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Meyerbröker K, Emmelkamp P. Take a Look at Me Now: The Use of Virtual Reality in the Treatment of Social Anxiety Disorder. J Clin Psychol 2025; 81:494-502. [PMID: 40056467 PMCID: PMC12050102 DOI: 10.1002/jclp.23782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 01/31/2025] [Accepted: 02/17/2025] [Indexed: 03/10/2025]
Abstract
In anxiety and related disorders, Virtual Reality Exposure Therapy (VRET) was one of the first steps toward integrating technology into psychological treatments. In this article, we discuss crucial therapeutical skills and provide a case conceptualisation for the treatment of social anxiety disorder with VRET. The case conceptualisation is based on evidence-based cognitive-behavioural treatment approaches. Social anxiety can be very challenging to treat with exposure in vivo, and virtual reality exposure offers the added benefit of being able to create social situations and real-time interactions within the therapeutic context. The case conceptualisation presented is worked out for a 23-year-old female with social anxiety disorder who is increasingly hindered by her anxiety in her professional and personal life. The treatment rationale of VRET, homework assignments, and progress of therapy are presented. Additionally, this paper discusses what steps to take if the first exposure experiences are not successful and how to progress in such cases. Therapeutic pitfalls are illustrated within this case and potential solutions on how to avoid these pitfalls are addressed.
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Affiliation(s)
- Katharina Meyerbröker
- Utrecht UniversityUtrechtNetherlands
- Altrecht Academic Anxiety CenterUtrechtNetherlands
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Miegel F, Jelinek L, Lohse L, Moritz S, Blömer J, Juckoff K, Yassari A, Rolvien L. Exposure Therapy in Mixed Reality for Obsessive-Compulsive Disorder: A Randomized Clinical Trial. JAMA Netw Open 2025; 8:e2511488. [PMID: 40392553 DOI: 10.1001/jamanetworkopen.2025.11488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2025] Open
Abstract
Importance Exposure therapy in virtual reality (VR) is well established for anxiety disorders. While early studies show promise for VR-based exposure and response prevention (ERP) in obsessive-compulsive disorder (OCD), a key challenge of traditional VR is the weak sense of presence, deemed crucial for effectiveness. Objective To evaluate the feasibility and efficacy of ERP in mixed reality (MERP). Design, Setting, and Participants This randomized clinical trial (RCT) included 2 outpatient treatment groups, MERP vs self-guided ERP (SERP) from March 15, 2022, to October 26, 2024. Participants were required to be 18 to 80 years of age and have contamination-related OCD (C-OCD). Exclusion criteria consisted of schizophrenia or bipolar disorder, severe substance use disorder, acute suicidality, and ongoing inpatient treatment. Patients' symptom severity was assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before (baseline) and after the 6-week intervention period as well as 3 months after posttreatment (follow-up). Intervention Six sessions of MERP or SERP. Main Outcomes and Measures Main outcome was the severity of OCD symptoms in the past 7 days on the Y-BOCS. Sense of presence and subjective appraisal were the secondary outcomes. Results Thirty-six participants fulfilled inclusion criteria. Twenty-four participants (66.7%) were female; mean (SD) age was 35.42 (14.03) years. Both groups had severe OCD symptoms, with major depressive disorder as the most common comorbidity (23 [63.9%]). Twenty-nine participants (80.6%) completed the postintervention and follow-up assessments. At baseline, patients in the MERP group had a mean (SD) Y-BOCS score of 26.94 (5.83), while the SERP group had a mean (SD) score of 24.22 (4.12). The decline in patients' OCD symptoms (Y-BOCS) was similar in the MERP (mean difference, 3.15) and the SERP groups (mean difference, 1.47) (ηp2 = 0.002; 95% CI, -3.187 to 3.893). Significant improvements were observed within the MERP group from baseline to post treatment across several psychopathological variables, including OCD symptoms, with a medium to large effect (Cohen d, 0.584-0.931; 95% CI, 0.026-1.551). Sense of presence was moderate (mean [SD], ≤3.24 [≤2.07]). Subjective appraisal was heterogeneous. Conclusions This RCT on MERP in C-OCD provided important insights. While there were no significant between-group differences, changes in psychopathology within the MERP group suggest some level of effectiveness. However, the limited impact indicates that the full potential of MERP has not yet been realized, and future research should aim to improve immersion and overall effectiveness. Trial Registration German Clinical Trial Registry: DRKS00020969.
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Affiliation(s)
- Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Luzie Lohse
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jannik Blömer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kim Juckoff
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Amir Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lara Rolvien
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Planert J, Hildebrand AS, Machulska A, Roesmann K, Neubert M, Pilgramm S, Pilgramm J, Klucken T. Blended Mobile-Based Interventions With Integrated Virtual Reality Exposure Therapy for Anxiety Disorders: Thematic Analysis of Patient Perspectives. JMIR Hum Factors 2025; 12:e60957. [PMID: 40273440 PMCID: PMC12062763 DOI: 10.2196/60957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 01/18/2025] [Accepted: 01/29/2025] [Indexed: 04/26/2025] Open
Abstract
BACKGROUND Guided mobile-based interventions may mitigate symptoms of anxiety disorders such as panic disorder, agoraphobia, or social anxiety disorder. With exposure therapy being efficacious in traditional treatments for these disorders, recent advancements have introduced 360° videos to deliver virtual reality exposure therapy (VRET) within mobile-based interventions. OBJECTIVE Despite ongoing trials evaluating the treatment's efficacy, research examining patient perceptions of this innovative approach is still scarce. Therefore, this study aimed to explore patient opinions on specific treatment aspects of mobile-based interventions using mobile VRET and psychotherapeutic guidance for anxiety disorders. METHODS A total of 11 patients diagnosed with panic disorder, agoraphobia, or social anxiety disorder who had previously taken part in the experimental conditions of 2 randomized controlled trials for a mobile intervention including mobile VRET participated in cross-sectional, retrospective interviews. Using a semistructured interview format, patients were asked to reflect on their treatment experiences; personal changes; helpful and hindering aspects; their motivation levels; and their encounters with the mobile-based intervention, manualized treatment sessions, and the mobile VRET. RESULTS Thematic analysis led to the formation of 14 themes in four superordinate categories: (1) perceived treatment outcomes, (2) aspects of the mobile intervention, (3) experiences with mobile VRET, and (4) contextual considerations. Patients offered their insights into factors contributing to treatment success or failure, delineated perceived treatment outcomes, and highlighted favorable aspects of the treatment while pointing out shortcomings and suggesting potential enhancements. Most strikingly, while using a blended app-based intervention, patients highlighted the role of psychotherapeutic guidance as a central contributing factor to their symptom improvement. CONCLUSIONS The findings of the thematic analysis and its diverse patient perspectives hold the potential to guide future research to improve mobile-based treatment options for anxiety disorders. Insights from these patient experiences can contribute to refining mobile-based interventions and optimizing the integration of VRET in accordance with patients' preferences, needs, and expectations.
