scholarly journals Behavioral and Magnetoencephalographic Correlates of Fear Generalization Are Associated with Responses to Later Virtual Reality Exposure Therapy in Spider Phobia

2021 ◽  
Author(s):  
Kati Roesmann ◽  
Elisabeth J. Leehr ◽  
Joscha Boehnlein ◽  
Christian Steinberg ◽  
Fabian Seeger ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Exposure Therapy ◽  
Treatment Success ◽  
Post Treatment ◽  
Spider Phobia ◽  
Virtual Reality Exposure Therapy ◽  
Fear Generalization ◽  
Spatio Temporal ◽  
Pre Treatment ◽  
Virtual Reality Exposure

As overgeneralization of fear is a pathogenic marker of anxiety disorders, we investigated whether pre-treatment levels of fear generalization in spider-phobic patients are associated with their response to exposure-based treatment, in order to identify pre-treatment correlates of treatment success. Ninety patients with spider phobia completed pre-treatment clinical and magnetoencephalography (MEG) assessments, one session of virtual reality exposure therapy, and a post-treatment clinical assessment. Based on the primary outcome (30% symptom reduction in self-reported symptoms from pre- to post-treatment) they were categorized as responders or non-responders. In a pre-treatment MEG fear generalization paradigm involving fear conditioning with two unconditioned stimuli (UCS), we obtained fear ratings, UCS-expectancy ratings, and event-related fields to conditioned stimuli (CS+, CS-) and 7 different generalization stimuli (GS) on a perceptual continuum from CS+ to CS-. Prior to treatment, non-responders showed behavioral overgeneralization indicated by more linear generalization gradients in fear ratings. Analyses of MEG source estimations revealed that non-responders showed a decline of their (inhibitory) frontal activations to safety-signaling CS- and GS compared to CS+ over time, while responders maintained these activations at early (<300ms) and late processing stages. Results provide initial evidence that pre-treatment differences of behavioral and neural markers of fear generalization are associated with later responses to behavioral exposure. Findings demonstrate the relevance of inhibitory learning functions and their spatio-temporal neural reflections in this interplay. Findings stimulate research on mechanism-based augmentation strategies for behavioral therapies.

Virtual Reality Exposure Therapy for treating social anxiety in stuttering: A scoping review

2021 ◽  
Author(s):  
Ian Chard ◽  
Nejra van Zalk
Keyword(s):  
Virtual Reality ◽  
Social Anxiety ◽  
Public Speaking ◽  
Exposure Therapy ◽  
Treatment Success ◽  
Future Research ◽  
Effective Technique ◽  
Virtual Reality Exposure Therapy ◽  
Research Questions ◽  
Virtual Reality Exposure

Virtual Reality Exposure Therapy (VRET) has been shown to be an effective technique for reducing social anxiety. People who stutter are at greater risk of developing heightened social anxiety. Cognitive behavior therapy protocols have shown promise in reducing social anxiety in people who stutter, but no studies have investigated VRET targeting social anxiety associated with stuttering. The aim of the current review is to provide an overview of VRET techniques used to treat social anxiety and insights into how VRET might be adopted in the case of comorbid stuttering and social anxiety. Twelve studies were reviewed to understand key distinctions in VRET protocols used to treat social anxiety. Distinctions include exercises targeting public speaking vs. general social anxiety, computer-generated virtual environments vs. 360 video, and therapist guided vs. automated VRET. An overview of wider research questions surrounding VRET is then presented to aid the understanding of treatment success and outline important directions for future research. Based on the review findings, suggestions are made regarding VRET design for stuttering. In sum, VRET should be tailored to situations and cognitive-behavioral processes that underlie the experience of social anxiety amongst people who stutter, with automated VRET using a virtual therapist a potentially suitable format for delivering treatment.

scholarly journals Experiences of Gamified and Automated Virtual Reality Exposure Therapy for Spider Phobia: Qualitative Study

