global health crisis. Being the most common cause of dementia, AD erodes the cognitive, functional, and social abilities of the individual and causes escalating medical and psychosocial needs. As yet, this disorder has no cure and current treatment options are palliative in nature. There is an urgent need for novel therapy to address this pressing challenge. Digital therapeutics (Dtx) is one such novel therapy that is gaining popularity globally. Dtx provides evidence based therapeutic interventions driven by internet and software, employing tools such as mobile devices, computers, videogames, apps, sensors, virtual reality aiding in the prevention, management, and treatment of ailments like neurological abnormalities and chronic diseases. Dtx acts as a supportive tool for the optimization of patient care, individualized treatment and improved health outcomes. Dtx uses visual, sound and other non-invasive approaches for instance-consistent therapy, reminiscence therapy, computerised cognitive training, semantic and phonological assistance devices, wearables and computer-assisted rehabilitation environment to find applications in Alzheimer's disease for improving memory, cognition, functional abilities and managing motor symptom. A few of the Dtx-based tools employed in AD include "Memory Matters", "AlzSense", "Alzheimer Assistant", "smart robotic dog", "Immersive virtual reality (iVR)" and the most current gamma stimulation. The purpose of this review is to summarize the current trends in digital health in AD and explore the benefits, challenges, and impediments of using Dtx as an adjunctive therapy for the management of AD.
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Affiliation(s)
- Namish Manchanda
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
| | - Akanksha Aggarwal
- Delhi Institute of Pharmaceutical Sciences And Research, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
| | - Sonal Setya
- Department of Pharmacy Practice, SGT College of Pharmacy, SGT University, Gurugram, Haryana-122505, India
| | - Sushama Talegaonkar
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
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Mavragani A, Tchao D, Lewis-Fung S, Pardini S, Harris LR, Appel L. Virtual Reality Therapy for People With Epilepsy and Related Anxiety: Protocol for a 3-Phase Pilot Clinical Trial. JMIR Res Protoc 2023; 12:e41523. [PMID: 36692939 PMCID: PMC9906303 DOI: 10.2196/41523] [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: 07/31/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Anxiety is one of the most common psychiatric comorbidities in people with epilepsy and often involves fears specifically related to the condition, such as anxiety related to the fear of having another seizure. These epilepsy- or seizure-related fears have been reported as being more disabling than the seizures themselves and significantly impact quality of life. Although research has suggested that exposure therapy (ET) is helpful in decreasing anxiety in people with epilepsy, no research to our knowledge has been conducted on ET in people with epilepsy using virtual reality (VR). The use of novel technologies such as an immersive VR head-mounted display for ET in this population offers several benefits. Indeed, using VR can increase accessibility for people with epilepsy with transportation barriers (eg, those who live outside urban centers or who have a suspended driver's license owing to their condition), among other advantages. In the present research protocol, we describe the design of an innovative VR-ET program administered in the home that focuses on decreasing anxiety in people with epilepsy, specifically anxiety related to their epilepsy or seizures. OBJECTIVE Our primary objective is to examine the feasibility of the study protocol and proposed treatment as well as identify suggestions for improvement when designing subsequent larger clinical trials. Our secondary objective is to evaluate whether VR-ET is effective in decreasing anxiety in a pilot study. We hypothesize that levels of anxiety in people with epilepsy will decrease from using VR-ET. METHODS This mixed methods study comprises 3 phases. Phase 1 involves engaging with those with lived experience through a web-based questionnaire to validate assumptions about anxiety in people with epilepsy. Phase 2 involves filming videos using a 360° camera for the VR-ET intervention (likely consisting of 3 sets of scenes, each with 3 intensity levels) based on the epilepsy- and seizure-related fears most commonly reported in the phase 1 questionnaire. Finally, phase 3 involves evaluating the at-home VR-ET intervention and study methods using a series of validated scales, as well as semistructured interviews. RESULTS This pilot study was funded in November 2021. Data collection for phase 1 was completed as of August 7, 2022, and had a final sample of 18 participants. CONCLUSIONS Our findings will add to the limited body of knowledge on anxiety in people with epilepsy and the use of VR in this population. We anticipate that the insights gained from this study will lay the foundation for a novel and accessible VR intervention for this underrecognized and undertreated comorbidity in people with epilepsy. TRIAL REGISTRATION ClinicalTrials.gov NCT05296057; https://clinicaltrials.gov/ct2/show/NCT05296057. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41523.
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Affiliation(s)
| | | | | | - Susanna Pardini
- OpenLab, University Health Network, Toronto, ON, Canada.,Department of General Psychology, University of Padova, Padova, Italy.,Digital Health Lab, Centre for Health and Wellbeing, Bruno Kessler Foundation, Trento, Italy
| | | | - Lora Appel
- OpenLab, University Health Network, Toronto, ON, Canada.,School of Health Policy & Management, York University, Toronto, ON, Canada.,Michael Garron Hospital, Toronto, ON, Canada
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13
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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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14
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Malighetti C, Sansoni M, Gaudio S, Matamala-Gomez M, Di Lernia D, Serino S, Riva G. From Virtual Reality to Regenerative Virtual Therapy: Some Insights from a Systematic Review Exploring Inner Body Perception in Anorexia and Bulimia Nervosa. J Clin Med 2022; 11:jcm11237134. [PMID: 36498708 PMCID: PMC9737310 DOI: 10.3390/jcm11237134] [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: 09/09/2022] [Revised: 11/10/2022] [Accepted: 11/20/2022] [Indexed: 12/02/2022] Open
Abstract
Despite advances in our understanding of the behavioral and molecular factors that underlie the onset and maintenance of Eating Disorders (EDs), it is still necessary to optimize treatment strategies and establish their efficacy. In this context, over the past 25 years, Virtual Reality (VR) has provided creative treatments for a variety of ED symptoms, including body dissatisfaction, craving, and negative emotions. Recently, different researchers suggested that EDs may reflect a broader impairment in multisensory body integration, and a particular VR technique-VR body swapping-has been used to repair it, but with limited clinical results. In this paper, we use the results of a systematic review employing PRISMA guidelines that explore inner body perception in EDs (21 studies included), with the ultimate goal to analyze the features of multisensory impairment associated with this clinical condition and provide possible solutions. Deficits in interoception, proprioception, and vestibular signals were observed across Anorexia and Bulimia Nervosa, suggesting that: (a) alteration of inner body perception might be a crucial feature of EDs, even if further research is needed and; (b) VR, to be effective with these patients, has to simulate/modify both the external and the internal body. Following this outcome, we introduce a new therapeutic approach-Regenerative Virtual Therapy-that integrates VR with different technologies and clinical strategies to regenerate a faulty bodily experience by stimulating the multisensory brain mechanisms and promoting self-regenerative processes within the brain itself.
