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Ruchiwit M, Vuthiarpa S, Ruchiwit K, Muijeen K, Phanphairoj K. A Synthesized Model for Applying Stress Management and Biofeedback Interventions in Research Utilization: A Systematic Review and Meta-analysis. Clin Pract Epidemiol Ment Health 2024; 20:e17450179276691. [PMID: 38660573 PMCID: PMC11037511 DOI: 10.2174/0117450179276691231229071003] [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: 08/10/2023] [Revised: 11/01/2023] [Accepted: 11/08/2023] [Indexed: 04/26/2024]
Abstract
Background Stress management and biofeedback interventions have been shown to be effective in improving mental and physical health outcomes. However, previous research studies and synthesized models for applying these interventions in research utilization are insufficient. Objective This study aimed to synthesize a model for applying stress management and biofeedback interventions in research utilization. Methods A systematic review and meta-analysis were conducted according to the PRISMA guidelines.Multiple studies were used to assess the effectiveness of applying stress management and biofeedback interventions published from 2017 to 2023. The process included identifying the research questions, conducting a comprehensive literature search, assessing study quality, extracting data, synthesizing the data, analyzing and interpreting the findings, drawing conclusions, and making recommendations. Results The results indicated a significant mean effect size without evidence of publication bias. The effect sizes of the subgroups among the study variables were not significantly different [Q = 4.02, p = .26]. However, there were significant differences regarding the mean effect sizes among the studies [Q = 63.59, p < .001] and also in terms of the test of subgroups among the participants [Q = 8.49, p = .04]. Conclusion The results emphasize the importance of evidence-based practice and highlight the need for ongoing evaluation and refinement of interventions. The proposed model was supported by related theories and research studies in order to ensure the robustness and reliability to guide practice and future research in the field of biofeedback interventions. By following this model, researchers and practitioners can ensure that stress management and biofeedback interventions are evidence-based and are effective in improving mental and physical health outcomes.
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Affiliation(s)
- Manyat Ruchiwit
- Faculty of Nursing, Rattana Bundit University, Pathumthani, Thailand
| | - Sararud Vuthiarpa
- Faculty of Nursing, Rattana Bundit University, Pathumthani, Thailand
| | - Kampol Ruchiwit
- Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Kasorn Muijeen
- Faculty of Nursing, Thammasat University, Pathumthani, Thailand
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Housand J, Cornelius A, Shackleford KE. Greater usage and positive mood change for users of a dynamic VR app before and after the COVID-19 pandemic onset. Front Psychol 2024; 15:1278207. [PMID: 38476392 PMCID: PMC10929007 DOI: 10.3389/fpsyg.2024.1278207] [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: 08/15/2023] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
Americans reported an increase in stress during the novel coronavirus disease 2019 (COVID-19). Virtual reality (VR) apps have been shown to distract users from stressors in the environment, but little is known about the efficacy of specific content features to reduce stress or improve mood for consumer users during a pandemic. The present study investigated secondary archival data to explore how mood and usage behavior changed before and after the onset of COVID-19 for consumer users of a VR app with dynamic, interactive content. Study findings indicate that the COVID-19 pandemic had significant effects on user behavior and mood. Users created more accounts and used app content more often during the pandemic, while reporting increased negative mood states. This suggests that users were motivated to use the content to cope with pandemic stressors. Users also experienced a greater positive mood change after using the content during the pandemic than before, which implies that elements related to the VR app content met users' psychological needs. Passive content with less interactivity resulted in a greater positive mood state after the COVID-19 onset, likely related to its capacity to reduce stress, facilitate restoration, and improve persistent affective states in stressful environments. This study offers a vital window into how consumer users respond to psychosocial pandemic stressors outside of a controlled environment as well as the prospective for VR app content to serve as a valuable mental health intervention during similar stressful events.
