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Results for “Desensitization, Psychologic”

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PubMed2001

Immersive virtual environments in cue exposure.

Cue reactivity to drug-related stimuli is a frequently observed phenomenon in drug addiction. Cue reactivity refers to a classical conditioned response pattern that occurs when an addicted subject is exposed to drug-related stimuli. This response consists of physiological and cognitive reactions. Craving, a subjective desire to use the drug of choice, is believed to play an important role in the occurrence of relapse in the natural setting. Besides craving, other subjective cue-elicited reactions have been reported, including withdrawal symptoms, drug-agonistic effects, and mood swings. Physiological reactions that have been investigated include skin conductance, heart rate, salivation, and body temperature. Conditioned reactivity to cues is an important factor in addiction to alcohol, nicotine, opiates, and cocaine. Cue exposure treatment (CET) refers to a manualized, repeated exposure to drug-related cues, aimed at the reduction of cue reactivity by extinction. In CET, different stimuli are presented, for example, slides, video tapes, pictures, or paraphernalia in nonrealistic, experimental settings. Most often assessments consist in subjective ratings by craving scales. Our pilot study will show that immersive virtual reality (IVR) is as good or even better in eliciting subjective and physiological craving symptoms as classical devices.

Adult↗
PubMed2002

Virtual reality system for treatment of the fear of public speaking using image-based rendering and moving pictures.

The fear of speaking is often cited as the world's most common social phobia. The rapid growth of computer technology enabled us to use virtual reality (VR) for the treatment of the fear of public speaking. There have been two techniques used to construct a virtual environment for the treatment of the fear of public speaking: model-based and movie-based. Virtual audiences and virtual environments made by model-based technique are unrealistic and unnatural. The movie-based technique has a disadvantage in that each virtual audience cannot be controlled respectively, because all virtual audiences are included in one moving picture file. To address this disadvantage, this paper presents a virtual environment made by using image-based rendering (IBR) and chroma keying simultaneously. IBR enables us to make the virtual environment realistic because the images are stitched panoramically with the photos taken from a digital camera. And the use of chroma keying allows a virtual audience to be controlled individually. In addition, a real-time capture technique was applied in constructing the virtual environment to give the subjects more interaction, in that they can talk with a therapist or another subject.

Desensitization, Psychologic↗
PubMed2002

Panic and agoraphobia in a virtual world.

Virtual reality (VR) offers a great new perspective on what it can offer an individual. These new approaches can give an individual the immersion and cognitive guidance that they need to help overcome his or her disorder. VR differs from the traditional displays in computer graphics as these various displays are integrated to give the user a sense of presence or immersion in the virtual world. To more effectively treat panic and agoraphobic patients using VR, it is necessary to determine the physiological responses of nonphobics when placed in the virtual panic and agoraphobia environments. This study exposed nonphobic participants to virtual panic and agoraphobia worlds with a program entitled "Virtual Medicine." Individuals without a diagnosis of panic and agoraphobia, as confirmed by intake and self-report questionnaires, were exposed to four different VR environments (elevator, supermarket, town square, and beach). During these VR experiences, physiology was measured by noninvasive sensors (peripheral skin temperature, heart rate, heart rate variability, respiration, and skin conductance). These measurements were compared to baseline physiology, which was recorded for five min prior to the VR exposure. These levels of physiological arousal will be useful in comparing against the phobic responses during virtual exposure. It will be useful to explore differences between immersion, physiological responses, and self-report responses in nonphobics versus phobics.

Adult↗
PubMed2003

Preliminary research on the efficacy of virtual reality exposure therapy to treat driving phobia.

This article presents a review of preliminary research of two studies of the efficacy of virtual reality exposure therapy (VRET) to treat driving phobia. Study 1 describes a case study of a patient who completed a 7-day baseline followed by three sessions of VRET. Her peak anxiety decreased within and across sessions. At the post-treatment assessment, her phobic-related symptoms had diminished and she no longer met diagnostic criteria for driving phobia. Clinical improvement was maintained at 1-, 3-, and 7-month follow-up. In study 2, a multiple baseline across-subjects design was used to treat five patients over eight weekly VRET sessions. Visual and statistical analyses showed clear improvement in driving anxiety and avoidance in three patients between pre- and post-treatment assessments, and they no longer met criteria for driving phobia. There was marginal improvement in one patient, and the remaining individual showed no treatment gains. There was negligible change in actual driving frequency for any of the patients. Some gains were lost at the follow-up, particularly for the two individuals with poorer treatment responses. The results from these preliminary studies suggest that VRET may be a promising intervention for treating driving phobia. Avenues for improving treatment outcome are discussed.

Adult↗
PubMed2003

Anxiety and presence during VR immersion: a comparative study of the reactions of phobic and non-phobic participants in therapeutic virtual environments derived from computer games.

