scholarly journals Using 360-degree videos for virtual reality exposure in CBT for panic disorder with agoraphobia: a feasibility study

2021 ◽  
pp. 1-13
Author(s):  
Johan Lundin ◽  
Anders Lundström ◽  
Jan Gulliksen ◽  
Joakim Blendulf ◽  
Kersti Ejeby ◽  
...  
Keyword(s):  
Primary Care ◽  
Virtual Reality ◽  
Panic Disorder ◽  
Virtual Environments ◽  
Health Care Services ◽  
Low Cost ◽  
Behavioural Therapy ◽  
Feasibility Trial

Abstract Background: Cognitive behavioural therapy (CBT) is an effective treatment for panic disorder with agoraphobia (PDA). However, implementation of some of the procedures involved, particularly in vivo exposure, can be time consuming and taxing for routine health care services. CBT with exposure taking place in virtual reality (VR-CBT) is a more time-efficient option and has shown promising results in the treatment of PDA. However, VR-CBT requires expensive equipment and appropriate virtual environments, which historically has been costly and cumbersome to produce. Thus, access to VR-CBT has been sparse in regular care environments. Aims: The aim of this study was to investigate whether VR-CBT using filmed virtual environments produced with a low-cost 360-degree film camera can be a feasible and acceptable treatment for PDA when implemented in a primary care context. Method: This was an open feasibility trial with a within-group design, with assessments conducted at pre-test, post-test, and 6-month follow-up. Participants (n = 12) received a 10–12 week treatment programme of VR-CBT and PDA-related symptoms were assessed by the primary outcome measure The Mobility Inventory for Agoraphobia (MIA) and the Panic-Disorder Severity Scale-Self Rated (PDSS-SR). Results: The results showed that treatment satisfaction was high and participants were significantly improved on PDA-related measures at post-treatment and at 6-month follow-up with large effect sizes (Cohen’s d range = 1.46–2.82). All 12 participants completed the treatment. Conclusions: These findings suggest that VR-CBT with 360-degree video virtual environments delivered to primary care patients with PDA is feasible, acceptable, and potentially efficacious.

Feasibility trial of virtual reality exposure therapy for selective mutism

2021 ◽  
pp. 135910452110569
Author(s):  
Yi Ren Tan ◽  
Yoon Phaik Ooi ◽  
Rebecca P Ang ◽  
Dion H Goh ◽  
Clare Kwan ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Exposure Therapy ◽  
Selective Mutism ◽  
Behavioural Therapy ◽  
Feasibility Trial ◽  
Virtual Reality Exposure Therapy ◽  
Cognitive Behavioural ◽  
Evidence Based Care ◽  
Virtual Reality Exposure

Virtual reality exposure therapy (VRET) has been commonly utilised as an extension of cognitive behavioural therapy (CBT). However, most studies examined its effectiveness among adults, with no study focusing on children with selective mutism (SM). We aimed to examine its feasibility and acceptability among children with SM. Twenty children aged 6–12 with SM diagnosis were recruited and completed six therapist-guided VRET sessions. Parents and clinicians completed measures at pre-VRET, post-VRET, 1-month and 3-month follow-up visits. At post-VRET, parent and child participants completed the acceptability questionnaires. Findings suggested the feasibility of VRET as all participants completed the programme with no attrition. Parents and child participants also reported VRET to be an acceptable and effective treatment for SM. Significant improvement in overall functioning were found at post-treatment and follow-up measures, but there were no significant changes in parent-rated speech frequency and anxiety measures. These support the acceptability of VRET as an adjunct modality (and not substitute) of CBT in SM treatment. Future studies, with more robust experimental designs and larger sample sizes, can be conducted to confirm its efficacy. As technology becomes more sophisticated, tools such as virtual environments can be explored to enhance evidence-based care for children and their families.

scholarly journals Virtual reality-based cognitive behavioural therapy for patients with generalized social anxiety disorder: a pilot study

2019 ◽  
Vol 47 (6) ◽  
pp. 745-750 ◽  
Author(s):  
Chris N.W. Geraets ◽  
Wim Veling ◽  
Maartje Witlox ◽  
Anton B.P. Staring ◽  
Suzy J.M.A. Matthijssen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Virtual Reality ◽  
Social Anxiety ◽  
Social Activity ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Cognitive Behavioural