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Affiliation(s)
- Jari Planert
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
| | - Anne-Sophie Hildebrand
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
| | - Alla Machulska
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
| | - Kati Roesmann
- Institute of Psychology, Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Osnabrück, Osnabrück, Germany
| | - Marie Neubert
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
| | - Sebastian Pilgramm
- Department of Psychology, IU International University of Applied Sciences, Erfurt, Germany
| | - Juliane Pilgramm
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
| | - Tim Klucken
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
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Uduwa Vidanalage ES, De Lee J, Hermans D, Engelhard IM, Scheveneels S, Meyerbröker K. VIRTUS: virtual reality exposure training for adolescents with social anxiety - a randomized controlled trial. BMC Psychiatry 2025; 25:401. [PMID: 40251576 PMCID: PMC12008921 DOI: 10.1186/s12888-025-06756-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Accepted: 03/20/2025] [Indexed: 04/20/2025] Open
Abstract
While virtual reality exposure (VRE) has shown effectiveness in treating social anxiety in adults, research on its efficacy for adolescents remains limited. Given that adolescence is a critical period for early intervention, this study aims to address this gap by evaluating the efficacy and acceptability of VRE compared to in vivo exposure (IVE) in a non-referred sample of socially anxious adolescents. Additionally, we seek to identify mechanisms of change-such as expectancy violation, habituation, and self-efficacy-as well as predictors of treatment response, including clinical, personality, and VR-related factors. Using a randomized controlled trial (RCT), 120 adolescents (ages 12-16) with subclinical to moderate social anxiety will be assigned to one of three conditions: VRE, IVE, or a waitlist control (WL). Participants in the active conditions will undergo a seven-session exposure-based intervention (either in VR or in vivo). Primary (SPAI-18, LSAS-avoidance) and secondary (SPWSS) measures of social anxiety, along with general well-being indicators (e.g., resilience, depression, psychosocial functioning), will be assessed at baseline, post-treatment, and 3- and 6-month follow-ups. A series of linear mixed model (LMM) analyses will be used to examine and compare the effects of the interventions. We hypothesize that both VRE and IVE will significantly reduce social anxiety symptoms compared to WL at post-assessment, with comparable long-term efficacy between the two exposure methods. Additionally, thematic analyses will be conducted to explore participants' experiences and acceptance of VRE and IVE through qualitative interviews. The findings of this study aim to advance digital mental health research by evaluating the potential of VRE as an early intervention and identifying mechanisms and predictors to inform personalized treatments for socially anxious youth.Trial registrationClinicaltrials.gov: NCT06379633, registered on April, 23, 2024.
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Hudson DDM, Heales DC. Virtual reality for MRI preparation: Participant perceptions from a feasibility study. J Med Imaging Radiat Sci 2025; 56:101890. [PMID: 40121863 DOI: 10.1016/j.jmir.2025.101890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 02/17/2025] [Accepted: 03/04/2025] [Indexed: 03/25/2025]
Abstract
INTRODUCTION Undergoing a Magnetic Resonance Imaging (MRI) procedure remains a source of fear and concern for many. Providing adequate information beforehand is essential to ease concerns, yet traditional methods have limitations, often hindered by time constraints. The aim of this study is to explore the acceptability of a Virtual Experience (VE) as an alternative method to prepare patients, with a focus on participant feedback to inform future development. METHODS Feedback metrics and qualitative responses were captured as part of a wider experimental mixed methods feasibility study. Feedback scores were collated and described, whilst qualitative data underwent a process of thematic analysis. RESULTS 15 participants underwent two exposures to the VE. The majority were female with an average age of 50, and a third having experienced virtual reality before. Feedback obtained supported perception of the VE to have been engaging, safe, and of benefit, with a willingness to use in the future. From the emerging themes, the experience was considered realistic, fostering acceptance and tolerance of the tool with a number of suggestions for improvement made. Participants would prefer use in a clinical setting with staff support, rather than at home, highlighting its potential to build trust with imaging staff away from pressurised scanning lists ahead of an actual scan. CONCLUSION Participants viewed the VE as a valuable preparatory tool, providing a realistic and acceptable means to familiarise themselves with the process. Their feedback highlights areas for improvement and supports its potential use in practice, underscoring the importance of the public's role in shaping acceptance and future enhancements. IMPLICATIONS FOR PRACTICE VR could become a commonplace means of patient preparation and help facilitate coping strategies before an actual scan.
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Affiliation(s)
- Dr Darren M Hudson
- Medical Imaging, Department of Health and Care Professions, University of Exeter, Exeter, UK.
| | - Dr Christine Heales
- Medical Imaging, Department of Health and Care Professions, University of Exeter, Exeter, UK
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Zhong C, Yao L, Chen L, Wang X, Zhu X, Wen Y, Deng L, Chen J, Hui J, Shi L, You L. The use of virtual reality-assisted interventions on psychological well-being and treatment adherence among kidney transplant recipients: A randomized controlled study. Acta Psychol (Amst) 2025; 253:104700. [PMID: 39864289 DOI: 10.1016/j.actpsy.2025.104700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 12/20/2024] [Accepted: 01/07/2025] [Indexed: 01/28/2025] Open
Abstract
This randomized controlled trial aims to investigate the effects of educational and psychological interventions on the health outcomes of patients suffering from chronic diseases. We recruited 372 patients and randomly assigned them to one of two intervention arms during the trial, which lasted for a year. Both groups participated in a 12-month intervention program, where the intervention group received health education and supportive psychological therapy utilizing virtual reality (VR) technology, while the control group received conventional health education guidance. Statistical analysis showed that compared to the control group, the intervention group demonstrated significant improvements (p < 0.05) in depression assessment scores, compliance scores, and Barthel functional scoring. However, the two groups had no significant difference in the incidence of complications and health knowledge mastery. Additionally, the intervention group had fewer hospitalization days than the control group, with statistically significant differences. The research results prove that targeted intervention effectively improves medication adherence, patient awareness, and reduces patient hospitalization days, which is particularly important for managing chronic diseases.
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Affiliation(s)
- Chao Zhong
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Lin Yao
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Lanlan Chen
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Xiaofen Wang
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Xiaohui Zhu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yihong Wen
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Lei Deng
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Jiafu Chen
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Jialiang Hui
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Lisha Shi
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Lijuan You
- Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China.
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Malbos E, Chichery N, Borwell B, Weindel G, Molitor J, Einig-Iscain M, Seimandi J, Lançon C. Virtual Reality and Relaxation for the Treatment of Generalized Anxiety Disorder: A Randomized Comparative Study with Standard Intervention. J Clin Med 2025; 14:1351. [PMID: 40004880 PMCID: PMC11856863 DOI: 10.3390/jcm14041351] [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: 01/17/2025] [Revised: 02/12/2025] [Accepted: 02/14/2025] [Indexed: 02/27/2025] Open
Abstract
Background/Objectives: Modern therapeutic strategies incorporating virtual reality (VR) have emerged as potential treatments for generalized anxiety disorder (GAD), a prevalent and debilitating condition that is challenging to cure. This study aimed to evaluate the efficacy of VR combined with relaxation techniques in patients with GAD by comparing VR-based relaxation with standard mental imagery (MI) relaxation. Methods: Fifty-eight patients with GAD participated in a randomized comparative trial. Specific virtual environments were created using an inexpensive game engine/level editor (GLE). Psychometric scales and physiological instruments were employed to assess the effects of relaxation therapy on anxiety, depression, quality of life, presence within virtual environments and cybersickness. Results: Both the VR and MI groups demonstrated statistically significant improvements in anxiety, worry and mental quality of life scores. However, no significant differences were observed between the two groups in pre-post comparisons of psychometric scores. The VR group exhibited a noticeably higher protocol completion rate and a significant increase in heart rate variability during the therapy. The level of presence in the VR group was satisfactory and significantly correlated with physiological improvements and anxiety reduction, while cybersickness remained low. Participants' preferences for specific virtual environments for relaxation are also discussed. Conclusions: These findings suggest that teaching and practicing relaxation in VR holds therapeutic potential for the treatment of GAD. Further research leveraging advanced VR sensory equipment and artificial intelligence agents is warranted to enhance therapeutic outcomes and explore additional applications.