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Affiliation(s)
- Jessica Housand
- School of Psychology, Fielding Graduate University, Santa Barbara, CA, United States
- Department of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Allen Cornelius
- School of Psychology, Fielding Graduate University, Santa Barbara, CA, United States
| | - Karen E. Shackleford
- School of Psychology, Fielding Graduate University, Santa Barbara, CA, United States
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Pardini S, Gabrielli S, Olivetto S, Fusina F, Dianti M, Forti S, Lancini C, Novara C. Personalized Virtual Reality Compared With Guided Imagery for Enhancing the Impact of Progressive Muscle Relaxation Training: Pilot Randomized Controlled Trial. JMIR Ment Health 2024; 11:e48649. [PMID: 38289673 PMCID: PMC10871070 DOI: 10.2196/48649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 12/07/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Empirical evidence has shown that virtual reality (VR) scenarios can increase the effects of relaxation techniques, reducing anxiety by enabling people to experience emotional conditions in more vivid settings. OBJECTIVE This pilot randomized controlled study aims to investigate whether the progressive muscle relaxation technique (PMRT) associated with a personalized scenario in VR promotes psychological well-being and facilitates the recall of relaxing images more than the standard complementary intervention that involves the integration of PMRT and guided imagery (GI). METHODS On the basis of a longitudinal, between-subject design, 72 university students were randomly exposed to one of two experimental conditions: (1) standard complementary procedure (PMRT and GI exposure) and (2) experimental procedure (PMRT and personalized VR exposure). Individuals were assessed by a therapist before and after 7 training sessions based on measures investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data were also collected. RESULTS Differences in changes between the 2 groups after the in vivo PMRT session conducted by the psychotherapist (T1) were statistically significant for state anxiety (F1,67=30.56; P<.001) and heart rate (F1,67=4.87; P=.01). Individuals in the VR group obtained lower scores both before (t67=-2.63; P=.01; Cohen d=0.91) and after (t67=-7.23; P<.001; Cohen d=2.45) the relaxation session when it was self-administered by participants (T2). A significant reduction in perceived state anxiety at T1 and T2 was observed for both groups (P<.001). After the VR experience, individuals reported feeling higher engagement in the experience than what was mentioned by participants in the GI group (F1,67=2.85; P=.03; ηp2=0.15), and they experienced the environment as more realistic (F1,67=4.38; P=.003; ηp2=0.21). No differences between groups regarding sense of presence were found (F1,67=1.99; P=.11; ηp2=0.11). Individuals exposed before to the VR scenario (T1) referred to perceiving the scenario recalled in-imagination at T2 as more realistic than what those in the GI group experienced (F1,67=3.21; P=.02; ηp2=0.12). The VR group had lower trait anxiety levels than the GI group after the relaxation session during session 7 (T2; t67=-2.43; P=.02). CONCLUSIONS Personalized relaxing VR scenarios can contribute to improving relaxation and decreasing anxiety when integrated with PMRT as a complementary relaxation method. TRIAL REGISTRATION ClinicalTrials.gov NCT05478941; https://classic.clinicaltrials.gov/ct2/show/NCT05478941. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/44183.
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Affiliation(s)
- Susanna Pardini
- Department of General Psychology, University of Padova, Padova, Italy
- Digital Health Research, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- Human Inspired Technology Research Centre (HIT), University of Padova, Padova, Italy
| | - Silvia Gabrielli
- Digital Health Research, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Olivetto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Francesca Fusina
- Department of General Psychology, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Marco Dianti
- Digital Health Research, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Forti
- Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Cristina Lancini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Caterina Novara
- Department of General Psychology, University of Padova, Padova, Italy
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Terzulli C, Chauvin C, Champagnol Di-Liberti C, Faisan S, Goffin L, Gianesini C, Graff D, Dufour A, Laroche E, Salvat E, Poisbeau P. Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses. FRONTIERS IN PAIN RESEARCH 2023; 4:1237090. [PMID: 38028428 PMCID: PMC10651739 DOI: 10.3389/fpain.2023.1237090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Immersive virtual reality (VR) is a promising tool to reduce pain in clinical setting. Digital scripts displayed by VR disposals can be enriched by several analgesic interventions, which are widely used to reduce pain. One of these techniques is hypnosis induced through the VR script (VRH) which is facilitated by immersive environment and particularly efficient even for low hypnotizable patients. The aim of this study is to assess the efficacy of a VRH script on experimentally induced cold pain perception (intensity and unpleasantness) and physiological expression. 41 healthy volunteers had been recruited in this within-subjects study. They received 9 stimulations of 20 s (3 non-nociceptive cold; 3 low nociceptive cold and 3 highly nociceptive cold) during a VRH session of 20 min (VRH condition) or without VRH (noVRH condition). Physiological monitoring during the cold pain stimulation protocol consisted of recording heart rate, heart rate variability and respiratory frequency. Maximum cold pain intensity perception, measured through the visual analog scale (VAS) on 10, was of 3.66 ± 1.84 (VAS score/10) in noVRH condition and 2.46 ± 1.54 in VRH (Wilcoxon, p < 0.0001). Considering pain unpleasantness perception, 3.68 ± 2.06 in noVRH and 2.21 ± 1.63 in VRH (Wilcoxon, p < 0.0001). Hypnotizability negatively correlated with the decrease in VAS intensity from noVRH to VRH (Spearman r = -0.45; p = 0.0038). In our sample, we found that 31/41 volunteers (75.6%) displayed a reduction of more than 10% of their VAS pain intensity and unpleasantness scores. Trait anxiety was the best predictor of the VRH responders, as well as heart rate variability. In addition, respiratory rate was diminished under VRH in every subgroup. VRH is an effective tool to reduced pain intensity and unpleasantness in a vast majority of healthy subjects. We further indicate in this study that heart rate variability parameter RMSSD (root mean square of successive differences) is a good predictor of this effect, as well as anxiety as a personality trait (but not state anxiety). Further studies are expected to determine more precisely to whom it will be the most useful to offer tailored, non-pharmacological pain management solutions to patients.
