1
|
Ribé-Viñes JM, Gutiérrez-Maldonado J, Zabolipour Z, Ferrer-Garcia M. Virtual reality exposure with vibrotactile stimulation for the treatment of fear of flying: A pilot study. J Behav Ther Exp Psychiatry 2024; 82:101915. [PMID: 37862878 DOI: 10.1016/j.jbtep.2023.101915] [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: 07/21/2022] [Revised: 08/30/2023] [Accepted: 09/28/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Virtual reality (VR) interventions are becoming more prevalent in treating fear of flying (FoF). Since multisensory stimulation can enhance the sense of presence in a virtual environment, the present study compared virtual reality exposure with and without vibrotactile cues to determine its contribution to the realism of the virtual experience. METHODS A repeated measures design was used. Thirty-one participants were exposed to two experimental conditions with a minimum of a one-week interval between them: one in which participants were exposed to the virtual environment with vibrotactile cues (smart chair, SC), and another in which participants were exposed to the virtual environment without vibrotactile cues (ordinary chair, OC). The administration order of both conditions was counterbalanced to avoid possible order effects. RESULTS Participants felt higher levels of sense of presence when using the SC than the OC. However, the addition of vibrotactile stimulation partially influenced experienced anxiety. Some personality traits were also associated with participants' sense of presence and anxiety responses during the exposure. LIMITATIONS The sample size was smaller than required. Moreover, only self-reported measures were used. Finally, a roller coaster instead of an airplane scenario was used for the exposure, which might not have been suitable enough for provoking anxiety in participants with FoF. CONCLUSIONS Vibrotactile cues enhanced the sense of presence. However, the addition of vibrotactile stimulation did not have a consistent effect on anxiety experienced during exposure. Therefore, the benefits of incorporating vibrotactile cues in virtual reality environments for exposure therapy are not clear.
Collapse
Affiliation(s)
- J M Ribé-Viñes
- Department of Clinical Psychology and Psychobiology. Universitat de Barcelona, Barcelona, Spain.
| | - J Gutiérrez-Maldonado
- Department of Clinical Psychology and Psychobiology. Universitat de Barcelona, Barcelona, Spain; Neuroscience Institute. Universitat de Barcelona, Barcelona, Spain
| | - Zahra Zabolipour
- Department of Clinical Psychology and Psychobiology. Universitat de Barcelona, Barcelona, Spain
| | - M Ferrer-Garcia
- Department of Clinical Psychology and Psychobiology. Universitat de Barcelona, Barcelona, Spain; Neuroscience Institute. Universitat de Barcelona, Barcelona, Spain.
| |
Collapse
|
2
|
Just SA, Lütt A, Siegle P, Döring-Brandl EJ. Feasibility of using virtual reality in geriatric psychiatry. Int J Geriatr Psychiatry 2024; 39:e6060. [PMID: 38241061 DOI: 10.1002/gps.6060] [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: 10/12/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVES Virtual Reality-based interventions have become an important element of digital mental health, offering accessible and scalable treatment options. However, studies on VR-based approaches in elderly patients are scarce. This explorative study examined the feasibility of using Virtual Reality (VR) for elderly patients with psychiatric illness, focusing on the sense of presence as the primary outcome. METHODS The study included N = 30 patients between the ages of 59-92 years who were currently in geriatric psychiatric inpatient and day clinic treatment. Participants were assessed before, during and after a relaxing ten-minute VR experience. Attitude towards digital media and VR, subjective digital competence, and previous experience were examined using questionnaires. Motion sickness was measured repeatedly during the VR experience using the Fast Motion Sickness Scale (FMS). Patients rated their motion sickness and their general well-being in the virtual environment. Sense of presence in the virtual environment was quantified with the Igroup Presence Questionnaire (IPQ). RESULTS Participants reported a notable sense of presence (M = 0.41 ± 1.4) in the virtual environment, particularly in terms of spatial presence. Motion sickness was reported by a minority of patients. Three patients terminated the VR application before it was finished. The average well-being during the VR experience was reported as high (70/100). Sense of presence and motion sickness showed a significant negative correlation. Presence, motion sickness and well-being were not significantly correlated with age, nor did they differ significantly between groups. CONCLUSIONS This study underscores the potential of VR-based experiences in the treatment of elderly psychiatric patients and highlights their willingness and ability to engage with VR technology. While the results are promising, future research should explore more interactive VR scenarios and assess their safety and feasibility in elderly populations.
Collapse
Affiliation(s)
- Sandra Anna Just
- Department of Psychiatry and Neurosciences, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu, Berlin, Germany
- Psychiatric University Hospital Charité at St. Hedwig Hospital, Berlin, Germany
- Berlin University Alliance, Berlin, Germany
| | - Alva Lütt
- Department of Psychiatry and Neurosciences, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu, Berlin, Germany
- Psychiatric University Hospital Charité at St. Hedwig Hospital, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Eva Janina Döring-Brandl
- Department of Psychiatry and Neurosciences, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu, Berlin, Germany
- Psychiatric University Hospital Charité at St. Hedwig Hospital, Berlin, Germany
| |
Collapse
|
3
|
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: 1.0] [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.
Collapse
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
| |
Collapse
|
4
|
Malbos E, Borwell B, Einig-Iscain M, Korchia T, Cantalupi R, Boyer L, Lancon C. Virtual reality cue exposure therapy for tobacco relapse prevention: a comparative study with standard intervention. Psychol Med 2023; 53:5070-5080. [PMID: 35924727 PMCID: PMC10476066 DOI: 10.1017/s0033291722002070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Successful interventions have been developed for smoking cessation although the success of smoking relapse prevention protocols has been limited. Cognitive behavioural therapy (CBT) in particular has been hampered by a high relapse rate. Because relapse can be due to conditions associated with tobacco consumption (such as drinking in bars with friends), virtual reality cue exposure therapy (VRCE) can be a potential tool to generate 3D interactive environments that simulate risk situations for relapse prevention procedures. METHODS To assess the effectiveness of VRCE with CBT, a comparative trial involving 100 smoking abstinent participants was designed with all required virtual environments (VE) created with an inexpensive graphic engine/game level editor. RESULTS Outcome measures confirmed the immersive and craving eliciting effect of these VEs. Results demonstrated that more participants in the VRCE group did not experience smoking relapse and that VRCE is at least as efficacious as traditional CBT in terms of craving reduction and decrease in nicotine dependence. Dropout and relapse rate in the VRCE group was noticeably lower than the CBT group. Aside from mood scores, no significant differences were found regarding the other scales. CONCLUSION The present clinical trial provides evidence that VRCE was effective in preventing smoking relapse. Improvement in technology and methodology for future research and applications is delineated.
Collapse
Affiliation(s)
- Eric Malbos
- Department of Adult Psychiatry, Conception University Hospital, Marseille, France
- Equipe Imothep, Institut Fresnel, UMR 7249, Aix-Marseille Université, CNRS, Ecole Centrale Marseille, Marseille, France
| | - Baptiste Borwell
- Department of Adult Psychiatry, Conception University Hospital, Marseille, France
| | - Mélodie Einig-Iscain
- Department of Adult Psychiatry, Conception University Hospital, Marseille, France
- Equipe Imothep, Institut Fresnel, UMR 7249, Aix-Marseille Université, CNRS, Ecole Centrale Marseille, Marseille, France
| | - Théo Korchia
- Department of Adult Psychiatry, Conception University Hospital, Marseille, France
| | - Robin Cantalupi
- Cognitive Psychology Lab, UMR 7290, Aix-Marseille University, Marseille, France
| | - Laurent Boyer
- CEReSS, EA 3279, Center, La Timone Faculty of Medicine, Aix-Marseille Université, Marseille, France
| | - Christophe Lancon
- Department of Adult Psychiatry, Conception University Hospital, Marseille, France
| |
Collapse
|
5
|
Horigome T, Yoshida S, Tanikawa T, Mimura M, Kishimoto T. Modification of the therapist's facial expressions using virtual reality technology during the treatment of social anxiety disorder: a case series. Front Psychol 2023; 14:1030050. [PMID: 37255521 PMCID: PMC10225735 DOI: 10.3389/fpsyg.2023.1030050] [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: 08/28/2022] [Accepted: 04/28/2023] [Indexed: 06/01/2023] Open
Abstract
Exposure therapy is a mainstream of treatment for social anxiety disorder (SAD). However, effort and time are required to recreate interpersonal situations that produce moderate anxiety. On the other hand, virtual reality exposure therapy can easily control anxiety-inducing conditions and allow for graduated exposure. However, artificial intelligence and animations that speak as naturally as actual humans are not yet practical, adding to the limitations of these treatments. The authors propose the use of a virtual reality technology that can transform facial expressions into smiling or sad faces in real time and display them on a monitor, potentially solving the above-mentioned problems associated with virtual reality animations. This feasibility study was conducted to determine whether this system can be safely applied to the treatment of SAD patients. A total of four SAD patients received 16 exposure therapy sessions led by an experienced therapist over a monitor; throughout the sessions, the facial expressions of the therapist were modified using software to display expressions ranging from smiling to sad on the monitor that was being viewed by the patient. Client satisfaction, treatment alliance, and symptom assessments were then conducted. Although one patient dropped out of the study, treatment satisfaction and treatment alliance were scored high in all the cases. In two of the four cases, the improvement in symptoms was sustained over time. Exposure therapy in which the interviewer's facial expressions are modified to induce appropriate levels of anxiety in the patient can be safely used for the treatment of SAD patients and may be effective for some patients.