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Affiliation(s)
- Clelia Malighetti
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Maria Sansoni
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
- Correspondence: ; Tel.: +39-02-72-343-863
| | - Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Husargatan 3, 75237 Uppsala, Sweden
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Montpellier 1, 00133 Rome, Italy
| | - Marta Matamala-Gomez
- Department of Psychology, Mind and Behavior Technological Center, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
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15
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Sansoni M, Scarzello G, Serino S, Groff E, Riva G. Mitigating negative emotions through virtual reality and embodiment. Front Hum Neurosci 2022; 16:916227. [PMID: 35992949 PMCID: PMC9381836 DOI: 10.3389/fnhum.2022.916227] [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: 04/08/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Oncological treatments are responsible for many of the physical changes (aesthetic and functional) associated with cancer. Because of this, cancer patients are at high risk of developing mental health problems. The aim of this study is to propose an innovative Virtual Reality (VR) training that uses a somatic technique (i.e., embodiment) to create a bridge with the bodily dimension of cancer. After undergoing a psycho-educational procedure, a combination of exposure, out-of-body experience, and body swapping will gradually train the patient to cope with cancer-related difficulties, increasing stress tolerance, and patient empowerment. The most engaging step of this advanced form of Stress Inoculation Training is the body swapping experience, which will guide the patient in embodying a resilient cancer patient who is facing similar difficulties. Through the VR ability to simulate the human brain functioning, and the potential of embodiment to hook to the somatic dimension of illness, we expect that once the concepts endured through the patient’s experience of resilience are triggered, the patient will be more prone to implement functional coping strategies in real life, reaching empowerment and adjusting to the post-treatment difficulties. When the scenarios are built and the training tested, our intervention could be used to support patients with different oncological diseases and who are treated in different cancer hospitals, as well as patients with other non-oncological problems (e.g., social anxiety). Future research should focus on using our paradigm for other clinical populations, and supporting cancer patients in coping with different distressing situations.
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Affiliation(s)
- Maria Sansoni
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- *Correspondence: Maria Sansoni
| | | | - Silvia Serino
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Elena Groff
- Radiotherapy, Veneto Institute of Oncology - IOV IRCCS, Padua, Italy
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Technology for Neuro-Psychology Lab, Istituto Auxologico, Milan, Italy
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16
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Wang Y, Zhang X, Gao J, Zhang L, Jiang J. The effect of immersive virtual reality-based attentional bias modification on anxiety mitigation in healthy population. Psych J 2022; 11:956-967. [PMID: 35922380 DOI: 10.1002/pchj.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/02/2022] [Indexed: 11/06/2022]
Abstract
The present study compared an immersive virtual reality-based attentional bias modification (immersive VR-ABM) with the desktop version of the VR-ABM and an immersive virtual reality-based game (immersive VR-game) to examine the possible effect of the immersive presence on self-reported emotional reactions to a stressful task. One hundred and twenty participants were randomly assigned into three groups, and each group received a three-turn induction-intervention training. Anxiety symptoms were assessed at pre-induction, post-induction, and post-training. Results showed that virtual reality-based anxiety was induced and alleviated successfully in all three groups, but only the immersive VR-ABM group showed an accumulated effect on self-reported anxiety across sessions. The attentional bias based on probe latencies indicated no significant change in either the immersive or desktop VR-ABM groups. The present findings support the hypothesized VR-ABM's effect on self-reported anxiety at the immersive presence. The practical implications of using immersive VR-ABM are discussed for obtaining ecological validity.
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Affiliation(s)
- Yamin Wang
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
| | - Xiaoxiang Zhang
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
| | - Jidong Gao
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
| | - Leran Zhang
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
| | - Jinhang Jiang
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
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17
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Schote AB, Dietrich K, Linden AE, Dzionsko I, Molano Moreno LDLA, Winnikes U, Zimmer P, Domes G, Meyer J. Real sweating in a virtual stress environment: Investigation of the stress reactivity in people with primary focal hyperhidrosis. PLoS One 2022; 17:e0272247. [PMID: 35917298 PMCID: PMC9345359 DOI: 10.1371/journal.pone.0272247] [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: 08/29/2020] [Accepted: 07/16/2022] [Indexed: 12/04/2022] Open
Abstract
Background Hyperhidrosis (excessive sweating, OMIM %114110) is a complex disorder with multifactorial causes. Emotional strains and social stress increase symptoms and lead to a vicious circle. Previously, we showed significantly higher depression scores, and normal cortisol awakening responses in patients with primary focal hyperhidrosis (PFH). Stress reactivity in response to a (virtual) Trier Social Stress Test (TSST-VR) has not been studied so far. Therefore, we measured sweat secretion, salivary cortisol and alpha amylase (sAA) concentrations, and subjective stress ratings in affected and non-affected subjects in response to a TSST-VR. Method In this pilot study, we conducted TSST-VRs and performed general linear models with repeated measurements for salivary cortisol and sAA levels, heart rate, axillary sweat and subjective stress ratings for two groups (diagnosed PFH (n = 11), healthy controls (n = 16)). Results PFH patients showed significantly heightened sweat secretion over time compared to controls (p = 0.006), with highest quantities during the TSST-VR. In both groups, sweating (p < 0.001), maximum cortisol levels (p = 0.002), feelings of stress (p < 0.001), and heart rate (p < 0.001) but not sAA (p = 0.068) increased significantly in response to the TSST-VR. However, no differences were detected in subjective ratings, cortisol concentrations and heart rate between PFH patients and controls (pall > 0.131). Conclusion Patients with diagnosed PFH showed stress-induced higher sweat secretion compared to healthy controls but did not differ in the stress reactivity with regard to endocrine or subjective markers. This pilot study is in need of replication to elucidate the role of the sympathetic nervous system as a potential pathway involved in the stress-induced emotional sweating of PFH patients.
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Affiliation(s)
- Andrea B. Schote
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Katharina Dietrich
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Adrian E. Linden
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Inga Dzionsko
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | | | - Ulrike Winnikes
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Patrick Zimmer
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer, Trier, Germany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer, Trier, Germany
| | - Jobst Meyer
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
- * E-mail:
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18
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The Computer Simulation for Triggering Anxiety in Panic Disorder Patients Modulates the EEG Alpha Power during an Oddball Task. NEUROSCI 2022. [DOI: 10.3390/neurosci3020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: The present study investigated the differences between the Panic Disorder (PD) patients groups’ and healthy controls for the EEG alpha dynamics under the frontal cortex and reaction time during the oddball task. Material and Methods: The reaction time during the oddball paradigm concomitant to EEG alpha power was tested in nine PD patients and ten healthy controls before and after a computer simulation presentation. Results: The findings revealed a decrease in EEG alpha power in PD patients concerning the control group (p ≤ 0.0125). However, both groups demonstrated an increased cortical oscillation after the computer simulation, except for the Fp1 electrode during M3 moment in the experimental group. The experimental group has a fast reaction time compared to healthy individuals during the oddball task (p = 0.002). Conclusions: We propose that the decrease in EEG alpha power in the PD patients may indicate an increase in processing related to an anxiogenic stimulus and interference of the anxiety state that compromises the inhibitory control. The reaction time task reveals cognitive symptoms in the experimental group, which may be related to the faster reactivity and high impulsivity to stimuli.
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19
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Vianez A, Marques A, Simões de Almeida R. Virtual Reality Exposure Therapy for Armed Forces Veterans with Post-Traumatic Stress Disorder: A Systematic Review and Focus Group. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010464. [PMID: 35010723 PMCID: PMC8744859 DOI: 10.3390/ijerph19010464] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 11/16/2022]
Abstract
Virtual reality exposure therapy (VRET) is an emerging treatment for people diagnosed with Post-Traumatic Stress Disorder (PTSD) due to the limited accessibility of psychotherapies. This research aims to determine the guidelines for developing a Virtual Reality–War Scenario program for Armed Forces veterans with PTSD and encompasses two studies: Study 1, a systematic electronic database review; Study 2, a focus group of twenty-two Portuguese Armed Forces veterans. Results showed a positive impact of VRET on PTSD; however, there were no group differences in most of the studies. Further, according to veterans, new VRET programs should be combined with the traditional therapy and must consider as requirements the sense of presence, dynamic scenarios, realistic feeling, and multisensorial experience. Regardless, these findings suggest VRET as a co-creation process, which requires more controlled, personalized, and in-depth research on its clinical applicability.
