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Ascione M, Carulla-Roig M, Miquel-Nabau H, Porras-Garcia B, Meschberger-Annweiler FA, Serrano-Troncoso E, Ferrer-Garcia M, Moreno-Sánchez M, Gutierrez-Maldonado J. Attentional Bias Modification Training Based on Virtual Reality and Eye Tracking in Anorexia Nervosa Patients. J Clin Med 2023; 12:5932. [PMID: 37762873 PMCID: PMC10531827 DOI: 10.3390/jcm12185932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Anorexia nervosa (AN) patients exhibit attentional bias (AB) related to the body, which is the tendency to pay greater attention to weight-related body areas compared to non-weight-related ones. This phenomenon has been linked to elevated levels of body dissatisfaction (BD) and may potentially reduce the effectiveness of body exposure therapy. The purpose of this pilot study is to assess the efficacy of a single session of a new body-related AB modification task (ABMT) that combines virtual reality with eye tracking in patients with AN. The goals of the ABMT are to reduce body-related AB by balancing attention between weight and non-weight-related body areas and to reduce BD levels. Twenty-three adolescent patients with AN were embodied in a virtual avatar and immersed in a virtual environment where they completed the ABMT. Body-related AB measures and BD levels were assessed before and after the training. A paired samples t-test showed statistically significant differences between pre-assessment and post-assessment; the complete fixation time on weight-related body parts was reduced and BD levels decreased. The initial evidence of the efficacy of this ABMT has important clinical implications, since AB and BD are considered risk factors for developing and maintaining eating disorder symptomatology among patients with AN.
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Affiliation(s)
- Mariarca Ascione
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain; (M.A.); (H.M.-N.); (F.-A.M.-A.); (M.F.-G.)
| | - Marta Carulla-Roig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.C.-R.); (E.S.-T.)
| | - Helena Miquel-Nabau
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain; (M.A.); (H.M.-N.); (F.-A.M.-A.); (M.F.-G.)
| | - Bruno Porras-Garcia
- Department of Population Health Science, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84112, USA;
| | - Franck-Alexandre Meschberger-Annweiler
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain; (M.A.); (H.M.-N.); (F.-A.M.-A.); (M.F.-G.)
| | - Eduardo Serrano-Troncoso
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, 08950 Barcelona, Spain; (M.C.-R.); (E.S.-T.)
| | - Marta Ferrer-Garcia
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain; (M.A.); (H.M.-N.); (F.-A.M.-A.); (M.F.-G.)
| | - Manuel Moreno-Sánchez
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain;
| | - Jose Gutierrez-Maldonado
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain; (M.A.); (H.M.-N.); (F.-A.M.-A.); (M.F.-G.)
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2
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Li BJ, Lee HM. Exploring the effects of habituation and scent in first-person 360-degree videos on consumption behavior. Sci Rep 2023; 13:8353. [PMID: 37221377 PMCID: PMC10205731 DOI: 10.1038/s41598-023-35669-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 05/18/2023] [Indexed: 05/25/2023] Open
Abstract
Although immersive virtual environments can influence food-related thoughts, emotions and behavior, the influence of repeated exposure to food cues in such environments has rarely been explored. This study seeks to understand if habituation, a decrease in one's physiological and behavioral response that results from repeated simulation, can take place while repeatedly watching 360-degrees of food being consumed. The influence of scent as an olfactory cue is further explored, based on past research on embodied cognition. In Study One (n = 42), participants who viewed 30 repetitions of someone eating an M&M ate significantly fewer M&Ms than those who viewed three repetitions. Study Two (n = 114) used a 2 (behavior: eating M&M/inserting a coin) × 2 (repetitions: 3/30) between-subjects experiment to confirm that results from Study One were due to habituation of the consumption video, finding that there were only significant differences between repetitions in the M&M condition. Finally, Study Three (n = 161) comprised a 2 (repetition: 3/30) × 2 (scent: present/absent) between-subjects experiment. Participants in the 30-repetition condition and those in the scent-present condition ate significantly fewer M&Ms respectively, but no interaction effects were found. The theoretical and practical implications of these findings are discussed.
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Affiliation(s)
- Benjamin J Li
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, WKWSCI Building #03-17, 31 Nanyang Link, Singapore, 637718, Singapore.