Collapse
Affiliation(s)
- Toshiro Horigome
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Psychiatry, Shonan Keiiku Hospital, Kanagawa, Japan
| | - Shigeo Yoshida
- Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
- OMRON SINIC X Corporation, Tokyo, Japan
| | - Tomohiro Tanikawa
- Next Generation Artificial Intelligence Research Center, The University of Tokyo, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taishiro Kishimoto
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, United States
| |
Collapse
|
6
|
Wong KP, Lai CYY, Qin J. Systematic review and meta-analysis of randomised controlled trials for evaluating the effectiveness of virtual reality therapy for social anxiety disorder. J Affect Disord 2023; 333:353-364. [PMID: 37084968 DOI: 10.1016/j.jad.2023.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of VR therapy (VRT) for symptoms related to social anxiety disorder (SAD), namely fear and avoidance of social interactions and performance situations (FASIP), fear of negative evaluation (FNE), anxiety and depression, a systematic review and meta-analysis were performed. METHODS Medline, PubMed, Science Direct, Web of Science, CINAHL, PsychINFO and Scopus were searched to include randomised controlled trials of VRT for SAD that met the criteria. A total of 15 RCTs with 720 participants published between 1998 and 2022 were included. Hedge's g with a 95 % confidence interval (CI) was adopted to compute the effect sizes. RESULTS Results showed no difference between the effect of VRT and CBT on FASIP, FNE, anxiety and depression and a large effect size for VRT versus the waitlist control group on FASIP (g = -1.170, 95 % CI: -2.056-0.283; p < 0.010). The moderator analysis demonstrated that VRT was superior to the controlled group in addressing FASIP, FNE and anxiety when the sample size was smaller than 50 and the number of sessions was five or fewer. LIMITATIONS Differences in hardware, software and intervention duration for VRT across studies. CONCLUSION This study confirmed the feasibility of VRT in alleviating the FASIP in patients with SAD, with the waitlist control group as a comparison. However, the effectiveness of VRT was not significant in FASIP, FNE, anxiety and depression compared to cognitive behavioural therapy (CBT). Additional social interaction scenarios should be developed in VRT, standardised hardware should be used and the proper length of exposure time to VR should be determined to enhance the efficacy of VRT.
Collapse
Affiliation(s)
- Ka Po Wong
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China; Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Cynthia Yuen Yi Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| |
Collapse
|
7
|
Ntakakis G, Plomariti C, Frantzidis C, Antoniou PE, Bamidis PD, Tsoulfas G. Exploring the use of virtual reality in surgical education. World J Transplant 2023; 13:36-43. [PMID: 36908307 PMCID: PMC9993190 DOI: 10.5500/wjt.v13.i2.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/14/2022] [Accepted: 01/04/2023] [Indexed: 02/16/2023] Open
Abstract
Virtual reality (VR) technologies have rapidly developed in the past few years. The most common application of the technology, apart from gaming, is for educational purposes. In the field of healthcare, VR technologies have been applied in several areas. Among them is surgical education. With the use of VR, surgical pathways along with the training of surgical skills can be explored safely, in a cost-effective manner. The aim of this mini-review was to explore the use of VR in surgical education and in the 3D reconstruction of internal organs and viable surgical pathways. Finally, based on the outcomes of the included studies, an ecosystem for the implementation of surgical training was proposed.
Collapse
Affiliation(s)
- Georgios Ntakakis
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Christina Plomariti
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Christos Frantzidis
- School of Computer Science, University of Lincoln, Lincoln LN6 7TS, United Kingdom
| | - Panagiotis E Antoniou
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Panagiotis D Bamidis
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Georgios Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| |
Collapse
|
8
|
Mavridou I, Balaguer-Ballester E, Nduka C, Seiss E. A reliable and robust online validation method for creating a novel 3D Affective Virtual Environment and Event Library (AVEL). PLoS One 2023; 18:e0278065. [PMID: 37053205 PMCID: PMC10101521 DOI: 10.1371/journal.pone.0278065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/09/2022] [Indexed: 04/14/2023] Open
Abstract
This paper describes the development and validation of 3D Affective Virtual environments and Event Library (AVEL) for affect induction in Virtual Reality (VR) settings with an online survey; a cost-effective method for remote stimuli validation which has not been sufficiently explored. Three virtual office-replica environments were designed to induce negative, neutral and positive valence. Each virtual environment also had several affect inducing events/objects. The environments were validated using an online survey containing videos of the virtual environments and pictures of the events/objects. They survey was conducted with 67 participants. Participants were instructed to rate their perceived levels of valence and arousal for each virtual environment (VE), and separately for each event/object. They also rated their perceived levels of presence for each VE, and they were asked how well they remembered the events/objects presented in each VE. Finally, an alexithymia questionnaire was administered at the end of the survey. User ratings were analysed and successfully validated the expected affect and presence levels of each VE and affect ratings for each event/object. Our results demonstrate the effectiveness of the online validation of VE material in affective and cognitive neuroscience and wider research settings as a good scientific practice for future affect induction VR studies.
Collapse
Affiliation(s)
- Ifigeneia Mavridou
- Centre of Digital Entertainment, Bournemouth University, Bournemouth, United Kingdom
- Emteq Labs, Sussex Innovation Centre, Brighton, United Kingdom
| | - Emili Balaguer-Ballester
- Department of Computing and Informatics, Faculty of Science and Technology and Interdisciplinary Neuroscience Research Centre, Bournemouth University, Poole, United Kingdom
- Bernstein Center for Computational Neuroscience Heidelberg-Mannheim, Medical Faculty of Mannheim and Heidelberg University, Mannheim, Germany
| | - Charles Nduka
- Emteq Labs, Sussex Innovation Centre, Brighton, United Kingdom
| | - Ellen Seiss
- Department of Psychology, Faculty of Science and Technology and Interdisciplinary Neuroscience Research Centre, Bournemouth University, Bournemouth, United Kingdom
| |
Collapse
|
9
|
Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, Blumenthal N, Li M, Asché L, Jonas S, Bey K, Schulze M, Steffens M, Pensel MC, Guth M, Rohlfsen F, Ekhlas M, Lügering H, Fileccia H, Pakos J, Lux S, Philipsen A, Braun N. Virtual reality in the diagnostic and therapy for mental disorders: A systematic review. Clin Psychol Rev 2022; 98:102213. [PMID: 36356351 DOI: 10.1016/j.cpr.2022.102213] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/21/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Virtual reality (VR) technologies are playing an increasingly important role in the diagnostics and treatment of mental disorders. OBJECTIVE To systematically review the current evidence regarding the use of VR in the diagnostics and treatment of mental disorders. DATA SOURCE Systematic literature searches via PubMed (last literature update: 9th of May 2022) were conducted for the following areas of psychopathology: Specific phobias, panic disorder and agoraphobia, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, eating disorders, dementia disorders, attention-deficit/hyperactivity disorder, depression, autism spectrum disorder, schizophrenia spectrum disorders, and addiction disorders. ELIGIBILITY CRITERIA To be eligible, studies had to be published in English, to be peer-reviewed, to report original research data, to be VR-related, and to deal with one of the above-mentioned areas of psychopathology. STUDY EVALUATION For each study included, various study characteristics (including interventions and conditions, comparators, major outcomes and study designs) were retrieved and a risk of bias score was calculated based on predefined study quality criteria. RESULTS Across all areas of psychopathology, k = 9315 studies were inspected, of which k = 721 studies met the eligibility criteria. From these studies, 43.97% were considered assessment-related, 55.48% therapy-related, and 0.55% were mixed. The highest research activity was found for VR exposure therapy in anxiety disorders, PTSD and addiction disorders, where the most convincing evidence was found, as well as for cognitive trainings in dementia and social skill trainings in autism spectrum disorder. CONCLUSION While VR exposure therapy will likely find its way successively into regular patient care, there are also many other promising approaches, but most are not yet mature enough for clinical application. REVIEW REGISTRATION PROSPERO register CRD42020188436. FUNDING The review was funded by budgets from the University of Bonn. No third party funding was involved.
Collapse
Affiliation(s)
- Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ann-Kathrin Thöne
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Pramme
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Nike Blumenthal
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mengtong Li
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Asché
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Stephan Jonas
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Marcel Schulze
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Maria Steffens
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Max Christian Pensel
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Matthias Guth
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Felicia Rohlfsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mogda Ekhlas
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Lügering
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Fileccia
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Julian Pakos
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
| |
Collapse
|
10
|
Tan J, Kannis-Dymand L, Jones C. Examining the potential of VR program Tilt Brush in reducing anxiety. VIRTUAL REALITY 2022; 27:1-13. [PMID: 36405877 PMCID: PMC9647245 DOI: 10.1007/s10055-022-00711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Recent advancement in technology has made virtual reality (VR) more accessible and immersive than ever before, resulting in its increasing utility in various industries. Despite this, VR has remained an underutilised tool within clinical psychology. This study aimed to explore the potential of using VR for therapeutic benefits through examining the level of flow and anxiety-reducing effects of freeform drawing in real life (on paper) versus drawing in VR (using Tilt Brush) via a randomised-controlled trial with 40 participants. State and trait anxiety was measured using the State-Trait Anxiety Inventory, level of flow was measured using the Long Flow State Scale, and level of presence was measured using the iGroup Presence Questionnaire. Overall level of flow was not significantly different between both groups, implying drawing in VR induces as much flow as drawing in real life. Level of flow was positively correlated to level of presence experienced in the VR group (p < .01). Although there was no significant interaction effect, both groups experienced an overall decrease in state anxiety, with the VR group experiencing a significant reduction of state anxiety from pre- to post-test (p < .01).
