Widening the scope of virtual reality and augmented reality in dermatology

Virtual reality (VR) and augmented reality (AR) are making headlines, pushing the boundaries of educational experiences and applicability in a variety of fields. Medicine has seen a rapid growth of utilization of these devices for various educational and practical purposes. With respect to the field of dermatology, very few uses are discussed in the literature. We briefly present the current status of VR/AR with regard to this specialty

PhobiAR, an artefact of augmented reality to support the exposure therapy of specific phobias

Dissertação de mestrado integrado em Informatics EngineeringPhobia is a type of anxiety disorder defined by a persistent and excessive fear of an object or situation. Currently, exposure therapy is the most practiced method to treat phobias, although it comes with limitations. We can reduce these limitations by combining Augmented Reality techniques with exposure therapy. Its benefits are a decrease in costs, versatility of the process, and full control of the procedure by the therapist. As shown in multiple research, Augmented Reality has obtained interesting results in the therapy of psychological disorders serving as a foundation for the development of this project. The recent technological advances in the field also allowed for easier access to Augmented Reality which is accessible to use even in old smartphones. The goal of this Master’s dissertation was to develop an artefact in conjunction with psychologists who treat phobic patients, to create a program to support the therapy of phobias with a gradual exposure system. Their help was essential to understand the most important features needed for the platform. The platform was deployed in the informatics department servers, which could be accessed by everyone that had internet connection. Multiple psychologists were invited to test the platform by following a user guide created and give their technical feedback in the end. The results gathered were positive, which proves the viability of this system as an extension to the current methods by providing comfort and efficiency.A fobia é um tipo de transtorno de ansiedade definido por um medo persistente e excessivo de um objeto ou situação. Atualmente, o terapia de exposição é o método mais praticado para tratar fobias, embora com limitações. Estas limitações são reduzidas combinando técnicas de Realidade Aumentada com a terapia de exposição. Os seus benefícios são uma redução de custos, versatilidade do processo e controle total do procedimento pelo terapeuta. Como foi demostrado em várias pesquisas, a Realidade Aumentada obteve resultados interessantes no tratamento de distúrbios psicológicos, servindo de base para o desenvolvimento deste projeto. Os recentes avanços tecnológicos no campo permitem também um acesso fácil à Realidade Aumentada, acessível para uso mesmo em smartphones antigos. Nosso objetivo é desenvolver um artefato em conjunto com psicólogos que tratam de pacientes fóbicos, para criar um programa para apoiar o tratamento de fobias com um sistema de exposição gradual. A ajuda deles foi essencial para entender os recursos que são mais importantes para a plataforma. A plataforma foi colocada nos servidores do departamento de informática e podia ser acedida por qualquer pessoa que tivesse conexão à internet. Vários psicólogos foram convidados a testar a plataforma seguindo um guião criado e dando seu feedback técnico no final. Os resultados recolhidos foram positivos, o que comprova a viabilidade deste sistema como uma extensão dos métodos atuais providenciando conforto e eficiência

An Augmented Reality system for the treatment of phobia to small animals viewed via an optical see-through HMD. Comparison with a similar system viewed via a video see-through