| | - Hui Min Lee
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, WKWSCI Building #03-17, 31 Nanyang Link, Singapore, 637718, Singapore
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3
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Gillouin PA, Mattatia D, Bouvet C. Virtual reality for clinical evaluation and treatment in schizophrenia: a systematic review. PSYCHOSIS 2023. [DOI: 10.1080/17522439.2023.2197030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
- Pierre-Antoine Gillouin
- Laboratoire de psychologique clinique UR CLIPSYD EA4430, Department of Psychology, Université Paris-Nanterre, Nanterre, France
| | - David Mattatia
- Laboratoire de psychologique clinique UR CLIPSYD EA4430, Department of Psychology, Université Paris-Nanterre, Nanterre, France
| | - Cyrille Bouvet
- Laboratoire de psychologique clinique UR CLIPSYD EA4430, Department of Psychology, Université Paris-Nanterre, Nanterre, France
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4
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Bofanova NS, Tychkov AY, Khanfar YA, Zolotarev RV. [Virtual reality technology as a promising direction in neurorehabilitation]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:131-136. [PMID: 36719129 DOI: 10.17116/jnevro2023123011131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Nervous system damage affects more than a billion people worldwide and is one of the leading causes of cognitive impairment. An urgent issue in modern medicine is the neurorehabilitation of this particular group of patients. The purpose of this article is to search for new approaches to achieve more effective recovery of cognitive functions, precisely by using virtual reality technology as a promising direction in neurorehabilitation. It has been shown that neurobiological effects of virtual reality have a positive effect on the plasticity of neurons, improve cognitive functions and positively affect the psychoemotional state. A case of the positive impact of being in the virtual environment «Outer Space» in a female patient with cognitive impairment and chronic pain is presented.
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5
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Philippe TJ, Sikder N, Jackson A, Koblanski ME, Liow E, Pilarinos A, Vasarhelyi K. Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review. JMIR Ment Health 2022; 9:e35159. [PMID: 35551058 PMCID: PMC9109782 DOI: 10.2196/35159] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions.
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Affiliation(s)
- Tristan J Philippe
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | | | - Anna Jackson
- School of Social Work, The University of British Columbia, Vancouver, BC, Canada
| | - Maya E Koblanski
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Eric Liow
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Andreas Pilarinos
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Krisztina Vasarhelyi
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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Ran L, Zhao N, Fan L, Zhou P, Zhang C, Yu C. Application of virtual reality on non-drug behavioral management of short-term dental procedure in children. Trials 2021; 22:562. [PMID: 34425901 PMCID: PMC8381489 DOI: 10.1186/s13063-021-05540-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 08/13/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Due to the inherent characteristics of immersion, imagination, and interactivity in virtual reality (VR), it might be suitable for non-drug behavior management of children in dental clinics. The purpose of this trial was to measure the role of VR distraction on behavior management in short-term dental procedures in children. METHODS A randomized clinical trial design was carried out on 120 children aged between 4 and 8 years to identify the comparative efficacy of VR and tell-show-do (TSD) to improve behavioral management during dental procedures. The primary outcomes were evaluated anxiety, pain, and compliance scores in perioperative children. The levels of operative anxiety and pain were assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Wong Baker FACES Pain Rating Scale (WBFS), respectively. The Frankl Behavior Rating Scale (FBRS) was tested before and during dental procedures. The length of the dental procedure was compared between both groups after treatment. RESULTS The average anxiety and behavioral scores of the VR group significantly reduced compared with the control. The decreased anxiety score for the VR group and control group were 8 (7, 11) and 5 (5, 7), p < 0.05. The compliance scores of the control group during treatment were 3 (2, 3), and the same in the VR intervention were 3 (3, 4), p = 0.02. A significant reduction in pain was observed when using VR distraction (p < 0.05). Comparing the length of the dental procedure, the VR group (19.0 2 ± 5.32 min) had a shorter treatment time than the control group (27.80 ± 10.40 min). CONCLUSION The use of VR significantly reduced the anxiety and pain of children and the length of the dental procedure and improved the compliance of children that underwent short-term dental procedures without an adverse reaction. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR2000029802 . Registered on February 14, 2020.
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Affiliation(s)
- Longkuan Ran
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Nan Zhao
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lin Fan
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Pinping Zhou
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Zhang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Cong Yu
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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7
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Modrego-Alarcón M, López-Del-Hoyo Y, García-Campayo J, Pérez-Aranda A, Navarro-Gil M, Beltrán-Ruiz M, Morillo H, Delgado-Suarez I, Oliván-Arévalo R, Montero-Marin J. Efficacy of a mindfulness-based programme with and without virtual reality support to reduce stress in university students: A randomized controlled trial. Behav Res Ther 2021; 142:103866. [PMID: 33957506 DOI: 10.1016/j.brat.2021.103866] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To evaluate the efficacy of a mindfulness-based programme (MBP) for reducing stress in university students and its action mechanisms and to explore the capacity of virtual reality (VR) exposure to enhance adherence to the intervention. METHODS This randomized controlled trial (RCT) involved assessment time points of baseline, posttreatment, and 6-month follow-up. A total of 280 students from two Spanish universities were randomly assigned to 'MBP', 'MBP + VR', or 'Relaxation' (active controls). Perceived stress posttreatment was the primary outcome; wellbeing and academic functional outcomes were assessed as well. Multilevel mixed-effects models were performed to estimate the efficacy of the programme. RESULTS Both 'MBP' (B = -2.77, d = -0.72, p = .006) and 'MBP + VR' (B = -2.44, d = -0.59, p = .014) were superior to 'Relaxation' in improving stress, as well as most of the secondary outcomes, with medium-to-large effects posttreatment and at follow-up. The long-term effects of MBPs on stress were mediated by mindfulness and self-compassion in parallel. Treatment adherence was improved in the 'MBP + VR' group, with higher retention rates and session attendance (p < .001). CONCLUSIONS This RCT supports the efficacy of an MBP compared to relaxation for reducing stress in university students through mindfulness and self-compassion as mechanisms of change. VR exposure may enhance treatment adherence. TRIAL REGISTRATION ClinicalTrials.gov NCT03771300.
