Chapter 4 AVATAR Therapy for Refractory Auditory Hallucinations

AVATAR therapy is part of a new and exciting wave of therapies which adopt an explicitly relational and dialogic approach to working with the distressing voices. To understand the AVATAR approach, it is important to consider its position in the evolution of psychological interventions for distressing voices

Schizotypy, Alexithymia and Affect as predictors of Facial Emotion Recognition Capability using static and dynamic images

The main purpose of the present study is to investigate the capacity of schizotypy and alexithymia traits, in combination with affectivity to predict facial emotion recognition capability in a sample of nonclinical adults. Consecutive healthy participants (N= 98) were investigated using the Toronto Alexithymia Scale-20 (TAS-20), the Oxford-Liverpool Inventory of Feelings and Experiences-Reduced Version (O-LIFE-R), and the Positive and NA Schedule (PANAS). A set of validated photographs (static images) and virtual faces (dynamic images) for presenting the basic emotions was used to assess emotion recognition. Pearson correlations were applied to investigate the relationship between the study variables; the amount of variance in emotion recognition capability predicted by OLIFE-R, TAS-20 and PANAS was calculated by using the linear regression model. Results showed that alexithymia was strongly associated with schizotypy and NA; furthermore, alexithymia and NA made a significant contribution to the prediction of emotion recognition capability. The predictive model was fitted for two types of presentations (photographs and virtual reality). The inclusion of virtual faces emerges as a response to the need to consider computer characters as new assessment and treatment material for research and therapy in psycholog

Schizotypy, Alexithymia and Affect as predictors of Facial Emotion Recognition Capability using static and dynamic images

The main purpose of the present study is to investigate the capacity of schizotypy and alexithymia traits, in combination with affectivity to predict facial emotion recognition capability in a sample of nonclinical adults. Consecutive healthy participants (N= 98) were investigated using the Toronto Alexithymia Scale-20 (TAS-20), the Oxford-Liverpool Inventory of Feelings and Experiences-Reduced Version (O-LIFE-R), and the Positive and NA Schedule (PANAS). A set of validated photographs (static images) and virtual faces (dynamic images) for presenting the basic emotions was used to assess emotion recognition. Pearson correlations were applied to investigate the relationship between the study variables; the amount of variance in emotion recognition capability predicted by OLIFE-R, TAS-20 and PANAS was calculated by using the linear regression model. Results showed that alexithymia was strongly associated with schizotypy and NA; furthermore, alexithymia and NA made a significant contribution to the prediction of emotion recognition capability. The predictive model was fitted for two types of presentations (photographs and virtual reality). The inclusion of virtual faces emerges as a response to the need to consider computer characters as new assessment and treatment material for research and therapy in psychologyEl objetivo principal del presente estudio es investigar la capacidad de predicción de los rasgos de esquizotípia y alexitímia, en combinación con la afectividad, de la habilidad de reconocimiento de emociones en una muestra de adultos sanos. Noventa y ocho pacientes sanos (N =98) fueron evaluados mediante la Escala de Alexitímia Toronto-20 (TAS-20), el Inventario de Sentimientos y Experiencias Oxford-Liverpool-Versión Reducida (O-LIFE-R), y la Escala de Afecto Positivo y Negativo (PANAS). Para la evaluación de la capacidad de reconocimiento de emociones a nivel facial, se utilizó un set validado de fotografías (imágenes estáticas) y caras en realidad virtual (imágenes dinámicas). Para el análisis correlacional de las variables de estudio se aplicó la prueba de correlación de Pearson; para el análisis de predicción de la capacidad de reconocimiento emocional se utilizó un modelo de regresión lineal en el que se incluyeron las variables derivadas de las escalas OLIFE-R, TAS-20 y PANAS. Los resultados mostraron la existencia de una relación significativa entre alexitímia, esquizotípia y afecto negativo; el modelo de regresión reveló una aportación significativa de la alexitímia y el afecto negativo en la predicción de los errores cometidos en la tarea de reconocimiento facial. El modelo predictivo propuesto fue válido para ambos tipos de presentación de las emociones (fotografías y caras virtuales). La inclusión de las caras virtuales surge como respuesta a la necesidad de considerar los personajes computarizados como nuevo material de evaluación y tratamiento para la investigación y psicoterapia en psicología

The assessment of Attention Deficit Hyperactivity Disorder in children using continous performance tasks in virtual environments

The assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) involves the use of different instruments, and one of the most frequently used is the Continuous Performance Test (CPT). Virtual reality allows for the achieving of the presentation of stimuli with high levels of control. In addition, it facilitates the presentation of distracters with a high level of resemblance to elements which in fact can be found in the real world by placing them in a similar context. Thus, it is possible to assume that a higher ecological validity can be found in CPT tests performed in this manner as compared to the traditional CPT test. During the last years Rizzo developed a virtual reality based CPT called "the Virtual Classroom". Several studies show that "Virtual Classroom" is an effective measure to identify attention difficulties in children with ADHD. Our research team developed a virtual CPT, similar to the "Virtual Classroom", that allows to execute four different tasks: an auditory task with non-distractive stimuli, an auditory task with distractive stimuli, a visual task with non-distractive stimuli and a visual task with distractive stimuli. In this study, we offer additional data supporting the validity of using this type of technology for the assessment of ADHD