Collapse
Affiliation(s)
- Janice Tan
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD Australia
| | - Lee Kannis-Dymand
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD Australia
| | - Christian Jones
- School of Law and Society, University of the Sunshine Coast, Maroochydore, QLD Australia
| |
Collapse
|
11
|
Delbes L, Mascret N, Goulon C, Montagne G. Validation of an immersive virtual reality device accepted by seniors that preserves the adaptive behavior produced in the real world. Front Bioeng Biotechnol 2022; 10:917486. [PMID: 36118569 PMCID: PMC9479106 DOI: 10.3389/fbioe.2022.917486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Falls in the elderly are a major societal issue. Virtual reality appears as a relevant tool to propose gait training programs to prevent the occurrence of falls. The use of a head-mounted display allows overground walking during fully immersive virtual training sessions. Our long-term ambition is to develop gait training programs with a head-mounted display to propose enjoyable and personalized training content for the elderly. Before proposing these programs, several methodological precautions must be taken. The first concerns the supposed similarity of the adaptive behavior produced in the real world and in virtual reality. The second concerns the acceptance of the virtual reality device before and after use. Twenty older adults performed a locomotor pointing task in three conditions including a real-world condition, a virtual-world condition consisting in a replica of the real-world condition, and a virtual condition in which the locomotor pointing task was performed in a different context. From feet positions in relation to the position of a target, gait adaptability behavior was investigated. In line with previous studies, step adjustments (needed and produced) were investigated through a combination of inter-trial and trial-by-trial analyses. The results highlighted that participants adopted the same gait adaptability behavior whatever the type of environment (real vs. virtual). Gait analyses suggested the use of a generic control mechanism based on information-movement coupling. We also demonstrated that older adults accepted the virtual reality device before and after use. With these methodological locks removed, it is now possible to design training programs in virtual reality to prevent falls in the elderly.
Collapse
|
12
|
Patients’ and therapists’ experiences of CBT videoconferencing in anxiety disorders. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Cognitive behavioural therapy (CBT) videoconferencing has been demonstrated to be an effective treatment for anxiety disorders and an equal alternative to face-to-face CBT. However, qualitative patient and therapist experiences of CBT videoconferencing have been less researched. Due to COVID-19, mental health services have shifted to remote therapy methods; thus, understanding patient and therapist experiences are crucial to better inform service policies and best practices. The current study focused on patient and therapist experiences of CBT videoconferencing at the Centre for Anxiety Disorders and Trauma (CADAT). Researchers used qualitative content analysis to explore patients’ (n = 54) and therapists’ (n = 15) responses to an online survey. Results yielded four themes: behavioural experiments work well if the problem lends itself to videoconferencing, overall practicalities but some home environment implications, privacy and technical issues, high telepresence and the negative impact on the therapeutic alliance, and COVID-19 influences attitude positively. The findings have clinical implications for CBT videoconferencing, including a need for specific training in assessment and intervention for therapists using videoconferencing.
Key learning aims
Readers of this paper will be able to:
(1)
Describe patient and therapist qualitative experiences of CBT videoconferencing.
(2)
Identify areas to consider when delivering CBT videoconferencing in anxiety disorders.
(3)
Understand therapist training needs for CBT videoconferencing in anxiety disorders.
(4)
Inform own service protocols and best practices for the delivery of CBT videoconferencing.
Collapse
|
13
|
Lobbestael J, Cima MJ. Virtual Reality for Aggression Assessment: The Development and Preliminary Results of Two Virtual Reality Tasks to Assess Reactive and Proactive Aggression in Males. Brain Sci 2021; 11:1653. [PMID: 34942955 PMCID: PMC8699434 DOI: 10.3390/brainsci11121653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
Validly measuring aggression is challenging because self-reports are plagued with biased answer tendencies and behavioral measures with ethical concerns and low ecological validity. The current study, therefore, introduces a novel virtual reality (VR) aggression assessment tool, differentially assessing reactive and proactive aggression. Two VR tasks were developed, one in an alley environment (N = 24, all male, Mage = 23.88, 83.3% students) and an improved second one in a bar (N = 50, all male, Mage = 22.54, 90% students). In this bar VR task, participants were randomly assigned to either the reactive condition where they were triggered by a cheating and insulting dart-player or to the proactive condition where they could earn extra money by aggressing. Participants' level of self-reported aggression and psychopathy was assessed, after which they engaged in either the reactive or proactive VR task. Changes in affect and blood pressure were also measured. Aggression in the reactive VR task was evidenced to mostly display convergent validity because it positively correlated with self-reported aggression and total and fearless dominance factor scores of psychopathy, and there was a trend relationship with increased systolic blood pressure. The validity of the proactive aggression variant of our VR bar paradigm received less support, and needs more refinement. It can be concluded that VR is a potentially promising tool to experimentally induce and assess (reactive) aggression, which has the potential to provide aggression researchers and clinicians with a realistic and modifiable aggression assessment environment.
Collapse
Affiliation(s)
- Jill Lobbestael
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, 6211 Maastricht, The Netherlands
| | - Maaike J. Cima
- Department Developmental Psychopathology, Brain Science Institute, Radboud University, 6525 Nijmegen, The Netherlands;
| |
Collapse
|
14
|
Chan SHM, Qiu L, Esposito G, Mai KP, Tam KP, Cui J. Nature in virtual reality improves mood and reduces stress: evidence from young adults and senior citizens. VIRTUAL REALITY 2021; 27:1-16. [PMID: 34849087 PMCID: PMC8617374 DOI: 10.1007/s10055-021-00604-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
Large populations worldwide have been deprived from nature experiences due to mass quarantines and lockdowns during the COVID-19 pandemic, and face a looming mental health crisis. Virtual reality offers a safe and practical solution to increase nature exposure. This research examined the effects of virtual nature using a within-subject design with young adults (Study 1) and senior citizens (Study 2). Results from the young adult sample showed that walking in a virtual forest reduced negative affect due to enhanced nature connectedness, and reduced stress measured by heart rate. Consistently, the senior citizen sample reported improved positive affect due to enhanced nature connectedness after the virtual nature walk. Our findings unveil the underlying mechanism of how virtual nature may improve psychological well-being and demonstrated how virtual nature can be used as an intervention to promote mental health. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10055-021-00604-4.
Collapse
Affiliation(s)
- Sarah Hian May Chan
- Division of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
- Global Asia, Interdisciplinary Graduate School, Nanyang Technological University, Singapore, Singapore
| | - Lin Qiu
- Division of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Division of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Ky Phong Mai
- Division of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Kim-Pong Tam
- Division of Social Science, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong
| | - Jian Cui
- Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
15
|
Carpita B, Muti D, Nardi B, Benedetti F, Cappelli A, Cremone IM, Carmassi C, Dell’Osso L. Biochemical Correlates of Video Game Use: From Physiology to Pathology. A Narrative Review. Life (Basel) 2021; 11:775. [PMID: 34440519 PMCID: PMC8401252 DOI: 10.3390/life11080775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 12/14/2022] Open
Abstract
In the last few decades, video game playing progressively became a widespread activity for many people, in childhood as well in adulthood. An increasing amount of literature has focused on pathological and non-pathological correlates of video game playing, with specific attention towards Internet Gaming Disorder (IGD). While many neurobiological studies in this field were based on neuroimaging, highlighting structural and functional brain changes among video game users, only a limited number of studies investigated the presence of biochemical correlates of video gaming. The present work aims to summarize and review the available literature about biochemical changes linked to video game use in IGD patients as well as non-pathological users, and the differences in between. Results may shed light on risks and benefits of video games, providing directions for further research on IGD treatment and, on other hand, on the potential role of video games in therapeutic or preventive protocols for specific conditions.
Collapse
Affiliation(s)
- Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.N.); (F.B.); (A.C.); (I.M.C.); (C.C.); (L.D.)
| | - Dario Muti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.N.); (F.B.); (A.C.); (I.M.C.); (C.C.); (L.D.)
| | | | | | | | | | | | | |
Collapse
|
16
|
Development of a Virtual Ecological Environment for Learning the Taipei Tree Frog. SUSTAINABILITY 2021. [DOI: 10.3390/su13115911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The learning objectives of environmental education emphasize investigation in real life to enhance students’ skills and experiences in solving practical problems. This study used the virtual reality (VR) technology to develop a virtual ecological environment for learning about the Taipei tree frog, supported by situated learning and game-based learning design to enhance students’ learning interest and motivation. Users can wear the head-mounted display (HMD) to explore the virtual environment for learning the Taipei tree frog’s ecological behavior, such as foraging and mating as well as its habitats and predators. A teaching experiment was conducted to investigate students’ learning effectiveness and the senses of presence and anxiety after using the virtual ecological environment. The experimental group (wearing the HMD) contained 40 students, the control group (using the desktop VR) contained 40 students, and both groups were used as samples to learn about the Taipei tree frog. The results indicated that using HMD VR and desktop VR could both enhance learning achievements, but the learning effectiveness of the former was significantly higher than that of the latter. The levels of anxiety for both groups were about the same, but the level of presence for the experimental group was higher than that of the control group because the HMD VR provided a more immersive experience than the desktop VR. The virtual ecological environment can save the time and effort of travelling to the natural habitat for observing the Taipei tree frog, and the design of role-playing game (RPG) can enhance learners’ interest and motivation. Therefore, it is a useful tool for promoting environmental education.