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Affiliation(s)
- Marta Modrego-Alarcón
- Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Yolanda López-Del-Hoyo
- Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Javier García-Campayo
- Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain; Miguel Servet University Hospital, Zaragoza, Spain
| | - Adrián Pérez-Aranda
- Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; AGORA Research Group; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain; Department of Basic Psychology, Autonomous University of Barcelona, Cerdanyola Del Vallès, Spain.
| | - Mayte Navarro-Gil
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - María Beltrán-Ruiz
- Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Héctor Morillo
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Irene Delgado-Suarez
- Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Rebeca Oliván-Arévalo
- AGORA Research Group; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
| | - Jesus Montero-Marin
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
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8
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Fowler LA, Grammer AC, Staiano AE, Fitzsimmons-Craft EE, Chen L, Yaeger LH, Wilfley DE. Harnessing technological solutions for childhood obesity prevention and treatment: a systematic review and meta-analysis of current applications. Int J Obes (Lond) 2021; 45:957-981. [PMID: 33627775 PMCID: PMC7904036 DOI: 10.1038/s41366-021-00765-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/24/2020] [Accepted: 01/20/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Technology holds promise for delivery of accessible, individualized, and destigmatized obesity prevention and treatment to youth. OBJECTIVES This review examined the efficacy of recent technology-based interventions on weight outcomes. METHODS Seven databases were searched in April 2020 following PRISMA guidelines. Inclusion criteria were: participants aged 1-18 y, use of technology in a prevention/treatment intervention for overweight/obesity; weight outcome; randomized controlled trial (RCT); and published after January 2014. Random effects models with inverse variance weighting estimated pooled mean effect sizes separately for treatment and prevention interventions. Meta-regressions examined the effect of technology type (telemedicine or technology-based), technology purpose (stand-alone or adjunct), comparator (active or no-contact control), delivery (to parent, child, or both), study type (pilot or not), child age, and intervention duration. FINDINGS In total, 3406 records were screened for inclusion; 55 studies representing 54 unique RCTs met inclusion criteria. Most (89%) included articles were of high or moderate quality. Thirty studies relied mostly or solely on technology for intervention delivery. Meta-analyses of the 20 prevention RCTs did not show a significant effect of prevention interventions on weight outcomes (d = 0.05, p = 0.52). The pooled mean effect size of n = 32 treatment RCTs showed a small, significant effect on weight outcomes (d = ‒0.13, p = 0.001), although 27 of 33 treatment studies (79%) did not find significant differences between treatment and comparators. There were significantly greater treatment effects on outcomes for pilot interventions, interventions delivered to the child compared to parent-delivered interventions, and as child age increased and intervention duration decreased. No other subgroup analyses were significant. CONCLUSIONS Recent technology-based interventions for the treatment of pediatric obesity show small effects on weight; however, evidence is inconclusive on the efficacy of technology based prevention interventions. Research is needed to determine the comparative effectiveness of technology-based interventions to gold-standard interventions and elucidate the potential for mHealth/eHealth to increase scalability and reduce costs while maximizing impact.
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Affiliation(s)
- Lauren A. Fowler
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Anne Claire Grammer
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Amanda E. Staiano
- grid.250514.70000 0001 2159 6024LSU’s Pennington Biomedical Research Center, Baton Rouge, LA USA
| | - Ellen E. Fitzsimmons-Craft
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Ling Chen
- grid.4367.60000 0001 2355 7002Division of Biostatistics, Washington University School of Medicine, St. Louis, MO USA
| | - Lauren H. Yaeger
- grid.4367.60000 0001 2355 7002Washington University School of Medicine, St. Louis, MO USA
| | - Denise E. Wilfley
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
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9
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Porras-Garcia B, Serrano-Troncoso E, Carulla-Roig M, Soto-Usera P, Ferrer-Garcia M, Figueras-Puigderrajols N, Yilmaz L, Onur Sen Y, Shojaeian N, Gutiérrez-Maldonado J. Virtual Reality Body Exposure Therapy for Anorexia Nervosa. A Case Report With Follow-Up Results. Front Psychol 2020; 11:956. [PMID: 32499742 PMCID: PMC7242758 DOI: 10.3389/fpsyg.2020.00956] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/17/2020] [Indexed: 01/26/2023] Open
Abstract
Objective Exposure-based therapies such as mirror exposure may help to improve the results of classic cognitive behavioral therapy in anorexia nervosa (AN). Virtual reality (VR)-based procedures provide interesting novelties for targeting body-related concerns. This study aimed to provide preliminary evidence of the usefulness of a VR body exposure therapy in a patient diagnosed with AN. Method Fear of gaining weight (FGW), body anxiety, drive for thinness, body image disturbances, body mass index and body-related attentional bias were assessed before and after the intervention, as well as 5 months later. Five sessions of VR body exposure therapy were included within the standard course of cognitive behavioral therapy. The sessions involved a systematic and hierarchical exposure of the patient to a virtual representation of her own silhouette, with the body mass index of the avatar progressively increasing in subsequent sessions. Results After the intervention, there was a clear reduction in AN symptoms such as the FGW, drive for thinness, body-related anxiety and dissatisfaction. Body mass index values rose continuously during the intervention and reached healthy levels. Finally, there was a notable change in the dysfunctional body-related attentional bias. Almost all these improvements were maintained after 5 months, except for the FGW. Conclusion To the best of our knowledge, this study is the first to focus on treating the FGW and body-related concerns in AN using a VR-based paradigm. To pursue this study further and assess the effectiveness of this new VR software, larger controlled clinical trials are needed.