This article presents an optical see-through (OST) Augmented Reality system for the treatment of phobia to small animals. The technical characteristics of the OST system are described, and a comparative study of the sense of presence and anxiety in a nonphobic population (24 participants) using the OST and an equivalent video see-though (VST) system is presented. The results indicate that if all participants are analyzed, the VST system induces greater sense of presence than the OST system. If the participants who had more fear are analyzed, the two systems induce a similar sense of presence. For the anxiety level, the two systems provoke similar and significant anxiety during the experiment. © Taylor & Francis Group, LLC.Juan, M.; Calatrava, J. (2011). An Augmented Reality system for the treatment of phobia to small animals viewed via an optical see-through HMD. Comparison with a similar system viewed via a video see-through. International Journal of Human-Computer Interaction. 27(5):436-449. doi:10.1080/10447318.2011.552059S436449275Azuma, R. and Bishop, G. Improving static and dynamic registration in an optical see-through HMD. Proceedings of 21st Annual Conference on Computer Graphics and Interactive techniques (SIGGRAPH'94). pp.197–204.Bimber, O., & Raskar, R. (2005). Spatial Augmented Reality. doi:10.1201/b10624Botella, C., Quero, S., Banos, R. M., Garcia-Palacios, A., Breton-Lopez, J., Alcaniz, M., & Fabregat, S. (2008). Telepsychology and Self-Help: The Treatment of Phobias Using the Internet. CyberPsychology & Behavior, 11(6), 659-664. doi:10.1089/cpb.2008.0012Botella, C. M., Juan, M. C., Baños, R. M., Alcañiz, M., Guillén, V., & Rey, B. (2005). Mixing Realities? An Application of Augmented Reality for the Treatment of Cockroach Phobia. CyberPsychology & Behavior, 8(2), 162-171. doi:10.1089/cpb.2005.8.162Carlin, A. S., Hoffman, H. G., & Weghorst, S. (1997). Virtual reality and tactile augmentation in the treatment of spider phobia: a case report. Behaviour Research and Therapy, 35(2), 153-158. doi:10.1016/s0005-7967(96)00085-xGarcia-Palacios, A., Hoffman, H., Carlin, A., Furness, T. ., & Botella, C. (2002). Virtual reality in the treatment of spider phobia: a controlled study. Behaviour Research and Therapy, 40(9), 983-993. doi:10.1016/s0005-7967(01)00068-7Genc, Y., Tuceryan, M., & Navab, N. (s. f.). Practical solutions for calibration of optical see-through devices. Proceedings. International Symposium on Mixed and Augmented Reality. doi:10.1109/ismar.2002.1115086Hoffman, H. G., Garcia-Palacios, A., Carlin, A., Furness III, T. A., & Botella-Arbona, C. (2003). Interfaces That Heal: Coupling Real and Virtual Objects to Treat Spider Phobia. International Journal of Human-Computer Interaction, 16(2), 283-300. doi:10.1207/s15327590ijhc1602_08Juan, M. C., Alcaniz, M., Monserrat, C., Botella, C., Banos, R. M., & Guerrero, B. (2005). Using Augmented Reality to Treat Phobias. IEEE Computer Graphics and Applications, 25(6), 31-37. doi:10.1109/mcg.2005.143Juan, M. C., Baños, R., Botella, C., Pérez, D., Alcaníiz, M., & Monserrat, C. (2006). An Augmented Reality System for the Treatment of Acrophobia: The Sense of Presence Using Immersive Photography. Presence: Teleoperators and Virtual Environments, 15(4), 393-402. doi:10.1162/pres.15.4.393Kato, H., & Billinghurst, M. (s. f.). Marker tracking and HMD calibration for a video-based augmented reality conferencing system. Proceedings 2nd IEEE and ACM International Workshop on Augmented Reality (IWAR’99). doi:10.1109/iwar.1999.803809Nash, E. B., Edwards, G. W., Thompson, J. A., & Barfield, W. (2000). A Review of Presence and Performance in Virtual Environments. International Journal of Human-Computer Interaction, 12(1), 1-41. doi:10.1207/s15327590ijhc1201_1Owen, C. B., Ji Zhou, Tang, A., & Fan Xiao. (s. f.). Display-Relative Calibration for Optical See-Through Head-Mounted Displays. Third IEEE and ACM International Symposium on Mixed and Augmented Reality. doi:10.1109/ismar.2004.28Özbek, C., Giesler, B. and Dillmann, R. Jedi training: Playful evaluation of head-mounted augmented reality display systems. SPIE Conference Medical Imaging. Vol. 5291, pp.454–463.Renaud, P., Bouchard, S., & Proulx, R. (2002). Behavioral avoidance dynamics in the presence of a virtual spider. IEEE Transactions on Information Technology in Biomedicine, 6(3), 235-243. doi:10.1109/titb.2002.802381Schwald, B. and Laval, B. An Augmented Reality system for training and assistance to maintenance in the industrial context. International Conference in Central Europe on Computer Graphics, Visualization and Computer Vision. pp.425–432.Slater, M., Usoh, M., & Steed, A. (1994). Depth of Presence in Virtual Environments. Presence: Teleoperators and Virtual Environments, 3(2), 130-144. doi:10.1162/pres.1994.3.2.130Szymanski, J., & O’Donohue, W. (1995). Fear of Spiders Questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 26(1), 31-34. doi:10.1016/0005-7916(94)00072-

Virtual and Augmented Reality Therapy Framework for Phobia Treatment

Phobias are a common type of anxiety disorder that affects a great number of people. Treating phobias is not always straightforward and require a significant effort from both the patient and the therapist. In recent years, Virtual Reality Exposure Therapy and Augmented Reality Exposure Therapy have emerged to help in phobia treatments by using virtual content. However, most available systems are not free and require expensive hardware. In this paper, we present a free and open-source framework for phobia treatment, designed for both the therapist and the patient. A Virtual Reality scenario for acrophobia (fear of heights) and an Augmented Reality scenario for arachnophobia were developed for validation.XVI Workshop Computación Gráfica, Imágenes y Visualización (WCGIV)Red de Universidades con Carreras en Informática (RedUNCI