Virtual reality can be used to provide phobic clients with therapeutic exposure to phobogenic stimuli. However, purpose-built therapeutic VR hardware and software can be expensive and difficult to adapt to individual client needs. In this study, inexpensive and readily adaptable PC computer games were used to provide exposure therapy to 13 phobic participants and 13 non-phobic control participants. It was found that anxiety could be induced in phobic participants by exposing them to phobogenic stimuli in therapeutic virtual environments derived from computer games (TVEDG). Assessments were made of the impact of simulator sickness and of sense of presence on the phobogenic effectiveness of TVEDGs. Participants reported low levels of simulator sickness, and the results indicate that simulator sickness had no significant impact on either anxiety or sense of presence. Group differences, correlations, and regression analyses indicate a synergistic relationship between presence and anxiety. These results do not support Slater's contention that presence and emotion are orthogonal.

Adolescent↗
PubMed2006

BusWorld: designing a virtual environment for post-traumatic stress disorder in Israel: a protocol.

A number of carefully controlled studies have documented the effectiveness of traditional imaginal exposure for the treatment of post-traumatic stress disorder (PTSD). Virtual reality (VR) exposure therapy is based on a similar logic but rather than self-generating imagery, patients wear a VR helmet and go into a three-dimensional (3-D) computer generated virtual world to help them gain access to their memory of the traumatic event. Recent preliminary research has shown that some patients who fail to respond to traditional therapy benefit from virtual reality exposure therapy, presumably because VR helps the patient become emotionally engaged while recollecting/recounting/re-interpreting/emotionally processing what happened during the traumatic event. The present paper presents a brief overview of a new VR World we developed to provide virtual reality therapy for terrorist bus bombing victims in Israel, and a brief description of our research protocol and measures (for details, see www.vrpain.com).

Clinical Protocols↗
PubMed2006

The appeal of violent video games to lower educated aggressive adolescent boys from two countries.

The objective of this study was to test the effect of individual differences on appeal and use of video games. Participants were 299 adolescent boys from lower and higher secondary schools in the Netherlands and Belgium. In general, boys were most attracted to violent video games. Boys that scored higher in trait aggressiveness and lower in empathy were especially attracted to violent games and spent more time playing video games than did boys lower in trait aggressiveness. Lower educated boys showed more appreciation for both violent and nonviolent games and spent more time playing them than did higher educated boys. The present study showed that aggressive and less empathic boys were most attracted to violent games. The fact that heavy users of violent games show less empathy and higher aggressiveness suggests the possibility of desensitization. Other studies have shown that playing violent games increases aggressiveness and decreases empathy. These results combined suggest the possibility of a violence cycle. Aggressive individuals are attracted to violent games. Playing violent games increases aggressiveness and decreases empathy, which in turn leads to increased appreciation and use of violent games.

Adolescent↗
PubMedDate not supplied

The treatment of fear of movement/(re)injury in chronic low back pain: further evidence on the effectiveness of exposure in vivo.

BACKGROUND AND OBJECTIVE: Several cognitive-behavioral factors contribute to the persistence of pain disability in patients with chronic back pain. Fear-avoidance beliefs and fear of movement/(re)injury in particular have been shown to be strong predictors of physical performance and pain disability. Patients reporting substantial pain-related fear might benefit from exposure in vivo to a set of individually tailored, fear-eliciting, and hierarchically ordered physical movements rather than more general graded activity. PATIENTS AND INTERVENTIONS: Six consecutive patients with chronic low back pain who reported substantial fear of movement/(re)injury were included in the study. After a no-treatment baseline measurement period, the patients were randomly assigned to one of two interventions. In the first intervention, patients received exposure in vivo first, followed by graded activity. In the second intervention, the sequence of treatment modules was reversed. Before each treatment module, treatment credibility was assessed. Daily measures of pain-related fear, pain catastrophizing, and pain intensity were completed using visual analog scales. In addition, standardized measures of pain disability, pain-related fear, and pain vigilance were taken before and after each treatment module and at the 1-year follow-up. To obtain more objective data on actual activity levels, an ambulatory activity monitor was carried by the patients during 1 week before and after each treatment module. RESULTS: Time series analysis of the daily measures showed that improvements in pain-related fear and pain catastrophizing occurred only during the exposure in vivo and not during the graded activity, irrespective of the treatment order. Analysis of the pretreatment to post-treatment differences also revealed that decreases in pain-related fear also concurred with decreases in pain disability and pain vigilance and an increase in physical activity levels. All improvements remained at the 1-year follow-up.

Activities of Daily Living↗
PubMed1992

Imipramine treatment of children with separation anxiety disorder.

The efficacy of imipramine was investigated in 20 children (ages 6 to 15) with separation anxiety disorder. Children were treated for a month with vigorous behavioral treatment. If they did not respond, they entered a double-blind, randomized, 6-week trial of imipramine or placebo. Of 45 children accepted, 21 (47%) entered the trial. About half the children improved with either treatment, and no superiority for imipramine was obtained. There was no instance of clinically significant EKG changes. This small study failed to replicate previous findings of imipramine efficacy in a similar, but larger, clinical population.

Adolescent↗