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Affiliation(s)
- Bruno Porras-Garcia
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Eduardo Serrano-Troncoso
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain.,Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Marta Carulla-Roig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain.,Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Pau Soto-Usera
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain.,Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Marta Ferrer-Garcia
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | | | - Lena Yilmaz
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Yigit Onur Sen
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Nazila Shojaeian
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
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10
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Montana JI, Matamala-Gomez M, Maisto M, Mavrodiev PA, Cavalera CM, Diana B, Mantovani F, Realdon O. The Benefits of emotion Regulation Interventions in Virtual Reality for the Improvement of Wellbeing in Adults and Older Adults: A Systematic Review. J Clin Med 2020; 9:jcm9020500. [PMID: 32059514 PMCID: PMC7073752 DOI: 10.3390/jcm9020500] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 01/23/2023] Open
Abstract
The impact of emotion regulation interventions on wellbeing has been extensively documented in literature, although only in recent years virtual reality (VR) technologies have been incorporated in the design of such interventions, in both clinical and non-clinical settings. A systematic search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, was therefore carried out to explore the state of the art in emotion regulation interventions for wellbeing using virtual reality. The literature on this topic was queried, 414 papers were screened, and 11 studies were included, covering adults and older adults. Our findings offer an overview of the current use of VR technologies for the enhancement of emotion regulation (ER) and wellbeing. The results are promising and suggest that VR-based emotion regulation training can facilitate the promotion of wellbeing. An overview of VR-based training interventions is crucial for better understanding how to use these tools in the clinical settings. This review offers a critical debate on the structure of such intervention protocols. It also analyzes and highlights the crucial role played by the selection of the objective and subjective wellbeing assessment measures of said intervention protocols.
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Affiliation(s)
- Jessica Isbely Montana
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
- Correspondence:
| | - Marta Matamala-Gomez
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Marta Maisto
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Petar Aleksandrov Mavrodiev
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Cesare Massimo Cavalera
- Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli 1, 20100 Milan, Italy;
| | - Barbara Diana
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Fabrizia Mantovani
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Olivia Realdon
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
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11
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Ventola CL. Virtual Reality in Pharmacy: Opportunities for Clinical, Research, and Educational Applications. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2019; 44:267-276. [PMID: 31080335 PMCID: PMC6487969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Virtual reality (VR) has been widely studied and applied in numerous medical applications.1 In pharmacy, VR can potentially be applied as follows: adjunctively or as a replacement for pharmacotherapy; in drug design and discovery; in pharmacist education; and in patient counseling and behavior modification.1-6 Research applying VR in pharmacy is currently limited; however, interest in these applications is increasing. The majority of studies conducted during the past decade have found VR to be safe and effective, and to promote a high degree of user satisfaction.4 VR technology has become increasingly affordable, flexible, and portable, enabling its use for therapeutic purposes in both inpatient and outpatient environments.4 But despite the compelling features of VR, a number of challenges exist, such as validation of clinical efficacy, cost/accessibility and usability issues, technical capabilities, and acceptance.1-5 This article discusses the potential for the use of VR in pharmacy for clinical, research, and educational applications.
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12
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Grau A, Magallón-Neri E, Faus G, Feixas G. Cognitive impairment in eating disorder patients of short and long-term duration: a case-control study. Neuropsychiatr Dis Treat 2019; 15:1329-1341. [PMID: 31190837 PMCID: PMC6535667 DOI: 10.2147/ndt.s199927] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 03/11/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction: Several studies have noted the potentially negative effect of eating disorders (ED) on cognitive performance. Objective: To compare the impact of the duration of abnormal eating behaviors on cognitive performance in a sample of people with short- and long-term eating disorders and in two control groups matched for age. Method: The neuropsychological performance of 82 women diagnosed with an eating disorder were compared with two control groups from the community of 66 healthy women. Time of duration of the disorder was less than two years in half of the clinical sample, and more than 10 years in the other half. The following instruments were used to measure neuropsychological performance: the Matrix Test, the Stroop task, the Trail-Making Test, the Tower of London Test, the Posner Spatial Task, the Rey's Complex Figure, the Wechsler Vocabulary Test, and the Hayling Completion Test. Results: It showed that persons with long-term ED presented more impaired neuropsychological profiles, but not in all areas. In contrast, the short-term ED group presented similar profiles to the control groups. Discussion: This study highlights the positive association between cognitive impairment and time of evolution of ED, above all in perceptual measures and non-verbal memory. Considering the effect of the evolution of ED cognitive performance (especially in long-term patients) may further our understanding of the development of the disorder and the factors that may favor its persistence.