Evaluación del Trastorno por Déficit de Atención con Hiperactividad en niños mediante tareas de ejecución contínua en entornos virtuales

The assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) involves the use of different instruments, and one of the most frequently used is the Continuous Performance Test (CPT). Virtual reality allows for the achieving of the presentation of stimuli with high levels of control. In addition, it facilitates the presentation of distracters with a high level of resemblance to elements which in fact can be found in the real world by placing them in a similar context. Thus, it is possible to assume that a higher ecological validity can be found in CPT tests performed in this manner as compared to the traditional CPT test. During the last years Rizzo developed a virtual reality based CPT called “the Virtual Classroom”. Several studies show that “Virtual Classroom” is an effective measure to identify attention difficulties in children with ADHD. Our research team developed a virtual CPT, similar to the “Virtual Classroom”, that allows to execute four different tasks: an auditory task with non-distractive stimuli, an auditory task with distractive stimuli, a visual task with non-distractive stimuli and a visual task with distractive stimuli. In this study, we offer additional data supporting the validity of using this type of technology for the assessment of ADHD.Uno de los instrumentos más empleados para la evaluación del Trastorno por Déficit de Atención con Hiperactividad (TDAH) es el Test de Ejecución Continua (CPT). Utilizando realidad virtual es posible presentar estímulos con un elevado grado de control, y algunos de ellos pueden ejercer la función de distractores muy similares a los que se encuentran en la realidad. Por ello cabe pensar que las pruebas CPT realizadas mediante realidad virtual pueden tener un mayor grado de validez ecológica que las que se realizan de modo tradicional. Durante los últimos años Rizzo ha desarrollado una prueba CPT denominada “Virtual Classroom” que puede ser presentada mediante realidad virtual, y diferentes estudios han encontrado que es un procedimiento eficaz y válido para evaluar el déficit de atención en niños con TDAH. Nuestro equipo de investigación ha desarrollado una prueba CPT virtual similar, mediante la que es posible aplicar cuatro tipos de tareas de ejecución continua: visuales y auditivas con y sin distractores. En este estudio se ofrecen datos adicionales que confirmar la validez de este tipo de pruebas para la evaluación de las dificultades atencionales

Evaluación del Trastorno por Déficit de Atención con Hiperactividad en niños mediante tareas de ejecución contínua en entornos virtuales

The assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) involves the use of different instruments, and one of the most frequently used is the Continuous Performance Test (CPT). Virtual reality allows for the achieving of the presentation of stimuli with high levels of control. In addition, it facilitates the presentation of distracters with a high level of resemblance to elements which in fact can be found in the real world by placing them in a similar context. Thus, it is possible to assume that a higher ecological validity can be found in CPT tests performed in this manner as compared to the traditional CPT test. During the last years Rizzo developed a virtual reality based CPT called “the Virtual Classroom”. Several studies show that “Virtual Classroom” is an effective measure to identify attention difficulties in children with ADHD. Our research team developed a virtual CPT, similar to the “Virtual Classroom”, that allows to execute four different tasks: an auditory task with non-distractive stimuli, an auditory task with distractive stimuli, a visual task with non-distractive stimuli and a visual task with distractive stimuli. In this study, we offer additional data supporting the validity of using this type of technology for the assessment of ADHD.Uno de los instrumentos más empleados para la evaluación del Trastorno por Déficit de Atención con Hiperactividad (TDAH) es el Test de Ejecución Continua (CPT). Utilizando realidad virtual es posible presentar estímulos con un elevado grado de control, y algunos de ellos pueden ejercer la función de distractores muy similares a los que se encuentran en la realidad. Por ello cabe pensar que las pruebas CPT realizadas mediante realidad virtual pueden tener un mayor grado de validez ecológica que las que se realizan de modo tradicional.Durante los últimos años Rizzo ha desarrollado una prueba CPT denominada “Virtual Classroom” que puede ser presentada mediante realidad virtual, y diferentes estudios han encontrado que es un procedimiento eficaz y válido para evaluar el déficit de atención en niños con TDAH. Nuestro equipo de investigación ha desarrollado una prueba CPT virtual similar, mediante la que es posible aplicar cuatro tipos de tareas de ejecución continua: visuales y auditivas con y sin distractores. En este estudio se ofrecen datos adicionales que confirmar la validez de este tipo de pruebas para la evaluación de las dificultades atencionales

