Exposição por Realidade Virtual no Tratamento do Medo de Dirigir

A growing number of researches has appeared on virtual reality exposure therapy (VRET) to treat anxiety disorders. The purpose of this article was to review some evidences that support the VRET efficacy to treat driving phobia. The studies were identified through computerized search (PubMed/Medline, Web of Science, and Scielo databases) from 1984 to 2007. Some findings are promising. Anxiety/avoidance ratings declined from pre to post-treatment. VRET may be used as a first step in the treatment of driving phobia, as long as it may facilitate the in vivo exposure, thus reducing risks and high costs of such exposure. Notwithstanding, more randomized/controlled clinical trials are required to prove its efficacy.Um crescente número de pesquisas têm surgido sobre a aplicação da terapia de exposição por realidade virtual (VRET) para transtornos ansiosos. O objetivo deste estudo foi revisar algumas evidências que apoiam a eficácia da VRET para tratar fobia de dirigir. Os estudos foram identificados por meio de buscas computadorizadas (PubMed/Medline, Web of Science e Scielo databases) no período de 1984 a 2007. Alguns achados são promissores. Índices de ansiedade/evitação caíram entre o início e o fim do tratamento. VRET poderia ser um primeiro passo no tratamento da fobia de dirigir, uma vez que pode facilitar a exposição ao vivo, evitando-se os riscos e elevados custos dessa exposição. Entretanto, mais estudos clínicos randomizados/controlados são necessários para comprovar sua eficácia. &nbsp

Playmancer project: a serious videogame as an additional therapy tool for eating and impulse control disorders

Reviews and few non-controlled studies showed the effectiveness of several specific designed computer video-games as an additional form of treatment in several areas. However, there is a lack in the literature of specially designed serious-games for treating mental disorders. Playmancer (ICT European initiative) aims to develop and assess a serious videogame that may help to treat underlying processes (e.g. lack of self-control strategies) in Eating and Impulse control disorders. Preliminary data will be shown

Virtual Reality for Obsessive-Compulsive Disorder: Past and the Future

The use of computers, especially for virtual reality (VR), to understand, assess, and treat various mental health problems has been developed for the last decade, including application for phobia, post-traumatic stress disorder, attention deficits, and schizophrenia. However, the number of VR tools addressing obsessive-compulsive disorder (OCD) is still lacking due to the heterogeneous symptoms of OCD and poor understanding of the relationship between VR and OCD. This article reviews the empirical literatures for VR tools in the future, which involve applications for both clinical work and experimental research in this area, including examining symptoms using VR according to OCD patients' individual symptoms, extending OCD research in the VR setting to also study behavioral and physiological correlations of the symptoms, and expanding the use of VR for OCD to cognitive-behavioral intervention

Impact of an interactive anti-speeding threat appeal: how much threat is too much?

This study investigates the impact of an interactive television public service announcement (PSA) containing an anti-speeding threat appeal on feelings of telepresence and behavioral intention. In a 2 x 2 x 2 between-subjects factorial design with 213 participants, the level of threat evoked by a traditional PSA, by the interactive part of the PSA (dedicated advertising location) and by the preceding program context are manipulated to be either low or high. The results support the assumptions of the Extended Parallel Processing Model with regard to the effect of the level of perceived threat and perceived efficacy in an interactive media environment, and the important role of telepresence as a processing variable. The results of the three-way interaction effect of threat evoked by the program, the PSA, and the DAL on telepresence show that when the threat levels of the program and the PSA are both either low or high, exposure to the threatening information in the DAL does not generate a significantly higher feeling of telepresence. However, when a low-threat program is followed by a high-threat PSA, the threat level of the DAL has a positive effect on telepresence. The same trend is found with a high-threat program and a low-threat PSA, although the effect of the threat evoked by the DAL on telepresence is not significant at conventional levels. Finally, there is a positive effect of telepresence on the behavioral intention to reduce speeding which is partly mediated by the viewer‟s perceived efficacy to follow the recommended behavior

Action-centered exposure therapy (ACET): a new approach to the use of virtual reality to the care of people with post-traumatic stress disorder