Collapse
|
17
|
Mor S, Botella C, Campos D, Tur C, Castilla D, Soler C, Quero S. An Internet-based treatment for Flying Phobia using 360° images: Study protocol for a feasibility pilot study. Internet Interv 2021; 24:100387. [PMID: 33936953 PMCID: PMC8076687 DOI: 10.1016/j.invent.2021.100387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Flying Phobia (FP) is a prevalent disorder that can cause serious interference in a person's life. ICBT interventions have already shown their efficacy in several studies, but studies in the field of specific phobias are still scarce. Moreover, few studies have investigated the feasibility of using different types of images in exposure scenarios in ICBTs and no studies have been carried out on the role of sense of presence and reality judgement. The aim of the present study is to explore the feasibility of an ICBT for FP (NO-FEAR Airlines) using two types of images with different levels of immersion (still and navigable images). A secondary aim is to explore the potential effectiveness of the two experimental conditions using two types of images compared to a waiting list control group. Finally, the role of navigable images compared to the still images in the level of anxiety, sense of presence, and reality judgement will also be explored. This paper presents the study protocol. METHODS This study is a three-armed feasibility pilot study with the following conditions: NO-FEAR Airlines with navigable images, NO-FEAR Airlines with still images, and a waiting list group. A minimum of 60 participants will be recruited. The intervention will have a maximum duration of 6 weeks. Measurements will be taken at four different moments: baseline, post-intervention, and two follow-ups (3- and 12-month). Participants' opinions, preference, satisfaction and acceptance regarding the images used in the exposure scenarios will be assessed. FP symptomatology outcomes will also be considered for secondary analyses. The anxiety, sense of presence, and reality judgement in the exposure scenarios will also be analysed. DISCUSSION This study will conduct a pilot study on the feasibility of an ICBT for FP and it is the first one to explore the evaluation of patients of the two type of images (still and navigable) and the role of presence and reality judgement in exposure scenarios delivered through the Internet. Research in this field can have an impact on the way these scenarios are designed and developed, as well as helping to explore whether they have any effect on adherence. TRIAL REGISTRATION NCT03900559. Trial Registration date 3 April 2019, retrospectively registered.
Collapse
Affiliation(s)
- Sonia Mor
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Cristina Botella
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| | - Daniel Campos
- Department of Psychology and Sociology, University of Zaragoza, Huesca, Spain
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | - Cintia Tur
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | | | | | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Carlos III Institute of Health, Madrid, Spain
| |
Collapse
|
18
|
Farrell LJ, Miyamoto T, Donovan CL, Waters AM, Krisch KA, Ollendick TH. Virtual Reality One-Session Treatment of Child-Specific Phobia of Dogs: A Controlled, Multiple Baseline Case Series. Behav Ther 2021; 52:478-491. [PMID: 33622515 DOI: 10.1016/j.beth.2020.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022]
Abstract
Specific phobia (SP) typically onsets in childhood and frequently predicts other mental health disorders later in life. Fortunately, childhood SP can be effectively treated with cognitive behavior therapy (CBT), including the exposure-based one-session treatment (OST) approach. Despite empirical support for CBT and OST, clinicians, for various reasons, frequently fail to implement exposure-based therapy in routine clinical practice, including perceived difficulties in implementing exposure. Virtual reality (VR) exposure therapy may overcome some of these challenges and provides an alternative modality of therapy. This preliminary study examined the efficacy of VR OST for 8 children with a SP of dogs (aged 8-12 years) (M = age 10.25; SD = 2.11) using a multiple-baseline controlled case series. Following a stable baseline period of either 2, 3, or 4 weeks, it was expected that specific phobia severity would significantly decline after VR OST and remain improved over the 3-week maintenance phase. Assessments were conducted posttreatment and at 1-month follow up (study end-point). It was found that phobia symptoms remained relatively stable across the baselines, with significant reductions from pretreatment to posttreatment and to follow-up on clinician severity ratings (pre- to post- g = 1.12; pre- to follow-up g = 2.40), target symptom ratings (g = 1.14; 1.29), and behavioral avoidance (g = -1.27; -1.96). The treatment was also associated with clinically significant outcomes, whereby at one-month follow up, 75% of children were considered "recovered" and 88% completed the BAT (interacted with their feared stimuli). This study provides support for the effectiveness of VR OST.
Collapse
|
19
|
Horigome T, Kurokawa S, Sawada K, Kudo S, Shiga K, Mimura M, Kishimoto T. Virtual reality exposure therapy for social anxiety disorder: a systematic review and meta-analysis. Psychol Med 2020; 50:2487-2497. [PMID: 33070784 DOI: 10.1017/s0033291720003785] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Virtual reality exposure therapy (VRET) is currently being used to treat social anxiety disorder (SAD); however, VRET's magnitude of efficacy, duration of efficacy, and impact on treatment discontinuation are still unclear. METHODS We conducted a meta-analysis of studies that investigated the efficacy of VRET for SAD. The search strategy and analysis method are registered at PROSPERO (#CRD42019121097). Inclusion criteria were: (1) studies that targeted patients with SAD or related phobias; (2) studies where VRET was conducted for at least three sessions; (3) studies that included at least 10 participants. The primary outcome was social anxiety evaluation score change. Hedges' g and its 95% confidence intervals were calculated using random-effect models. The secondary outcome was the risk ratio for treatment discontinuation. RESULTS Twenty-two studies (n = 703) met the inclusion criteria and were analyzed. The efficacy of VRET for SAD was significant and continued over a long-term follow-up period: Hedges' g for effect size at post-intervention, -0.86 (-1.04 to -0.68); three months post-intervention, -1.03 (-1.35 to -0.72); 6 months post-intervention, -1.14 (-1.39 to -0.89); and 12 months post-intervention, -0.74 (-1.05 to -0.43). When compared to in vivo exposure, the efficacy of VRET was similar at post-intervention but became inferior at later follow-up points. Participant dropout rates showed no significant difference compared to in vivo exposure. CONCLUSION VRET is an acceptable treatment for SAD patients that has significant, long-lasting efficacy, although it is possible that during long-term follow-up, VRET efficacy lessens as compared to in vivo exposure.
Collapse
Affiliation(s)
- Toshiro Horigome
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shunya Kurokawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Shun Kudo
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
| | - Kiko Shiga
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taishiro Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Psychiatry at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA
| |
Collapse
|
20
|
Mittelstaedt JM. Individual predictors of the susceptibility for motion-related sickness: A systematic review. J Vestib Res 2020; 30:165-193. [DOI: 10.3233/ves-200702] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
21
|
Malbos E, Burgess GH, Lançon C. Virtual Reality and Fear of Shark Attack: A Case Study for the Treatment of Squalophobia. Clin Case Stud 2020. [DOI: 10.1177/1534650120940014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research treatment protocols are rare regarding an unusual anxiety disorder, namely the fear of sharks (squalophobia). As a possible solution, the effectiveness of virtual reality (VR) exposure therapy for this phobia was tested. The advantage of using VR becomes clearer when a real life set up is impractical, such as exposing a phobic patient to a feared large marine organism, the shark. The effects were evaluated in a single case study involving multiple context-graded aquatic virtual environments with a virtual shark and using affordable VR apparatus and software. Assessment was based on self-report questionnaires. Scores the psychometric instruments exhibited a discernable reduction in fear toward sharks. Such gains were maintained at a 12-month follow-up. Presence rates indicated immersion when confronted to a three-dimensional (3D) virtual shark. This initial study revealed the potential of VR for the treatment of marine biota phobia and its potential to recreate diverse situations for exposure therapy.
Collapse
Affiliation(s)
- Eric Malbos
- Fresnel Institute, UMR 7249, CNRS, Aix-Marseille University, France
- Department of Psychiatry, Conception University Hospital, AP-HM, Marseille, France
| | - George H. Burgess
- Florida Program for Shark Research, University of Florida, Gainesville, USA
| | - Christophe Lançon
- Department of Psychiatry, Conception University Hospital, AP-HM, Marseille, France
| |
Collapse
|
22
|
Baniasadi T, Ayyoubzadeh SM, Mohammadzadeh N. Challenges and Practical Considerations in Applying Virtual Reality in Medical Education and Treatment. Oman Med J 2020; 35:e125. [PMID: 32489677 PMCID: PMC7232669 DOI: 10.5001/omj.2020.43] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 02/11/2019] [Indexed: 12/12/2022] Open
Abstract
Despite the benefits of using virtual reality (VR) in medical education and treatment, some challenges and limitations result in the uselessness or misuse of this technology. Therefore, recognizing potential challenges related to VR might be helpful in the strategic decision-making process to implement and develop this technology in the healthcare field. Accordingly, our review aimed to determine the challenges associated with the application of VR in the field of medical education and treatment. We searched Science Direct, Google Scholar, and PubMed databases for relevant papers using a defined search query. We restricted the search to articles in English or Persian language published by the end of 2018. The main challenges of developing and using VR with educational and therapeutic objectives are categorized as general and specific. General challenges include reduced face-to-face communications, education, cost challenges, users' attitudes, and specific challenges such as designing, safety considerations, VR side effects, evaluation, and validation of VR applications. Challenges related to VR will have different effects, thus identifying each of them helps to determine the solutions for each challenge. Also, it is suggested to develop and update laws, standards, and protocols, which play an important role in increasing the effective application of VR at the national level.
