scholarly journals M36. VIRTUAL REALITY COGNITIVE BEHAVIORAL THERAPY FOR PARANOID DELUSIONS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S148-S148
Author(s):  
Maureen Berkhof ◽  
Elisabeth van der Stouwe ◽  
Bart Lestestuiver ◽  
Erna van ‘t Hag ◽  
de Vos Maarten ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Cognitive Behavioral Therapy ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Psychological Treatment ◽  
Daily Life ◽  
Behavioral Therapy ◽  
Cost Effective ◽  
Social Situations

Abstract Background Seventy percent of patients with schizophrenia and other psychotic disorders has paranoid delusions. Paranoid delusions are associated with great distress, hospital admission and social isolation. Cognitive behavioral therapy (CBT) is the main psychological treatment, but the median effect size is only small to medium. Virtual reality (VR) has a great potential to improve psychological treatment of paranoid delusions. In a previous study, we found that VR based CBT (VRcbt) for paranoid delusions is effective compared to waiting list. As a next step, a direct comparison with standard CBT is needed. The aim of this project is to investigate if VRcbt is more (cost-)effective than standard CBT for treatment of paranoid delusions and improving daily life social functioning of patients with schizophrenia and related psychotic disorders. Three research questions will be addressed: 1. Does VRcbt lead to better clinical and social outcomes? 2. Are fewer treatment sessions needed to achieve meaningful clinical change? 3. Is VRcbt more cost-effective at 6 months follow-up? Methods A total of 106 patients with DSM-5 diagnosis of psychotic disorder and at least moderate level of paranoid ideations will be randomized to either VRcbt or standard CBT treatment for paranoid delusions. VRcbt consists of maximum 16 sessions in virtual social situations that trigger paranoid ideations and distress, delivered in an 8–12 week time frame. Standard CBT also consists of maximum 16 sessions, aiming at reappraisal of the meaning of paranoid beliefs to reduce distress and improve coping in daily life, including the use of exposure and behavioral experiments. Participants will be interviewed and tested at baseline, post-treatment and at six months follow-up. Primary outcome is level of paranoid ideations in daily life social situations, measured with ecological momentary assessments (EMA) at semi-random moments ten times a day during seven days, before and after treatment. Every session, participants and therapists will rate level of paranoid ideation and global clinical impression. Results Seven mental health services throughout the Netherlands participate in this RCT. Up until now, fourteen psychologists have been trained in VRcbt and the first patients have been included in the trial. Discussion Comparison of VRcbt and cbt will provide information about the relative (cost-)effectiveness of VRcbt for this population. VRcbt may become the preferred psychological treatment for paranoid delusions and social anxiety in patients with psychotic disorder.

scholarly journals Virtual reality cognitive-behavioural therapy versus cognitive-behavioural therapy for paranoid delusions: a study protocol for a single-blind multi-Centre randomised controlled superiority trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Berkhof ◽  
E. C. D. van der Stouwe ◽  
B. Lestestuiver ◽  
E. van’t Hag ◽  
R. van Grunsven ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Psychotic Disorder ◽  
Cognitive Behavioural Therapy ◽  
Psychotic Disorders ◽  
Psychological Treatment ◽  
Daily Life ◽  
Time Frame ◽  
Behavioural Therapy ◽  
Social Situations ◽  
Cognitive Behavioural