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Affiliation(s)
- Claire Terzulli
- Centre National de la Recherche Scientifique, University of Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France
- HypnoVR, Strasbourg, France
| | - Chloé Chauvin
- HypnoVR, Strasbourg, France
- Anesthesiology and Intensive Care, University Hospital of Strasbourg, Strasbourg, France
| | | | - Sylvain Faisan
- ICube Laboratory, University of Strasbourg, Strasbourg, France
| | - Laurent Goffin
- ICube Laboratory, University of Strasbourg, Strasbourg, France
| | | | - Denis Graff
- HypnoVR, Strasbourg, France
- Anesthesiology Department, Clinique Rhéna, Strasbourg, France
| | - André Dufour
- Centre National de la Recherche Scientifique, University of Strasbourg, Laboratoire de Neurosciences Cognitives et Adaptatives, Strasbourg, France
| | - Edouard Laroche
- ICube Laboratory, University of Strasbourg, Strasbourg, France
| | - Eric Salvat
- Centre National de la Recherche Scientifique, University of Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France
| | - Pierrick Poisbeau
- Centre National de la Recherche Scientifique, University of Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France
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Pardini S, Gabrielli S, Olivetto S, Fusina F, Dianti M, Forti S, Lancini C, Novara C. Personalized, Naturalistic Virtual Reality Scenarios Coupled With Web-Based Progressive Muscle Relaxation Training for the General Population: Protocol for a Proof-of-Principle Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e44183. [PMID: 37067881 PMCID: PMC10152380 DOI: 10.2196/44183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Virtual reality (VR) is an innovative tool that can facilitate exposure to either stressful or relaxing stimuli and enables individuals who have difficulties visualizing scenes to be involved in a more realistic sensorimotor experience. It also facilitates multisensory stimulation, a sense of presence, and achievement of relaxation. VR scenarios representing visual and auditory elements of natural relaxing environments can facilitate the learning of relaxation techniques such as the progressive muscle relaxation technique (PMRT). A complementary standardized technique deployed to reduce anxiety symptoms is the integration of PMRT and guided imagery (GI). Exposure to a pleasant imaginary environment helps the establishment of an association between a relaxing scenario and the relaxation technique, consequently promoting relaxation. Empirical evidence has shown that VR scenarios can increase the effects of relaxation techniques by enabling people to experience emotional conditions in more vivid settings. OBJECTIVE The main aim of this pilot study protocol is to investigate the impact on state anxiety of PMRT, associated with a personalized relaxing scenario in VR, and the role of VR scenarios in facilitating the recall of relaxing images and a sense of presence. A secondary aim is to understand if relaxing sessions administered via Zoom are more effective for managing anxiety and stress than a procedural setting based on audio-track guidance. METHODS Based on a longitudinal, between-subject design, 108 university students will be randomly exposed to one of three experimental conditions: (1) PMRT via Zoom and GI exposure, (2) PMRT via Zoom and personalized VR exposure, and (3) PMRT based on audio-track guidance and personalized VR exposure. Individuals are assessed before and after 7 training sessions based on self-report questionnaires investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data are also detected by an Mi Band 2 sensor. RESULTS The experimental procedure is ongoing. In this paper, preliminary data from a sample of 40 participants will be illustrated. The experimental phase is expected to conclude in May 2023, and the final results of the research will be presented in June 2023. CONCLUSIONS The results of this study will help shape the experimental design to apply it on a subsequent randomized controlled trial, also considering clinical samples. This work is expected to measure whether VR is a more engaging and helpful technique in promoting relaxation and decreasing anxiety levels than GI, by making the visualization process easier and by helping people to face more realistic sensory experiences. Assessing the efficacy of the PMRT in alternative delivery modes may extend its applications, especially in situations where the standard procedure is more challenging to be administered. To our knowledge, no equivalent study has been published so far on this matter. TRIAL REGISTRATION ClinicalTrials.gov NCT05478941; https://clinicaltrials.gov/ct2/show/NCT05478941. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44183.