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Affiliation(s)
- Eric Malbos
- Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique Hôpitaux de Marseille APHM, 13009 Marseille, France
- Equipe Imothep, Institut Fresnel, UMR 7249, Ecole Centrale Marseille, Aix-Marseille University, 13005 Marseille, France
| | - Nadège Chichery
- Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique Hôpitaux de Marseille APHM, 13009 Marseille, France
| | - Baptiste Borwell
- Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique Hôpitaux de Marseille APHM, 13009 Marseille, France
| | - Gabriel Weindel
- Laboratory of Cognitive Neuroscience, UMR 7291, Aix-Marseille University, 13331 Marseille, France
| | - Jordan Molitor
- Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique Hôpitaux de Marseille APHM, 13009 Marseille, France
| | - Mélodie Einig-Iscain
- Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique Hôpitaux de Marseille APHM, 13009 Marseille, France
| | - Julien Seimandi
- Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique Hôpitaux de Marseille APHM, 13009 Marseille, France
| | - Christophe Lançon
- Department of Adult Psychiatry, Sainte Marguerite University Hospital, Assistance Publique Hôpitaux de Marseille APHM, 13009 Marseille, France
- Centre de Recherche en Santé Mentale et Psychiatrie, 13090 Montperrin, France
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Beele G, Liesong P, Bojanowski S, Hildebrand K, Weingart M, Asbrand J, Correll CU, Morina N, Uhlhaas PJ. Virtual Reality Exposure Therapy for Reducing School Anxiety in Adolescents: Pilot Study. JMIR Ment Health 2024; 11:e56235. [PMID: 39499549 PMCID: PMC11576610 DOI: 10.2196/56235] [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: 01/10/2024] [Revised: 07/11/2024] [Accepted: 07/30/2024] [Indexed: 11/07/2024] Open
Abstract
BACKGROUND Virtual reality exposure therapy (VRET) is a promising treatment approach for anxiety disorders. However, while its efficacy has been demonstrated in adults, research on the efficacy of VRET in the treatment of adolescents with anxiety disorders is largely lacking. OBJECTIVE A pilot study was carried out to test whether exposure to a virtual reality (VR) school environment elicits state anxiety and autonomic arousal in adolescents with school anxiety (diagnoses covering social anxiety disorder or specific phobia involving school contexts). In addition, we examined whether repeated VR exposure led to a reduction in this fear response, trait school anxiety, and social anxiety symptoms. Moreover, the relationship of presence, the subjective sense of "being there," during VR exposure with anxiety measures and treatment response was examined. METHODS In a pilot study, 10 adolescents with school anxiety (age range 14 to 17 years) participated in five VRET sessions. Self-reported state anxiety, heart rate, and presence during exposure, as well as trait school anxiety and social anxiety before and after treatment, were measured. RESULTS The VR scenario induced state anxiety and autonomic arousal. After VRET, a significant reduction in state anxiety (η2=0.74) and social anxiety symptoms (d=0.82) as well as a trend toward a decrease in trait school anxiety were observed, while autonomic arousal did not change. In addition, presence during VR exposure was associated with state anxiety and treatment response. CONCLUSIONS Our findings indicate the feasibility and potential effectiveness of VRET as a treatment method for symptoms of school and social anxiety in adolescents.
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Affiliation(s)
- Gesa Beele
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paula Liesong
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sabine Bojanowski
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Malte Weingart
- Berlin University of Applied Sciences and Technology, Berlin, Germany
| | - Julia Asbrand
- Department of Clinical Psychology for Childhood and Adolescence, University of Jena, Jena, Germany
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hostra/Northwell, Hempstead, NY, United States
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
| | - Peter J Uhlhaas
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
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Kiuchi K, Umehara H, Irizawa K, Kang X, Nakataki M, Yoshida M, Numata S, Matsumoto K. An Exploratory Study of the Potential of Online Counseling for University Students by a Human-Operated Avatar Counselor. Healthcare (Basel) 2024; 12:1287. [PMID: 38998822 PMCID: PMC11241672 DOI: 10.3390/healthcare12131287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 06/19/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Recently, the use of digital technologies, such as avatars and virtual reality, has been increasingly explored to address university students' mental health issues. However, there is limited research on the advantages and disadvantages of counselors using avatars in online video counseling. Herein, 25 university students were enrolled in a pilot online counseling session with a human counselor-controlled avatar, and asked about their emotional experiences and impressions of the avatar and to provide qualitative feedback on their communication experience. Positive emotions during the session were associated with impressions of the avatar's intelligence and likeability. The anthropomorphism, animacy, likeability, and intelligent impressions of the avatar were interrelated, indicating that the avatar's smile and the counselor's expertise in empathy and approval may have contributed to these impressions. However, no associations were observed between participant experiences and their prior communication with avatars, or between participant experiences and their gender or the perceived gender of the avatar. Accordingly, recommendations for future practice and research are provided. Accumulating practical and empirical findings on the effectiveness of human-operated avatar counselors is crucial for addressing university students' mental health issues.