Abstract Background Seventy per cent of patients with psychotic disorders has paranoid delusions. Paranoid delusions are associated with significant distress, hospital admission and social isolation. Cognitive-behavioural therapy for psychosis (CBTp) is the primary psychological treatment, but the median effect size is only small to medium. Virtual reality (VR) has a great potential to improve the effectiveness of CBTp. In a previous study, we found that VR based CBT (VRcbt) for paranoid delusions is superior to waiting list. As a next step, a direct comparison with CBTp is needed. The present study aims to investigate whether VRcbt is more effective and cost-effective than regular CBTp in treating paranoid delusions and improving daily life social functioning of patients with psychotic disorders. Methods A total of 106 patients with DSM-5 diagnosis of psychotic disorder and at least moderate level of paranoid ideations will be recruited for this multicentre randomized controlled trial (RCT). Patients will be randomized to either VRcbt or standard CBTp for paranoid delusions. VRcbt consists of maximum 16 sessions in virtual social situations that trigger paranoid ideations and distress, delivered in an 8–12 week time frame. Standard CBTp also consists of maximum 16 sessions including exposure and behavioural experiments, delivered in an 8–12 week time frame. The two groups will be compared at baseline, post-treatment and six months follow-up. Primary outcome is the level of paranoid ideations in daily life social situations, measured with ecological momentary assessments (EMA) at semi-random moments ten times a day during seven days, before and after treatment. Every session, participants and therapists will rate the level of paranoid ideation and global clinical impression. Discussion Comparison of VRcbt and CBTp will provide information about the relative (cost-) effectiveness of VRcbt for this population. VRcbt may become a preferred psychological treatment for paranoid delusions and social anxiety in patients with psychotic disorder. Trial registration Netherlands Trial Register, NL7758. Registered on 23 May 2019.

scholarly journals One-year randomized trial comparing virtual reality-assisted therapy to cognitive–behavioral therapy for patients with treatment-resistant schizophrenia

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Laura Dellazizzo ◽  
Stéphane Potvin ◽  
Kingsada Phraxayavong ◽  
Alexandre Dumais
Keyword(s):  
Virtual Reality ◽  
Cognitive Behavioral Therapy ◽  
Psychiatric Symptoms ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Comparative Trial ◽  
Cognitive Behavioral ◽  
Treatment Resistant ◽  
Auditory Verbal Hallucinations

AbstractThe gold-standard cognitive–behavioral therapy (CBT) for psychosis offers at best modest effects. With advances in technology, virtual reality (VR) therapies for auditory verbal hallucinations (AVH), such as AVATAR therapy (AT) and VR-assisted therapy (VRT), are amid a new wave of relational approaches that may heighten effects. Prior trials have shown greater effects of these therapies on AVH up to a 24-week follow-up. However, no trial has compared them to a recommended active treatment with a 1-year follow-up. We performed a pilot randomized comparative trial evaluating the short- and long-term efficacy of VRT over CBT for patients with treatment-resistant schizophrenia. Patients were randomized to VRT (n = 37) or CBT (n = 37). Clinical assessments were administered before and after each intervention and at follow-up periods up to 12 months. Between and within-group changes in psychiatric symptoms were assessed using linear mixed-effects models. Short-term findings showed that both interventions produced significant improvements in AVH severity and depressive symptoms. Although results did not show a statistically significant superiority of VRT over CBT for AVH, VRT did achieve larger effects particularly on overall AVH (d = 1.080 for VRT and d = 0.555 for CBT). Furthermore, results suggested a superiority of VRT over CBT on affective symptoms. VRT also showed significant results on persecutory beliefs and quality of life. Effects were maintained up to the 1-year follow-up. VRT highlights the future of patient-tailored approaches that may show benefits over generic CBT for voices. A fully powered single-blind randomized controlled trial comparing VRT to CBT is underway.

scholarly journals Changes in Brain Activation through Cognitive-Behavioral Therapy with Exposure to Virtual Reality: A Neuroimaging Study of Specific Phobia

2021 ◽  
Vol 10 (16) ◽  
pp. 3505
Author(s):  
Yolanda Álvarez-Pérez ◽  
Francisco Rivero ◽  
Manuel Herrero ◽  
Conrado Viña ◽  
Ascensión Fumero ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Brain Activity ◽  
Brain Activation ◽  
Specific Phobia ◽  
Post Treatment ◽  
Cognitive Behavioral ◽  
Specific Phobias

