Virtual Reality and Anxiety Disorders Treatment: Evolution and Future Perspectives

Virtual reality (VR) is a technology that allows the simulation of different real-life situations on a tridimensional computer-generated environment where the user can interact with the environment as if he/she were the real world. VR has potential as an exposure technique for treating anxiety disorders because VR and real objects have similar characteristics, which creates the illusion that the user is immersed and engaged with objects in the real world. Regarding the efficacy of using virtual reality exposure-based therapy (VR-EBT), for more than two decades, there has been sufficient empirical evidence regarding VR-EBT for treating anxiety disorders. Finally, this chapter ends with some directions and perspectives for future VR-EBT developments and treatments protocols

Anxiety, Phobias, Treatment and Associated Costs: A Review

Anxiety disorders are the most commonly occurring mental disorders and understanding them is important. Learning theorists suggest that phobias, a type of anxiety disorder, are conditioned responses to unconditioned stimuli. Research supports the theory that extinction of these conditioned responses may actually be the learning of a new memory rather than the unlearning of an old memory. Mounting evidence also points to sleep as an important factor in learning and memory and research suggests that sleep plays a role in phobia-extinction. However, while the majority of evidence is supportive, it is far from all inclusive. Future research should be conducted to clarify the role that sleep plays in phobia-extinction. Sleep roles such as sleep latency, sleep duration, and sleep staging may all play a part in the process

Integrating Virtual Realities and Psychotherapy: SWOT Analysis on VR and MR Based Treatments of Anxiety and Stress-related Disorders

The use of virtual reality (VR) and mixed reality (MR) technology in clinical psychology is growing. Efficacious VR-based treatments for a variety of disorders have been developed. However, the field of technology-assisted psychotherapy is constantly changing with the advancement in technology. Factors such as interdisciplinary collaboration, consumer familiarity and adoption of VR products, and progress in clinical science all need to be taken into consideration when integrating virtual technologies into psychotherapies. We aim to present an overview of current expert opinions on the use of virtual technologies in the treatment of anxiety and stress-related disorders. An anonymous survey was distributed to a select group of researchers and clinicians, using an analytic framework known as Strengths, Weaknesses, Opportunities, and Threats (SWOT). Overall, the respondents had an optimistic outlook regarding the current use as well as future development and implementation of technology-assisted interventions. VR and MR psychotherapies offer distinct advantages that can overcome shortcomings associated with traditional therapy. The respondents acknowledged and discussed current limitations of VR and MR psychotherapies. They recommended consolidation of existing knowledge and encouraged standardisation in both theory and practice. Continued research is needed to leverage the strengths of VR and MR to develop better treatments

Évaluation de l'efficacité et des facteurs prédicteurs de l'exposition in virtuo et in vivo dans le traitement de l'arachnophobie

Dans la thérapie cognitive et comportementale, l'exposition demeure une des stratégies d'intervention les plus efficaces pour traiter les troubles anxieux et particulièrement la phobie spécifique (PS). L'application de l'exposition à l'aide de la réalité virtuelle offre la possibilité de faciliter l'exposition de par la variété et la rareté des stimuli, le contrôle des stimuli et la possibilité d'administrer l'intervention dans le bureau du thérapeute. Cette modalité d'application alternative à l'exposition in vivo doit être validée empiriquement afin d'évaluer son efficacité réelle et de justifier son utilisation. À cet effet, le présent programme de recherche compare deux modalités d'expositions, in vivo et in virtuo, dans le traitement de l'arachnophobie. L'expérimentation comprenant 32 participants a été faite selon un protocole d'essai clinique contrôlé avec assignation aléatoire et groupe contrôle. Les données indiquent que les deux types d'exposition semblent comparables en termes d'efficacité. Elles ne présentent pas de différences significativement sur 4 des 5 mesures de la peur des araignées. Dans la perspective d'offrir le traitement optimal selon les besoins de l'individu, le programme de recherche a porté également sur l'étude des facteurs pouvant prédire l'efficacité du traitement. Les données obtenues permettent d'observer que les individus ayant une perception favorable de leur traitement présentent moins de symptômes phobiques à la suite du traitement tout comme ceux occupant un emploi lors du traitement. Une intervention ciblant spécifiquement la perception du traitement pourrait donc potentiellement augmenter son efficacité. Occuper un emploi lors du traitement semble un prédicteur d'une plus grande diminution de symptômes suite au traitement. Ce prédicteur nécessiterait une évaluation plus poussée afin d'en comprendre ses effets et son fonctionnement. Le présent programme de recherche permet de conclure que la réalité virtuelle est une modalité d'intervention qui pourrait s'avérer un outil de traitement aussi efficace que l'exposition in vivo. Le développement de la réalité virtuelle comme modalité d'exposition s'avère une avenue d'intervention prometteuse qu'il faudrait continuer d'investir. De plus, les avantages de cette modalité pourraient en faire un traitement de choix \ud ______________________________________________________________________________ \ud MOTS-CLÉS DE L’AUTEUR : Réalité virtuelle, phobie spécifique, exposition in vivo, exposition in virtuo, araignée

How Avatar Customization Affects Fear in a Game-based Digital Exposure Task for Social Anxiety

The treatment of social anxiety through digital exposure therapy is challenging due to the cognitive properties of social anxiety-individuals need to be fully engaged in the task and feel themselves represented in the social situation; however, avatar customization has been shown to increase both engagement and social presence. In this paper, we harness techniques used in commercial games, and investigate how customizing self-representation in a novel digital exposure task for social anxiety influences the experience of social threat. In an online experiment with 200 participants, participants either customized their avatar or were assigned a predefined avatar. Participants then controlled the avatar through a virtual shop, where they had to solve a math problem, while a simulated audience within the virtual world observed them and negatively judged their performance. Our findings show that we can stimulate the fear of evaluation by others in our task, that fear is driven primarily by trait social anxiety, and that this relationship is strengthened for people higher in trait social anxiety. We provide new insights into the effects of customization in a novel therapeutic context, and embed the discussion of avatar customization into related work in social anxiety and human-computer interaction

Virtual Reality for Anxiety Disorders

Virtual reality is a relatively new exposure tool that uses three-dimensional computer-graphics-based technologies which allow the individual to feel as if they are physically inside the virtual environment by misleading their senses. As virtual reality studies have become popular in the field of clinical psychology in recent years, it has been observed that virtual-reality-based therapies have a wide range of application areas, especially on anxiety disorders. Studies indicate that virtual reality can be more realistic than mental imagery and can create a stronger feeling of ԰resenceԻ that it is a safer starting point compared to in vivo exposure; and that it can be applied in a more practical and controlled manner. The aim of this review is to investigate exposure studies based on virtual reality in anxiety disorders (specific phobias, panic disorder and agoraphobias, generalized anxiety disorder, social phobia), posttraumatic stress disorder and obsessive compulsive disorder