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Affiliation(s)
- Susanna Pardini
- Department of General Psychology, University of Padova, Padova, Italy
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
| | - Silvia Gabrielli
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Olivetto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Francesca Fusina
- Department of General Psychology, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Marco Dianti
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Forti
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Cristina Lancini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Caterina Novara
- Department of General Psychology, University of Padova, Padova, Italy
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Ugras GA, Kanat C, Yaman Z, Yilmaz M, Turkmenoglu MO. The Effects of Virtual Reality on Preoperative Anxiety in Patients Undergoing Colorectal and Abdominal Wall Surgery: A Randomized Controlled Trial. J Perianesth Nurs 2023; 38:277-283. [PMID: 36319521 DOI: 10.1016/j.jopan.2022.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/24/2022] [Accepted: 07/13/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effects of a virtual reality (VR) application on preoperative anxiety (PA) in patients undergoing colorectal and abdominal wall surgery. DESIGN A prospective, parallel two-armed, randomized controlled trial. METHODS Eighty six patients were divided into the control group (n = 43) and in the experimental group (n = 43). The experimental group received a preoperative VR application for 10 minutes. The routine preoperative procedure used at the clinic was used for the patients in the control group. The anxiety level was assessed using the Anxiety Specific to Surgery Questionnaire (ASSQ) and measured with physiological responses to anxiety, such as changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), and peripheral oxygen saturation (SpO2), before and after the VR application. FINDINGS The VR application reduced PA levels in the experimental group (P < .001) and changes in the SBP (P < .001), DBP (P < .001), HR (P < .001), RR (P = .041) and SpO2(P = .019) values) compared to the levels in the control group. CONCLUSIONS VR applications can reduce psychological and physiological responses to PA in patients undergoing colorectal and abdominal wall surgery.
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Affiliation(s)
- Gülay Altun Ugras
- Department of Surgical Nursing, Mersin University, Nursing Faculty, Mersin, Turkey.
| | - Canan Kanat
- Department of Surgical Nursing, Mersin University, Nursing Faculty, Mersin, Turkey
| | - Zeliha Yaman
- Department of Mental Health Nursing, Mersin University, Nursing Faculty, Mersin, Turkey
| | - Mualla Yilmaz
- Department of Mental Health Nursing, Mersin University, Nursing Faculty, Mersin, Turkey
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Vasil’ev Y, Diachkova E, Darawsheh H, Kashtanov A, Molotok E, Volel B, Batov A, Kytko O, Saleev R, Saleeva G, Saleeva L, Smilyk I, Tiunova N. Cross-Sectional Study on the Comparative Assessment of Mandibular Anesthesia (Inferior Alveolar Nerve Blockage) Manual Skills Shaping among Dentists on Plastic and Biomaterial Models. Dent J (Basel) 2022; 10:dj10070124. [PMID: 35877398 PMCID: PMC9318609 DOI: 10.3390/dj10070124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/30/2022] [Accepted: 06/27/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Providing regional anesthesia skills shaping remains relevant nowadays. A number of studies show that dentists have difficulties with these working independently. The study aim is the comparative analysis of the results of mandibular anesthesia (IANB) manual-skills shaping among dentists on plastic models and cadavers. Methods: In total, 999 participants were training in the skills of mandibular anesthesia from 2017 to 2021. The participants were divided in a random way into two groups: 700 participants were trained on plastic models, and 299 were trained on the cadaver material. After a lecture on the clinical and anatomical guidelines for IANB, a demonstration of the technique was provided, with subsequent testing of the injection technique. Satisfaction with the aspects of the training was assessed using the Likert scale. Results: the analysis of average values showed that participants from the group in which the manual skills were practiced on cadavers were more satisfied with the main aspects of the training, according to the sum of the main criteria of the modified scale. Conclusions: The important advantages of cadaver educational technology are that the sensations of tissue resistance are identical to natural ones, the individuality of each object, and the possibility of the visual study of the anesthesia technique, by dissection of the needle course and the location of the anesthetic depot.
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Affiliation(s)
- Yuriy Vasil’ev
- N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., 119991 Moscow, Russia; (E.M.); (B.V.); (A.B.); (O.K.)
- Correspondence: (Y.V.); (E.D.); (A.K.)
| | - Ekaterina Diachkova
- N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., 119991 Moscow, Russia; (E.M.); (B.V.); (A.B.); (O.K.)