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Affiliation(s)
- Keita Kiuchi
- Japan National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Kawasaki 214-8585, Japan
| | - Hidehiro Umehara
- Graduate School of Biomedical Sciences, Department of Psychiatry, Tokushima University, Tokushima 770-0042, Japan
| | - Koushi Irizawa
- Graduate School of Biomedical Sciences, Department of Psychiatry, Tokushima University, Tokushima 770-0042, Japan
| | - Xin Kang
- Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima 770-8506, Japan
| | - Masahito Nakataki
- Graduate School of Biomedical Sciences, Department of Psychiatry, Tokushima University, Tokushima 770-0042, Japan
| | - Minoru Yoshida
- Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima 770-8506, Japan
| | - Shusuke Numata
- Graduate School of Biomedical Sciences, Department of Psychiatry, Tokushima University, Tokushima 770-0042, Japan
| | - Kazuyuki Matsumoto
- Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima 770-8506, Japan
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Colombo V, Mondellini M, Fumagalli A, Aliverti A, Sacco M. A virtual reality-based endurance training program for COPD patients: acceptability and user experience. Disabil Rehabil Assist Technol 2024; 19:1590-1599. [PMID: 37272556 DOI: 10.1080/17483107.2023.2219699] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE To investigate the acceptability and user experience of an in-hospital endurance training program based on the Virtual Park, a semi-immersive Virtual Reality (VR) system for patients with Chronic Obstructive Pulmonary Disease (COPD).Materials and methodsPatients performed 20 min of cycling two times/day for around ten days. The evaluation included adherence, exercise capacity, physical performance, and user experience. RESULTS Fourteen patients (6 F/8 M; age = 71.29 ± 6.93 years) with mild/moderate COPD participated. The adherence rate was satisfying: 85.71% of patients attended the program without adverse events; the individual attendance rate (86.85% ± 27.43) was also high. The exercise capacity assessed before and after the training significantly improved in our group (6MWT pre-post: t(11)= -5.040, p < 0.05), as happens in standard PR programs. The physical performance metrics of each session indicate that all participants could sustain the proposed training protocol over the whole period. Patients judged the VR experience positively (User Experience Questionnaire = 1.84 ± 0.22) and were highly engaged in the activity for the whole period (Short Flow State Scale pre-post: 4.61 ± 0.27/4.40 ± 0.36). CONCLUSIONS Our preliminary results open the possibility for further investigations on long-term motivation and clinical effectiveness of more immersive VR interventions for COPD.
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Affiliation(s)
- Vera Colombo
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council (CNR), Lecco, Italy
- Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milano, Italy
| | - Marta Mondellini
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council (CNR), Lecco, Italy
| | | | - Andrea Aliverti
- Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milano, Italy
| | - Marco Sacco
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing (STIIMA), National Research Council (CNR), Lecco, Italy
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Ko H, Lim HJ, Park J, Kim K, Suh H, Lee BD, Lee YM, Moon E, Kim DR, Park JH, Shin MJ, Lee YH. Subjective Experience on Virtual Reality-Assisted Mental Health Promotion Program. Psychiatry Investig 2024; 21:380-386. [PMID: 38695045 PMCID: PMC11065531 DOI: 10.30773/pi.2023.0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/18/2023] [Accepted: 01/12/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE Mental health promotion programs using virtual reality (VR) technology have been developed in various forms. This study aimed to investigate the subjective experience of a VR-assisted mental health promotion program for the community population, which was provided in the form of VR experience on a bus to increase accessibility. METHODS Ninety-six people participated in this study. The relationship between the subjective experience and mental health states such as depression, anxiety, perceived stress, and quality of life was explored. The subjective experience on depression and stress before and after VR program treatment was compared using the Wilcoxon signed-rank test. The satisfaction with the VR-assisted mental health promotion program was examined after using the VR program. RESULTS The VR-assisted mental health promotion program on a bus significantly improved subjective symptoms such as depression (p=0.036) and perceived stress (p=0.010) among all the participants. Among the high-risk group, this VR program significantly relieved subjective depressive feeling score (p=0.033), and subjective stressful feeling score (p=0.035). In contrast, there were no significant changes in subjective depressive feelings (p=0.182) and subjective stressful feelings (p=0.058) among the healthy group. Seventy-two percent of the participants reported a high level of satisfaction, scoring 80 points or more. CONCLUSION The findings of this study suggest that the VR-assisted mental health promotion program may effectively improve the subjective depressive and stressful feelings. The use of VR programs on buses to increase of accessibility for the community could be a useful approach for promoting mental health among the population.
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Affiliation(s)
- Hyebin Ko
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
| | - Hyun Ju Lim
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychology, Gyeoungsang National University, Jinju, Republic of Korea
| | - Jeonghyun Park
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Kyungwon Kim
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychology, Gyeoungsang National University, Jinju, Republic of Korea
| | - Hwagyu Suh
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychology, Gyeoungsang National University, Jinju, Republic of Korea
| | - Byung Dae Lee
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Young Min Lee
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Eunsoo Moon
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Du-Ri Kim
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Health Convergence Medicine Laboratory, Pusan National University Hospital, Busan, Republic of Korea
| | - Jong-Hwan Park
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Health Convergence Medicine Laboratory, Pusan National University Hospital, Busan, Republic of Korea
| | - Myung-Jun Shin
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
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12
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Ong T, Ivanova J, Soni H, Wilczewski H, Barrera J, Cummins M, Welch BM, Bunnell BE. Therapist perspectives on telehealth-based virtual reality exposure therapy. VIRTUAL REALITY 2024; 28:73. [PMID: 39238767 PMCID: PMC11376200 DOI: 10.1007/s10055-024-00956-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/14/2023] [Indexed: 09/07/2024]
Abstract
Virtual reality (VR) can enhance mental health care. In particular, the effectiveness of VR-based exposure therapy (VRET) has been well-demonstrated for treatment of anxiety disorders. However, most applications of VRET remain localized to clinic spaces. We aimed to explore mental health therapists' perceptions of telehealth-based VRET (tele-VRET) by conducting semi-structured, qualitative interviews with 18 telemental health therapists between October and December 2022. Interview topics included telehealth experiences, exposure therapy over telehealth, previous experiences with VR, and perspectives on tele-VRET. Therapists described how telehealth reduced barriers (88.9%, 16/18), enhanced therapy (61.1%, 11/18), and improved access to clients (38.9%, 7/18), but entailed problems with technology (61.1%, 11/18), uncontrolled settings (55.6%, 10/18), and communication difficulties (50%, 9/18). Therapists adapted exposure therapy to telehealth by using online resources (66.7%, 12/18), preparing client expectations (55.6%, 10/18), and adjusting workflows (27.8%, 5/18). Most therapists had used VR before (72.2%, 13/18) and had positive impressions of VR (55.6%, 10/18), but none had used VR clinically. In response to tele-VRET, therapists requested interactive session activities (77.8%, 14/18) and customizable interventions components (55.6%, 10/18). Concerns about tele-VRET included risks with certain clients (77.8%, 14/18), costs (50%, 9/18), side effects and privacy (22.2%, 4/18), and inappropriateness for specific forms of exposure therapy (16.7%, 3/18). These results reveal how combining telehealth and VRET may expand therapeutic options for mental healthcare providers and can help inform collaborative development of immersive health technologies.