10.2196/17807 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e17807 ◽  
Author(s):  
Philip Lindner ◽  
Alexander Rozental ◽  
Alice Jurell ◽  
Lena Reuterskiöld ◽  
Gerhard Andersson ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorders ◽  
Exposure Therapy ◽  
Real Life ◽  
Spider Phobia ◽  
Semistructured Interview ◽  
User Experiences ◽  
Virtual Reality Exposure Therapy ◽  
Virtual Reality Exposure

Background Virtual reality exposure therapy is an efficacious treatment of anxiety disorders, and recent research suggests that such treatments can be automated, relying on gamification elements instead of a real-life therapist directing treatment. Such automated, gamified treatments could be disseminated without restrictions, helping to close the treatment gap for anxiety disorders. Despite initial findings suggesting high efficacy, very is little is known about how users experience this type of intervention. Objective The aim of this study was to examine user experiences of automated, gamified virtual reality exposure therapy using in-depth qualitative methods. Methods Seven participants were recruited from a parallel clinical trial comparing automated, gamified virtual reality exposure therapy for spider phobia against an in vivo exposure equivalent. Participants received the same virtual reality treatment as in the trial and completed a semistructured interview afterward. The transcribed material was analyzed using thematic analysis. Results Many of the uncovered themes pertained directly or indirectly to a sense of presence in the virtual environment, both positive and negative. The automated format was perceived as natural and the gamification elements appear to have been successful in framing the experience not as psychotherapy devoid of a therapist but rather as a serious game with a psychotherapeutic goal. Conclusions Automated, gamified virtual reality exposure therapy appears to be an appealing treatment modality and to work by the intended mechanisms. Findings from the current study may guide the next generation of interventions and inform dissemination efforts and future qualitative research into user experiences.

scholarly journals Experiences of Gamified and Automated Virtual Reality Exposure Therapy for Spider Phobia: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Philip Lindner ◽  
Alexander Rozental ◽  
Alice Jurell ◽  
Lena Reuterskiöld ◽  
Gerhard Andersson ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Anxiety Disorders ◽  
Exposure Therapy ◽  
Real Life ◽  
Spider Phobia ◽  
Semistructured Interview ◽  
User Experiences ◽  
Virtual Reality Exposure Therapy ◽  
Virtual Reality Exposure

BACKGROUND Virtual reality exposure therapy is an efficacious treatment of anxiety disorders, and recent research suggests that such treatments can be automated, relying on gamification elements instead of a real-life therapist directing treatment. Such automated, gamified treatments could be disseminated without restrictions, helping to close the treatment gap for anxiety disorders. Despite initial findings suggesting high efficacy, very is little is known about how users experience this type of intervention. OBJECTIVE The aim of this study was to examine user experiences of automated, gamified virtual reality exposure therapy using in-depth qualitative methods. METHODS Seven participants were recruited from a parallel clinical trial comparing automated, gamified virtual reality exposure therapy for spider phobia against an in vivo exposure equivalent. Participants received the same virtual reality treatment as in the trial and completed a semistructured interview afterward. The transcribed material was analyzed using thematic analysis. RESULTS Many of the uncovered themes pertained directly or indirectly to a sense of presence in the virtual environment, both positive and negative. The automated format was perceived as natural and the gamification elements appear to have been successful in framing the experience not as psychotherapy devoid of a therapist but rather as a serious game with a psychotherapeutic goal. CONCLUSIONS Automated, gamified virtual reality exposure therapy appears to be an appealing treatment modality and to work by the intended mechanisms. Findings from the current study may guide the next generation of interventions and inform dissemination efforts and future qualitative research into user experiences.

Automated virtual reality exposure therapy for spider phobia vs. in-vivo one-session treatment: A randomized non-inferiority trial

2019 ◽  
Vol 118 ◽  
pp. 130-140 ◽  
Author(s):  
Alexander Miloff ◽  
Philip Lindner ◽  
Peter Dafgård ◽  
Stefan Deak ◽  
Maria Garke ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Exposure Therapy ◽  
Spider Phobia ◽  
Virtual Reality Exposure Therapy ◽  
Virtual Reality Exposure
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