Virtual Reality Relaxation for Patients With a Psychiatric Disorder: Crossover Randomized Controlled Trial

Background Virtual reality (VR) relaxation is a promising mental health intervention that may be an effective tool for stress reduction but has hardly been tested in clinical trials with psychiatric patients. We developed an easy-to-use VR self-management relaxation tool (VRelax) with immersive 360° nature videos and interactive animated elements. Objective To investigate the immediate effects of VR relaxation on negative and positive affective states and short-term effects on perceived stress and symptoms in patients with a psychiatric disorder, compared to standard relaxation exercises. Methods A randomized crossover trial was conducted in 50 patients receiving ambulatory treatment for anxiety, psychotic, depressive, or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation and used both interventions for 10 days at home. They completed 8 visual analog scales of momentary negative and positive affective states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel mixed model regression analyses and 2-way analysis of variance. Results Both VRelax and standard relaxation exercises led to a statistically significant immediate improvement of all negative and positive affective states. Compared to standard relaxation, VRelax resulted in a significantly greater reduction of total negative affective state (change 16.2% versus 21.2%; t1684=−2.02, 95% CI −18.70 to −0.28; P=.04). Specifically, VRelax had a stronger beneficial effect on momentary anxiety (t1684=−3.24, 95% CI −6.86 to −1.69), sadness (t1684=−2.32, 95% CI −6.51 to −0.55), and cheerfulness (t1684=2.35, 95% CI 0.51 to 5.75). There were no significant differences between short-term effects of the two treatments on global perceived stress and symptoms. Conclusions If the results of this trial are replicated and extended, VRelax may provide a much-needed, effective, easy-to-use self-management relaxation intervention to enhance psychiatric treatments. Trial Registration Netherlands Trial Register NTR7294; https://www.trialregister.nl/trial/7096

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Virtual Reality Relaxation for Patients With a Psychiatric Disorder: Crossover Randomized Controlled Trial (Preprint)

10.2196/preprints.17233 ◽

2019 ◽

Author(s):

Wim Veling ◽

Bart Lestestuiver ◽

Marieke Jongma ◽

H J Rogier Hoenders ◽

Catheleine van Driel

Keyword(s):

Virtual Reality ◽

Psychiatric Disorder ◽

Perceived Stress ◽

Psychiatric Symptoms ◽

Self Management ◽

Affective States ◽

Short Term ◽

Before And After ◽

Relaxation Exercises ◽

Short Term Effects

BACKGROUND Virtual reality (VR) relaxation is a promising mental health intervention that may be an effective tool for stress reduction but has hardly been tested in clinical trials with psychiatric patients. We developed an easy-to-use VR self-management relaxation tool (VRelax) with immersive 360° nature videos and interactive animated elements. OBJECTIVE To investigate the immediate effects of VR relaxation on negative and positive affective states and short-term effects on perceived stress and symptoms in patients with a psychiatric disorder, compared to standard relaxation exercises. METHODS A randomized crossover trial was conducted in 50 patients receiving ambulatory treatment for anxiety, psychotic, depressive, or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation and used both interventions for 10 days at home. They completed 8 visual analog scales of momentary negative and positive affective states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel mixed model regression analyses and 2-way analysis of variance. RESULTS Both VRelax and standard relaxation exercises led to a statistically significant immediate improvement of all negative and positive affective states. Compared to standard relaxation, VRelax resulted in a significantly greater reduction of total negative affective state (change 16.2% versus 21.2%; t1684=−2.02, 95% CI −18.70 to −0.28; P=.04). Specifically, VRelax had a stronger beneficial effect on momentary anxiety (t1684=−3.24, 95% CI −6.86 to −1.69), sadness (t1684=−2.32, 95% CI −6.51 to −0.55), and cheerfulness (t1684=2.35, 95% CI 0.51 to 5.75). There were no significant differences between short-term effects of the two treatments on global perceived stress and symptoms. CONCLUSIONS If the results of this trial are replicated and extended, VRelax may provide a much-needed, effective, easy-to-use self-management relaxation intervention to enhance psychiatric treatments. CLINICALTRIAL Netherlands Trial Register NTR7294; https://www.trialregister.nl/trial/7096

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T94. VIRTUAL REALITY STRESS REDUCTION FOR PATIENTS WITH PSYCHIATRIC DISORDERS: CROSS-OVER RANDOMIZED CONTROLLED TRIAL

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.654 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S267-S267

Author(s):

Wim Veling ◽

Bart Lestestuiver ◽

Marieke Jongma ◽

Rogier Hoenders ◽

Catheleine van Driel

Keyword(s):