Virtual and Augmented Reality Therapy Framework for Phobia Treatment

Phobias are a common type of anxiety disorder that affects a great number of people. Treating phobias is not always straightforward and require a significant effort from both the patient and the therapist. In recent years, Virtual Reality Exposure Therapy and Augmented Reality Exposure Therapy have emerged to help in phobia treatments by using virtual content. However, most available systems are not free and require expensive hardware. In this paper, we present a free and open-source framework for phobia treatment, designed for both the therapist and the patient. A Virtual Reality scenario for acrophobia (fear of heights) and an Augmented Reality scenario for arachnophobia were developed for validation.XVI Workshop Computación Gráfica, Imágenes y Visualización (WCGIV)Red de Universidades con Carreras en Informática (RedUNCI

Improving the efficacy of exposure therapy using projection-based augmented reality for the treatment of cockroach phobia: a randomised clinical trial protocol

Introduction: In vivo exposure is the treatment of choice for specific phobia (SP), but this technique presents limitations related to access and acceptability. Augmented reality (AR) offers advantages like maximising strategies such as ‘variability’ (varying stimuli, durations, levels of intensity or the order of the items), control by the therapist, or ‘exposure to multiple contexts’, which can produce positive effects in terms of fear renewal and generalisation of the results. The aim of this study is to test the efficacy of varying the phobic stimuli during treatment with AR: using multiple stimuli (MS) versus a single stimulus (SS) in participants with SP. Methods and analysis: Participants (N=80) with a diagnosis of an SP of cockroaches will be randomised into two conditions: (1) projection-based AR exposure therapy with MS (P-ARET MS); (2) P-ARET with an SS (P-ARET SS). The measures are related to the efficacy results (fear, avoidance and negative thoughts, performance on the behavioural avoidance test (BAT) and preferences). The primary outcome measure is the BAT, and the secondary outcome measures are the BAT through AR, Fear of Cockroaches Questionnaire, Cockroach Phobia Beliefs Questionnaire, Fear and Avoidance Scales Patient’s Improvement Scale, and Beck Depression Inventory Second Edition. Five evaluation moments will be included: preintervention, postintervention, and 1-month, 6-month, and 12-month follow-ups. The treatment will follow the guidelines of the ‘one-session treatment’. Student’s t-tests to compare the two groups on the post-test will be applied. In addition, two-way analysis of variances with repeated measures in one of the two factors (pretest, post-test and follow-ups) will be carried out to compare intragroup differences. Ethics and dissemination: The Universitat Jaume I Ethics Committee (Castellón, Spain) granted approval for the study (CD/64/2019). Dissemination will include publications and presentations at national and international conferences

Beyond the screen – The potential of smartphone apps and immersive technologies in exposure-based interventions for phobias

Specific phobias are extremely common among adults. They are characterized by strong emotional reactions and avoidance behavior when exposed to the feared stimuli. Specifically fears concerning heights or animals such as spiders are highly prevalent, followed by fear of social situations such as fear of public speaking. The gold standard in treating specific phobias is exposure-based therapy. However, exposure-based therapy is limited in its practicability in clinical routine and poses a high hurdle for affected individuals. Virtual and augmented reality (VR/AR) smartphone apps offer attractive platforms to simulate exposure situations and by that increase the accessibility of mental health services in general. Thus, novel smartphone-based treatments hold the potential to facilitate the dissemination of exposure-based treatments for specific phobias. The studies presented as part of this thesis aimed at investigating three newly developed interventions for fear of heights, fear of public speaking and fear of spiders, using the currently available advanced technologies. In the first study (Bentz et al., 2021), a stand-alone, automated and gamified VR exposure app Easyheights was developed using 360° images. The app’s effectiveness to reduce fear of heights and avoidance behavior was investigated in a randomized controlled trial in an adult population with clinical and subclinical fear of heights. The repeated use of the app led to reduced fear and avoidance behavior in a real-life situation on a tower. For the second study (Müller, Fehlmann et al., 2022), the developed stand-alone, automated and gamified VR exposure app Fearless Speech aimed at reducing public speaking anxiety (PSA) and avoidance of eye contact. A virtual audience with 360° videos was used for the exposure and gaze control for the eye contact training. The app was investigated in a randomized controlled trial in healthy adults with subclinical PSA. After the repeated use of the app, participants showed reduced fear and improved eye contact in a real-life speech situation. The third study (Zimmer et al., 2021) examined the developed stand-alone, automated and gamified AR exposure app Phobys. In comparison to VR, AR has only recently been introduced to clinical research. The app was designed to reduce fear, disgust and avoidance behavior in adults with clinical and subclinical fear of spiders. The results of the randomized controlled trial showed that repeatedly using the app led to reduced fear, disgust and avoidance behavior in a real-life situation with a real spider. The results of these studies support the potential of stand-alone, automated VR and AR interventions delivered through smartphone apps. The developed apps allow for a high-quality user experience with a highly realistic environment, gaze control for an easy navigation as well as the possibility of interaction. In addition, gamification elements foster engagement with the apps. All three investigated apps offer low-threshold and low-cost treatment for individuals affected by specific phobias. Testing the effectiveness of these newly developed apps in real-life settings sets them apart from previous studies. Hence, this thesis highlights the potential of using smartphone apps with immersive technologies to advance and disseminate exposure-based treatments for specific phobias