Collapse
Affiliation(s)
- Tayebeh Baniasadi
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Ayyoubzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Mohammadzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
23
|
Brown T, Nauman Vogel E, Adler S, Bohon C, Bullock K, Nameth K, Riva G, Safer DL, Runfola CD. Bringing Virtual Reality From Clinical Trials to Clinical Practice for the Treatment of Eating Disorders: An Example Using Virtual Reality Cue Exposure Therapy. J Med Internet Res 2020; 22:e16386. [PMID: 32324145 PMCID: PMC7206518 DOI: 10.2196/16386] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/07/2019] [Accepted: 12/15/2019] [Indexed: 12/11/2022] Open
Abstract
Novel treatment options for eating disorders (EDs) are critically needed to enhance treatment outcomes and reduce the rates of treatment dropouts. On average, only 50% of individuals receiving evidence-based care remit, whereas 24% drop out before treatment completion. One particularly promising direction involves integrating virtual reality (VR) with existing evidence-based treatments (EBTs) such as cue exposure therapy (CET). Across psychiatric disorders, VR-based interventions are demonstrating at least preliminary efficacy and noninferiority to traditional treatments. Furthermore, VR technology has become increasingly portable, resulting in improved acceptance, increased access, and reductions in cost. However, more efficient research processes may be needed to uncover the potential benefits of these rapid technological advances. This viewpoint paper reviews existing empirical support for integrating VR with EBTs (with a focus on its use with EDs) and proposes key next steps to more rapidly bring this innovative technology-based intervention into real-world clinic settings, as warranted. VR-CET for EDs is used to illustrate a suggested process for developing such treatment enhancements. We recommend following a deployment-focused model of intervention development and testing to enable rapid implementation of robust, practice-ready treatments. In addition, our review highlights the need for a comprehensive clinical protocol that supports clinicians and researchers in the implementation and testing of VR-CET and identifies key missing protocol components with rationale for their inclusion. Ultimately, this work may lead to a more complete understanding of the full potential of the applications and integrations of VR into mental health care globally.
Collapse
Affiliation(s)
- Theresa Brown
- PGSP-Stanford PsyD Consortium, Palo Alto, CA, United States
| | | | - Sarah Adler
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Kim Bullock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Katherine Nameth
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,Centro Studi e Ricerche di Psicologia della Comunicazione, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Debra L Safer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Cristin D Runfola
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| |
Collapse
|
24
|
Viaud-Delmon I, Warusfel O, Seguelas A, Rio E, Jouvent R. High sensitivity to multisensory conflicts in agoraphobia exhibited by virtual reality. Eur Psychiatry 2020; 21:501-8. [PMID: 17055951 DOI: 10.1016/j.eurpsy.2004.10.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2004] [Revised: 10/13/2004] [Accepted: 10/21/2004] [Indexed: 11/16/2022] Open
Abstract
AbstractThe primary aim of this study was to evaluate the effect of auditory feedback in a VR system planned for clinical use and to address the different factors that should be taken into account in building a bimodal virtual environment (VE). We conducted an experiment in which we assessed spatial performances in agoraphobic patients and normal subjects comparing two kinds of VEs, visual alone (Vis) and auditory–visual (AVis), during separate sessions. Subjects were equipped with a head-mounted display coupled with an electromagnetic sensor system and immersed in a virtual town. Their task was to locate different landmarks and become familiar with the town. In the AVis condition subjects were equipped with the head-mounted display and headphones, which delivered a soundscape updated in real-time according to their movement in the virtual town. While general performances remained comparable across the conditions, the reported feeling of immersion was more compelling in the AVis environment. However, patients exhibited more cybersickness symptoms in this condition. The result of this study points to the multisensory integration deficit of agoraphobic patients and underline the need for further research on multimodal VR systems for clinical use.
Collapse
Affiliation(s)
- Isabelle Viaud-Delmon
- CNRS - UPMC UMR 7593, Pavillon Clérambault, Hôpital de la Salpêtrière, 47, boulevard de l'Hôpital, 75013 Paris, France.
| | | | | | | | | |
Collapse
|
25
|
A Psychophysiological and Behavioural Study of Slot Machine Near-Misses Using Immersive Virtual Reality. J Gambl Stud 2019; 35:929-944. [PMID: 30684139 DOI: 10.1007/s10899-018-09822-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
During slot machine gambling, near-miss outcomes occur when the final winning icon lands one position off the pay-line. To understand how near-misses promote gambling behaviour in healthy populations, autonomic arousal is often used to index outcome response valence. Findings remain equivocal, possibly owing to the limited ecological validity of computer simulations. Relevant psychological traits, such as impulsivity, which increase the risk of problem gambling, are often not examined. Here, we used immersive virtual reality (VR) to investigate near-miss-induced changes in physiological arousal and VR gambling behaviour. Sixty adult participants with no history of problem gambling were immersed in a VR casino-bar where they engaged with a self-selected slot machine. Real-time heart rate (HR) data were acquired during immersion. Within-subjects analyses were conducted on HR and post-reinforcement pauses (PRPs; i.e., time taken to initiate next-spin) across wins, losses and near-misses. Significant HR acceleration occurred for both near-misses and losses compared to wins, indexing an initial orientation response. Both types of losses were associated with faster next-spin responses. Near-misses did not apparently have unique HR or PRP profiles from losses, although this may reflect our loss control condition, which in itself may have been a subtler near-miss outcome. Impulsivity measured by the SUPPS-P was not associated with near-miss responses. Losses may encourage gambling as participants experience more immediate HR acceleration (indexing arousal unique to losing) and initiate faster responses. Future studies should clarify this effect by investigating problem gambling cohorts and develop VR paradigms taking into consideration the current findings and limitations.
Collapse
|
26
|
The impact of virtual reality versus 2D pornography on sexual arousal and presence. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2019.02.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
27
|
Hajesmaeel Gohari S, Gozali E, Niakan Kalhori SR. Virtual reality applications for chronic conditions management: A review. Med J Islam Repub Iran 2019; 33:67. [PMID: 31456991 PMCID: PMC6708122 DOI: 10.34171/mjiri.33.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Indexed: 01/09/2023] Open
Abstract
Background: Virtual Reality (VR) as a computer technology that simulating real environments and situations exploited in numerous healthcare areas such as chronic diseases. The significance of timely treatment and rehabilitation of patients with chronic conditions is high due to the long lasting nature of these conditions. This paper sought to perform a review of published works in the field of VR application in chronic conditions for treatment and rehabilitation purposes.
Methods: We searched the MEDLINE database through PubMed in April 2016 for retrieving published papers from January 2001 to December 2015. From 117 retrieved papers, 52had the inclusion criteria, and their full texts were accessible. Data were extracted from papers based on following items: the name of the first author, year of the study, applied VR methods, type of condition and disease, number of subjects that participated in the study, and finally the status of success and failure of VR application. Data were analyzed using descriptive analysis.
Results: Results of the reviewed investigations have been considered in two main categories including treatment oriented papers (n=38, 73%) while twenty of these papers have been conducted on phobias (53%); also, there are rehabilitation-oriented experiments (n=14, 27%) while thirteen of these papers have been performed on stroke. In 40 papers (77%), the VR technology application reported proper and in 11 papers (21%) the application of VR resulted in relatively proper outcomes and only there is a work (2%) with poor results for VR intervention.
Conclusion: VR technology has been increasingly used in recent years for treatment and rehabilitation purposes among patients affected by chronic conditions in order to motivate them for more successful management.
Collapse
Affiliation(s)
- Sadrieh Hajesmaeel Gohari
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Gozali
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh R Niakan Kalhori
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
28
|
Guitard T, Bouchard S, Bélanger C, Berthiaume M. Exposure to a Standardized Catastrophic Scenario in Virtual Reality or a Personalized Scenario in Imagination for Generalized Anxiety Disorder. J Clin Med 2019; 8:jcm8030309. [PMID: 30841509 PMCID: PMC6463165 DOI: 10.3390/jcm8030309] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 02/21/2019] [Accepted: 02/26/2019] [Indexed: 11/16/2022] Open
Abstract
The cognitive behavioral treatment of generalized anxiety disorder (GAD) often involves exposing patients to a catastrophic scenario depicting their most feared worry. The aim of this study was to examine whether a standardized scenario recreated in virtual reality (VR) would elicit anxiety and negative affect and how it compared to the traditional method of imagining a personalized catastrophic scenario. A sample of 28 participants were first exposed to a neutral non-catastrophic scenario and then to a personalized scenario in imagination or a standardized virtual scenario presented in a counterbalanced order. The participants completed questionnaires before and after each immersion. The results suggest that the standardized virtual scenario induced significant anxiety. No difference was found when comparing exposure to the standardized scenario in VR and exposure to the personalized scenario in imagination. These findings were specific to anxiety and not to the broader measure of negative affect. Individual differences in susceptibility to feel present in VR was a significant predictor of increase in anxiety and negative affect. Future research could use these scenarios to conduct a randomized control trial to test the efficacy and cost/benefits of using VR in the treatment of GAD.
Collapse
Affiliation(s)
- Tanya Guitard
- Département de Psychologie, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada.
| | - Stéphane Bouchard
- Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada.
| | - Claude Bélanger
- Département de Psychologie, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada.
| | - Maxine Berthiaume
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada.
| |
Collapse
|
29
|
Weech S, Kenny S, Barnett-Cowan M. Presence and Cybersickness in Virtual Reality Are Negatively Related: A Review. Front Psychol 2019; 10:158. [PMID: 30778320 PMCID: PMC6369189 DOI: 10.3389/fpsyg.2019.00158] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/16/2019] [Indexed: 12/21/2022] Open
Abstract
In order to take advantage of the potential offered by the medium of virtual reality (VR), it will be essential to develop an understanding of how to maximize the desirable experience of "presence" in a virtual space ("being there"), and how to minimize the undesirable feeling of "cybersickness" (a constellation of discomfort symptoms experienced in VR). Although there have been frequent reports of a possible link between the observer's sense of presence and the experience of bodily discomfort in VR, the amount of literature that discusses the nature of the relationship is limited. Recent research has underlined the possibility that these variables have shared causes, and that both factors may be manipulated with a single approach. This review paper summarizes the concepts of presence and cybersickness and highlights the strengths and gaps in our understanding about their relationship. We review studies that have measured the association between presence and cybersickness, and conclude that the balance of evidence favors a negative relationship between the two factors which is driven principally by sensory integration processes. We also discuss how system immersiveness might play a role in modulating both presence and cybersickness. However, we identify a serious absence of high-powered studies that aim to reveal the nature of this relationship. Based on this evidence we propose recommendations for future studies investigating presence, cybersickness, and other related factors.