Background: Cognitive-behavioral therapy (CBT) with exposure is the treatment of choice for specific phobia. Virtual reality exposure therapy (VRET) has shown benefits for the treatment and prevention of the return of fear in specific phobias by addressing the therapeutic limitations of exposure to real images. Method: Thirty-one participants with specific phobias to small animals were included: 14 were treated with CBT + VRET (intervention group), and 17 were treated with CBT + exposure to real images (active control group). Participants’ scores in anxiety and phobia levels were measured at baseline, post-treatment, and 3-month follow-up, and brain activation was measured through functional magnetic resonance imaging (fMRI) baseline and post-treatment. Results: Both groups showed a significant decrease in anxiety and phobia scores after the therapy and were maintained until follow-up. There were no significant differences between both groups. Overall, fMRI tests showed a significant decrease in brain activity after treatment in some structures (e.g., prefrontal and frontal cortex) and other structures (e.g., precuneus) showed an increasing activity after therapy. However, structures such as the amygdala remained active in both groups. Conclusions: The efficacy of CBT + VRET was observed in the significant decrease in anxiety responses. However, the results of brain activity observed suggest that there was still a fear response in the brain, despite the significant decrease in subjective anxiety levels.

Cognitive behavioral therapy focused upon communicational skills enhancement in anorexia nervosa- a case series

2011 ◽  
Vol 26 (S2) ◽  
pp. 740-740
Author(s):  
D. Vasile ◽  
O. Vasiliu ◽  
A.G. Mangalagiu ◽  
C. Tudor ◽  
V. Bogdan ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Cognitive Behavioral Therapy ◽  
Binge Eating ◽  
Psychological Treatment ◽  
Behavioral Therapy ◽  
Case Series ◽  
Eating Attitudes ◽  
Cognitive Behavioral ◽  
The Third

IntroductionAnorexia nervosa (AN) has been approached from multiple medical, social and psychological perspectives, but it still stands as a major challenge for the clinician, due to its resistance to treatment, low therapeutic compliance and severe complications.ObjectiveTo asses the efficacy of an interpersonal focused cognitive-behavioral therapy (CBT) in patients diagnosed with AN.MethodsWe enrolled in 12 weeks, 3 sessions a week, CBT program a number of three patients, females, admitted successively in our departments, diagnosed with AN, who didn’t have previously any kind of psychotherapy. The first patient was 22, diagnosed with AN-restricting type, had a BMI of 14.5 and a score on Eating Attitudes Test (EAT) of 34. The second patient was 19, presented AN-binge eating-purging, had a BMI of 14 and an EAT score of 35. The third patient was 25, had also AN-binge eating-purging, a BMI of 15 and an EAT score of 32.ResultsThe first two patients responded well to the CBT program, but the first signs of recovery (EAT decreases of at least 5 points and increases of at least 1 unit on BMI) appeared after 10 weeks (15 sessions). The third patient discontinued rather fast the psychological treatment. The follow up (12 weeks after endpoint) showed relapse in one CBT-treated patient and a severe status of the patient that discontinued psychotherapy.ConclusionThe CBT focused on communicational skills enhancement is beneficial in patients with AN, but responses appear rather late and need to be boosted by frequent follow-up sessions.

RELATED FACTORS TO RELAPSE IN DEPRESSED PATIENTS AFTER COGNITIVE BEHAVIOURAL THERAPY DURING ONE YEAR PROSPECTIVE FOLLOW-UP

2011 ◽  
pp. 13-19
Author(s):  
Nhu Minh Hang Tran ◽  
Huu Cat Nguyen ◽  
Dang Doanh Nguyen ◽  
Van Luong Ngo ◽  
Vu Hoang Nguyen ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Relapse Rate ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Related Factors ◽  
Depressed Patients ◽  
One Year

Objectives: To determine factors impact on the relapse in depressed patients treated with Cognitive Behavioral Therapy (CBT) during one year follow-up. Materials and Methods: 80 depressed patients divided into two groups, group 1: included 40 patients treated with CBT; group 2: 40 patients on amitriptyline. Non-randomized controlled clinical trial, opened, longiditual and prospective research. Results and Conclusions: relapse rate after CBT during 1 year follow-up is 10% (compared to 25% in control group), related factors to relapse rate in depression after CBT are age and education. Shared predictors between 2 groups are severity and recurrence of depression. Key words: Depression, relapse, Cognitive Behavioral Therapy (CBT)

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