Effectiveness of a projection-based augmented reality exposure system in treating cockroach phobia: study protocol of a randomised controlled trial

Background: Despite being the treatment of choice for phobic disorders, in vivo exposure treatment (IVET) presents some important limitations related mainly to low acceptance and high drop-out rates. Augmented reality (AR) technologies can help to overcome these limitations. Evidence supports the use of AR in exposure treatment for small animal phobia. A new projection-based AR exposure treatment system (P-ARET) that offers the possibility of projecting the animals in a natural and non-intrusive environment has been developed. There are no randomised controlled trials (RCTs) available that have tested the efficacy of this system in cockroach phobia. This paper aims to present the protocol of an RCT that evaluates the efficacy of the P-ARET, versus an IVET group and a waiting list control group (WL), in carrying out exposure treatment for cockroach phobia. Methods/design: Participants will be randomly allocated to one of three conditions: (1) P-ARET, (2) IVET and (3) WL. Both treatment conditions will follow the ‘one-session treatment’ guidelines. As a diagnostic measure, the Anxiety Disorders Interview Schedule for Diagnostic and Statistical Manual for Mental Health Disorders-Version 5 will be used. The Behavioral Avoidance Test will be used as the primary outcome measure. Secondary outcome measures will include an attentional biases task (measured using eye-tracking technology), the Fear of Cockroaches Questionnaire, Cockroach Phobia Beliefs Questionnaire, Fear and Avoidance Scales, Beck Depression Inventory second edition, Disgust Propensity and Sensitivity Scale-Revised-12, State-Trait Anxiety Inventory, Clinician Severity Scale, and Expectation and Satisfaction with the Treatment Scale. The evaluation protocol will include pretreatment and post-treatment evaluations and 1, 6 and 12 months of follow-ups. Intention-to-treat and per-protocol analyses will be performed. Ethics and dissemination: This study has been approved by the Ethics Committee of Universitat Jaume I (Castellón, Spain; 13 December 2019). The results of the presented RCT will be disseminated in presentations at international scientific meetings and peer-reviewed scientific journals.Funding for the study was provided by Grant Ministerio de Ciencia, Innovación y Universidades (Spain) (Programa Estatal I+D+I) (grant number: RTI2018-100993-B-100) funded by MCIN/AEI/10.13039/501100011033 and by 'ERDF A way of making Europe', by the European Union.Funding for the study was provided by Grant Ministerio de Ciencia, Innovación y Universidades (Spain) (Programa Estatal I+D+i RTI2018-100993-B-100) funded by MCIN/AEI/ 10.13039/501100011033 and by 'ERDF A way of making Europe', by the 'European Union'

Virtual Reality as a Tool in the Treatment of Claustrophobia - A Review

Within the context of psychology, virtual reality (VR) is presented as a technological tool to address and treat the symptoms of claustrophobia. Claustrophobia is distinguished by a fear of small or enclosed environments, which can be a challenge for conventional treatments. This research work focused on conducting a detailed analysis of the existing literature on using VR as an alternative tool to treat claustrophobia symptoms. The research results indicated that treatment with VR technology may be effective in providing a controlled and safe way to expose patients to situations such as those they fear, allowing them to overcome their fears more effectively. This review article provides a comprehensive analysis of the use of VR to treat laustrophobia. A total of 384 manuscripts from different virtual databases were analyzed, from which 61 major articles were selected. The results showed that VR allows for treating different types of phobias such as Acrophobia, Agoraphobia, rachnophobia, claustrophobia, Fear of flying, Fear of public speaking and Fear of injections, achieving significant patient results. Studies have proven the effectiveness of VR in reducing the symptoms of claustrophobia, and it is anticipated that it will continue to be an important tool in the future

Interactive multiplatform software to mitigate arachnophobia through augmented reality

Abstract: Augmented Reality (RA) is a technology that mixes physical reality with virtual elements, resulting in mixed reality in real time. He is currently widely accepted for his ease of adaptation in human activities. Superimposing data and digital information in a real environment for educational, commercial, social, therapeutic, industrial, among others. The objective of this research is to develop an interactive software to mitigate arachnophobia by using the engine and graphic editor of Unity Games, focusing on augmented reality. In this project the agile scrum methodology was used. Because it is based on incremental development. Enabling application requirements and development to be flexible for patients and developers. Obtained as a result of a sample of 16 people, that 93.19% improved equal or greater than 50% in their level of anxiety and fear according to their score obtained in the test FSQ after using the proposed application. While 6.81% obtained a percentage lower than 50% because the use of the application was carried out in times less than 20 minutes per day, causing no significant changes