Collapse
Affiliation(s)
- Séamas Weech
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
- The Games Institute, University of Waterloo, Waterloo, ON, Canada
| | - Sophie Kenny
- The Games Institute, University of Waterloo, Waterloo, ON, Canada
| | - Michael Barnett-Cowan
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
- The Games Institute, University of Waterloo, Waterloo, ON, Canada
| |
Collapse
|
30
|
Gromer D, Reinke M, Christner I, Pauli P. Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure. Front Psychol 2019; 10:141. [PMID: 30761054 PMCID: PMC6363698 DOI: 10.3389/fpsyg.2019.00141] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/15/2019] [Indexed: 12/13/2022] Open
Abstract
Virtual reality plays an increasingly important role in research and therapy of pathological fear. However, the mechanisms how virtual environments elicit and modify fear responses are not yet fully understood. Presence, a psychological construct referring to the ‘sense of being there’ in a virtual environment, is widely assumed to crucially influence the strength of the elicited fear responses, however, causality is still under debate. The present study is the first that experimentally manipulated both variables to unravel the causal link between presence and fear responses. Height-fearful participants (N = 49) were immersed into a virtual height situation and a neutral control situation (fear manipulation) with either high versus low sensory realism (presence manipulation). Ratings of presence and verbal and physiological (skin conductance, heart rate) fear responses were recorded. Results revealed an effect of the fear manipulation on presence, i.e., higher presence ratings in the height situation compared to the neutral control situation, but no effect of the presence manipulation on fear responses. However, the presence ratings during the first exposure to the high quality neutral environment were predictive of later fear responses in the height situation. Our findings support the hypothesis that experiencing emotional responses in a virtual environment leads to a stronger feeling of being there, i.e., increase presence. In contrast, the effects of presence on fear seem to be more complex: on the one hand, increased presence due to the quality of the virtual environment did not influence fear; on the other hand, presence variability that likely stemmed from differences in user characteristics did predict later fear responses. These findings underscore the importance of user characteristics in the emergence of presence.
Collapse
Affiliation(s)
- Daniel Gromer
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Max Reinke
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Isabel Christner
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany.,Center of Mental Health, Medical Faculty, University of Würzburg, Würzburg, Germany
| |
Collapse
|
31
|
Felnhofer A, Hlavacs H, Beutl L, Kryspin-Exner I, Kothgassner OD. Physical Presence, Social Presence, and Anxiety in Participants with Social Anxiety Disorder During Virtual Cue Exposure. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2018; 22:46-50. [PMID: 30407091 DOI: 10.1089/cyber.2018.0221] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although social anxiety disorders (SADs) are increasingly treated by means of virtual cue exposure, the mechanisms leading to sufficient anxiety levels and thus to a success of virtual reality exposure therapy are still poorly understood. Also, most studies with SAD participants fail to evaluate social presence, although it may be a more appropriate indicator for virtual social stress scenarios than physical presence. Hence, for the first time, this study sets out to examine the link between social presence, physical presence, and emotional responses to phobogenic virtual social stimuli. A group of n = 12 participants with SAD and n = 12 healthy controls were exposed to three social tasks in an interactive virtual environment (VE). Self-report measures of physical and social presence as well as state anxiety were used alongside heart rate measures to evaluate the virtual experience. Results show significantly higher anxiety levels-both self-report and physiological-in SAD participants than in controls. Also, socially anxious subjects reported to experience more copresence and mutual attention as well as a higher sense of being in the VE than their healthy peers. In sum, social presence experiences may be more predicative of the anxiety response in SAD individuals than physical presence. Especially attentional processes seem to crucially shape the interplay between presence and affective responses.
Collapse
Affiliation(s)
- Anna Felnhofer
- 1 Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.,2 Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Helmut Hlavacs
- 3 Entertainment Computing Research Group, University of Vienna, Vienna, Austria
| | - Leon Beutl
- 3 Entertainment Computing Research Group, University of Vienna, Vienna, Austria
| | - Ilse Kryspin-Exner
- 2 Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Oswald D Kothgassner
- 2 Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Vienna, Austria.,4 Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| |
Collapse
|
32
|
Gromer D, Madeira O, Gast P, Nehfischer M, Jost M, Müller M, Mühlberger A, Pauli P. Height Simulation in a Virtual Reality CAVE System: Validity of Fear Responses and Effects of an Immersion Manipulation. Front Hum Neurosci 2018; 12:372. [PMID: 30319376 PMCID: PMC6167601 DOI: 10.3389/fnhum.2018.00372] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/30/2018] [Indexed: 12/05/2022] Open
Abstract
Acrophobia is characterized by intense fear in height situations. Virtual reality (VR) can be used to trigger such phobic fear, and VR exposure therapy (VRET) has proven effective for treatment of phobias, although it remains important to further elucidate factors that modulate and mediate the fear responses triggered in VR. The present study assessed verbal and behavioral fear responses triggered by a height simulation in a 5-sided cave automatic virtual environment (CAVE) with visual and acoustic simulation and further investigated how fear responses are modulated by immersion, i.e., an additional wind simulation, and presence, i.e., the feeling to be present in the VE. Results revealed a high validity for the CAVE and VE in provoking height related self-reported fear and avoidance behavior in accordance with a trait measure of acrophobic fear. Increasing immersion significantly increased fear responses in high height anxious (HHA) participants, but did not affect presence. Nevertheless, presence was found to be an important predictor of fear responses. We conclude that a CAVE system can be used to elicit valid fear responses, which might be further enhanced by immersion manipulations independent from presence. These results may help to improve VRET efficacy and its transfer to real situations.
Collapse
Affiliation(s)
- Daniel Gromer
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Octávia Madeira
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Philipp Gast
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Markus Nehfischer
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Michael Jost
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Mathias Müller
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Andreas Mühlberger
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Paul Pauli
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany.,Center of Mental Health, Medical Faculty, University of Würzburg, Würzburg, Germany
| |
Collapse
|
33
|
Botella C, Fernández-Álvarez J, Guillén V, García-Palacios A, Baños R. Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review. Curr Psychiatry Rep 2017; 19:42. [PMID: 28540594 DOI: 10.1007/s11920-017-0788-4] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This review is designed to systematically examine the available evidence about virtual reality exposure therapy's (VRET) efficacy for phobias, critically describe some of the most important challenges in the field and discuss possible directions. Evidence reveals that virtual reality (VR) is an effective treatment for phobias and useful for studying specific issues, such as pharmacological compounds and behavioral manipulations, that can enhance treatment outcomes. In addition, some variables, such as sense of presence in virtual environments, have a significant influence on outcomes, but further research is needed to better understand their role in therapeutic outcomes. We conclude that VR is a useful tool to improve exposure therapy and it can be a good option to analyze the processes and mechanisms involved in exposure therapy and the ways this strategy can be enhanced. In the coming years, there will be a significant expansion of VR in routine practice in clinical contexts.
Collapse
Affiliation(s)
- Cristina Botella
- Universitat Jaume I, Castellón, Spain.
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain.
| | | | - Verónica Guillén
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Universitat de Valencia, Valencia, Spain
| | - Azucena García-Palacios
- Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Rosa Baños
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Universitat de Valencia, Valencia, Spain
| |
Collapse
|
34
|
Arcelus J, Bouman WP, Jones BA, Richards C, Jimenez-Murcia S, Griffiths MD. Video gaming and gaming addiction in transgender people: An exploratory study. J Behav Addict 2017; 6:21-29. [PMID: 28198637 PMCID: PMC5572994 DOI: 10.1556/2006.6.2017.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background There is anecdotal clinical evidence that transgender people use the online world - such as forums and online video gaming - for the purpose of experiencing their gender identity in a safe, non-threatening, non-alienating, non-stigmatizing, and non-critical environment. Aims To describe gaming behavior, degree of problematic gaming behavior and associated factors with problematic gaming in a comparatively large group of transgender people accessing transgender health services. Methods Every individual referred to a national transgender health service in the United Kingdom during a 12-month period was invited to complete a series of questionnaires to measure gaming behavior, interpersonal functioning, severity of autistic features, and anxiety and depressive symptoms. Results A total of 245 people agreed to participate in the study with 154 (62.9%) describing themselves as current gamers. Gaming behavior in the transgender population attending transgender health services was prevalent, but less than 1% of them presented with clinical scores for Internet Gaming Disorder, with no differences according to gender. Problematic gaming behavior was associated with general interpersonal problems, depression, and young age. Discussion and conclusions Transgender people who engage in problematic gaming behavior are younger, and present with high interpersonal problems, and depression, which can affect a successful transition. In view of the high levels of gaming activity in this population games that are designed to address these psychological problems may be well received by transgender people.