Post-Traumatic Stress Disorder (PTSD) can be seen as the result of dysfunctional beliefs that associate stimuli with a danger or a threat leading to anxious reactions. Exposure therapy is so far considered to be the most effective treatment, and research suggests that it is mainly based on a habituation process. Based on learning theories, it appears that a passive systemic exposure to traumatic stimuli should not be the best option for the treatment of PTSD. We hypothesis that an active learning of safer and healthier coping strategies combined with systematic exposure should be more effective in reducing the psychological distress associated with PTSD. In this paper, we describe the theoretical foundations of this approach that focuses on the action and activity of the patient in his or her exposure environment. In this approach, we take advantage of Virtual Reality technologies and learning mechanics of serious games to allow the patient to learn new safe associations while promoting the empowerment. We named this action-centered exposure therapy (ACET). This approach exploits behaviorism, cognitivism, and constructivism learning theories. With the different benefits of virtual reality technologies, this approach would easily integrate with in-virtuo exposure therapy and would allow us to exploit as much as possible the enormous potential of these technologies. As a first step toward validation, we present a case study that supports the ACET approach

Terapia por meio de exposição à realidade virtual para medo e fobia de dirigir: uma revisão da literatura

Virtual reality exposure therapy (VRET) is an increasing method of intervention for specific phobias, and can be part of psychotherapy for fear and driving phobia. This review examined the research methods on VRET for fear and driving phobia. The databases Web of Science, PubMed, Medline PsycNet - APA, SciELO, PePsi and IEEE Xplore Digital Library were consulted, regarding the period of January 2000 and October 2014. The search terms were: virtual reality exposure therapy, virtual reality, driving phobia, and driving fear. Searches yielded 1876 articles, and of these, eight articles met de inclusion criteria. Assessments before, during and after the intervention were applied in all studies, except in one of them. Scenarios hierarchies were applied, starting with the less complex, which caused less anxiety, until reaching the most complex ones, which generated more difficulty of coping. The therapeutic procedures were briefly described with an insufficient number of data for systematic replication. This allows emphasize the need for future research that report detailed therapeutic procedures.La terapia de exposición de realidad virtual (VRET) es un método creciente de la intervención para las fobias específicas y puede ser parte de la psicoterapia para el miedo y la fobia a conducir. Esta revisión examinó los métodos de investigación sobre VRET para el miedo y la fobia a conducir a partir de las bases de datos: Web of Science, PubMed, MedlinePsycNet-APA, SciELO, Pepsi y IEEE Xplore Digital Library, considerando el periodo enero de 2000 a octubre de 2014. Los términos de la búsqueda fueron: virtual reality exposure therapy, virtual reality, driving phobia y driving fear. Las búsquedas identificaron 1876 artículos y, de estos, 8 cumplieron los criterios de inclusión. Evaluaciones antes, durante y después de la intervención se aplicaron en todo, excepto en un estudio. Se aplicaron jerarquías de escenarios, comenzando con lo que causó menos ansiedad hasta llegar a la que genera más dificultad de afrontamiento. Los procedimientos terapéuticos se describieron brevemente con un número insuficiente de datos para replicaciones sistemáticas. Esto permite hacer hincapié en la necesidad de futuras investigaciones que reporten procedimientos terapéuticos detallados.A terapia de exposição por meio de realidade virtual (VRET) é um método de intervenção crescente para fobias específicas e pode ser parte da psicoterapia de medo e fobia de dirigir. Esta revisão examinou os métodos de pesquisa sobre VRET para medo e fobia de dirigir. As bases de dados Web of Science, PubMed, MedlinePscyNet-APA, Scielo, PePsic e IEE Xplore Digital Library foram consultadas, considerando o período de janeiro de 2000 a outubro de 2014. Os descritores da busca foram: virtual reality exposure therapy, virtual reality, driving phobia, and driving fear. As buscas identificaram 1876 artigos e, desses, oito artigos alcançaram os critérios de inclusão. Avaliações antes, durante e depois da intervenção foram realizadas em todos, exceto em um dos estudos. Hierarquias de cenários foram aplicadas, iniciando com as que causavam menos ansiedade, até chegar as que geravam maior dificuldade de enfrentamento. Os procedimentos terapêuticos foram descritos sucintamente com um número insuficiente de dados para replicações sistemáticas. Isso permite enfatizar a necessidade de pesquisas que relatem os procedimentos terapêuticos com detalhes

