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

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

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

Enhancing in vivo exposure in the treatment of panic disorder and agoraphobia using location-based technologies: a case study

Abstract Panic disorder (PD) is quite prevalent and often appears along with agoraphobia (PD/A). The treatment of choice is cognitive behavioral therapy (CBT). Transdiagnostic intervention, an emotion-focused, cognitive behavioral intervention that has led to the Unified Protocol (UP), emphasizes the common underlying mechanisms that contribute to the development and maintenance of emotional disorders such as PD/A. A core feature of this treatment approach is in vivo exposure (IVE) to feared situations, which aims to prevent avoidance behaviors and encourages the patient to confront feared situations gradually. It is a difficult component for patients, especially when implementing the exposure on their own. Different feedback formats can be used to increase adequate IVE and reduce overt or subtle avoidance. The use of smartphones is a very useful option to initiate and sustain exposure behavior. The purpose of this study is to describe the use of location-based technologies (LBTs) during the IVE component of the UP treatment of a 47-year-old patient with PD/A. The acceptability and usability of the system were assessed. The Symptoms platform was employed during the exposure module, using LBT with a smartphone app. The patient reported positive expectations, high satisfaction scores, and an overall satisfactory experience. Enhancing key therapeutic components during treatment through the development of media-based tools is a very promising future research aim, and the possibility of using advanced smartphone features should be explored

Pharmacotherapy of panic disorder

Panic disorder (PD) is a common, persistent and disabling mental disorder. It is often associated with agoraphobia. The present article reviews the current status of pharmacotherapy for PD with or without agoraphobia as well as the current status of treatments combing pharmacotherapy with cognitive behavior therapy (CBT). The review has been written with a focus on randomized controlled trials, meta-analyses, and reviews that have been published over the past few years. Effective pharmacological treatments include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and various benzodiazepines. Treatment results obtained with CBT compare well with pharmacotherapy, with evidence that CBT is at least as effective as pharmacotherapy. Combining pharmacotherapy with CBT has been found to be superior to antidepressant pharmacotherapy or CBT alone, but only in the acute-phase treatment. Long term studies on treatments combining pharmacotherapy and CBT for PD with or without agoraphobia have found little benefit, however, for combination therapies versus monotherapies. New investigations explore the potential additional value of sequential versus concomitant treatments, of cognitive enhancers and virtual reality exposure therapy, and of education, self management and Internet-based interventions

Cyberbullying and traditional bullying in relation with adolescents’ perception of parenting

This study investigates the relation between parenting and involvement in cyberbullying. We predicted that cyberbullies and cyberbully-victims report less responsiveness and de manding reactions from their parents than victims and youthswho are not involved in cyberbullying. Furthermore, we predicted that youths with neglectful parents cyberbully the most often and youth with authoritative parents cyberbully the least. The same differences were predicted for traditional bullying. behavio and for youth involved in both forms of bullying behavior. Participants were made up to 1200 youths from 10-14 years old. They responded to a survey measuring cyberbullying and traditional bullying with questions based on the sub-scales from the Bully?Victim Questionnaire, and parenting with an adjusated version of the Parenting Style Questionnaire. Most results confirm out predictions. Results on authoritative, autoritarian, permissive and neglectful parenting styles suggest that for bullies, demanding actions are an important dimension of thier behavior and for victims, responsiveness is an important dimension of their behavior