Collapse
Affiliation(s)
- Jon Arcelus
- Nottingham Centre for Transgender
Health, Nottingham, UK,Institute of Mental Health, Faculty of Medicine &
Health Sciences, University of Nottingham,
Nottingham, UK,Corresponding author: Jon Arcelus; Institute of
Mental Health, Faculty of Medicine & Health Sciences, Nottingham National
Centre for Transgender Health, University of Nottingham, Oxford Street 3, NG1
5BH Nottingham, UK; Phone: +44 115 8760160; Fax: +44 115 947 5609; E-mail:
| | | | - Bethany Alice Jones
- Nottingham Centre for Transgender
Health, Nottingham, UK,School of Sport, Exercise, and Health Sciences,
Loughborough University, Loughborough,
UK
| | | | - Susana Jimenez-Murcia
- Department of Psychiatry, University
Hospital of Bellvitge-IDIBELL, Barcelona,
Spain
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology
Division, Nottingham Trent University, Nottingham,
UK
| |
Collapse
|
35
|
Ortiz de Gortari AB, Oldfield B, Griffiths MD. An empirical examination of factors associated with Game Transfer Phenomena severity. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.06.060] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
36
|
Laforest M, Bouchard S, Crétu AM, Mesly O. Inducing an Anxiety Response Using a Contaminated Virtual Environment: Validation of a Therapeutic Tool for Obsessive–Compulsive Disorder. ACTA ACUST UNITED AC 2016. [DOI: 10.3389/fict.2016.00018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
37
|
St-Pierre-Delorme ME, O'Connor K. Using Virtual Reality in the Inference-Based Treatment of Compulsive Hoarding. Front Public Health 2016; 4:149. [PMID: 27486574 PMCID: PMC4949239 DOI: 10.3389/fpubh.2016.00149] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 07/04/2016] [Indexed: 12/04/2022] Open
Abstract
The present study evaluated the efficacy of adding a virtual reality (VR) component to the treatment of compulsive hoarding (CH), following inference-based therapy (IBT). Participants were randomly assigned to either an experimental or a control condition. Seven participants received the experimental and seven received the control condition. Five sessions of 1 h were administered weekly. A significant difference indicated that the level of clutter in the bedroom tended to diminish more in the experimental group as compared to the control group F(2,24) = 2.28, p = 0.10. In addition, the results demonstrated that both groups were immersed and present in the environment. The results on posttreatment measures of CH (Saving Inventory revised, Saving Cognition Inventory and Clutter Image Rating scale) demonstrate the efficacy of IBT in terms of symptom reduction. Overall, these results suggest that the creation of a virtual environment may be effective in the treatment of CH by helping the compulsive hoarders take action over their clutter.
Collapse
Affiliation(s)
| | - Kieron O'Connor
- Institut universitaire en santé mentale de Montréal , Montreal, QC , Canada
| |
Collapse
|
38
|
Kato PM, Beale IL. Factors Affecting Acceptability to Young Cancer Patients of a Psychoeducational Video Game About Cancer. J Pediatr Oncol Nurs 2016; 23:269-75. [PMID: 16902082 DOI: 10.1177/1043454206289780] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study explored whether an action video game about cancer would be acceptable to adolescent and young adult cancer patients as a tool for learning about cancer and self-care during treatment. Interviews about a proposed video game were conducted with 43 young cancer patients, who also completed questionnaires measuring personality and adaptive style. Data were analyzed to assess the overall acceptability of the proposed video game and to reveal any factors associated with measures of acceptability. Most participants expressed willingness to play the game and a moderate degree of interest in it. Cancer content in the game was not a deterrent for most participants. Game acceptability was not affected by personality variables or adaptive style. It is concluded that an action video game using cancer themes could be useful to nurses as a tool to improve understanding and self care of adolescent and young adult cancer patients.
Collapse
|
39
|
Taffou M, Ondřej J, O'Sullivan C, Warusfel O, Dubal S, Viaud-Delmon I. Multisensory aversive stimuli differentially modulate negative feelings in near and far space. PSYCHOLOGICAL RESEARCH 2016; 81:764-776. [PMID: 27150637 DOI: 10.1007/s00426-016-0774-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 04/25/2016] [Indexed: 12/19/2022]
Abstract
Affect, space, and multisensory integration are processes that are closely linked. However, it is unclear whether the spatial location of emotional stimuli interacts with multisensory presentation to influence the emotional experience they induce in the perceiver. In this study, we used the unique advantages of virtual reality techniques to present potentially aversive crowd stimuli embedded in a natural context and to control their display in terms of sensory and spatial presentation. Individuals high in crowdphobic fear navigated in an auditory-visual virtual environment, in which they encountered virtual crowds presented through the visual channel, the auditory channel, or both. They reported the intensity of their negative emotional experience at a far distance and at a close distance from the crowd stimuli. Whereas auditory-visual presentation of close feared stimuli amplified negative feelings, auditory-visual presentation of distant feared stimuli did not amplify negative feelings. This suggests that spatial closeness allows multisensory processes to modulate the intensity of the emotional experience induced by aversive stimuli. Nevertheless, the specific role of auditory stimulation must be investigated to better understand this interaction between multisensory, affective, and spatial representation processes. This phenomenon may serve the implementation of defensive behaviors in response to aversive stimuli that are in position to threaten an individual's feeling of security.
Collapse
Affiliation(s)
- Marine Taffou
- Sciences et Technologies de la Musique et du Son, CNRS UMR 9912, IRCAM, Sorbonne Universités, UPMC Univ Paris 06, 1 place Igor Stravinsky, 75004, Paris, France.
- Social and Affective Neuroscience (SAN) Laboratory, Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, 47 boulevard de l'hôpital, 75013, Paris, France.
| | - Jan Ondřej
- School of Computer Science and Statistics, Trinity College Dublin, Dublin 2, Ireland
| | - Carol O'Sullivan
- School of Computer Science and Statistics, Trinity College Dublin, Dublin 2, Ireland
| | - Olivier Warusfel
- Sciences et Technologies de la Musique et du Son, CNRS UMR 9912, IRCAM, Sorbonne Universités, UPMC Univ Paris 06, 1 place Igor Stravinsky, 75004, Paris, France
| | - Stéphanie Dubal
- Social and Affective Neuroscience (SAN) Laboratory, Institut du Cerveau et de la Moelle épinière, ICM, Inserm, U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, 47 boulevard de l'hôpital, 75013, Paris, France
| | - Isabelle Viaud-Delmon
- Sciences et Technologies de la Musique et du Son, CNRS UMR 9912, IRCAM, Sorbonne Universités, UPMC Univ Paris 06, 1 place Igor Stravinsky, 75004, Paris, France
| |
Collapse
|
40
|
Zielhorst T, van den Brule D, Visch V, Melles M, van Tienhoven S, Sinkbaek H, Schrieken B, Tan ESH, Lange A. Using a digital game for training desirable behavior in cognitive-behavioral therapy of burnout syndrome: a controlled study. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2015; 18:101-11. [PMID: 25684611 DOI: 10.1089/cyber.2013.0690] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Burnout is a globally increasing illness, and as a result, many forms of burnout therapy have arisen. The use of digital games can be psychotherapeutically effective because they can transform exercises that are by themselves unattractive into intrinsically motivated action. This pilot study aims to test whether a specially designed game contributes to patients learning desired behavior and achieving other specific therapeutic goals in an online cognitive-behavioral therapy (CBT)-based burnout treatment context. In total, 101 participants took part in the experiment, under four conditions: (a) Game+Therapy, (b) Therapy Only, (c) Game Only, and (d) No Game+No Therapy. Pre- and postmeasures were taken online. Results showed that the two therapy conditions (Game+Therapy and Therapy Only) showed a greater decrease in complaints and disengagement, and a stronger increase in coping skills than the nontherapy conditions (Game Only and No Game+No Therapy). As expected, the Game+Therapy condition outperformed the Therapy Only condition on combined improvement measures of burnout symptoms. However, analyses of individual measures showed no effects. It can be cautiously concluded that the therapeutic digital game may be a useful tool when embedded in a therapeutic burnout treatment program and is probably more efficient than CBT, as it is used in current practice.
Collapse
Affiliation(s)
- Thomas Zielhorst
- 1 Department of Communication Science, University of Amsterdam , Amsterdam, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Peperkorn HM, Diemer J, Mühlberger A. Temporal dynamics in the relation between presence and fear in virtual reality. COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2015.02.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
42
|
Diemer J, Alpers GW, Peperkorn HM, Shiban Y, Mühlberger A. The impact of perception and presence on emotional reactions: a review of research in virtual reality. Front Psychol 2015; 6:26. [PMID: 25688218 PMCID: PMC4311610 DOI: 10.3389/fpsyg.2015.00026] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 01/07/2015] [Indexed: 11/13/2022] Open
Abstract
Virtual reality (VR) has made its way into mainstream psychological research in the last two decades. This technology, with its unique ability to simulate complex, real situations and contexts, offers researchers unprecedented opportunities to investigate human behavior in well controlled designs in the laboratory. One important application of VR is the investigation of pathological processes in mental disorders, especially anxiety disorders. Research on the processes underlying threat perception, fear, and exposure therapy has shed light on more general aspects of the relation between perception and emotion. Being by its nature virtual, i.e., simulation of reality, VR strongly relies on the adequate selection of specific perceptual cues to activate emotions. Emotional experiences in turn are related to presence, another important concept in VR, which describes the user’s sense of being in a VR environment. This paper summarizes current research into perception of fear cues, emotion, and presence, aiming at the identification of the most relevant aspects of emotional experience in VR and their mutual relations. A special focus lies on a series of recent experiments designed to test the relative contribution of perception and conceptual information on fear in VR. This strand of research capitalizes on the dissociation between perception (bottom–up input) and conceptual information (top-down input) that is possible in VR. Further, we review the factors that have so far been recognized to influence presence, with emotions (e.g., fear) being the most relevant in the context of clinical psychology. Recent research has highlighted the mutual influence of presence and fear in VR, but has also traced the limits of our current understanding of this relationship. In this paper, the crucial role of perception on eliciting emotional reactions is highlighted, and the role of arousal as a basic dimension of emotional experience is discussed. An interoceptive attribution model of presence is suggested as a first step toward an integrative framework for emotion research in VR. Gaps in the current literature and future directions are outlined.