Virtual reality exposure therapy for school phobia

School phobia is characterized by fear to diverse events associated to school such as being beaten by a classmate, bullied or criticised in front of the lass, having to speak in public, doing exams, getting undressed to practice sports, etc. and can frequently cause young children to a chronic school refusal leading to significant social and academic difficulties. In older children and adolescents, the risk of a low school performance and an early school dropout is increased. Diverse techniques of graded and non-graded exposure have been used in the treatment of this problem. In vivo exposure alone or preceded by imagery exposure is the treatment more frequently applied. Clinical practice with children suggests the use of behavioural procedures requires a considerable amount of flexibility and creativity and procedures that warrantee their comprehension and cooperation. techniques based on virtual reality address these requirements and are capable of increasing the motivation of children to participate in treatment. In line with this, our group of research has developed a series of virtual environments that can be integrated to a treatment program for children and adolescents with school phobia. To study its efficacy, 18 participants with high scores on school phobia measures were randomly assigned to a group of treatment whereas other 18 participants were assigned to a waiting list group. A specific treatment effect on schoolrelated fears was found suggesting that exposure by means of virtual environments might be an effective treatment for school phobia

Tratamiento de la fobia escolar mediante exposición con realidad virtual

School phobia is characterized by fear to diverse events associated to school such as being beaten by a classmate, bullied or criticised in front of the lass, having to speak in public, doing exams, getting undressed to practice sports, etc. and can frequently cause young children to a chronic school refusal leading to significant social and academic difficulties. In older children and adolescents, the risk of a low school performance and an early school dropout is increased. Diverse techniques of graded and non-graded exposure have been used in the treatment of this problem. In vivo exposure alone or preceded by imagery exposure is the treatment more frequently applied. Clinical practice with children suggests the use of behavioural procedures requires a considerable amount of flexibility and creativity and procedures that warrantee their comprehension and cooperation. techniques based on virtual reality address these requirements and are capable of increasing the motivation of children to participate in treatment. In line with this, our group of research has developed a series of virtual environments that can be integrated to a treatment program for children and adolescents with school phobia. To study its efficacy, 18 participants with high scores on school phobia measures were randomly assigned to a group of treatment whereas other 18 participants were assigned to a waiting list group. A specific treatment effect on schoolrelated fears was found suggesting that exposure by means of virtual environments might be an effective treatment for school phobia.La fobia escolar se caracteriza por el miedo a diversos eventos relacionados con la escuela, tales como ser golpeado por un compañero, ser objeto de burlas, ser criticado en clase, hablar delante del resto de la clase, hacer exámenes, desvestirse a la hora del deporte, etc. y lleva con frecuencia en niños pequeños a un rechazo crónico, que desemboca en una significativa dificultad social y académica. En niños mayores y adolescentes se incrementa el riesgo de un bajo aprovechamiento escolar y/o un abandono escolar prematuro. Para el tratamiento de este problema se han empleado diversas técnicas de exposición, graduada o no. Lo más frecuente ha sido emplear exposición en vivo sola o precedida por exposición con imaginación. Trabajando con niños, se ha encontrado que el uso de procedimientos conductuales requiere de una considerable flexibilidad y creatividad, así como procedimientos que garanticen su comprensión y cooperación. Las técnicas basadas en realidad virtual pueden cumplir con esos requisitos e incrementar la motivación del niño para participar en el tratamiento. Con ese objetivo,nuestro grupo ha desarrollado una serie de entornos virtuales que pueden ser integrados en un programa de tratamiento de niños y adolescentes con fobia escolar. Para estudiar su eficacia, se asignaron aleatoriamente 18 niños con puntuaciones altas en instrumentos empleados para evaluar la fobia escolar a un grupo de tratamiento y 18 a un grupo en lista de espera, Se encontró un efecto específico del tratamiento sobre los miedos escolares, que hace pensar que la exposición mediante entornos virtuales es un tratamiento probablemente eficaz para la fobia escola

Peak provoked craving after smoking cessation

Peak provoked craving (PPC) is an alternative approach to cue-induced craving that focuses on the highest craving level experienced during the exposure to drug-related cues. The main objective of this study was to assess the effect of abstinence on PPC in smokers and to determine whether PPC is altered by continuous abstinence. Results showed reductions on PPC levels only 24 hours after achieving abstinence and craving levels remain significantly lower after 7 days of abstinence

Advances in the use of virtual reality to treat mental health conditions

Virtual reality (VR) has emerged as a promising tool in the field of mental health. Central to this technology are immersive environments, which enable exposure to highly controlled virtual experiences that feel real. In this Review, we elaborate on the active elements of immersive experiences and how VR-based treatments work. We provide an overview of developments in the use of VR to treat mental health conditions (anxiety, psychotic symptoms, post-traumatic stress, eating disorders, depression and stress management) with a focus on the core mechanisms that drive effective interventions. Artificial intelligence, biofeedback and gamification are emerging areas of development, and we discuss how they might enhance the accessibility, engagement and effectiveness of psychological treatments. Conducting rigorous studies with user-centred designs in diverse populations is a key research priority. As the use of VR in mental health continues to evolve, addressing ethical and implementation considerations is critical for ensuring ongoing treatment improvements.</p