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Affiliation(s)
- Antoni Grau
- ITA Mental Health Specialist, Madrid, Spain.,ITA Foundation, Barcelona, Spain
| | - Ernesto Magallón-Neri
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Gustavo Faus
- ITA Mental Health Specialist, Madrid, Spain.,ITA Foundation, Barcelona, Spain
| | - Guillem Feixas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
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13
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Riva G, Gutiérrez-Maldonado J, Dakanalis A, Ferrer-García M. Virtual Reality in the Assessment and Treatment of Weight-Related Disorders. VIRTUAL REALITY FOR PSYCHOLOGICAL AND NEUROCOGNITIVE INTERVENTIONS 2019. [DOI: 10.1007/978-1-4939-9482-3_7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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14
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Garrett B, Taverner T, Gromala D, Tao G, Cordingley E, Sun C. Virtual Reality Clinical Research: Promises and Challenges. JMIR Serious Games 2018; 6:e10839. [PMID: 30333096 PMCID: PMC6231864 DOI: 10.2196/10839] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/31/2018] [Accepted: 08/07/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Virtual reality (VR) therapy has been explored as a novel therapeutic approach for numerous health applications, in which three-dimensional virtual environments can be explored in real time. Studies have found positive outcomes for patients using VR for clinical conditions such as anxiety disorders, addictions, phobias, posttraumatic stress disorder, eating disorders, stroke rehabilitation, and for pain management. OBJECTIVE This work aims to highlight key issues in the implementation of clinical research for VR technologies. METHODS A discussion paper was developed from a narrative review of recent clinical research in the field, and the researchers' own experiences in conducting VR clinical research with chronic pain patients. RESULTS Some of the key issues in implementing clinical VR research include theoretical immaturity, a lack of technical standards, the problems of separating effects of media versus medium, practical in vivo issues, and costs. CONCLUSIONS Over the last decade, some significant successes have been claimed for the use of VR. Nevertheless, the implementation of clinical VR research outside of the laboratory presents substantial clinical challenges. It is argued that careful attention to addressing these issues in research design and pilot studies are needed in order to make clinical VR research more rigorous and improve the clinical significance of findings.
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Affiliation(s)
- Bernie Garrett
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Tarnia Taverner
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Diane Gromala
- School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC, Canada
| | - Gordon Tao
- Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Elliott Cordingley
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Crystal Sun
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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15
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Serino S, Scarpina F, Dakanalis A, Keizer A, Pedroli E, Castelnuovo G, Chirico A, Catallo V, di Lernia D, Riva G. The Role of Age on Multisensory Bodily Experience: An Experimental Study with a Virtual Reality Full-Body Illusion. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2018; 21:304-310. [PMID: 29762066 PMCID: PMC5961744 DOI: 10.1089/cyber.2017.0674] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A growing body of evidence demonstrated that it is feasible to induce ownership over an artificial body to alter bodily experience. However, several uncharted aspects about full-body illusion applications need to be tackled before a complete exploitation of these methods in clinical practice. This work is devoted to explore possible individual age-related differences in shaping changes in body representations induced with a full-body illusion. A total of 40 women were divided into two different age groups according to the median of the variable age. Participants estimated the width of three different body parts (i.e., shoulders, abdomen, and hips) before the entire illusion was induced (baseline), and after the synchronous and the asynchronous conditions. Results revealed that 26-to-55-year-old participants were more resistant to changes induced by the bodily illusion, whereas 19-to-25-year-old participants underestimated their bodies after both conditions. The findings were discussed in terms of the literature exploring age differences in responses to bodily illusion, which could suggest a Bayesian mechanism underlying these individual differences.
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Affiliation(s)
- Silvia Serino
- 1 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy .,2 Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano , Milan, Italy
| | - Federica Scarpina
- 3 Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano , Ospedale San Giuseppe, Piancavallo, Italy
| | - Antonios Dakanalis
- 4 Department of Brain and Behavioral Sciences, University of Pavia , Pavia, Italy .,5 Department of Medicine and Surgery, University of Milano-Bicocca , Monza, Italy
| | - Anouk Keizer
- 6 Department of Experimental Psychology, Faculty of Social and Behavioural Sciences, Utrecht University , Utrecht, Netherlands
| | - Elisa Pedroli
- 2 Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano , Milan, Italy
| | - Gianluca Castelnuovo
- 1 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy .,3 Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano , Ospedale San Giuseppe, Piancavallo, Italy
| | - Alice Chirico
- 1 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
| | - Valentina Catallo
- 2 Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano , Milan, Italy
| | - Daniele di Lernia
- 1 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
| | - Giuseppe Riva
- 1 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy .,2 Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano , Milan, Italy
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16
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Riva G, Wiederhold BK, Mantovani F. Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2018; 22:82-96. [PMID: 30183347 PMCID: PMC6354552 DOI: 10.1089/cyber.2017.29099.gri] [Citation(s) in RCA: 160] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Is virtual reality (VR) already a reality in behavioral health? To answer this question, a meta-review was conducted to assess the meta-analyses and systematic and narrative reviews published in this field in the last twenty-two months. Twenty-five different articles demonstrated the clinical potential of this technology in both the diagnosis and the treatment of mental health disorders: VR compares favorably to existing treatments in anxiety disorders, eating and weight disorders, and pain management, with long-term effects that generalize to the real world. But why is VR so effective? Here, the following answer is suggested: VR shares with the brain the same basic mechanism: embodied simulations. According to neuroscience, to regulate and control the body in the world effectively, the brain creates an embodied simulation of the body in the world used to represent and predict actions, concepts, and emotions. VR works in a similar way: the VR experience tries to predict the sensory consequences of an individual's movements, providing to him/her the same scene he/she will see in the real world. To achieve this, the VR system, like the brain, maintains a model (simulation) of the body and the space around it. If the presence in the body is the outcome of different embodied simulations, concepts are embodied simulations, and VR is an embodied technology, this suggests a new clinical approach discussed in this article: the possibility of altering the experience of the body and facilitating cognitive modeling/change by designing targeted virtual environments able to simulate both the external and the internal world/body.