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Affiliation(s)
- Ana Vianez
- Psychosocial Rehabilitation Laboratory, Center for Rehabilitation Research, School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal;
| | - António Marques
- Psychosocial Rehabilitation Laboratory, Center for Rehabilitation Research, School of Health, Polytechnic Institute of Porto, 4200-072 Porto, Portugal;
- Correspondence:
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20
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Lenormand D, Piolino P. In search of a naturalistic neuroimaging approach: Exploration of general feasibility through the case of VR-fMRI and application in the domain of episodic memory. Neurosci Biobehav Rev 2021; 133:104499. [PMID: 34914938 DOI: 10.1016/j.neubiorev.2021.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 12/22/2022]
Abstract
Virtual Reality (VR) is an increasingly widespread tool for research as it allows the creation of experiments taking place in multimodal and daily-life-like environments, while keeping a strong experimental control. Adding neuroimaging to VR leads to a better understanding of the underlying brain networks activated during a naturalistic task, whether for research purposes or rehabilitation. The present paper focuses on the specific use of concurrent VR and fMRI and its technical challenges and feasibility, with a brief examination of the general existing solutions. Following the PRISMA guidelines, the review investigates the particular case of how VR-fMRI has explored episodic memory so far, with a comparison of object- and place-based episodic memory. This review confirms the involvement of cerebral regions well-known to be implicated in episodic memory and unravels other regions devoted to bodily and narrative aspects of the self, promoting new avenues of research in the domain of naturalistic episodic memory. Future studies should develop more immersive and interactive virtual neuroimaging features to increase ecological and embodied neurocognition aspects.
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Affiliation(s)
- Diane Lenormand
- Université de Paris, MC(2)Lab, 71 avenue Edouard Vaillant, 92100, Boulogne-Billancourt, France.
| | - Pascale Piolino
- Université de Paris, MC(2)Lab, 71 avenue Edouard Vaillant, 92100, Boulogne-Billancourt, France; Institut Universitaire de France (IUF), Paris, France
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21
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Simonetti V, Tomietto M, Comparcini D, Vankova N, Marcelli S, Cicolini G. Effectiveness of virtual reality in the management of paediatric anxiety during the peri‑operative period: A systematic review and meta-analysis. Int J Nurs Stud 2021; 125:104115. [PMID: 34781118 DOI: 10.1016/j.ijnurstu.2021.104115] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Children undergoing surgery generally experience anxiety during the perioperative period, which could impact the surgical outcome, cause long-term psychological consequences and result in later healthcare avoidance. Preoperative anxiety in children is managed using both pharmacological and non-pharmacological therapies. The latter include distraction, a tour of the operating room and parental presence until the induction of anaesthesia. A novel and effective non-pharmacological therapies is the use of virtual reality to reduce anxiety and pain in children scheduled for medical procedures. However, the effectiveness of virtual reality in paediatric surgery has yet to be evaluated in a systematic review. OBJECTIVE To evaluate the effectiveness of virtual reality in the management of anxiety in paediatric patients during the perioperative period. DESIGN Both a systematic review and a meta-analysis of randomised controlled trials were performed according to the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and in accordance with the Cochrane Effective Practice and Organisation of Care. The results are reported as prescribed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. DATA SOURCES A systematic search of randomised controlled trials was conducted using Medline, SCOPUS, Web of Science, Ovid MEDLINE and CINAHL. REVIEW METHODS Two researchers screened potentially eligible articles and then assessed the quality of the reported studies using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions Section 8.5 and according to Cochrane Effective Practice and Organisation of Care. The data were synthesised using the random-effects models to incorporate the estimated heterogeneity in the weighting. Heterogeneity was tested using the Q and I2 statistics. The τ2 statistic, an estimate of the amount of variation between the included studies, was also determined. Studies whose heterogeneity with respect to primary outcome measurements hindered pooling of the results for meta-analysis were summarised narratively. RESULTS Seven studies were eligible for inclusion in this systematic review. An effect size for anxiety could be determined in six. The results support the effectiveness of virtual reality in reducing anxiety in paediatric patients undergoing elective surgery. The overall effect was supported by a confidence interval < 0 (PL = -0.341, 95% confidence interval: -0.620 to -0.107) and by heterogenity indexes that were non significant (Q = 9.49, p = 0.091) or not important (I2 = 38.64%). CONCLUSIONS Paediatric patients undergoing elective surgery may benefit from virtual reality as a distraction method that can reduce anxiety. PROSPERO register, number: (blinded for Referee).
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Affiliation(s)
- Valentina Simonetti
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
| | - Marco Tomietto
- Department Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom; Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Dania Comparcini
- Azienda Ospedaliera Universitaria "Ospedali Riuniti" di Ancona, di Ancona, via Conca 71 - 60100, Ancona, Italy.
| | | | | | - Giancarlo Cicolini
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
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22
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Ma L, Mor S, Anderson PL, Baños RM, Botella C, Bouchard S, Cárdenas-López G, Donker T, Fernández-Álvarez J, Lindner P, Mühlberger A, Powers MB, Quero S, Rothbaum B, Wiederhold BK, Carlbring P. Integrating virtual realities and psychotherapy: SWOT analysis on VR and MR based treatments of anxiety and stress-related disorders. Cogn Behav Ther 2021; 50:509-526. [PMID: 34342251 DOI: 10.1080/16506073.2021.1939410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The use of virtual reality (VR) and mixed reality (MR) technology in clinical psychology is growing. Efficacious VR-based treatments for a variety of disorders have been developed. However, the field of technology-assisted psychotherapy is constantly changing with the advancement in technology. Factors such as interdisciplinary collaboration, consumer familiarity and adoption of VR products, and progress in clinical science all need to be taken into consideration when integrating virtual technologies into psychotherapies. We aim to present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders. An anonymous survey was distributed to a select group of researchers and clinicians, using an analytic framework known as Strengths, Weaknesses, Opportunities, and Threats (SWOT). Overall, the respondents had an optimistic outlook regarding the current use as well as future development and implementation of technology-assisted interventions. VR and MR psychotherapies offer distinct advantages that can overcome shortcomings associated with traditional therapy. The respondents acknowledged and discussed current limitations of VR and MR psychotherapies. They recommended consolidation of existing knowledge and encouraged standardisation in both theory and practice. Continued research is needed to leverage the strengths of VR and MR to develop better treatments.Abbreviations: AR: Augmented Reality; MR: Mixed Reality; RCT: Randomised Controlled Trial; SWOT: Strengths, Weaknesses, Opportunities, and Threats; VR: Virtual Reality; VR-EBT: Virtual Reality Exposure-Based Therapy.