AbstractBackground:Patients with generalized social anxiety disorder (SAD) avoid various social situations and can be reluctant to engage in in vivo exposure therapy. Highly personalized practising can be required before patients are ready to perform in vivo exposure. Virtual reality-based therapy could be beneficial for this group.Aims:To assess the feasibility and potential effect of virtual reality-based cognitive behavioural therapy (VR-CBT) for patients with severe generalized SAD.Methods:Fifteen patients with generalized SAD attended up to 16 VR-CBT sessions. Questionnaires on clinical and functional outcomes, and diary assessments on social activity, social anxiety and paranoia were completed at baseline, post-treatment and at 6-months follow-up.Results:Two patients dropped out of treatment. Improvements in social anxiety and quality of life were found at post-treatment. At follow-up, depressive symptoms had decreased, and the effect on social anxiety was maintained. With respect to diary assessments, social anxiety in company and paranoia were significantly reduced by post-treatment. These improvements were maintained at follow-up. No increase was observed in social activity.Conclusions:This uncontrolled pilot study demonstrates the feasibility and treatment potential of VR-CBT in a difficult-to-treat group of patients with generalized SAD. Results suggest that VR-CBT may be effective in reducing anxiety as well as depression, and can increase quality of life.

Importance of knowledge in the behavioural treatment of panic disorder

2019 ◽  
Vol 47 (5) ◽  
pp. 611-615
Author(s):  
Kathleen M. Grubbs ◽  
James D. Broussard ◽  
Emily L. Hiatt ◽  
Melissa A. Beason-Smith ◽  
Ellen J. Teng
Keyword(s):  
Panic Disorder ◽  
Intensive Therapy ◽  
Behavioural Therapy ◽  
Behavioural Treatment ◽  
Knowledge Domains ◽  
Cognitive Behavioural ◽  
Severity Scores ◽  
Good Internal Consistency ◽  
Knowledge Scale

AbstractBackground:Cognitive behavioural therapy (CBT) for panic disorder encourages patients to learn about and make changes to thoughts and behaviour patterns that maintain symptoms of the disorder. Instruments to assess whether or not patients understand therapy content do not currently exist.Aims:The aim of this study was to examine if increases within specific knowledge domains of panic disorder were related to improvement in panic symptoms following an intensive 2-day panic treatment.Method:Thirty-nine Veterans enrolled in an intensive weekend panic disorder treatment completed knowledge measures immediately before the first session of therapy and at the end of the last day of therapy. Four panic disorder experts evaluated items and reached consensus on subscales. Subscales were reduced further to create psychometrically sound subscales of catastrophic misinterpretation (CM), behaviours (BE), and self-efficacy (SE). A simple regression analysis was conducted to determine whether increased knowledge predicted symptom change at a 3-month follow-up assessment.Results:The overall knowledge scale was reduced to three subscales BE (n = 7), CM (n = 13) and SE (n = 8) with good internal consistency. Veterans’ knowledge of panic disorder improved from pre- to post-treatment. Greater increase in scores on the knowledge assessment predicted lower panic severity scores at a 3-month follow-up. A follow-up analysis using the three subscales as predictors showed that only changes in CM significantly contributed to the prediction.Conclusions:In an intensive therapy format, reduction in panic severity was related to improved knowledge overall, but particularly as a result of fewer catastrophic misinterpretations.

scholarly journals Therapist-guided internet-delivered cognitive–behavioural therapy supplemented with group exposure sessions for adolescents with social anxiety disorder: a feasibility trial

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018345 ◽  
Author(s):  
Martina Nordh ◽  
Sarah Vigerland ◽  
Lars-Göran Öst ◽  
Brjánn Ljótsson ◽  
David Mataix-Cols ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Social Anxiety Disorder ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Feasibility Trial ◽  
Cognitive Behavioural ◽  
Exposure Sessions

ObjectivesSocial anxiety disorder (SAD) is one of the most common psychiatric disorders in youth, with a prevalence of about 3%–4% and increased risk of adverse long-term outcomes, such as depression. Cognitive–behavioural therapy (CBT) is considered the first-line treatment for youth with SAD, but many adolescents remain untreated due to limited accessibility to CBT. The aim of this study was to develop and evaluate the feasibility and preliminary efficacy of a therapist-guided internet-delivered CBT treatment, supplemented with clinic-based group exposure sessions (BIP SOFT).DesignA proof-of-concept, open clinical trial with 6-month follow-up.ParticipantsThe trial was conducted at a child and adolescent psychiatric research clinic, and participants (n=30) were 13–17 years old (83% girls) with a principal diagnosis of SAD.Intervention12 weeks of intervention, consisting of nine remote therapist-guided internet-delivered CBT sessions and three group exposure sessions at the clinic for the adolescents and five internet-delivered sessions for the parents.ResultsAdolescents were generally satisfied with the treatment, and the completion rate of internet modules, as well as attendance at group sessions, was high. Post-treatment assessment showed a significant decrease in clinician-rated, adolescent-rated and parent-rated social anxiety (d=1.17, 0.85 and 0.79, respectively), as well as in general self-rated and parent-rated anxiety and depression (d=0.76 and 0.51), compared with pretreatment levels. Furthermore, 47% of participants no longer met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for SAD at post-treatment. At a 6-month follow-up, symptom reductions were maintained, or further improved, and 57% of participants no longer met criteria for SAD.ConclusionTherapist-guided and parent-guided internet-delivered CBT, supplemented with a limited number of group exposure sessions, is a feasible and promising intervention for adolescents with SAD.Trial registration numberNCT02576171; Results.