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Affiliation(s)
- Triton Ong
- Doxy.Me Research, Doxy.Me Inc, Rochester, NY, USA
| | | | - Hiral Soni
- Doxy.Me Research, Doxy.Me Inc, Rochester, NY, USA
| | | | - Janelle Barrera
- Doxy.Me Research, Doxy.Me Inc, Rochester, NY, USA
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Mollie Cummins
- Doxy.Me Research, Doxy.Me Inc, Rochester, NY, USA
- College of Nursing and Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA
| | - Brandon M Welch
- Doxy.Me Research, Doxy.Me Inc, Rochester, NY, USA
- Biomedical Informatics Center, Medical University of South Carolina, Public Health and Sciences, Charleston, SC, USA
| | - Brian E Bunnell
- Doxy.Me Research, Doxy.Me Inc, Rochester, NY, USA
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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Roesmann K, Leehr EJ, Böhnlein J, Gathmann B, Herrmann MJ, Junghöfer M, Schwarzmeier H, Seeger FR, Siminski N, Straube T, Dannlowski U, Lueken U. Mechanisms of action underlying virtual reality exposure treatment in spider phobia: Pivotal role of within-session fear reduction. J Anxiety Disord 2023; 100:102790. [PMID: 37879242 DOI: 10.1016/j.janxdis.2023.102790] [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: 11/07/2022] [Revised: 09/07/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Abstract
Although virtual-reality exposure treatment (VRET) for anxiety disorders is an efficient treatment option for specific phobia, mechanisms of action for immediate and sustained treatment response need to be elucidated. Towards this aim, core therapy process variables were assessed as predictors for short- and long-term VR treatment outcomes. In a bi-centric study, n = 186 patients with spider phobia completed a baseline-assessment, a one-session VRET, a post-therapy assessment, and a 6-month-follow-up assessment (ClinicalTrials.gov, ID: NCT03208400). Short- and long-term outcomes regarding self-reported symptoms in the spider phobia questionnaire (SPQ) and final patient-spider distance in the behavioral avoidance test (BAT) were predicted via logistic regression models with the corresponding baseline score, age, initial fear activation, within-session fear reduction and fear expectancy violation as predictors. To predict long-term remission status at 6-month-follow-up, dimensional short-term changes in the SPQ and BAT were additionally included. Higher within-session fear reductions predicted better treatment outcomes (long-term SPQ; short- and long-term BAT). Lower initial fear activation tended to be associated with better long-term outcomes (SPQ), while fear expectancy violation was not associated with any outcome measure. Short-term change in the SPQ predicted remission status. Findings highlight that in VRET for spider phobia, the experience of fear reduction is central for short- and long-term treatment success and should be focused by therapists.
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Affiliation(s)
- Kati Roesmann
- Institute for Clinical Psychology and Psychotherapy, University of Siegen, Germany; Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany; Institute for Psychology, Unit for Clinical Psychology and Psychotherapy in Childhood and Adolescence, University of Osnabrück, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Germany.
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Bettina Gathmann
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Germany
| | - Markus Junghöfer
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany; Otto-Creutzfeld Center for Cognitive and Behavioral Neuroscience, University of Münster, Germany
| | - Hanna Schwarzmeier
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Germany
| | - Fabian R Seeger
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Germany; Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Niklas Siminski
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Ulrike Lueken
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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14
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Brown NB, Milani S, Jabs F, Kingstone A, Brotto LA. Exploring Women's State-Level Anxiety in Response to Virtual Reality Erotica. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:137-151. [PMID: 37807833 DOI: 10.1080/0092623x.2023.2265924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Virtual Reality (VR)-based treatments for anxiety disorders are efficacious but there is a lack of research examining anxious responses to VR erotica, which could innovate treatments for sexual difficulties. We examined erotica features that elicited anxiety and sexual presence in women. Thirty-eight women viewed erotic videos from different modalities (2D, VR) and points of view (1st, 3rd person) and completed anxiety and sexual presence measures before and after each video. Women experienced greater anxiety for VR than 2D films and reported the most anxiety for VR 1st person films. Sexual presence was affected by modality and point of view.
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Affiliation(s)
- Natalie B Brown
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Sonia Milani
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Faith Jabs
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Alan Kingstone
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Lori A Brotto
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, Canada
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15
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Kako N, Waugh CE, McRae K. The Future of Immersive Mood Induction in Affective Science: Using Virtual Reality to Test Effects of Mood Context on Task Performance. AFFECTIVE SCIENCE 2023; 4:570-579. [PMID: 37744975 PMCID: PMC10514247 DOI: 10.1007/s42761-023-00213-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/30/2023] [Indexed: 09/26/2023]
Abstract
A fundamental premise of affective and clinical science is that fluctuations in mood drive meaningful changes in cognition and behavior. These theories are often tested via laboratory mood induction procedures followed by performing an established task. Despite advances in understanding the temporal dynamics of emotions, it is still unclear whether it is the enduring mood that impacts subsequent task performance. Additionally, this design requires task switching, which may limit the impact of mood and affect task performance. We suggest that virtual reality (VR) offers a more powerful, immersive alternative to traditional mood induction methods and effectively addresses these limitations because it can be used to create mood contexts that occur simultaneously with task performance. VR creates an immersive, real-world experience while benefiting from a well-controlled laboratory setting (Diniz Bernardo et al., 2021). We first summarize the literature on mood induction methodologies, including evidence that VR creates a more immersive environment, leading to mood inductions that are greater in magnitude than other methods. We then report a novel empirical study on the feasibility of utilizing VR to create a mood context that occurs simultaneously with a gold-standard emotion regulation task. Our results indicate that VR was a powerful and enduring positive mood induction tool, resulting in immediate changes in mood and greater trial-by-trial positivity ratings during the concurrent task. Portions of this study were pre-registered on August 3, 2020, on the Clinical Trials website (project citation: https://clinicaltrials.gov/ct2/show/NCT04496258). Supplementary Information The online version contains supplementary material available at 10.1007/s42761-023-00213-1.
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Affiliation(s)
- Nadia Kako
- Department of Psychology, University of Denver, 2155 S Race St, Denver, CO 80210 USA
| | - Christian E. Waugh
- Department of Psychology, Wake Forest University, 1834 Wake Forest Rd, Winston-Salem, NC 27109 USA
| | - Kateri McRae
- Department of Psychology, University of Denver, 2155 S Race St, Denver, CO 80210 USA
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16
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Zeka F, Clemmensen L, Arnfred BT, Nordentoft M, Glenthøj LB. Examination of gaze behaviour in social anxiety disorder using a virtual reality eye-tracking paradigm: protocol for a case -control study. BMJ Open 2023; 13:e071927. [PMID: 37620268 PMCID: PMC10450086 DOI: 10.1136/bmjopen-2023-071927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION Social anxiety disorder (SAD) has an early onset, a high lifetime prevalence, and may be a risk factor for developing other mental disorders. Gaze behaviour is considered an aberrant feature of SAD. Eye-tracking, a novel technology device, enables recording eye movements in real time, making it a direct and objective measure of gaze behaviour. Virtual reality (VR) is a promising tool for assessment and diagnostic purposes. Developing an objective screening tool based on examination of gaze behaviour in SAD may potentially aid early detection. The objective of this current study is, therefore to examine gaze behaviour in SAD utilising VR. METHODS AND ANALYSIS A case-control study design is employed in which a clinical sample of 29 individuals with SAD will be compared with a matched healthy control group of 29 individuals. In the VR-based eye-tracking paradigm, participants will be presented to stimuli consisting of high-res 360° 3D stereoscopic videos of three social-evaluative tasks designed to elicit social anxiety. The study will investigate between-group gaze behaviour differences during stimuli presentation. ETHICS AND DISSEMINATION The study has been approved by the National Committee on Health Research Ethics for the Capital Region of Denmark (H-22041443). The study has been preregistered on OSF registries: https://doi.org/10.17605/OSF.IO/XCTAKAll participants will be provided with written and oral information. Informed consent is required for all the participants. Participation is voluntarily, and the participants can at any time terminate their participation without any consequences. Study results; positive, negative or inconclusive will be published in relevant scientific journals.