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Affiliation(s)
- Lichen Ma
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Sonia Mor
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Page L Anderson
- Department of Psychology, Georgia State University, Atlanta, USA
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, Universitat de València, Valencia, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Stephane Bouchard
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
| | | | - Tara Donker
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Albert-LudwigsUniversität Freiburg, Freiburg, Germany
| | - Javier Fernández-Álvarez
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Philip Lindner
- Centre for Psychiatry Research, Karolinska Institutet & Stockholm Healthcare Services, Sweden
| | | | | | - Soledad Quero
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,Instituto Salud Carlos III, Madrid, Spain
| | - Barbara Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, USA
| | | | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
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23
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Remote Virtual Simulation for Incident Commanders—Cognitive Aspects. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11146434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Due to the COVID-19 restrictions, on-site Incident Commander (IC) practical training and examinations in Sweden were canceled as of March 2020. The graduation of one IC class was, however, conducted through Remote Virtual Simulation (RVS), the first such examination to our current knowledge. This paper presents the necessary enablers for setting up RVS and its influence on cognitive aspects of assessing practical competences. Data were gathered through observations, questionnaires, and interviews from students and instructors, using action-case research methodology. The results show the potential of RVS for supporting higher cognitive processes, such as recognition, comprehension, problem solving, decision making, and allowed students to demonstrate whether they had achieved the required learning objectives. Other reported benefits were the value of not gathering people (imposed by the pandemic), experiencing new, challenging incident scenarios, increased motivation for applying RVS based training both for students and instructors, and reduced traveling (corresponding to 15,400 km for a class). While further research is needed for defining how to integrate RVS in practical training and assessment for IC education and for increased generalizability, this research pinpoints current benefits and limitations, in relation to the cognitive aspects and in comparison, to previous examination formats.
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Knobel SEJ, Kaufmann BC, Gerber SM, Urwyler P, Cazzoli D, Müri RM, Nef T, Nyffeler T. Development of a Search Task Using Immersive Virtual Reality: Proof-of-Concept Study. JMIR Serious Games 2021; 9:e29182. [PMID: 34255653 PMCID: PMC8285750 DOI: 10.2196/29182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/03/2021] [Accepted: 05/19/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Serious games are gaining increasing importance in neurorehabilitation since they increase motivation and adherence to therapy, thereby potentially improving its outcome. The benefits of serious games, such as the possibility to implement adaptive feedback and the calculation of comparable performance measures, can be even further improved by using immersive virtual reality (iVR), allowing a more intuitive interaction with training devices and higher ecological validity. OBJECTIVE This study aimed to develop a visual search task embedded in a serious game setting for iVR, including self-adapting difficulty scaling, thus being able to adjust to the needs and ability levels of different groups of individuals. METHODS In a two-step process, a serious game in iVR (bird search task) was developed and tested in healthy young (n=21) and elderly (n=23) participants and in a group of patients with impaired visual exploration behavior (ie, patients with hemispatial neglect after right-hemispheric stroke; n=11). Usability, side effects, game experience, immersion, and presence of the iVR serious game were assessed by validated questionnaires. Moreover, in the group of stroke patients, the performance in the iVR serious game was also considered with respect to hemispatial neglect severity, as assessed by established objective hemispatial neglect measures. RESULTS In all 3 groups, reported usability of the iVR serious game was above 4.5 (on a Likert scale with scores ranging from 1 to 5) and reported side effects were infrequent and of low intensity (below 1.5 on a Likert scale with scores ranging from 1 to 4). All 3 groups equally judged the iVR serious game as highly motivating and entertaining. Performance in the game (in terms of mean search time) showed a lateralized increase in search time in patients with hemispatial neglect that varied strongly as a function of objective hemispatial neglect severity. CONCLUSIONS The developed iVR serious game, "bird search task," was a motivating, entertaining, and immersive task, which can, due to its adaptive difficulty scaling, adjust and be played by different populations with different levels of skills, including individuals with cognitive impairments. As a complementary finding, it seems that performance in the game is able to capture typical patterns of impaired visual exploration behavior in hemispatial neglect, as there is a high correlation between performance and neglect severity as assessed with a cancellation task.
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Affiliation(s)
| | - Brigitte Charlotte Kaufmann
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | | | - Prabitha Urwyler
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland
| | - Dario Cazzoli
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
| | - René M Müri
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Nef
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Thomas Nyffeler
- Gerontechnology & Rehabilitation Group, University of Bern, Bern, Switzerland.,Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, Bern, Switzerland.,Neurocenter, Luzerner Kantonsspital, Lucerne, Switzerland
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Colombo D, Díaz-García A, Fernandez-Álvarez J, Botella C. Virtual reality for the enhancement of emotion regulation. Clin Psychol Psychother 2021; 28:519-537. [PMID: 34048621 DOI: 10.1002/cpp.2618] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/22/2021] [Accepted: 05/21/2021] [Indexed: 01/21/2023]
Abstract
In recent decades, a growing body of literature has focused on emotion regulation (ER), which refers to the ability to implement strategies in order to modulate emotional responses and reach desirable goals. To date, impaired ER (i.e., emotion dysregulation) has been identified as a transdiagnostic factor across a wide range of psychopathological conditions, which shows the importance of improving patients' ability to regulate negative and positive emotions in clinical practice. In addition to the increasing evidence showing its efficacy in the treatment of several clinical conditions, virtual reality (VR) has recently emerged as a potentially powerful tool for enhancing ER, thus breaking new ground in the development of cutting-edge transdiagnostic interventions. In the present narrative review, we will provide an overview of the existing evidence about VR-based interventions in the field of ER, emphasizing the promising findings and the barriers that still have to be addressed. To this aim, the available VR-based literature will be analysed in relation to four categories of ER strategies: situational strategies, attentional strategies, cognitive strategies, and response modulation strategies. Furthermore, new emerging fields of research targeting innovative aspects of ER will be highlighted, including the use of VR to promote positive emotions and interpersonal ER skills. Besides, its cost-effectiveness will be discussed, taking into account the costs for both developers (e.g., clinicians and researchers) and end-users. Finally, future directions in this promising field of research will be outlined.
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Affiliation(s)
- Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón de la Plana, Spain
| | - Amanda Díaz-García
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | | | - Cristina Botella
- Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellón de la Plana, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
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26
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Considerations and practical protocols for using virtual reality in psychological research and practice, as evidenced through exposure-based therapy. Behav Res Methods 2021; 53:2725-2742. [PMID: 34080173 DOI: 10.3758/s13428-021-01543-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 12/12/2022]
Abstract
Everyday client stressors are often challenging to replicate in clinical and research environments, which hinders the ability to reliably reproduce clinical outcomes. To overcome this obstacle, tools that can bridge the inherent disconnect between these settings and the real-world experiences of clients are urgently needed. Virtual reality (VR) promises to provide immersive experiences within controlled laboratory or clinical settings. While the potential opportunities and challenges of VR applications have been scientifically reviewed, clinical adoptions into psychology are hampered by a paucity of practical and methodological publications. This paper intends to address that gap, by providing a four-step process for decision-making considerations, including practical recommendations and an applied case study of developing an exposure-based system for obsessive-compulsive disorder. We provide a framework to make VR accessible for clinician-researchers to create similar systems that realise the promise while encouraging ongoing scientific rigour.
