The use of virtual reality in the treatment of eating disorders

A high percentage of patients with eating disorders (ED) respond to treatments such as cognitive-behavioural therapy. However, some patients do not progress significantly with these treatments, or suffer relapses. The incorporation of new technologies may help to increase the efficacy of standard treatments. Virtual reality has been successfully used to treat body image disturbances in ED patients and seems a suitable technology for cue exposure therapy in this setting. We review the published literature and discuss the results

The use of virtual reality in the study, assessment, and treatment of body image in eating disorders and nonclinical samples: A review of the literature

This article reviews research into the use of virtual reality in the study, assessment, and treatment of body image disturbances in eating disorders and nonclinical samples. During the last decade, virtual reality has emerged as a technology that is especially suitable not only for the assessment of body image disturbances but also for its treatment. Indeed, several virtual environment-based software systems have been developed for this purpose. Furthermore, virtual reality seems to be a good alternative to guided imagery and in vivo exposure, and is therefore very useful for studies that require exposure to life-like situations but which are difficult to conduct in the real world. Nevertheless, review highlights the lack of published controlled studies and the presence of methodological drawbacks that should be considered in future studies. This article also discusses the implications of the results obtained and proposes directions for future research

Technology use in the treatment and prevention of eating disorders

Technology is changing rapidly in this global world. A radically different delivery of nutrition information and counseling is technologically feasible in fewer than five years. With about half of girls and a quarter of boys being dissatisfied with their bodies during adolescence into young adulthood, some negative consequences including development of disordered eating, eating disorders (ED) and poor psychological well-being may increase. New methods of delivery, from social media to virtual worlds will allow health care providers (HCP) to reach and interact with patients in different cities or even countries. Simple tweets to online videos may have a place in the near future of treatment and prevention of eating disorders. PURPOSE: The purpose of this formative, mixed method, two-phase research study was to examine the usage, usefulness, effectiveness and convenience of technologies utilized by health care providers (HCP) in eating disorder (ED) treatment programs. METHODS: In phase one, HCP currently working with ED patients were intensively recruited to complete an online survey on technology usage, usefulness, effectiveness, and convenience in ED treatment programs; followed by a second phase where focus groups were conducted on discussion of technology use, hindrance or asset when working with patients, how demographics effect the use of technology, whether technology aided in ED outcomes, and privacy concerns. RESULTS: Participants (N=54) completing the survey represented various disciplines (e.g., 40% Registered Dietitians (RD), 35% school counselors, 10% physicians), and mostly worked in private practice (38%) or a college setting (33%). Technology use reported were email (62%), text messaging (36%), smartphone apps (34%), CD-ROM /DVD (18%), internet-based programs (16%), and virtual reality (7%). Additionally, both email and text messaging were reported as the most convenient technologies used in ED treatment programs. Focus groups (n=9) discussion points were divided into similar practice environments (private practice or university). CONCLUSION: Findings suggest that HCP use a smorgasbord of technologies in ED treatment programs and find them useful, effective, and convenient. Further there is interest on the part of the HCP to utilize technologies; however a lack of knowledge about available technologies limits use. General attitude about technology `it can be a useful tool for integrating into ED treatment plans when it is tailored directly to the client\u27s needs\u27. LIMITATIONS: Smaller sample then anticipated in both parts of the formative research with a small representation of the different health care practitioners including dietitians

Technology in Practice (Section 2.31 of the Comprehensive Clinical Psychology: Vol. 2. Professional Issues)

The contemporary practice of psychology requires a prudent balance of traditional and emerging communication methods. Interpersonal interactions in the context of human relationship (e.g., speech, emotional expressions, and nonverbal gestures) have been a vital part of emotional healing throughout many centuries, and research findings in the 1990s underscore the importance of relational factors in effective psychological interventions (Whiston & Sexton, 1993). In addition to the time honored interpersonal communication methods of professional psychology, rapid technological advances have propelled psychologists into another sphere of communication. Today\u27s professional psychologist is increasingly expected to attain mastery in both of these communication methods-the very old and the very new

A Review into eHealth Services and Therapies: Potential for Virtual Therapeutic Communities - Supporting People with Severe Personality Disorder

eHealth has expanded hugely over the last fifteen years and continues to evolve, providing greater benefits for patients, health care professionals and providers alike. The technologies that support these systems have become increasingly more sophisticated and have progressed significantly from standard databases, used for patient records, to highly advanced Virtual Reality (VR) systems for the treatment of complex mental health illnesses. The scope of this paper is to initially explore e-Health, particularly in relation to technologies supporting the treatment and management of wellbeing in mental health. It then provides a case study of how technology in e-Health can lend itself to an application that could support and maintain the wellbeing of people with a severe mental illness. The case study uses Borderline Personality Disorder as an example, but could be applicable in many other areas, including depression, anxiety, addiction and PTSD. This type of application demonstrates how e-Health can empower the individuals using it but also potentially reducing the impact upon health care providers and services.Comment: Book chapte