Collapse
Affiliation(s)
- Julia Diemer
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Regensburg Regensburg, Germany
| | - Georg W Alpers
- Chair of Clinical and Biological Psychology and Psychotherapy, Mannheim School of Social Sciences, University of Mannheim Mannheim, Germany
| | | | - Youssef Shiban
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Regensburg Regensburg, Germany
| | - Andreas Mühlberger
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Regensburg Regensburg, Germany
| |
Collapse
|
43
|
Ling Y, Nefs HT, Morina N, Heynderickx I, Brinkman WP. A meta-analysis on the relationship between self-reported presence and anxiety in virtual reality exposure therapy for anxiety disorders. PLoS One 2014; 9:e96144. [PMID: 24801324 PMCID: PMC4011738 DOI: 10.1371/journal.pone.0096144] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 04/03/2014] [Indexed: 11/18/2022] Open
Abstract
In virtual reality exposure therapy (VRET) for anxiety disorders, sense of presence in the virtual environment is considered the principal mechanism that enables anxiety to be felt. Existing studies on the relation between sense of presence and level of anxiety, however, have yielded mixed results on the correlation between the two. In this meta-analysis, we reviewed publications on VRET for anxiety that included self-reported presence and anxiety. The comprehensive search of the literature identified 33 publications with a total of 1196 participants. The correlation between self-reported sense of presence and anxiety was extracted and meta-analyzed. Potential moderators such as technology characteristics, sample characteristics including age, gender and clinical status, disorder characteristics and study design characteristics such as measurements were also examined. The random effects analysis showed a medium effect size for the correlation between sense of presence and anxiety (r = .28; 95% CI: 0.18-0.38). Moderation analyses revealed that the effect size of the correlation differed across different anxiety disorders, with a large effect size for fear of animals (r = .50; 95% CI: 0.30-0.66) and a no to small effect size for social anxiety disorder (r = .001; 95% CI: -0.19-0.19). Further, the correlation between anxiety and presence was stronger in studies with participants who met criteria for an anxiety disorder than in studies with a non-clinical population. Trackers with six degrees of freedom and displays with a larger field of view resulted in higher effect sizes, compared to trackers with three degrees of freedom and displays with a smaller field of view. In addition, no difference in effect size was found for the type of presence measurement and the type of anxiety measurement. This meta-analysis confirms the positive relation between sense of presence and anxiety and demonstrates that this relation can be affected by various moderating factors.
Collapse
Affiliation(s)
- Yun Ling
- Interactive Intelligence Group, Delft University of Technology, Delft, the Netherlands
| | - Harold T. Nefs
- Interactive Intelligence Group, Delft University of Technology, Delft, the Netherlands
| | - Nexhmedin Morina
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Ingrid Heynderickx
- Human Technology Interaction Group, Eindhoven University of Technology, Eindhoven, the Netherlands
- Visual Experiences Group, Philips Research Laboratories, Eindhoven, the Netherlands
| | - Willem-Paul Brinkman
- Interactive Intelligence Group, Delft University of Technology, Delft, the Netherlands
| |
Collapse
|
44
|
Stinson C, Bowman DA. Feasibility of training athletes for high-pressure situations using virtual reality. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2014; 20:606-615. [PMID: 24650988 DOI: 10.1109/tvcg.2014.23] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Virtual reality (VR) has been successfully applied to a broad range of training domains; however, to date there is little research investigating its benefits for sport psychology training. We hypothesized that using high-fidelity VR systems to display realistic 3D sport environments could trigger anxiety, allowing resilience-training systems to prepare athletes for real-world, highpressure situations. In this work we investigated the feasibility and usefulness of using VR for sport psychology training. We developed a virtual soccer goalkeeping application for the Virginia Tech Visionarium VisCube (a CAVE-like display system), in which users defend against simulated penalty kicks using their own bodies. Using the application, we ran a controlled, within-subjects experiment with three independent variables: known anxiety triggers, field of regard, and simulation fidelity. The results demonstrate that a VR sport-oriented system can induce increased anxiety (physiological and subjective measures) compared to a baseline condition. There were a number of main effects and interaction effects for all three independent variables in terms of the subjective measures of anxiety. Both known anxiety triggers and simulation fidelity had a direct relationship to anxiety, while field of regard had an inverse relationship. Overall, the results demonstrate great potential for VR sport psychology training systems; however, further research is needed to determine if training in a VR environment can lead to long-term reduction in sport-induced anxiety.
Collapse
|
45
|
Felnhofer A, Kothgassner OD, Hetterle T, Beutl L, Hlavacs H, Kryspin-Exner I. Afraid to be there? Evaluating the relation between presence, self-reported anxiety, and heart rate in a virtual public speaking task. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2014; 17:310-6. [PMID: 24605993 DOI: 10.1089/cyber.2013.0472] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The link between anxiety and presence in a virtual environment (VE) is still a subject of an unresolved debate, with little empirical research to support theoretical claims. Thus, the current study analyzed presence, self-reported anxiety, and a physiological parameter (heart rate [HR]) in a sample of 30 high anxious and 35 low anxious participants. Both groups delivered a 5 minute speech in a virtual lecture hall. Results indicate no mediating influences of presence on group differences in self-reported state anxiety during the speech, but point toward negative correlations between state anxiety and the iGroup Presence Questionnaire (IPQ) scales "sense of being there" and "realism." Furthermore, HR was found to be unrelated to self-reported presence. Only the IPQ scale "spatial presence" showed a marginally significant influence on group differences in state anxiety. The present results support the assumption that presence and anxiety are logically distinct, meaning that presence does not directly influence the intensity of an emotion felt in a VE. Rather, it constitutes a precondition for an emotion to be at all elicited by a VE. Also, HR has proven to be no adequate substitute measure for presence, since it only assesses anxiety not presence. It may, however, mediate the interplay between trait anxiety and state anxiety. Possible implications of the current findings are discussed alongside the problem of using presence questionnaires that seem to be prone to subjective bias (i.e., participants confusing presence and emotion).
Collapse
Affiliation(s)
- Anna Felnhofer
- 1 Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna , Vienna, Austria
| | | | | | | | | | | |
Collapse
|
46
|
Bouchard S. Could virtual reality be effective in treating children with phobias? Expert Rev Neurother 2014; 11:207-13. [DOI: 10.1586/ern.10.196] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
47
|
Smith SP, Stibric M, Smithson D. Exploring the effectiveness of commercial and custom-built games for cognitive training. COMPUTERS IN HUMAN BEHAVIOR 2013. [DOI: 10.1016/j.chb.2013.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
48
|
Diemer J, Domschke K, Mühlberger A, Winter B, Zavorotnyy M, Notzon S, Silling K, Arolt V, Zwanzger P. Acute anxiolytic effects of quetiapine during virtual reality exposure--a double-blind placebo-controlled trial in patients with specific phobia. Eur Neuropsychopharmacol 2013; 23:1551-60. [PMID: 23375006 DOI: 10.1016/j.euroneuro.2013.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 12/04/2012] [Accepted: 01/05/2013] [Indexed: 01/09/2023]
Abstract
Anxiety disorders are among the most frequent psychiatric disorders. With regard to pharmacological treatment, antidepressants, the calcium modulator pregabalin and benzodiazepines are recommended according to current treatment guidelines. With regard to acute states of anxiety, so far practically only benzodiazepines provide an immediate anxiolytic effect. However, the risk of tolerance and dependency limits the use of this class of medication. Therefore, there is still a need for alternative pharmacologic strategies. Increasing evidence points towards anxiety-reducing properties of atypical antipsychotics, particularly quetiapine. Therefore, we aimed to evaluate the putative acute anxiolytic effects of this compound, choosing the induction of acute anxiety in patients with specific phobia as a model for the evaluation of ad-hoc anxiolytic properties in a proof-of-concept approach. In a randomized, double-blind, placebo-controlled study, 58 patients with arachnophobia were treated with a single dose of quetiapine XR or placebo prior to a virtual reality spider challenge procedure. Treatment effects were monitored using rating scales for acute anxiety as well as measurements of heart rate and skin conductance. Overall, quetiapine showed significant anxiolytic effects compared to placebo. However, effects were not seen on the primary outcome measure (VAS Anxiety), but were limited to somatic anxiety symptoms. Additionally, a significant reduction of skin conductance was observed. Further exploratory analyses hint towards a mediating role of the (COMT) val158met genotype on treatment response. The present results thus suggest a possible suitability of quetiapine in the acute treatment of anxiety, particularly with regard to somatic symptoms.
Collapse
Affiliation(s)
- Julia Diemer
- Department of Psychiatry, University of Muenster, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Suied C, Drettakis G, Warusfel O, Viaud-Delmon I. Auditory-visual virtual reality as a diagnostic and therapeutic tool for cynophobia. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:145-52. [PMID: 23425570 DOI: 10.1089/cyber.2012.1568] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Traditionally, virtual reality (VR) exposure-based treatment concentrates primarily on the presentation of a high-fidelity visual experience. However, adequately combining the visual and the auditory experience provides a powerful tool to enhance sensory processing and modulate attention. We present the design and usability testing of an auditory-visual interactive environment for investigating VR exposure-based treatment for cynophobia. The specificity of our application involves 3D sound, allowing the presentation and spatial manipulations of a fearful stimulus in the auditory modality and in the visual modality. We conducted an evaluation test with 10 participants who fear dogs to assess the capacity of our auditory-visual virtual environment (VE) to generate fear reactions. The specific perceptual characteristics of the dog model that were implemented in the VE were highly arousing, suggesting that VR is a promising tool to treat cynophobia.
Collapse
Affiliation(s)
- Clara Suied
- UMR STMS IRCAM-CNRS-UPMC, 1 place Igor Stravinsky, Paris, France.
| | | | | | | |
Collapse
|
50
|
Ling Y, Nefs HT, Brinkman WP, Qu C, Heynderickx I. The relationship between individual characteristics and experienced presence. COMPUTERS IN HUMAN BEHAVIOR 2013. [DOI: 10.1016/j.chb.2012.12.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|