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Brander M, Egger ST, Hürlimann N, Seifritz E, Sumner RW, Vetter S, Magnenat S. Virtual Reality Human-Human Interface to Deliver Psychotherapy to People Experiencing Auditory Verbal Hallucinations: Development and Usability Study. JMIR Serious Games 2021; 9:e26820. [PMID: 33769295 PMCID: PMC8207250 DOI: 10.2196/26820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/05/2021] [Accepted: 03/19/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Digital technologies have expanded the options for delivering psychotherapy, permitting for example, the treatment of schizophrenia using Avatar Therapy. Despite its considerable potential, this treatment method has not been widely disseminated. As a result, its operability and functionality remain largely unknown. OBJECTIVE We aimed to study the usability of a therapeutic virtual reality human-human interface, created in a game engine. METHODS Participants were psychiatric hospital staff who were introduced to the therapeutic platform in a hands-on session. The System Usability Scale (SUS) was employed for evaluation purposes. Statistical evaluation was conducted using descriptive statistics, the chi-square test, analysis of variance, and multilevel factor analysis. RESULTS In total, 109 staff members were introduced to the therapeutic tool and completed the SUS. The mean SUS global score was 81.49 (SD 11.1). Psychotherapists (mean 86.44, SD 8.79) scored significantly higher (F2,106=6.136; P=.003) than nursing staff (mean 79.01, SD 13.30) and administrative personnel (mean 77.98, SD 10.72). A multilevel factor analysis demonstrates a different factor structure for each profession. CONCLUSIONS In all professional groups in this study, the usability of a digital psychotherapeutic tool developed using a game engine achieved the benchmark for an excellent system, scoring highest among the professional target group (psychotherapists). The usability of the system seems, to some extent, to be dependent on the professional background of the user. It is possible to create and customize novel psychotherapeutic approaches with gaming technologies and platforms. TRIAL REGISTRATION Clinicaltrials.gov NCT04099940; http://clinicaltrials.gov/ct2/show/NCT04099940.
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Affiliation(s)
- Mischa Brander
- Game Technology Center, Department of Computer Science, Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
| | - Stephan T Egger
- Psychotherapy and Psychosomatics, Department of Psychiatry, Psychiatric University Hospital of Zurich, University of Zürich, Zurich, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain
| | - Noa Hürlimann
- Psychotherapy and Psychosomatics, Department of Psychiatry, Psychiatric University Hospital of Zurich, University of Zürich, Zurich, Switzerland
| | - Erich Seifritz
- Psychotherapy and Psychosomatics, Department of Psychiatry, Psychiatric University Hospital of Zurich, University of Zürich, Zurich, Switzerland
| | - Robert W Sumner
- Game Technology Center, Department of Computer Science, Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
| | - Stefan Vetter
- Psychotherapy and Psychosomatics, Department of Psychiatry, Psychiatric University Hospital of Zurich, University of Zürich, Zurich, Switzerland
| | - Stéphane Magnenat
- Game Technology Center, Department of Computer Science, Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
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Zhang S, Chen M, Yang N, Lu S, Ni S. Effectiveness of VR based mindfulness on psychological and physiological health: A systematic review. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01777-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Riches S, Pisani S, Bird L, Rus-Calafell M, Garety P, Valmaggia L. Virtual reality-based assessment and treatment of social functioning impairments in psychosis: a systematic review. Int Rev Psychiatry 2021; 33:337-362. [PMID: 34121587 DOI: 10.1080/09540261.2021.1918648] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People with psychosis can experience social functioning impairments. Virtual reality (VR) has been used to assess and treat these difficulties. This systematic review (Prospero CRD42015026288) provides an evaluation of these VR applications. PsycINFO, MEDLINE, Embase, Web of Science, Cochrane Library, and Scopus were searched until May 2020. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess studies. Database searching identified 3810 titles. Fifty-eight studies (published 2005-2020; N = 2,853), comprising twenty-six head-mounted display studies (20 assessment, 6 treatment) and thirty-two immersive 2D screen studies (23 assessment, 9 treatment), were included. There were forty-eight observational studies and ten randomised controlled trials, with 1570 participants (of which, 185 were at ultra-high risk of psychosis) in VR test groups. Nearly half the studies were published since 2016. Assessments targeted cognitive and behavioural indicators of social functioning, e.g. paranoia, eye gaze, or interpersonal distance. Treatments promoted cognitive-behavioural social skills or job interview training. Studies indicate feasibility, acceptability, and effectiveness of VR for social functioning impairments in psychosis. Limitations of studies include the narrow scope of social functioning, small sample sizes, and limited randomised controlled trials and standardised interventions. Findings suggest VR has potential to be integrated with existing psychological approaches.
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Affiliation(s)
- Simon Riches
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Sara Pisani
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Leanne Bird
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Mar Rus-Calafell
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
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Cullen AJ, Dowling NL, Segrave R, Carter A, Yücel M. Exposure therapy in a virtual environment: Validation in obsessive compulsive disorder. J Anxiety Disord 2021; 80:102404. [PMID: 33894550 DOI: 10.1016/j.janxdis.2021.102404] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/29/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
Exposure and response prevention (ERP) is the current first-line psychological treatment for Obsessive-compulsive disorder (OCD). However, substantial inter-individual variability exists in treatment outcomes, including inadequate symptom improvements, and notable refusal and attrition rates. These are driven, in part, by impracticalities in simulating intrusive thoughts within clinical settings. Virtual reality (VR) offers the potential of overcoming these limitations in a manner that allows for finely controlled anxiety-provoking scenarios to be created within supportive clinical settings. To validate the potential of VR for treating contamination-based OCD, 22 patients undertook a VR ERP session and a matched session of the current gold-standard of in vivo ERP. In VR, patients were immersed within a contamination environment that permitted flexible delivery of customisable, graded exposure tasks. The VR environment utilised HTC Vive hardware, to allow for patients to both interact with, and physically move through the environment. Subjective and objective measures of distress were recorded, including heart and respiration rates. These measures indicate virtual and in vivo ERP sessions provoke consistent anxiety profiles across an exposure hierarchy. Virtual exposure was advantageous for engagement and adherence to tasks, and the therapeutic alliance was upheld. VR is a promising mechanism for ERP in contamination OCD.
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Affiliation(s)
- Alison J Cullen
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn Rd, Clayton, Victoria, Australia; The Melbourne Clinic Professorial Unit, Salisbury Street, Richmond, Victoria, Australia.
| | - Nathan L Dowling
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn Rd, Clayton, Victoria, Australia; The Melbourne Clinic Professorial Unit, Salisbury Street, Richmond, Victoria, Australia
| | - Rebecca Segrave
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn Rd, Clayton, Victoria, Australia
| | - Adrian Carter
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn Rd, Clayton, Victoria, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn Rd, Clayton, Victoria, Australia.
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31
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Asiain J, Braun M, Roussos AJ. Virtual reality as a psychotherapeutic tool: current uses and limitations. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2021. [DOI: 10.1080/03069885.2021.1885008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Joaquín Asiain
- Laboratorio para la investigación en Psicología y tecnología de la información y comunicación, LIPSTIC, Universidad de Belgrano, Buenos Aires, Argentina
| | - Malena Braun
- Laboratorio para la investigación en Psicología y tecnología de la información y comunicación, LIPSTIC, Universidad de Belgrano, Buenos Aires, Argentina
| | - Andrés J. Roussos
- Laboratorio para la investigación en Psicología y tecnología de la información y comunicación, LIPSTIC, Universidad de Belgrano, Buenos Aires, Argentina
- CONICET, LIPSTIC, Universidad de Buenos Aires, Buenos Aires, Argentina
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Alqithami S. A serious-gamification blueprint towards a normalized attention. Brain Inform 2021; 8:6. [PMID: 33856585 PMCID: PMC8050194 DOI: 10.1186/s40708-021-00127-3] [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: 06/10/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
Attention is an important commodity in the human skills set. It can be trained to overcome deficits in the short term which might be based on multiple cognitive complications to entail inability to keep focus and mined wondering. On the long term, however, it might be a symptom of chronic diseases that acquire attention to include the spectra of many mental health disorders, e.g., attention deficit hyperactivity disorder (ADHD). This paper, therefore, introduces a generic reference model that guides in the design of proper treatment method for patients in short of attention to engage in a game-based environment in order to enhance the behavior of their current state of attention which may hopefully lead to a better focus. When considering the volatility of traditional cognitive behavioral therapies (CBTs), the model reflects and analyzes evolving serious games design directed for the treatment of ADHD. It serves as an instrument that spawn over a specific treatment design since it introduces essential components that depicts essential units of traditional CBT when they are modularly combined. The components will be introduced and the processes of the reference model will be elaborated as a roadmap for the formation and the operation of augmented reality treatment games.
