Virtual Reality Relaxation for Reducing Perceived Stress of Intensive Care Nurses During the COVID-19 Pandemic

During the COVID-19 pandemic ICU nurses endure high levels of stress. VR relaxation (VRelax, containing 360° immersive environments) provides an easy-to-use and effective means to induce positive affect and reduce perceived stress. We investigated feasibility and immediate effect on perceived stress of VRelax use by ICU nurses during work shifts. ICU nurses working with COVID-19 patients in an academic hospital could use VRelax as a 10-min break during their shift. Primary outcome was the difference between perceived stress immediately before and after VRelax use measured by a single-question VAS-stress scale. Statistically significant difference of the mean VAS-stress before and after use was determined using the paired t student test. A socio-demographic questionnaire, a questionnaire on perceived stress and stress resilience and VRelax user experiences were sent by email. Eighty-six (26%) nurses used VRelax at least once; 77% (N=66) of these filled out the VAS-stress scale before and after use of VRelax. Mean perceived stress lowered with 39.9% after use of VRelax (mean difference=14.0, SD=13.3, p<0.005). Mean score on the perceived stress scale-10 was 11.4 (SD=6.50), mean score on the Connor-Davidson Resilience Scale-10 was 29.0 (SD=5.51). Sixty-two percentage of the ICU nurses thought VRelax was helpful to reduce stress. Main barrier for use was a high workload. It is feasible for nurses to use VRelax in an ICU context. VRelax is an effective intervention to reduce immediate perceived stress and is of added value in stressful situations as during the COVID-19 pandemic, inducing a positive affective state and lowering perceived stress

Training motor responses to food: A novel treatment for obesity targeting implicit processes.

PublishedREVIEWJOURNAL ARTICLEThis is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.The present review first summarizes results from prospective brain imaging studies focused on identifying neural vulnerability factors that predict excessive weight gain. Next, findings from cognitive psychology experiments evaluating various interventions involving food response inhibition training or food response facilitation training are reviewed that appear to target these neural vulnerability factors and that have produced encouraging weight loss effects. Findings from both of these reviewed research fields suggest that interventions that reduce reward and attention region responses to high calorie food cues and increase inhibitory region responses to high calorie food cues could prove useful in the treatment of obesity. Based on this review, a new conceptual model is presented to describe how different cognitive training procedures may contribute to modifying eating behavior and important directions for future research are offered. It is concluded that there is a need for evaluating the effectiveness of more intensive food response training interventions and testing whether adding such training to extant weight loss interventions increases their efficacy

Pilot test of a novel food response and attention training treatment for obesity: Brain imaging data suggest actions shape valuation.

PublishedJournal ArticleThis is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Elevated brain reward and attention region response, and weaker inhibitory region response to high-calorie food images have been found to predict future weight gain. These findings suggest that an intervention that reduces reward and attention region response and increases inhibitory control region response to such foods might reduce overeating. We conducted a randomized pilot experiment that tested the hypothesis that a multi-faceted food response and attention training with personalized high- and low-calorie food images would produce changes in behavioral and neural responses to food images and body fat compared to a control training with non-food images among community-recruited overweight/obese adults. Compared to changes observed in controls, completing the intervention was associated with significant reductions in reward and attention region response to high-calorie food images (Mean Cohen's d = 1.54), behavioral evidence of learning, reductions in palatability ratings and monetary valuation of high-calorie foods (p = 0.009, d's = 0.92), and greater body fat loss over a 4-week period (p = 0.009, d = 0.90), though body fat effects were not significant by 6-month follow-up. Results suggest that this multifaceted response and attention training intervention was associated with reduced reward and attention region responsivity to food cues, and a reduction in body fat. Because this implicit training treatment is both easy and inexpensive to deliver, and does not require top-down executive control that is necessary for negative energy balance obesity treatment, it may prove useful in treating obesity if future studies can determine how to create more enduring effects.National Institutes of Health grant DK-080760 supported this study. The National Institutes of Health had no role in the study design, collection, interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. The authors thank the Lewis Center for Neuroimaging at the University of Oregon for their assistance with the fMRI scans

What is trained during food go/no-go training? A review focusing on mechanisms and a research agenda

This is the final version of the article. Available from the publisher via the DOI in this record.Purpose of Review: During food go/no-go training, people consistently withhold responses toward no-go food items. We discuss how food go/no-go training may change people’s behavior toward no-go food items by comparing three accounts: (a) the training strengthens ‘top-down’ inhibitory control over food-related responses, (b) the training creates automatic ‘bottom-up’ associations between no-go food items and stopping responses, and (c) the training leads to devaluation of no-go food items. Recent Findings: Go/no-go training can reduce intake of food and choices for food and facilitate short-term weight loss. It appears unlikely that food go/no-go training strengthens top-down inhibitory control. There is some evidence suggesting the training could create automatic stop associations. There is strong evidence suggesting go/no-go training reduces evaluations of no-go food items. Summary: Food go/no-go training can change behavior toward food and evaluation of food items. To advance knowledge, more research is needed on the underlying mechanisms of the training, the role of attention during go/no-go training, and on when effects generalize to untrained food items.© The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. About this articl