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Affiliation(s)
- Fatime Zeka
- VIRTU Research Group, Copenhagen Research Centre on Mental Health (CORE), Hellerup, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Lars Clemmensen
- VIRTU Research Group, Copenhagen Research Centre on Mental Health (CORE), Hellerup, Denmark
| | | | - Merete Nordentoft
- Copenhagen Research Centre on Mental Health (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise Birkedal Glenthøj
- VIRTU Research Group, Copenhagen Research Centre on Mental Health (CORE), Hellerup, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Ong T, Wilczewski H, Soni H, Ivanova J, Barrera J, Cummins M, Welch B, Bunnell B. Therapist perspectives on telehealth-based virtual reality exposure therapy. RESEARCH SQUARE 2023:rs.3.rs-3161151. [PMID: 37503192 PMCID: PMC10371164 DOI: 10.21203/rs.3.rs-3161151/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Virtual reality (VR) can enhance mental health care. In particular, the effectiveness of VR-based exposure therapy (VRET) has been well-demonstrated for treatment of anxiety disorders. However, most applications of VRET remain localized to clinic spaces. We aimed to explore mental health therapists' perceptions of telehealth-based VRET (tele-VRET) by conducting semi-structured, qualitative interviews with 18 telemental health therapists between October and December 2022. Interview topics included telehealth experiences, exposure therapy over telehealth, perceptions of VR in therapy, and perspectives on tele-VRET. Therapists described how telehealth reduced barriers (88.9%, 16/18), enhanced therapy (61.1%, 11/18), and improved access to clients (38.9%, 7/18), but entailed problems with technology (61.1%, 11/18), uncontrolled settings (55.6%, 10/18), and communication di culties (50%, 9/18). Therapists adapted exposure therapy to telehealth by using online resources (66.7%, 12/18), preparing client expectations (55.6%, 10/18), and adjusting workflows (27.8%, 5/18). Most therapists had used VR before (72.2%, 13/18) and had positive impressions (55.6%, 10/18), but none had used VR clinically. In response to tele-VRET, therapists requested interactive session activities (77.8%, 14/18) and customizable interventions components (55.6%, 10/18). Concerns about tele-VRET included risks with certain clients (77.8%, 14/18), costs (50%, 9/18), side effects and privacy (22.2%, 4/18), and inappropriateness for specific forms of exposure therapy (16.7%, 3/18). These results show how designing for telehealth may extend VRET and can help inform collaborative development of health technologies.
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18
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Benmahdjoub M, Thabit A, van Veelen MLC, Niessen WJ, Wolvius EB, Walsum TV. Evaluation of AR visualization approaches for catheter insertion into the ventricle cavity. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; 29:2434-2445. [PMID: 37027733 DOI: 10.1109/tvcg.2023.3247042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Augmented reality (AR) has shown potential in computer-aided surgery. It allows for the visualization of hidden anatomical structures as well as assists in navigating and locating surgical instruments at the surgical site. Various modalities (devices and/or visualizations) have been used in the literature, but few studies investigated the adequacy/superiority of one modality over the other. For instance, the use of optical see-through (OST) HMDs has not always been scientifically justified. Our goal is to compare various visualization modalities for catheter insertion in external ventricular drain and ventricular shunt procedures. We investigate two AR approaches: (1) 2D approaches consisting of a smartphone and a 2D window visualized through an OST (Microsoft HoloLens 2), and (2) 3D approaches consisting of a fully aligned patient model and a model that is adjacent to the patient and is rotationally aligned using an OST. 32 participants joined this study. For each visualization approach, participants were asked to perform five insertions after which they filled NASA-TLX and SUS forms. Moreover, the position and orientation of the needle with respect to the planning during the insertion task were collected. The results show that participants achieved a better insertion performance significantly under 3D visualizations, and the NASA-TLX and SUS forms reflected the preference of participants for these approaches compared to 2D approaches.
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Lohse L, Jelinek L, Moritz S, Blömer J, Bücker L, Miegel F. Efficacy of exposure and response prevention therapy in mixed reality for patients with obsessive-compulsive disorder: study protocol for a randomized controlled trial. BMC Psychol 2023; 11:113. [PMID: 37055854 PMCID: PMC10100604 DOI: 10.1186/s40359-023-01116-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/07/2023] [Indexed: 04/15/2023] Open
Abstract
Many patients with obsessive-compulsive disorder (OCD) do not receive cognitive behavioral therapy with exposure and response prevention (first line treatment for OCD), for example, due to patients' fear of the exposure and reservations of the therapists. Technology-supported exposure (e.g., exposure therapy with response prevention in mixed reality [MERP]) for patients with OCD may help to overcome this obstacle. Building upon findings of our pilot study objectives of this study are to evaluate the efficacy, expectations of treatment success, feasibility, and acceptance of MERP as well as to identify possible limitations. In total, 64 outpatients with contamination-related OCD will be recruited and randomized to one of two conditions: MERP (six sessions in six weeks) and self-guided exposure therapy (six exercises in six weeks). Participants will be assessed before (baseline), after the six-week intervention period (post), as well as three months after post assessment (follow-up) regarding symptomatology (Yale-Brown Obsessive Compulsive Scale; Y-BOCS), their subjective evaluation of MERP (acceptance) and sense of presence. The planned study is the first to investigate MERP in patients with OCD.
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Affiliation(s)
- Luzie Lohse
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Jannik Blömer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Lara Bücker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Volovik M, Belova A, Kuznetsov A, Polevaia A, Vorobyova O, Khalak M. Use of Virtual Reality Techniques to Rehabilitate Military Veterans with Post-Traumatic Stress Disorder (Review). Sovrem Tekhnologii Med 2023; 15:74-85. [PMID: 37388756 PMCID: PMC10306958 DOI: 10.17691/stm2023.15.1.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Indexed: 09/22/2024] Open
Abstract
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder developing after a traumatic event like participation in combat activities. Objective diagnosis of combat PTSD and effective rehabilitation of war veterans is a current multifaceted problem with particularly high social costs. This review aims to evaluate the potential of virtual reality technique used as exposure therapy tool (VRET) to rehabilitate combat veterans and service members with PTSD. The review was written following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The final analysis includes 75 articles published in 2017-2022. VRET therapeutic effect mechanisms were examined along with protocols and scenarios of VRET combined with other interventions influencing PTSD treatment like pharmacotherapy, motion-assisted multi-modular memory desensitization and reconsolidation (3MDR), transcranial magnetic stimulation. The necessity is substantiated of psychophysiological measurements for objectification of PTSD clinical criteria and its dynamics during treatment. It was shown that inclusion of VRET to the package of PTSD rehabilitation interventions positively affects the results due to the enhanced effect of presence and greater experience personalization. Thus, VRET may be an effective, controlled, and cost-effective alternative for PTSD treatment in combatants, including those not responding to conventional therapy.