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Affiliation(s)
- Giuseppe Riva
- 1 Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.,2 Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Brenda K Wiederhold
- 3 Virtual Reality Medical Center, La Jolla, California.,4 Virtual Reality Medical Institute, Brussels, Belgium
| | - Fabrizia Mantovani
- 5 Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milan, Italy
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17
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Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures. Clin J Pain 2018; 34:858-877. [DOI: 10.1097/ajp.0000000000000599] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Li BJ, Bailenson JN. Exploring the Influence of Haptic and Olfactory Cues of a Virtual Donut on Satiation and Eating Behavior. ACTA ACUST UNITED AC 2018. [DOI: 10.1162/pres_a_00300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract
Olfactory research in immersive virtual environments (IVEs) have often examined the addition of scent as part of the environment or atmosphere that act as experimental stimuli. There appears to be a lack of research on the influence of virtual foods in IVEs on human satiation. Studies based on situational cues or self-perception theory provide support for the hypothesis that touching and smelling a virtual food item may lead to increased consumption as a result of modeling expected behavior. On the other hand, studies grounded in embodied cognition suggest that satiation may take place as a result of mental simulation that resembles actual consumption behavior. In this preliminary study, we sought to explore the effects of haptic and olfactory cues through virtual food on human satiation and eating behavior. In our study, 101 participants took part in a 2 (touch: present vs absent) × 2 (scent: present vs absent) experiment where they interacted with a donut in an IVE. Findings showed that participants in the touch and scent present conditions ate significantly fewer donuts than those who were not exposed to these cues, and reported higher satiation as compared to their counterparts. However, findings were less clear with respect to participants who received both haptic and olfactory cues. As a whole, results provide preliminary support for satiation effects as a result of sensory simulation.
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Affiliation(s)
- Benjamin J. Li
- Wee Kim Wee School of Communication and Information Nanyang Technological University 31 Nanyang Link, Singapore 637718
| | - Jeremy N. Bailenson
- Department of Communication Stanford University 450 Serra Mall, Building 110, Stanford CA 94305, USA
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19
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Spence C. “Mirror, mirror on the wall”: Can visual illusions be used to ‘trick’ people into eating less? Int J Gastron Food Sci 2018. [DOI: 10.1016/j.ijgfs.2017.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Velasco C, Obrist M, Petit O, Spence C. Multisensory Technology for Flavor Augmentation: A Mini Review. Front Psychol 2018; 9:26. [PMID: 29441030 PMCID: PMC5797544 DOI: 10.3389/fpsyg.2018.00026] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 01/09/2018] [Indexed: 01/17/2023] Open
Abstract
There is growing interest in the development of new technologies that capitalize on our emerging understanding of the multisensory influences on flavor perception in order to enhance human–food interaction design. This review focuses on the role of (extrinsic) visual, auditory, and haptic/tactile elements in modulating flavor perception and more generally, our food and drink experiences. We review some of the most exciting examples of recent multisensory technologies for augmenting such experiences. Here, we discuss applications for these technologies, for example, in the field of food experience design, in the support of healthy eating, and in the rapidly growing world of sensory marketing. However, as the review makes clear, while there are many opportunities for novel human–food interaction design, there are also a number of challenges that will need to be tackled before new technologies can be meaningfully integrated into our everyday food and drink experiences.