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Affiliation(s)
- Saad Alqithami
- Department of Computer Science, Albaha University, Al Bahah, Saudi Arabia.
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33
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Artistic creation in virtual reality for art therapy: A qualitative study with expert art therapists. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2020.101745] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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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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Malischnig D, Baumgartner C, Schaub MP. CANreduce 2.0: Reduzierung des Cannabiskonsums unter Berücksichtigung von psychischen Komorbiditäten wie der Generalisierten Angststörung – Zwei Fliegen auf einen Schlag? SUCHTTHERAPIE 2020. [DOI: 10.1055/a-1257-9681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Ziel der Studie Zahlreiche Studien weisen auf ein breites Spektrum häufig gleichzeitig auftretender psychischer Störungen wie jene der Generalisierten Angststörung bei der Behandlung von Personen mit Cannabiskonsumstörungen hin (GAD). Bisherige Internet-basierte Studien konnten zwar vereinzelt die Reduktion von Cannabiskonsum zeigen, berücksichtigten aber keine komorbide Störungen. Ziel des E-Coach gestützten Online-Selbsthilfeprogramm CANreduce 2.0 ist die Reduzierung des Cannabiskonsums und der gegebenenfalls vorhandenen GAD.
Methodik Sekundäranalyse der in der Allgemeinbevölkerung rekrutierten Cannabiskonsumierenden der CANreduce 2.0 Studie der beiden aktiven Interventionsgruppen (N=367). Für die Analysen wurden diese Teilnehmende aufgrund ihres erreichten Symptomatik-Wertes der General Anxiety Disorder Scale (GAD-7) in 4 Gruppen eingeteilt: Minimale (GAD-7 Werte: 0–4; N=102), Milde (5–9; N=151), Moderate (10–14; N=78) und Schwere (15–21; N=36) Angststörung und anschliessend ihre Behandlungsverläufe mittels Intention-to-Treat Analysen bezüglich ihrer Cannabiskonsumtage und ihrer Werte auf dem Cannabis Use Disorder Identification Test (CUDIT), der Severity of Dependence Scale (SDS), der GAD-7, der Center of Epidemiologic Studies of Depression Scale (CES-D) sowie bezüglich ihrer Adhärenz verglichen.
Ergebnisse Alle 4 Gruppen reduzierten unabhängig von ihrer GAD-Symptomatik die Anzahl ihrer Cannabiskonsumtage, ihren CUDIT und SDS Score sowohl 6 Wochen als auch 3 Monate nach der Baselineerhebung. Weiter haben mit Ausnahme von der minimalen GAD-7-Gruppe alle Gruppen eine Reduktion der Angstsymptomatik nach 3 Monaten aufgewiesen. Analog zeigten mit Ausnahme der minimalen GAD-7-Gruppe alle GAD-7-Gruppen eine deutliche Reduktion in der depressiven Symptomatik. Bezüglich der gemessenen Adhärenz zeigten sich keine Unterschiede zwischen den GAD-7-Gruppen.
Schlussfolgerungen CANreduce 2.0 scheint sowohl den Cannabiskonsum, die Ausprägung der Cannabiskonsumstörung bzw. die Cannabisabhängigkeit wie auch eine gegebenenfalls vorhandene GAD-Symptomatik zu reduzieren.
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Affiliation(s)
- Doris Malischnig
- Institut für Suchtprävention der Sucht- und Drogenkoordination Wien, Austria
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Casas J, Senft E, Gutiérrez LF, Rincón-Rocancio M, Múnera M, Belpaeme T, Cifuentes CA. Social Assistive Robots: Assessing the Impact of a Training Assistant Robot in Cardiac Rehabilitation. Int J Soc Robot 2020. [DOI: 10.1007/s12369-020-00708-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sousa AD, Shrivastava A, Shah B. Telepsychiatry and Telepsychotherapy: Critical Issues Faced by Indian Patients and Psychiatrists. Indian J Psychol Med 2020; 42:74S-80S. [PMID: 33354069 PMCID: PMC7736729 DOI: 10.1177/0253717620960407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Telepsychiatry and telepsychotherapy are new treatment modalities that have been used more than ever during the COVID-19 pandemic. There are many challenges that are faced with the use of this modality for both patients and psychiatrists alike. There are critical issues faced with regard to the development of rapport, managing the entire teleconsultation set up, privacy and issues related to fees, issues related to prescribing and monitoring, and issues while handling emergencies. The challenges faced are discussed and some solutions if possible are laid out.
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Affiliation(s)
- Avinash De Sousa
- De Sousa Foundation, Mumbai, Maharashtra, India
- Dept. of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
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Dellazizzo L, Potvin S, Phraxayavong K, Dumais A. Exploring the Benefits of Virtual Reality-Assisted Therapy Following Cognitive-Behavioral Therapy for Auditory Hallucinations in Patients with Treatment-Resistant Schizophrenia: A Proof of Concept. J Clin Med 2020; 9:E3169. [PMID: 33007909 PMCID: PMC7601104 DOI: 10.3390/jcm9103169] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/20/2020] [Accepted: 09/27/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Combining cognitive behavioral therapy (CBT) for psychosis with another psychosocial intervention comprising virtual reality (VR)-assisted therapy (VRT) may improve targeted outcomes in treatment-resistant schizophrenia patients. METHODS Ten participants having followed CBT were part of our comparative clinical trial comparing VRT to CBT and were selected at the end of the study as they desired to continue to achieve improvements with VRT (CBT + VRT). Clinical assessments were administered before/after treatments and at follow-ups. Changes in outcomes were examined using linear mixed-effects models. To gain a more in depth understanding on CBT + VRT, therapists' notes, and open interviews on a sub-group of patients were qualitatively analyzed. RESULTS Findings showed that the sequence of both interventions was appreciated by all patients. Several significant improvements were found throughout time points on auditory verbal hallucinations, beliefs about voices, depressive symptoms, symptoms of schizophrenia and quality of life. Although most of these improvements were in similar range to those observed in our comparative trial, effects of CBT + VRT on depressive symptoms and symptoms of schizophrenia were larger than those found for either intervention alone. CONCLUSION This proof of concept is the first to merge gold-standard CBT with VRT for treatment refractory voices and to suggest a certain synergistic effect.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | | | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
- Services et Recherches Psychiatriques AD, Montreal, QC, Canada
- Institut National de Psychiatrie légale Philippe-Pinel, Montreal, QC H1C 1H1, Canada
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Dilgul M, Martinez J, Laxhman N, Priebe S, Bird V. Cognitive behavioural therapy in virtual reality treatments across mental health conditions: a systematic review. CONSORTIUM PSYCHIATRICUM 2020; 1:30-46. [PMID: 38680386 PMCID: PMC11047275 DOI: 10.17650/2712-7672-2020-1-1-30-46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/10/2020] [Indexed: 05/01/2024] Open
Abstract
Background Virtual reality (VR) has been effectively used in the treatment of many mental health disorders.However, significant gaps exist in the literature. There is no treatment framework for researchers to use when developing new VR treatments. One recommended treatment across a range of diagnoses, which may be suitable for use in VR treatments, is Cognitive Behavioural Therapy (CBT). The aim of this systematic review is to investigateCBT treatment methods that utilize VR to treat mental health disorders. Objectives To investigate how CBT has been used in VR to treat mental health disorders and to report onthe treatment characteristics (number of sessions, duration, and frequency) that are linked to effective and ineffective trials. Methods Studies were included if patients had a mental health diagnosis and their treatment included immersiveVR technology and CBT principles. Data were extracted in relation to treatment characteristics and outcomes,and analysed using narrative synthesis. Results Ninety-three studies were analysed. Exposure-based VR treatments were mainly used to treat anxiety related disorders. Treatments generally consisted of eight sessions, once a week for approximately one hour. VR treatments were commonly equal to or more effective than traditional face-to-face methods. No specific treatment characteristics were linked to this effectiveness. Conclusion The number, frequency and duration of the VR treatment sessions identified in this review, could be used as a treatment framework by researchers and clinicians. This could potentially save researchers time and money when developing new interventions.