Immersive Virtual Reality Training Improved Upper Extremity Function in Patients with Spinal Cord Injuries: A Case Series

Virtual reality (VR) is an emerging treatment tool to engage people in environments that appear and feel similar to real-world objects and events.1 There are various levels of evidence that VR can potentially promote functional activity and neuroplasticity in patients with neurological disorders like spinal cord injury (SCI).2,3 In this case series, we explored the feasibility of using commercially available immersive VR technology as an augmented treatment in the SCI population and compare participant’s suitability for this intervention. Three male SCI participants were recruited in a subacute inpatient rehabilitation facility and participated in VR intervention twice a week in addition to their conventional therapies. Manual strength and functional testing were recorded biweekly until participants discharged. Training includes reaching activities, wrist rotation, gripping, and thumb movement to simulate real-life activities. A questionnaire regarding their experience with VR training was administered at the end. All participants had improvement in strength and functional tests. 9-hole peg test demonstrated clinically meaningful change in two of three participants. Manual muscle test changes were 2, 4.5 and 13.5 points individually. Participants with lower manual muscle test scores at baseline showed more potential to change compared to those who had high scores, which would possibly due to plateau effect. Pinch and grip strength demonstrated small changes which were not clinically important. Participants also rated VR technology of high reality level and great enjoyment in the questionnaire. This case series suggests that immersive VR with head mount display may be viable to provide safe and effective treatment for patients with SCI. VR training appears to be a possible adjunct to physical and occupational therapy as a method of muscle strengthening, improving upper extremity function and improving motivation during subacute rehabilitation

Using Microsoft HoloLens to improve memory recall in anatomy and physiology: A pilot study to examine the efficacy of using augmented reality in education

This paper explores the use of augmented reality (AR) to improve memory recall and learning experiences in human anatomy and physiology. In particular, the opportunity to assess new computer technologies to improve learning environments may allow for an improvement in self-efficacy and a reduction in test anxiety. Twenty-two undergraduates participated in one of two study groups, the Microsoft HoloLens group (HLNS) or the traditional projector-based Microsoft Power Point group (PPT). Each group completed a five-minute, three-subject anatomy identification and brain physiology memory test. After a three-minute time delay, participants completed a fill-in-the-blank anatomy identification test and brain physiology question test, followed by questionnaires for systems self-efficacy and test anxiety. Results indicated the PPT group significantly outperformed the HLNS group in the brain lobe identification portion of the exam and had reported higher mean test anxiety scores (though not high enough to be considered unhealthy levels). However, the HLNS group showed a significantly higher preference to the learning experience compared to the PPT group based on the systems self-efficacy questionnaire. This pilot study demonstrates an opportunity for the HLNS to use used in learning environments to improve the psychological aspects of studying and test taking

Exploring Predictors of Older Adults\u27 Performance on a Novel Driving Simulator Task

On a per-mile driven basis, older adults are at increased risk of being involved in an automobile accident. The development and implementation of driving assessment tools is necessary to inform decisions about driving reduction and cessation. Driving simulators are one method of assessing driving performance and safety, however many simulators are cost-prohibitive for most researchers and clinicians. Additionally, while driving performance has been previously explored with respect to clinical populations (e.g., Alzheimer’s Disease), less work has evaluated this topic in a cognitively healthy sample. The present study sought to determine whether a novel, cost-effective driving simulator (Assetto Corsa (AC)) might be useful in the evaluation of driving performance in a sample of cognitively healthy older adults. A total of 53 participants completed a battery of paper-and-pencil and computerized cognitive performance measures and self-reports regarding their driving safety and behaviors, and a subset of participants (n = 35) completed the driving simulator task. Hierarchical regressions revealed that paper-and-pencil measures of simple attention and executive functioning and a computerized measure of processing speed were associated with aspects of driving simulator performance. Pearson correlation coefficients revealed that lower self-rated driving was associated with slower completion of the simulator task, and decrements in several cognitive domains were associated with greater self-reported difficulty driving in various conditions, greater aberrant driving behaviors, and higher likelihood of having legal difficulties as a result of driving (e.g., traffic tickets). Implications for future work are discussed