- E.V. Borovsky Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 11 Mozhaiskiy Val St., 121059 Moscow, Russia
- Correspondence: (Y.V.); (E.D.); (A.K.)
| | - Hadi Darawsheh
- Institute of Anatomy “Skolkovo”, Skolkovo, 42-1 Bolshoy Boulevard St., 121205 Moscow, Russia; (H.D.); (I.S.)
| | - Artem Kashtanov
- N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., 119991 Moscow, Russia; (E.M.); (B.V.); (A.B.); (O.K.)
- Correspondence: (Y.V.); (E.D.); (A.K.)
| | - Ekaterina Molotok
- N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., 119991 Moscow, Russia; (E.M.); (B.V.); (A.B.); (O.K.)
| | - Beatrice Volel
- N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., 119991 Moscow, Russia; (E.M.); (B.V.); (A.B.); (O.K.)
| | - Artem Batov
- N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., 119991 Moscow, Russia; (E.M.); (B.V.); (A.B.); (O.K.)
| | - Olesya Kytko
- N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., 119991 Moscow, Russia; (E.M.); (B.V.); (A.B.); (O.K.)
| | - Rinat Saleev
- Dentistry Faculty, Kazan State Medical University, 49 Butlerova Street St., 420012 Kazan, Russia; (R.S.); (G.S.); (L.S.)
| | - Gulshat Saleeva
- Dentistry Faculty, Kazan State Medical University, 49 Butlerova Street St., 420012 Kazan, Russia; (R.S.); (G.S.); (L.S.)
| | - Laysan Saleeva
- Dentistry Faculty, Kazan State Medical University, 49 Butlerova Street St., 420012 Kazan, Russia; (R.S.); (G.S.); (L.S.)
| | - Irina Smilyk
- Institute of Anatomy “Skolkovo”, Skolkovo, 42-1 Bolshoy Boulevard St., 121205 Moscow, Russia; (H.D.); (I.S.)
| | - Natalya Tiunova
- Dentistry Faculty, Privolzhsky Research Medical University, Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia;
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Sekula AD, Downey L, Puspanathan P. Virtual Reality as a Moderator of Psychedelic-Assisted Psychotherapy. Front Psychol 2022; 13:813746. [PMID: 35310225 PMCID: PMC8931418 DOI: 10.3389/fpsyg.2022.813746] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/11/2022] [Indexed: 12/20/2022] Open
Abstract
Psychotherapy with the use of psychedelic substances, including psilocybin, lysergic acid diethylamide (LSD), ketamine, and 3,4-methylenedioxymethamphetamine (MDMA), has demonstrated promise in treatment of post-traumatic stress disorder (PTSD), anxiety, addiction, and treatment-resistant depression. Psychedelic-assisted psychotherapy (PP) represents a unique psychopharmacological model that leverages the profound effects of the psychedelic experience. That experience is characterized by strong dependency on two key factors: participant mindset and the therapeutic environment. As such, therapeutic models that utilize psychedelics reflect the need for careful design that promotes an open, flexible, trusting mindset and a supportive setting. To meet this need, the PP model is increasingly supplemented by auxiliary methods, including meditation, relaxation, visualization or spiritual practices. We suggest virtual reality (VR) as a full-spectrum tool able to capitalize on and catalyze the innately therapeutic aspects of the psychedelic experience, such as detachment from familiar reality, alteration of self-experience, augmentation of sensory perception and induction of mystical-type experiences. This is facilitated by VR’s evidenced capacity to: aid relaxation and reduce anxiety; buffer from external stimuli; promote a mindful presence; train the mind to achieve altered states of consciousness (ASC); evoke mystical states; enhance therapeutic alliance and encourage self-efficacy. While these unique VR features appear promising, VR’s potential role in PP remains speculative due to lack of empirical evidence on the combined use of VR and PP. Given the increased commercial interest in this synergy there is an urgent need to evaluate this approach. We suggest specific VR models and their role within PP protocols to inspire future direction in scientific research, and provide a list of potential disadvantages, side effects and limitations that need to be carefully considered. These include sensory overstimulation, cyber-sickness, triggering memories of past traumatic events as well as distracting from the inner experience or strongly influencing its contents. A balanced, evidence-based approach may provide continuity across all phases of treatment, support transition into and out of an ASC, deepen acute ASC experiences including mystical states and enrich the psychotherapeutic process of integration. We conclude that the potential application of VR in modulating psychedelic-assisted psychotherapy demands further exploration and an evidence-based approach to both design and implementation.
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Affiliation(s)
- Agnieszka D. Sekula
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia
- Enosis Therapeutics Pty. Ltd., Melbourne, VIC, Australia
- *Correspondence: Agnieszka D. Sekula,
| | - Luke Downey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia
- Institute for Breathing and Sleep, Austin Hospital, Melbourne, VIC, Australia
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