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Affiliation(s)
- M.G. Volovik
- Leading Researcher, University Clinic; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A.N. Belova
- Professor, Head of the Medical Rehabilitation Department; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A.N. Kuznetsov
- Head of the Laboratory of Immersive and Remote Technologies; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A.V. Polevaia
- Junior Researcher, University Clinic; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - O.V. Vorobyova
- Junior Researcher, University Clinic; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - M.E. Khalak
- Associate Professor, Department of General and Clinical Psychology Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
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Tsamitros N, Beck A, Sebold M, Schouler-Ocak M, Bermpohl F, Gutwinski S. [The application of virtual reality in the treatment of mental disorders]. DER NERVENARZT 2023; 94:27-33. [PMID: 36053303 PMCID: PMC9859917 DOI: 10.1007/s00115-022-01378-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Virtual reality (VR) enables immersion in an interactive digital world with realistic experiences, that can be applied for controlled and personalized interventions. This review summarizes the current research on VR in the treatment of mental disorders. METHODS Selective literature search in PubMed and Google Scholar. RESULTS An increasing number of publications report the therapeutic application of VR for the treatment of mental disorders. Most VR applications are based on established therapy approaches, such as exposure therapy. According to meta-analytic data, virtual exposure therapy (VRET) for specific phobia and agoraphobia with panic disorder is as effective as traditional in vivo exposure therapy. VRET for the treatment of social phobia is significantly more effective than waitlist and placebo control groups with, however, currently inconsistent metanalytic results when compared to in vivo exposure therapy. VRET for the treatment of posttraumatic stress disorder (PTSD) is similar in effectiveness compared to active psychotherapy. For psychosis, positive results have been reported for the VR-based treatment of auditory verbal hallucinations. For patients with a substance use disorder, VR can induce craving, with still unverified diagnostic and therapeutic relevance. CONCLUSIONS VRET can broaden the psychotherapy options for anxiety disorders. Encouraging results of VR-based treatments for psychosis and PTSD indicate the need for further research concerning its effectiveness and safety. In the field of substance use disorders, evaluation of clinical-orientated VR applications is needed.
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Affiliation(s)
- N. Tsamitros
- Psychiatrische Universitätsklinik der Charité – Universitätsmedizin Berlin im St. Hedwig-Krankenhaus/Institutsambulanz, Müllerstr. 56–58, 13349 Berlin, Deutschland ,Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland ,Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland
| | - A. Beck
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland ,Fakultät Gesundheit, Health and Medical University, Campus Potsdam, Potsdam, Deutschland
| | - M. Sebold
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland
| | - M. Schouler-Ocak
- Psychiatrische Universitätsklinik der Charité – Universitätsmedizin Berlin im St. Hedwig-Krankenhaus/Institutsambulanz, Müllerstr. 56–58, 13349 Berlin, Deutschland ,Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland
| | - F. Bermpohl
- Psychiatrische Universitätsklinik der Charité – Universitätsmedizin Berlin im St. Hedwig-Krankenhaus/Institutsambulanz, Müllerstr. 56–58, 13349 Berlin, Deutschland ,Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland
| | - S. Gutwinski
- Psychiatrische Universitätsklinik der Charité – Universitätsmedizin Berlin im St. Hedwig-Krankenhaus/Institutsambulanz, Müllerstr. 56–58, 13349 Berlin, Deutschland ,Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland
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22
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Javaherirenani R, Mortazavi SS, Shalbafan M, Ashouri A, Farani AR. Virtual reality exposure and response prevention in the treatment of obsessive-compulsive disorder in patients with contamination subtype in comparison with in vivo exposure therapy: a randomized clinical controlled trial. BMC Psychiatry 2022; 22:740. [PMID: 36443695 PMCID: PMC9706986 DOI: 10.1186/s12888-022-04402-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Obsessive-Compulsive Disorder (OCD) is characterized by disturbing and unwanted thoughts as well as repetitive and time-consuming behaviors that interfere with performance. Cognitive Behavior Therapy (CBT) has shown to have beneficial effects on reducing OCD symptoms as the first line of treatment. Moreover, Virtual Reality (VR) has been a more feasible and accessible intervention for OCD in recent years. Regarding the point, the objective of this study was to evaluate the effectiveness of virtual reality exposure and response prevention (VRERP) in the treatment of the OCD contamination subtype. METHODS A total number of 36 adults with OCD-contamination subtype were registered and randomly assigned to the intervention and control groups. The intervention group received a 60-min CBT including a "contaminated" virtual environment while the control group received CBT as a standardized treatment. Out of these, 29 patients completed the treatment in 12 weekly sessions. The patients completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Obsessive Beliefs Questionnaire-44(OBQ-44), and World Health Organization Disability Assessment Scale-2 (WHODAS-2) at week 0, week 12 and after 3 months follow-up. RESULTS Based on the results of the repeated measure analysis of variances, the total score of obsession and compulsion subscales of Y-BOCS significantly decreased as a primary outcome in the intervention group (F = 60.97, P < 0.001, partial eta squared = 0.82; F = 20.46, P < 0.001, partial eta squared = 0.61; F = 29.57, P < 0.001, partial eta squared = 0.69; respectively). The total score of BDI-II and BAI was reduced in both groups but there was no significant difference between them (BDI-II: F = 0.54, P = 0.47, partial eta squared = 0.02; BAI: F = 3.12, P = 0.06, partial eta squared = 0.19). However, there was a significant difference in the OBQ-44 (F = 16.78, P < 0.001, partial eta squared = 0.56) and the total WHODAS-2 score between the groups (F = 14.64, P < 0.001, partial eta squared = 0.53). CONCLUSIONS This study demonstrated the effectiveness of VRERP in the treatment of the OCD-contamination subtype. Therefore, VRERP can be used in CBT as an alternative exposure tool. TRIAL REGISTRATION Iranian Registry of Clinical Trials, IRCT ID: IRCT20210214050353N1 , Registered on 16/10/2021.
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Affiliation(s)
- Razieh Javaherirenani
- Present Address: Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Seyede Salehe Mortazavi
- Present Address: Geriatric Mental Health Research Center, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Shalbafan
- Present Address: Mental Health Research Center, Psychosocial Health Research Institute. Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Brain and Cognition Clinic, Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Ahmad Ashouri
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Ramezani Farani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
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23
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Virtual reality for pain and anxiety of pediatric oncology patients: A systematic review and meta-analysis. Asia Pac J Oncol Nurs 2022; 9:100152. [DOI: 10.1016/j.apjon.2022.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/17/2022] [Indexed: 11/23/2022] Open
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24
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Chitale V, Baghaei N, Playne D, Liang HN, Zhao Y, Erensoy A, Ahmad Y. The Use of Videogames and Virtual Reality for the Assessment of Anxiety and Depression: A Scoping Review. Games Health J 2022; 11:341-354. [PMID: 35881854 DOI: 10.1089/g4h.2021.0227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This study provides a comprehensive review about the use of videogames and virtual reality (VR) for the assessment of anxiety and depression. This review aimed to answer the research question of the viability of games and VR for the assessment of anxiety and depression. An extensive literature search spanning across several databases published since the year 2000 returned a total of 4566 records. Based on the eligibility criteria, the screening process resulted in the selection of 10 articles for the final review. Equal number of studies utilized games (n = 5) and VR. Three studies made use of machine learning techniques. Only two were found to be clinical studies. An interesting finding was that the studies that focused on anxiety disorders relied mostly on VR, whereas those focused on depression disorders relied mostly on the use of videogames for the assessment. Majority of studies reported encouraging findings that support the use of games or VR for the assessment of anxiety and depression. This study identified potential digital biomarkers or correlates of anxiety and depression that may guide researchers in the design process. It is necessary to highlight that researchers should consider consultation with trained mental health experts, while designing such assessments to ensure safety and privacy. However, due to limited number of articles as well as lack of clinical studies, more clinical evidence is required to strongly support this notion of using videogames or VR as assessment tools for anxiety and depression.