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Affiliation(s)
- Merve Dilgul
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
| | - Jasmine Martinez
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
| | - Neelam Laxhman
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
| | - Victoria Bird
- Unit for Social and Community Psychiatry, Queen Mary University of London
- East London NHS Foundation Trust
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41
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Dellazizzo L, Potvin S, Luigi M, Dumais A. Evidence on Virtual Reality-Based Therapies for Psychiatric Disorders: Meta-Review of Meta-Analyses. J Med Internet Res 2020; 22:e20889. [PMID: 32812889 PMCID: PMC7468638 DOI: 10.2196/20889] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 12/17/2022] Open
Abstract
Background Among all diseases globally, mental illnesses are one of the major causes of burden. As many people are resistant to conventional evidence-based treatments, there is an unmet need for the implementation of novel mental health treatments. Efforts to increase the effectiveness and benefits of evidence-based psychotherapy in psychiatry have led to the emergence of virtual reality (VR)–based interventions. These interventions have shown a wide range of advantages over conventional psychotherapies. Currently, VR-based interventions have been developed mainly for anxiety-related disorders; however, they are also used for developmental disorders, severe mental disorders, and neurocognitive disorders. Objective This meta-review aims to summarize the current state of evidence on the efficacy of VR-based interventions for various psychiatric disorders by evaluating the quality of evidence provided by meta-analytical studies. Methods A systematic search was performed using the following electronic databases: PubMed, PsycINFO, Web of Science, and Google Scholar (any time until February 2020). Meta-analyses were included as long as they quantitatively examined the efficacy of VR-based interventions for symptoms of a psychiatric disorder. To avoid overlap among meta-analyses, for each subanalysis included within this meta-review, only one analysis provided from one meta-analysis was selected based on the best quality of evidence. Results The search retrieved 11 eligible meta-analyses. The quality of evidence varied from very low to moderate quality. Several reasons account for the lower quality evidence, such as a limited number of randomized controlled trials, lack of follow-up analysis or control group, and the presence of heterogeneity and publication bias. Nonetheless, evidence has shown that VR-based interventions for anxiety-related disorders display overall medium-to-large effects when compared with inactive controls but no significant difference when compared with standard evidence-based approaches. Preliminary data have highlighted that such effects appear to be sustained in time, and subjects may fare better than active controls. Neurocognitive disorders also appear to improve with VR-based approaches, with small effects being found for various clinical outcomes (eg, cognition, emotion). Finally, there are insufficient data to classify VR-based interventions as an evidence-based practice for social skills training in neurodevelopmental disorders and compliance among patients with schizophrenia. Conclusions VR provides unlimited opportunities by tailoring approaches to specific complex problems and individualizing the intervention. However, VR-based interventions have not shown superiority compared with usual evidence-based treatments. Future VR-based interventions should focus on developing innovative approaches for complex and treatment-resistant symptoms that are difficult to address with traditional treatments. Future research should also aim to gain a better understanding of the potential factors that may mediate VR outcomes to improve treatment.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada
| | - Mimosa Luigi
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,University of Montreal, Montreal, QC, Canada.,Institut national de psychiatrie légale Philippe-Pinel, Montreal, QC, Canada
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42
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Sobral M, Pestana M. Virtual reality and dementia: A bibliometric analysis. THE EUROPEAN JOURNAL OF PSYCHIATRY 2020. [DOI: 10.1016/j.ejpsy.2020.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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43
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Frewen P, Mistry D, Zhu J, Kielt T, Wekerle C, Lanius RA, Jetly R. Proof of Concept of an Eclectic, Integrative Therapeutic Approach to Mental Health and Well-Being Through Virtual Reality Technology. Front Psychol 2020; 11:858. [PMID: 32581898 PMCID: PMC7290015 DOI: 10.3389/fpsyg.2020.00858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/07/2020] [Indexed: 01/12/2023] Open
Abstract
Across three studies, we provide a proof-of-concept evaluation of an integrative psychotherapeutic application of virtual reality (VR) technology. Study 1 (n = 36) evaluated an unguided “safe-place” imagery task, where participants were instructed “to create a safe space… [such as] a scene, item, design, or any visual representation that makes you feel safe” using either the Google Tilt Brush application (VR condition), the standard Microsoft Paint application (2-D condition), or via eyes-closed mental imagery alone (IMG condition). Study 2 (n = 48) evaluated a narrative episodic recall task, where participants viewed their childhood and adult homes and places of schooling either using either the Google Earth VR application (VR condition) or the standard Google Earth application (2-D condition) or recalled these places with their eyes closed via mental imagery alone (IMG condition). Finally, Study 3 (n = 48) evaluated a guided wilderness imagery task, during which different scripts were narrated, specifically, a trail walk in autumn, a spring meadow, and a hillside walk in snowy winter, while either these same scenes were visually presented using the Nature Treks VR application (VR condition), the scenes were presented using the same software but shown on standard computer monitor (2-D condition), or participants’ eyes were closed (IMG condition). Order of intervention format was randomized across participants. Across all three studies, quantitative survey ratings showed that the VR format of intervention delivery produced greater positive affect and satisfaction and perceived credibility ratings as an intervention for trauma- and stressor-related disorders and psychological well-being as rated by university students who varied in traumatic and stressful life event history and symptoms of posttraumatic stress disorder, whereas qualitative findings revealed additional themes of experiential response including increased experience of presence and vividness in the VR condition. Future research directions and clinical applications are discussed.
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Affiliation(s)
- Paul Frewen
- University of Western Ontario, London, ON, Canada
| | - Divya Mistry
- University of Western Ontario, London, ON, Canada
| | - Jenney Zhu
- University of Western Ontario, London, ON, Canada
| | - Talia Kielt
- University of Western Ontario, London, ON, Canada
| | | | | | - Rakesh Jetly
- Canadian Armed Forces, Ottawa, ON, Canada.,University of Ottawa, Ottawa, ON, Canada
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44
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ELhamid AA, Salama AA, Hassan SI, Ayad NMA. Towards Virtual Technology Vision in Critical Cases. IOP CONFERENCE SERIES: MATERIALS SCIENCE AND ENGINEERING 2020; 870:012134. [DOI: 10.1088/1757-899x/870/1/012134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Undoubtedly, Information and Communication Technology (ICT) is the most popular and widespread trend of many fields around the globe, and a smart tool for the emergence of several technological services such as web service and virtual technology. Nowadays, development and growth in computers and communications field are dynamically changing. ICT plays a key role in the digital transformation which led to the appearance of a new age called the digital age. Hence, many organizations and countries have supported modern technological trends such as the Virtual University (VU), Virtual Reality (VR) and Virtual Learning Environments (VLE), as a virtual technology. ICT can be used in positive and negative aspects, so it must be observed and considered. As a virtual technology, VU can offer extraordinary opportunities to avoid obstacles caused by critical circumstances.