Evaluation of a tertiary and district general hospital menopause service

2020 ◽  
pp. 205336912094762
Author(s):  
Kristyn M Manley ◽  
T Hillard ◽  
D Holloway ◽  
D Bruce ◽  
J Rymer
Keyword(s):  
Primary Care ◽  
Hormone Replacement ◽  
Treatment Options ◽  
Treatment Resistance ◽  
District General Hospital ◽  
Behavioural Therapy ◽  
Alternative Methods ◽  
Require Time ◽  
Co Morbidity

Objective Requests for management of menopausal symptoms and hormone replacement are increasing in the UK. Referrals to specialist clinics have to be balanced with increasing recommendations within the NHS to improve efficiency and patient care. Study design Retrospective evaluation of clinic records over two months at a district general (Poole Hospital) and tertiary (Guy’s Hospital) menopause service. Data on referral origin, reason for referral, interval from referral to review and outcome were collected and compared between trusts. Main outcome measures To evaluate and compare referrals and outcomes in a tertiary and district general menopause service and provide recommendations for improving efficiency. Results Most referrals are from primary care but up to 25% are from other specialties. Half of the appointments are new referrals and 95% of women attend. Of the new referrals, 50% have multiple medical comorbidities, 25% a personal or family history of cancer and 25% treatment resistance; 30% have premature ovarian insufficiency. At Guy’s Hospital, 30% are reviewed more than 18 weeks after referral, at Poole Hospital this is 6%. Treatment resistance is reported in half of the women reviewed at follow-up. Conclusions Menopause services review a complex patient population and the majority of referred women have more than one co-morbidity; they require time, specialist knowledge of current treatment options and a multidisciplinary approach. The main barrier to service efficiency is capacity, particularly in population dense areas; cognitive behavioural therapy and non-hormonal methods appear under-utilised in primary care, as do alternative methods of follow-up within the clinics such as telephone and patient-initiated appointments.

scholarly journals Cognitive–behavioural therapy v. usual care in recurrent depression

2008 ◽  
Vol 193 (6) ◽  
pp. 505-506 ◽  
Author(s):  
Henk Jan Conradi ◽  
Peter de Jonge ◽  
Johan Ormel
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Beck Depression Inventory ◽  
Cognitive Behavioural Therapy ◽  
Acute Phase ◽  
Behavioural Therapy ◽  
Recurrent Depression ◽  
Cognitive Behavioural ◽  
Cognitive Problems

SummaryWe examined in a primary care sample whether acute-phase cognitive–behavioural therapy (CBT) would be more effective than usual care for patients with multiple prior episodes of depression. Depression outcome was based on a 3-monthly administered Beck Depression Inventory (BDI) during a 2-year follow-up. We confirmed that in patients with four or more prior episodes, CBT outperformed usual care by four points on the BDI, but not in patients with three or fewer prior episodes. Subsequent analyses suggested that CBT may be able to tackle cognitive problems related to rumination in patients with recurrent depression.

scholarly journals Posttraumatic Stress Disorder Intervention for People with Severe Mental Illness in a Low-Income Country Primary Care Setting: A Randomized Feasibility Trial Protocol

2021 ◽  
Author(s):  
Lauren Ng ◽  
Eyerusalem Getachew Serba ◽  
Benyam W. Dubale ◽  
Abebaw Fekadu ◽  
Charlotte Hanlon
Keyword(s):  
Primary Care ◽  
Posttraumatic Stress Disorder ◽  
Mental Illness ◽  
Randomized Controlled Trial ◽  
Stress Disorder ◽  
Controlled Trial ◽  
Feasibility Trial ◽  
Intervention Delivery ◽  
Randomized Controlled