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Affiliation(s)
- Vibhav Chitale
- School of Mathematical and Computational Sciences, College of Sciences, Massey University, Auckland, New Zealand
| | - Nilufar Baghaei
- School of Mathematical and Computational Sciences, College of Sciences, Massey University, Auckland, New Zealand
- School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Daniel Playne
- School of Mathematical and Computational Sciences, College of Sciences, Massey University, Auckland, New Zealand
| | - Hai-Ning Liang
- Department of Computing, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Yinshu Zhao
- School of Mathematical and Computational Sciences, College of Sciences, Massey University, Auckland, New Zealand
| | - Aysu Erensoy
- School of Mathematical and Computational Sciences, College of Sciences, Massey University, Auckland, New Zealand
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25
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Almedhesh SA, Elgzar WT, Ibrahim HA, Osman HA. The effect of virtual reality on anxiety, stress, and hemodynamic parameters during cesarean section: A randomized controlled clinical trial. Saudi Med J 2022; 43:360-369. [PMID: 35414614 PMCID: PMC9998068 DOI: 10.15537/smj.2022.43.4.20210921] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the effect of virtual reality (VR) on anxiety, stress, and hemodynamic parameters during cesarean section (CS). METHODS This is a randomized controlled clinical trial conducted at the operating theatre / Maternal and Children Hospital, Najran, Saudi Arabia from February to October 2021. The study comprised a random sample of 351(176 study and 175 control) low-risk pregnant women undergoing elective CS with regional anesthesia. Data collection was carried out using 5 instruments. Basic and clinical data sheet, maternal hemodynamic parameters assessment sheet, brief measure of preoperative emotional stress, a novel visual facial anxiety scale, and maternal satisfaction scale. Virtual reality group exposed to 3D natural videos associated with calm Quran or music voices via phone using VR glasses immediately after anesthesia until completion of skin suture. The control group left for routine hospital care. RESULTS The VR group showed significantly lower stress and anxiety levels immediately after skin suture and 2h postoperative (p=0.000). Maternal satisfaction 2 hours after CS showed that 58% of the VR group were completely satisfied compared to 11.3% of the control group (FET=135.359 p=0.000). Virtual reality have an impact on hemodynamic parameters at some time points while peripheral oxygen saturation did not differ significantly (p>0.05). CONCLUSION Virtual reality significantly reduced anxiety and stress among women undergoing CS under regional anesthesia. Virtual reality may be added to the routine intraoperative techniques that help induce patient relaxation and increase satisfaction.
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Affiliation(s)
- Sultan A. Almedhesh
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Wafaa T. Elgzar
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Heba A. Ibrahim
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
| | - Hiba A. Osman
- From the Department of Pediatric And Pediatric Cardiologist (Almedhesh), College of
Medicine; from the Department of Maternity and Childhood Nursing (Elgzar, Ibrahim),
Nursing College Najran University; and from the Department of Obstetrics and Gynecology
(Osman), Maternity and Children Hospital, Najran, Kingdom of Saudi Arabia.
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26
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Meyerbröker K, Morina N. The use of virtual reality in assessment and treatment of anxiety and related disorders. Clin Psychol Psychother 2021; 28:466-476. [PMID: 34097318 PMCID: PMC8362145 DOI: 10.1002/cpp.2623] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 12/20/2022]
Abstract
In recent years the development of new virtual environments has been qualitatively high and fast at the same time, but the dissemination of virtual reality (VR) in clinical practice is still scarce. The aim of this review is to give an insight into the state of the art of the use of VR as an assessment tool and treatment intervention in anxiety and related disorders as posttraumatic stress disorder and obsessive-compulsive disorders. Besides an overview into the efficacy of VR, a summary will be given on assumed working mechanisms in virtual reality exposure therapy and how this aligns with current theoretical models. Further, it will be discussed how VR is accepted by patients and research into the reluctance of therapist to use this technology during treatment with focus on the therapeutic alliance and how it may be influenced by the use of VR. Finally, we discuss clinical and future issues as, for example, dissemination into clinical practice and what VR has to offer therapists in future. This not only in adult population but as well in younger patients, as young adolescents VR has a great potential as it connects easily with its playful elements to this population and might be a low threshold step to offer treatment or preventive interventions.
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Affiliation(s)
- Katharina Meyerbröker
- Department of Clinical PsychologyUtrecht UniversityUtrechtThe Netherlands
- Altrecht Academic Anxiety CentreUtrechtThe Netherlands
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27
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Dehghan B, Saeidimehr S, Sayyah M, Rahim F. The Effect of Virtual Reality on Emotional Response and Symptoms Provocation in Patients With OCD: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:733584. [PMID: 35177996 PMCID: PMC8846333 DOI: 10.3389/fpsyt.2021.733584] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/22/2021] [Indexed: 12/15/2022] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the effectiveness of virtual reality (VR)-based technology on emotional response and symptoms in patients with obsessive-compulsive disorder (OCD). We systematically searched major electronic databases, including PubMed/Medline, Scopus, Embase, ISI Web of Science, PsycINFO, and Cochrane central, up to April 14, 2021, with no data or language limits. We performed reference, related articles, and citation searches to find additional articles. We included original articles comparing and studying VR-based technology in patients with OCD against the control group. We observed that VR significantly increases in anxiety (SMD = 2.92; 95% CI 1.89-3.94, p < 0.0001; I 2 = 95%), disgust (SMD = 2.52; 95% CI 1.36-3.68, p < 0.0001; I 2 = 95%), urge to wash (SMD = 3.12; 95% CI 1.92-4.32, p < 0.0001; I 2 = 94%), checking time (SMD = 1.06; 95% CI 0.71-1.4, p < 0.0001; I 2 = 44%), number of checking behavior (SMD = 1.45; 95% CI 0.06-2.83, p = 0.04; I 2 = 93%), and uncertainty (SMD = 2.59; 95% CI 0.90-4.27, p = 0.003; I 2 = 70%) in OCD patients compared with healthy controls using a random-effect model. This meta-analysis found that this environment has a moderate enhancement in emotional response and symptoms test scores of patients with OCD. However, our findings should be generalized with caution due to the lack of standardized methods and high heterogeneity among included evidence. The appropriate mode of integrating VR-based technology for patients with OCD requires more exploration.
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Affiliation(s)
- Bahram Dehghan
- Department of Medicine, Naft Grand Hospital, The Health Affair Organization of Oils and Refineries Industry, Ahvaz, Iran
| | - Saied Saeidimehr
- Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Sayyah
- Education Development Center (EDC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- Research Center of Thalassemia and Hemoglobinopathies, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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