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Alcañiz Raya M, Marín-Morales J, Minissi ME, Teruel Garcia G, Abad L, Chicchi Giglioli IA. Machine Learning and Virtual Reality on Body Movements' Behaviors to Classify Children with Autism Spectrum Disorder. J Clin Med 2020; 9:jcm9051260. [PMID: 32357517 PMCID: PMC7287942 DOI: 10.3390/jcm9051260] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 12/18/2022] Open
Abstract
Autism spectrum disorder (ASD) is mostly diagnosed according to behavioral symptoms in sensory, social, and motor domains. Improper motor functioning, during diagnosis, involves the qualitative evaluation of stereotyped and repetitive behaviors, while quantitative methods that classify body movements' frequencies of children with ASD are less addressed. Recent advances in neuroscience, technology, and data analysis techniques are improving the quantitative and ecological validity methods to measure specific functioning in ASD children. On one side, cutting-edge technologies, such as cameras, sensors, and virtual reality can accurately detect and classify behavioral biomarkers, as body movements in real-life simulations. On the other, machine-learning techniques are showing the potential for identifying and classifying patients' subgroups. Starting from these premises, three real-simulated imitation tasks have been implemented in a virtual reality system whose aim is to investigate if machine-learning methods on movement features and frequency could be useful in discriminating ASD children from children with typical neurodevelopment. In this experiment, 24 children with ASD and 25 children with typical neurodevelopment participated in a multimodal virtual reality experience, and changes in their body movements were tracked by a depth sensor camera during the presentation of visual, auditive, and olfactive stimuli. The main results showed that ASD children presented larger body movements than TD children, and that head, trunk, and feet represent the maximum classification with an accuracy of 82.98%. Regarding stimuli, visual condition showed the highest accuracy (89.36%), followed by the visual-auditive stimuli (74.47%), and visual-auditive-olfactory stimuli (70.21%). Finally, the head showed the most consistent performance along with the stimuli, from 80.85% in visual to 89.36% in visual-auditive-olfactory condition. The findings showed the feasibility of applying machine learning and virtual reality to identify body movements' biomarkers that could contribute to improving ASD diagnosis.
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Affiliation(s)
- Mariano Alcañiz Raya
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, 46022 Valencia, Spain; (M.A.R.); (J.M.-M.); (M.E.M.); (G.T.G.)
| | - Javier Marín-Morales
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, 46022 Valencia, Spain; (M.A.R.); (J.M.-M.); (M.E.M.); (G.T.G.)
| | - Maria Eleonora Minissi
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, 46022 Valencia, Spain; (M.A.R.); (J.M.-M.); (M.E.M.); (G.T.G.)
| | - Gonzalo Teruel Garcia
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, 46022 Valencia, Spain; (M.A.R.); (J.M.-M.); (M.E.M.); (G.T.G.)
| | - Luis Abad
- Red Cenit, Centros de Desarrollo Cognitivo, 46020 Valencia, Spain;
| | - Irene Alice Chicchi Giglioli
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, 46022 Valencia, Spain; (M.A.R.); (J.M.-M.); (M.E.M.); (G.T.G.)
- Correspondence:
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46
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A Review of Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s41347-020-00126-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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47
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De Sousa A, Lodha P, Karia S. Virtual reality and its therapeutic uses in the elderly: A narrative clinical review. JOURNAL OF GERIATRIC MENTAL HEALTH 2020. [DOI: 10.4103/jgmh.jgmh_8_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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48
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A Computational Approach for the Assessment of Executive Functions in Patients with Obsessive-Compulsive Disorder. J Clin Med 2019; 8:jcm8111975. [PMID: 31739514 PMCID: PMC6912564 DOI: 10.3390/jcm8111975] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/07/2019] [Accepted: 11/12/2019] [Indexed: 11/16/2022] Open
Abstract
Previous studies on obsessive–compulsive disorder (OCD) showed impairments in executive domains, particularly in cognitive inhibition. In this perspective, the use of virtual reality showed huge potential in the assessment of executive functions; however, unfortunately, to date, no study on the assessment of these patients took advantage of the use of virtual environments. One of the main problems faced within assessment protocols is the use of a limited number of variables and tools when tailoring a personalized program. The main aim of this study was to provide a heuristic decision tree for the future development of tailored assessment protocols. To this purpose, we conducted a study that involved 58 participants (29 OCD patients and 29 controls) to collect both classic neuropsychological data and precise data based on a validated protocol in virtual reality for the assessment of executive functions, namely, the VMET (virtual multiple errands test). In order to provide clear indications for working on executive functions with these patients, we carried out a cross-validation based on three learning algorithms and computationally defined two decision trees. We found that, by using three neuropsychological tests and two VMET scores, it was possible to discriminate OCD patients from controls, opening a novel scenario for future assessment protocols based on virtual reality and computational techniques.
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49
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Heydarpour S, Dehghan F. Comparing the effectiveness of relaxation by hypnotherapy and virtual reality technology in alleviation of the symptoms of premenstrual syndrome. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1686962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Sousan Heydarpour
- Department of Midwifery, Nursing and Midwifery Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fateme Dehghan
- Department of Midwifery, Nursing and Midwifery Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran
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50
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Boeldt D, McMahon E, McFaul M, Greenleaf W. Using Virtual Reality Exposure Therapy to Enhance Treatment of Anxiety Disorders: Identifying Areas of Clinical Adoption and Potential Obstacles. Front Psychiatry 2019; 10:773. [PMID: 31708821 PMCID: PMC6823515 DOI: 10.3389/fpsyt.2019.00773] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/25/2019] [Indexed: 12/30/2022] Open
Abstract
Despite strong evidence of effectiveness, exposure therapy is an underutilized treatment for anxiety disorders at a time when effective treatment for anxiety is greatly needed. The significant worldwide prevalence and negative impact of anxiety are documented and highlight the importance of increasing therapist and patient use of effective treatment. Obstacles to the use of exposure therapy are explored and steps to lessen these obstacles are proposed. In particular, virtual reality (VR) technology is discussed as a way to increase the availability of exposure therapy. Incorporating VR in therapy can increase the ease, acceptability, and effectiveness of treatment for anxiety. VR exposure therapy (VRET) permits individualized, gradual, controlled, immersive exposure that is easy for therapists to implement and often more acceptable to patients than in vivo or imaginal exposure. VR is presented as a scalable tool that can augment access to and effectiveness of exposure therapy thus improving treatment of anxiety disorders. VR also has the potential to help with assessment and with therapist training standardization. The authors advocate for providing continuing education in VRET to practicing clinicians and including training in exposure therapy and VRET in training programs. Ongoing development of VR applications for clinical use is encouraged, especially when developed in collaboration with software developers, clinical users, therapists who are experienced in VRET, and researchers.
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Affiliation(s)
- Debra Boeldt
- National Mental Health Innovation Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | | | - Mimi McFaul
- National Mental Health Innovation Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Walter Greenleaf
- Department of Communication, Stanford University, Stanford, CA, United States
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