Abstract BackgroundIn this protocol, we outline a mixed-methods randomized feasibility trial of Brief Relaxation, Education and Trauma Healing (BREATHE) Ethiopia. BREATHE Ethiopia is a culturally and contextually adapted intervention for PTSD in participants with severe mental illness. BREATHE Ethiopia maps onto the World Health Organization’s guidelines for posttraumatic stress disorder (PTSD) treatment in low- and middle-income country primary care settings. MethodsSpecifically, this study includes a non-randomized pre-pilot (n=5) and a randomized feasibility trial comparing BREATHE Ethiopia to Treatment as Usual (n=40) to assess trial procedures, acceptability and feasibility of intervention delivery, and investigate potential effectiveness and implementation. In a process evaluation we will collect data that will be critical for a future fully randomized controlled trial, including the numbers of participants who are eligible, who consent, who engage in treatment, and who complete the assessments, as well as the feasibility and acceptability of assessments and the intervention. Qualitative data on facilitators and barriers to intervention delivery and quantitative data on provider fidelity to the intervention and participant and provider satisfaction will also be collected. Quantitative assessments at baseline, post-treatment, one-month follow-up, and three-month follow-up will assess change in mental health symptoms and functional impairment and hypothesized intervention mechanisms, including knowledge about PTSD, stigma, trauma-related cognitions, and physiological arousal. DiscussionFindings from this study will inform a future fully-powered randomized controlled trial, and if found to be effective, the intervention has the potential to be integrated into mental healthcare scale-up efforts in other low-resource settings. Trial RegistrationRegistered with ClinicalTrials.gov (NCT04385498) first posted May 13th, 2020; https://www.clinicaltrials.gov/ct2/show/NCT04385498?term=ethiopia&cond=PTSD&draw=2&rank=1.

scholarly journals LOW-COST DEVELOPMENT OF AN INTERACTIVE, IMMERSIVE VIRTUAL REALITY EXPERIENCE OF THE HISTORIC CITY MODEL STADE 1620

2019 ◽  
Vol XLII-2/W17 ◽  
pp. 405-411 ◽  
Author(s):  
A. Walmsley ◽  
T. P. Kersten
Keyword(s):  
Virtual Reality ◽  
Virtual Environments ◽  
Low Cost ◽  
Simple Game ◽  
Texture Mapping ◽  
Immersive Virtual Reality ◽  
City Model ◽  
Virtual City ◽  
The Individual ◽  
The Town

Abstract. As virtual reality and 3D documentation and modelling technologies become increasingly powerful and affordable tools for architecture, planning, and cultural heritage preservation and communication, it has become increasingly important to develop low-cost methodologies for the creation of 3D immersive virtual environments and interactive experiences. Doing so makes this technology more viable for institutions such as museums and other cultural institutions, who often work within strict budgets. In this paper, we describe a workflow used to build an interactive, immersive virtual reality experience around a virtual city model of the town of Stade (Germany) in the year 1620. This virtual city model is based on a physical 3D model of the town, exhibited in the Stade town hall. The workflow begins with the digitization of this model using digital photogrammetry, followed by the subsequent low- and high-polygon modelling of the individual architectural assets in Autodesk Maya, texture mapping in Substance Painter and finally visualisation within Unreal Engine 4. The results of this workflow are a detailed 3D historical environment with a high degree of realism and in which interactivity can easily be added. In addition, the workflow takes a highly iterative approach that allows the performance of the virtual environments in the game engine to be monitored at each stage of the process, and that allows adjustments to be made quickly. To increase the potential of the virtual environment as a tool for education and communication, interactive elements and simple game mechanics are currently being integrated.

scholarly journals Exploring Drugbank in Virtual Reality Chemical Space

2018 ◽  
Author(s):  
Daniel Probst ◽  
Jean-Louis Reymond
Keyword(s):  
Virtual Reality ◽  
Virtual Environments ◽  
Chemical Space ◽  
3D Visualization ◽  
Low Cost ◽  
Natural Extension ◽  
Web Based ◽  
3D Engine ◽  
Abstract Data ◽  
2D And 3D

The recent general availability of low-cost virtual reality headsets, and accompanying 3D engine support, presents an opportunity to bring the concept of chemical space into virtual environments. While virtual reality applications represent a category of widespread tools in other fields, their use in the visualization and exploration of abstract data such as chemical spaces has been experimental. In our previous work we established the concept of interactive 2D maps of chemical spaces, followed by interactive web-based 3D visualizations, culminating in the interactive web-based 3D visualization of extremely large chemical spaces. Virtual reality chemical spaces are a natural extension of these concepts. As 2D and 3D embeddings, and projections of high-dimensional chemical fingerprint spaces were shown to be valuable tools in chemical space visualization and exploration, existing pipelines of data mining and preparation can be extended to be used in virtual reality applications. Here we present an application based on the Unity engine and the virtual reality toolkit (VRTK), allowing for the interactive exploration of chemical space populated by Drugbank compounds in virtual reality. The source code of the application as well as the most recent build are available on GitHub.

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