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Affiliation(s)
- Carlos Velasco
- Center for Multisensory Marketing, Department of Marketing, BI Norwegian Business School, Oslo, Norway
| | - Marianna Obrist
- Sussex Computer Human Interaction Lab, Creative Technology Research Group, School of Engineering and Informatics, University of Sussex, Brighton, United Kingdom
| | | | - Charles Spence
- Crossmodal Research Laboratory, Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
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21
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Virtual Reality as a Promising Strategy in the Assessment and Treatment of Bulimia Nervosa and Binge Eating Disorder: A Systematic Review. Behav Sci (Basel) 2017; 7:bs7030043. [PMID: 28698483 PMCID: PMC5618051 DOI: 10.3390/bs7030043] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 07/05/2017] [Accepted: 07/06/2017] [Indexed: 11/16/2022] Open
Abstract
Several lines of evidence suggest that Virtual Reality (VR) has a potential utility in eating disorders. The objective of this study is to review the literature on the use of VR in bulimia nervosa (BN) and binge eating disorder (BED). Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for reporting systematic reviews, we performed a PubMed, Web of Knowledge and SCOPUS search to identify studies employing VR in the assessment and treatment of BN and BED. The following search terms were used: "virtual reality", "eating disorders", "binge eating", and "bulimia nervosa". From the 420 articles identified, 19 were selected, nine investigated VR in assessment and 10 were treatment studies (one case-report, two non-controlled and six randomized controlled trials). The studies using VR in BN and BED are at an early stage. However, considering the available evidence, the use of VR in the assessment of those conditions showed some promise in identifying: (1) how those patients experienced their body image; and (2) environments or specific kinds of foods that may trigger binge-purging cycle. Some studies using VR-based environments associated to cognitive behavioral techniques showed their potential utility in improving motivation for change, self-esteem, body image disturbances and in reducing binge eating and purging behavior.
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22
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Castelnuovo G, Pietrabissa G, Manzoni GM, Cattivelli R, Rossi A, Novelli M, Varallo G, Molinari E. Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives. Psychol Res Behav Manag 2017; 10:165-173. [PMID: 28652832 PMCID: PMC5476722 DOI: 10.2147/prbm.s113278] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Obesity is a chronic condition associated with risk factors for many medical complications and comorbidities such as cardiovascular diseases, some types of cancer, osteoarthritis, hypertension, dyslipidemia, hypercholesterolemia, type-2 diabetes, obstructive sleep apnea syndrome, and different psychosocial issues and psychopathological disorders. Obesity is a highly complex, multifactorial disease: genetic, biological, psychological, behavioral, familial, social, cultural, and environmental factors can influence in different ways. Evidence-based strategies to improve weight loss, maintain a healthy weight, and reduce related comorbidities typically integrate different interventions: dietetic, nutritional, physical, behavioral, psychological, and if necessary, pharmacological and surgical ones. Such treatments are implemented in a multidisciplinary context with a clinical team composed of endocrinologists, nutritionists, dietitians, physiotherapists, psychiatrists, psychologists, and sometimes surgeons. Cognitive behavioral therapy (CBT) is traditionally recognized as the best established treatment for binge eating disorder and the most preferred intervention for obesity, and could be considered as the first-line treatment among psychological approaches, especially in a long-term perspective; however, it does not necessarily produce a successful weight loss. Traditional CBT for weight loss and other protocols, such as enhanced CBT, enhanced focused CBT, behavioral weight loss treatment, therapeutic education, acceptance and commitment therapy, and sequential binge, are discussed in this review. The issue of long-term weight management of obesity, the real challenge in outpatient settings and in lifestyle modification, is discussed taking into account the possible contribution of mHealth and the stepped-care approach in health care.
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Affiliation(s)
- Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
- Department of Psychology, Catholic University of Milan, Milan
| | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
- Department of Psychology, Catholic University of Milan, Milan
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Roberto Cattivelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
- Department of Psychology, Catholic University of Milan, Milan
| | - Alessandro Rossi
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
| | - Margherita Novelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
| | - Giorgia Varallo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Verbania
- Department of Psychology, Catholic University of Milan, Milan
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23
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Nararro-Haro MV, Hoffman HG, Garcia-Palacios A, Sampaio M, Alhalabi W, Hall K, Linehan M. The Use of Virtual Reality to Facilitate Mindfulness Skills Training in Dialectical Behavioral Therapy for Borderline Personality Disorder: A Case Study. Front Psychol 2016; 7:1573. [PMID: 27853437 PMCID: PMC5089996 DOI: 10.3389/fpsyg.2016.01573] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/27/2016] [Indexed: 11/13/2022] Open
Abstract
Borderline personality disorder (BPD) is a severe mental disorder characterized by a dysfunctional pattern of affective instability, impulsivity, and disturbed interpersonal relationships. Dialectical Behavior Therapy (DBT®) is the most effective treatment for Borderline Personality Disorder, but demand for DBT® far exceeds existing clinical resources. Most patients with BPD never receive DBT®. Incorporating computer technology into the DBT® could help increase dissemination. Immersive Virtual Reality technology (VR) is becoming widely available to mainstream consumers. This case study explored the feasibility/clinical potential of using immersive virtual reality technology to enhance DBT® mindfulness skills training of a 32 year old female diagnosed with BPD. Prior to using VR, the patient experienced difficulty practicing DBT® mindfulness due to her emotional reactivity, and difficulty concentrating. To help the patient focus her attention, and to facilitate DBT® mindfulness skills learning, the patient looked into virtual reality goggles, and had the illusion of slowly “floating down” a 3D computer-generated river while listening to DBT® mindfulness training audios. Urges to commit suicide, urges to self harm, urges to quit therapy, urges to use substances, and negative emotions were all reduced after each VR mindfulness session and VR mindfulness was well accepted/liked by the patient. Although case studies are scientifically inconclusive by nature, results from this feasibility study were encouraging. Future controlled studies are needed to quantify whether VR-enhanced mindfulness training has long term benefits e.g., increasing patient acceptance and/or improving therapeutic outcome. Computerizing some of the DBT® skills treatment modules would reduce cost and increase dissemination.