The words of the body: psychophysiological patterns in dissociative narratives

Trauma has severe consequences on both psychological and somatic levels, even affecting the genetic expression and the cell\u2019s DNA repair ability. A key mechanism in the understanding of clinical disorders deriving from trauma is identified in dissociation, as a primitive defense against the fragmentation of the self originated by overwhelming experiences. The dysregulation of the interpersonal patterns due to the traumatic experience and its detrimental effects on the body are supported by influent neuroscientific models such as Damasio\u2019s somatic markers and Porges\u2019 polyvagal theory. On the basis of these premises, and supported by our previous empirical observations on 40 simulated clinical sessions, we will discuss the longitudinal process of a brief psychodynamic psychotherapy (16 sessions, weekly frequency) with a patient who suffered a relational trauma. The research design consists of the collection of self-report and projective tests, pre-post therapy and after each clinical session, in order to assess personality, empathy, clinical alliance and clinical progress, along with the verbatim analysis of the transcripts trough the Psychotherapy Process Q-Set and the Collaborative Interactions Scale. Furthermore, we collected simultaneous psychophysiological measures of the therapeutic dyad: skin conductance and hearth rate. Lastly, we employed a computerized analysis of non-verbal behaviors to assess synchrony in posture and gestures. These automated measures are able to highlight moments of affective concordance and discordance, allowing for a deep understanding of the mutual regulations between the patient and the therapist. Preliminary results showed that psychophysiological changes in dyadic synchrony, observed in body movements, skin conductance and hearth rate, occurred within sessions during the discussion of traumatic experiences, with levels of attunement that changed in both therapist and the patient depending on the quality of the emotional representation of the experience. These results go in the direction of understanding the relational process in trauma therapy, using an integrative language in which both clinical and neurophysiological knowledge may take advantage of each other

Editorial: Positive Technology: Designing E-experiences for Positive Change

While there is little doubt that our lives are becoming increasingly digital, whether this change is for the better or for the worse is far from being settled. Rather, over the past years concerns about the personal and social impacts of technologies have been growing, fueled by dystopian Orwellian scenarios that almost on daily basis are generously dispensed by major Western media outlets. According to a recent poll involving some 1,150 experts, 47% of respondents predict that individuals’ well-being will bemore helped than harmed by digital life in the next decade, while 32% say people’s well-being will bemore harmed than helped. Only 21% of those surveyed indicated that the impact of technologies on people well-being will be negligible compared to now (Pew Research Center, 2018)

The mediating effect of self-esteem, depression and anxiety between satisfaction with body appearance and problematic Internet use

Background and objectives: Given that dissatisfaction with bodily appearance can sometimes lead to the avoidance of personal contacts and the increase of internet use, this study examines this relationship. The direct role of dissatisfaction with bodily appearance along with the possible mediation effects of depression, anxiety and self-esteem were tested. Methods: A total of 694 participants completed an online questionnaire (58.5% male, mean age 21.5 years), containing measures on problematic internet use, depression and anxiety symptoms, self-esteem and satisfaction with body image. Path analyses were used to test direct and indirect effects. Results: Satisfaction with body appearance had a significant negative direct effect on problematic internet use among both sexes. Though, satisfaction with body appearance had a positive effect on self-esteem and negative on anxiety, neither self-esteem nor anxiety had a direct significant effect on problematic internet use. The effect of dissatisfaction with body appearance was mediated via the self-esteem–depression path toward problematic internet use. Conclusions: Dissatisfaction with physical appearance seems to have a significant role in individuals’ immersing themselves in internet use

La realidad virtual como entorno fortalecedor para el cambio personal: la contribución del laboratorio de tecnología aplicada a la neuropsicología

When we exercise real choice, we gain increased control over our lives and are able to change ourselves. However for many subjects it is not easy to exercise effective choices: patients often don’t have the knowledge, skills, assertiveness, or self esteem needed. In this situation Virtual Reality (VR), an artificial reality that projects the user into a 3D space generated by the computer, may offer a critical advantage to the therapist. The enriched experience and the total level of control on its features, transform VR in an “empowering environment”, where patients can start to explore and act without feeling actually threatened. The attempt of defining, developing and testing VR tools supporting personal empowerment is the main goal of the Applied Technology for Neuro-Psychology Laboratory –ATN-P Lab– at the Istituto Auxologico Italiano. The paper describes the actual work done by the ATN-P Lab. in this area. Specifically, the open source "NeuroVR" system and its potential clinical applications –anxiety disorders, obesity and eating disorders– are presented and discussed.La capacidad de elección nos proporciona control sobre nuestras vidas y nos ofrece posibilidades de cambio. Sin embargo, para muchas personas no es fácil realizar elecciones efectivas; por ejemplo, los pacientes carecen muchas veces del conocimiento, la habilidad, la asertividad o autoestima necesarias. En esas situaciones, la realidad virtual (RV), una realidad artificial que coloca al sujeto en un espacio generado por el ordenador, puede ser para el terapeuta un recurso decisivo. La experiencia enriquecida y el control total sobre todos sus aspectos transforman la RV en un “entorno fortalecedor”, en el que los pacientes pueden comenzar a explorar y actuar sin sentirse amenazados. El principal objetivo del “Applied Technology for Neuro-Psychology Laboratory” (ATN-P Lab), perteneciente al Instituto Auxologico Italiano, es intentar definir, desarrollar y probar aplicaciones basadas en RV que faciliten el fortalecimiento personal. En este artículo se describe el trabajo que se viene realizando sobre este tema en ese laboratorio. Se presenta y discute, específicamente, el sistema de código abierto denominado “NeuroVR”, así como sus aplicaciones clínicas potenciales sobre los trastornos de ansiedad, la obesidad y los trastornos alimentarios