Social Cognition Training for People With a Psychotic Disorder:A Network Meta-analysis

Deficits in social cognition are common in people with psychotic disorders and negatively impact functioning. Social Cognition Training (SCT) has been found to improve social cognition and functioning, but it is unknown which interventions are most effective, how characteristics of treatments and participants moderate efficacy, and whether improvements are durable. This meta-analysis included 46 randomized studies. SCTs were categorized according to their focus (targeted/broad-based) and inclusion of cognitive remediation therapy (CRT). Network meta-analysis was conducted, using both direct (original) and indirect (inferred from the network of comparisons) evidence. All SCT types were compared to treatment as usual (TAU; the chosen reference group). Moderators of outcome were investigated with meta-regression and long-term efficacy with multivariate meta-analysis. Compared to TAU, emotion perception was improved by targeted SCT without CRT (d = 0.68) and broad-based SCT without CRT (d = 0.46). Individual treatments worked better for emotion perception. All treatments significantly improved social perception (active control, d = 0.98, targeted SCT with and without CRT, d = 1.38 and d = 1.36, broad-based SCT with and without CRT, d = 1.45 and d = 1.35). Only broad-based SCT (d = 0.42) improved ToM. Broad-based SCT (d = 0.82 without and d = 0.41 with CRT) improved functioning; group treatments worked significantly better. Male gender was negatively related to effects on social functioning and psychiatric symptoms. At follow-up, a moderate effect on social functioning (d = 0.66) was found. No effect was found on attribution, social cognition (miscellaneous), and psychiatric symptoms. While targeted SCT is the most effective for emotion perception and social perception, broad-based SCT produces the best overall outcomes. CRT did not enhance SCT effects

Virtual reality for psycho-education on self-stigma in depression:Design of a randomised controlled trial

Background: Major Depressive Disorder (MDD) is a prevalent and disabling mental health condition. Patients with MDD often deal with self-stigma, which can lead to more depressive symptoms. Psychoeducation about depression has proven to be effective in reducing depressive symptomatology and self-stigma. Involving a significant other in psychoeducation for depression, might increase mutual understanding. Virtual reality (VR) offers the opportunity to experience the perspective of having or living with someone with a mental condition. For this study an immersive VR environment is developed. The main objective of this study is to test whether our VR psychoeducation intervention is more successful in reducing self-stigma than standard psychoeducation for MDD.Methods: In this randomised controlled trial (RCT), 80 couples of patients and their significant other will be included and randomly assigned to one of two conditions: the VR psychoeducation intervention and standard psychoeducation. Patients will be aged 18 to 65, diagnosed with MDD. The main study parameter is self-stigma, as measured by the Internalized Stigma of Mental Illness scale. Secondary parameters include depressive symptoms, loneliness and perceived social support for the patient and burden of care and quality of life for the significant other.Limitations: No control for nonspecific factors, limited individual adjustment, patients are not able to participate without a significant other.Conclusions: VR might open up the opportunity to reduce self-stigma and thereby improve the efficacy of psychoeducation in MDD.</p

Virtual reality for psycho-education on self-stigma in depression:Design of a randomised controlled trial

Background: Major Depressive Disorder (MDD) is a prevalent and disabling mental health condition. Patients with MDD often deal with self-stigma, which can lead to more depressive symptoms. Psychoeducation about depression has proven to be effective in reducing depressive symptomatology and self-stigma. Involving a significant other in psychoeducation for depression, might increase mutual understanding. Virtual reality (VR) offers the opportunity to experience the perspective of having or living with someone with a mental condition. For this study an immersive VR environment is developed. The main objective of this study is to test whether our VR psychoeducation intervention is more successful in reducing self-stigma than standard psychoeducation for MDD.Methods: In this randomised controlled trial (RCT), 80 couples of patients and their significant other will be included and randomly assigned to one of two conditions: the VR psychoeducation intervention and standard psychoeducation. Patients will be aged 18 to 65, diagnosed with MDD. The main study parameter is self-stigma, as measured by the Internalized Stigma of Mental Illness scale. Secondary parameters include depressive symptoms, loneliness and perceived social support for the patient and burden of care and quality of life for the significant other.Limitations: No control for nonspecific factors, limited individual adjustment, patients are not able to participate without a significant other.Conclusions: VR might open up the opportunity to reduce self-stigma and thereby improve the efficacy of psychoeducation in MDD.</p