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Affiliation(s)
| | - Hunter G Hoffman
- Virtual Reality Research Center at the Human Photonics Lab, Mechanical Engineering, University of Washington SeattleSeattle, WA, USA; Virtual Reality Research Center, Computer Science Department, Effat UniversityJeddah, Saudi Arabia
| | - Azucena Garcia-Palacios
- Psychology, Universitat Jaume ICastellon, Spain; Ciber Bisiopatologia Obesidad y NutricionMadrid, Spain
| | - Mariana Sampaio
- Virtual Reality Research Center at the Human Photonics Lab, Mechanical Engineering, University of Washington Seattle Seattle, WA, USA
| | - Wadee Alhalabi
- Virtual Reality Research Center, Computer Science Department, Effat UniversityJeddah, Saudi Arabia; Faculty of Computing and Information Technology, King Abdulaziz UniversityJeddah, Saudi Arabia
| | - Karyn Hall
- The DBT Center of Houston Houston, TX, USA
| | - Marsha Linehan
- Behavioral Research & Therapy Clinics, University of Washington Seattle, WA, USA
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24
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Wiederhold BK. Lessons Learned as We Begin the Third Decade of Virtual Reality. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2016; 19:577-578. [PMID: 27732073 DOI: 10.1089/cyber.2016.29052.bkw] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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25
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Riva G, Gutiérrez-Maldonado J, Wiederhold BK. Virtual Worlds versus Real Body: Virtual Reality Meets Eating and Weight Disorders. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2016; 19:63-6. [PMID: 26882322 PMCID: PMC4770913 DOI: 10.1089/cyber.2016.29025.gri] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Giuseppe Riva
- 1 Department of Psychology, Università Cattolica del Sacro Cuore , Milan, Italy
- 2 Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano , Milan, Italy
| | | | - Brenda K Wiederhold
- 4 Virtual Reality Medical Center , San Diego, California
- 5 Virtual Reality Medical Institute , Brussels, Belgium
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26
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Riva G, Baños RM, Botella C, Mantovani F, Gaggioli A. Transforming Experience: The Potential of Augmented Reality and Virtual Reality for Enhancing Personal and Clinical Change. Front Psychiatry 2016; 7:164. [PMID: 27746747 PMCID: PMC5043228 DOI: 10.3389/fpsyt.2016.00164] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 09/15/2016] [Indexed: 01/12/2023] Open
Abstract
During life, many personal changes occur. These include changing house, school, work, and even friends and partners. However, the daily experience shows clearly that, in some situations, subjects are unable to change even if they want to. The recent advances in psychology and neuroscience are now providing a better view of personal change, the change affecting our assumptive world: (a) the focus of personal change is reducing the distance between self and reality (conflict); (b) this reduction is achieved through (1) an intense focus on the particular experience creating the conflict or (2) an internal or external reorganization of this experience; (c) personal change requires a progression through a series of different stages that however happen in discontinuous and non-linear ways; and (d) clinical psychology is often used to facilitate personal change when subjects are unable to move forward. Starting from these premises, the aim of this paper is to review the potential of virtuality for enhancing the processes of personal and clinical change. First, the paper focuses on the two leading virtual technologies - augmented reality (AR) and virtual reality (VR) - exploring their current uses in behavioral health and the outcomes of the 28 available systematic reviews and meta-analyses. Then the paper discusses the added value provided by VR and AR in transforming our external experience by focusing on the high level of personal efficacy and self-reflectiveness generated by their sense of presence and emotional engagement. Finally, it outlines the potential future use of virtuality for transforming our inner experience by structuring, altering, and/or replacing our bodily self-consciousness. The final outcome may be a new generation of transformative experiences that provide knowledge that is epistemically inaccessible to the individual until he or she has that experience, while at the same time transforming the individual's worldview.
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Affiliation(s)
- Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy; Centro Studi e Ricerche di Psicologia della Comunicazione, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Rosa M Baños
- Universidad de Valencia, Valencia, Spain; Instituto Salud Carlos III, Ciber Fisiopatología Obesidad y Nutrición (CB06/03), Madrid, Spain; Red de Excelencia PROMOSAM, Mineco, Spain
| | - Cristina Botella
- Instituto Salud Carlos III, Ciber Fisiopatología Obesidad y Nutrición (CB06/03), Madrid, Spain; Red de Excelencia PROMOSAM, Mineco, Spain; Universitat Jaume I, Castelló de la Plana, Spain
| | - Fabrizia Mantovani
- Università degli Studi Milano Bicocca, Dipartimento di Scienze Umane per la Formazione "Riccardo Massa" , Milan , Italy
| | - Andrea Gaggioli
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy; Centro Studi e Ricerche di Psicologia della Comunicazione, Università Cattolica del Sacro Cuore, Milano, Italy
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