Virtual Reality ◽

Psychiatric Disorder ◽

Psychiatric Disorders ◽

Perceived Stress ◽

Stress Level ◽

Psychiatric Symptoms ◽

Mood States ◽

Self Management ◽

Before And After ◽

Relaxation Exercises

Abstract Background Psychosocial stress is associated with onset and relapse of psychosis, and stress-reactivity is high in patients with psychotic disorder. Stress management is an important part of treatment, but stress-reducing interventions are challenging for people with psychotic or other psychiatric disorder. We developed a virtual reality self-management relaxation tool (VRelax; 360o nature videos with interactive elements) and investigated its immediate effects on stress level, mood states and symptoms in patients with a psychotic or other psychiatric disorder, compared to standard relaxation exercises. Methods A randomized cross-over trial was conducted in 50 patients receiving ambulatory treatment for psychotic, anxiety, depressive or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation, and used both interventions for 10 days at home. They completed Visual Analogue Scales (VAS) of stress level and mood states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel repeated-measures regression models and two-way ANOVA. Results Both VRelax and standard relaxation exercises reduced subjective stress and improved momentary mood states. Compared to standard relaxation, VRelax resulted in a significantly greater immediate improvement of anxiety (B=-4.30, 95%CI=-5.86;-2.73), sadness (B=-3.65, 95%CI =-5.39;-1.91), cheerfulness (B=3.67, 95%CI=2.15;5.18), overall positive mood (B=7.59, 95%CI=2.28;12.89), and overall negative mood (B=10.88, 95%CI=5.89;15.87). There were no significant differences between short-term effects of the two treatments on symptoms and global perceived stress. Discussion If the results of this trial are replicated and extended, VRelax may provide a much needed effective self-management stress intervention to enhance treatment of patients with psychotic and other psychiatric disorders.

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Analytical psychodrama with adolescents suffering from psycho-behavioral disorder: Short-term effects on psychiatric symptoms

The Arts in Psychotherapy ◽

10.1016/j.aip.2010.04.010 ◽

2010 ◽

Vol 37 (3) ◽

pp. 240-247 ◽

Cited By ~ 12

Author(s):

Michela Gatta ◽

Dal Zotto Lara ◽

Del Col Lara ◽

Spoto Andrea ◽

Testa Costantino Paolo ◽

...

Keyword(s):

Psychiatric Symptoms ◽

Behavioral Disorder ◽

Short Term ◽

Short Term Effects

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Using “Stages of Behavioral Change” Constructs to Measure the Short-Term Effects of a Worksite-Based Intervention to Increase Moderate Physical Activity

Psychological Reports ◽

10.2466/pr0.1998.82.2.615 ◽

1998 ◽

Vol 82 (2) ◽

pp. 615-618 ◽

Cited By ~ 17

Author(s):

Galen Cole ◽

Sharon Hammond ◽

Bruce Leonard ◽

Fred Fridinger

Keyword(s):

Physical Activity ◽

Stages Of Change ◽

Transtheoretical Model ◽

Moderate Physical Activity ◽

Short Term ◽

Incentive Program ◽

Maintenance Stage ◽

Before And After ◽

Change Concept ◽

Short Term Effects

We evaluated a three-level incentive program to promote regular, moderate physical activity among employees working in a federal agency. The objective was to assess the short-term effects of the intervention by examining the stages people go through as they attempt to make permanent changes in physical activity. Indicators of the process by which changes in physical activity take place were based on a modified version of the Transtheoretical Model of Behavior. A one-group pretest/posttest design was used to ascertain which of the stages the 1,192 participants were in both before and after the intervention. Analysis indicated that, of the 1,192 participants, 6.5% regressed one or more stages, 30.3% did not regress or progress from one stage to another, 27.7% remained in the maintenance stage, and 35.4% progressed one (21.1%) or more (14.3%) stages during the 50-day intervention. Among those who progressed, the most common change was from preparation to late preparation (20.8%) and from late preparation to action (19.4%). Findings reinforce the notion that the stages of change concept can serve as indicators of the change process which, in turn, can be used as evidence of the short-term effectiveness of interventions. Findings also indicate this type of intervention holds promise for increasing physical activity among willing participants of a worksite population.

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Short-term effects of psychiatric symptoms and interpersonal stressors on criminal violence

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-006-0056-0 ◽

2006 ◽

Vol 41 (7) ◽

pp. 532-540 ◽

Cited By ~ 13

Author(s):

Ulrika Haggård-Grann ◽

Johan Hallqvist ◽

Niklas Långström ◽

Jette Möller

Keyword(s):

Psychiatric Symptoms ◽

Short Term ◽

Criminal Violence ◽

Interpersonal Stressors ◽

Short Term Effects

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Restore or get restored: The effect of control on stress reduction and restoration in virtual nature settings

10.31234/osf.io/5weuk ◽

2021 ◽

Author(s):

Gerhard Reese ◽

Elias Kohler ◽

Claudia Menzel

Keyword(s):

Virtual Reality ◽

Stress Reduction ◽

Well Being ◽

Control Beliefs ◽

Future Research ◽

Affective States ◽

Positive Effects ◽

Main Effect ◽

Before And After ◽

And Control

Virtual nature experiences can improve physiological and psychological well-being. While there is ample research on the positive effects of nature, both in virtual and physical settings, we know little about potential moderators of restoration effects in virtual reality settings. According to theories of needs and control beliefs, it is plausible to assume that control over one’s actions affects how people respond to nature experiences. In this Virtual Reality (VR) experiment, 64 participants could either actively navigate through a VR landscape or they were navigated by the experimenter. We measured their perceived stress, mood, and vitality before and after the VR experience, as well as subjective restoration outcome and perceived restorativeness of the landscape afterwards. Results revealed that participants’ positive affective states increased after the VR experience, regardless of control. There was also a main effect such that participants reported lower stress after the VR experience – however, qualified by an interaction showing that this was only the case in the “no control” condition. These results suggest that - unexpectedly - active VR experiences may be more stressful than passive ones, opening pathways for future research on how handling of and navigating in VR can attenuate effects of virtual nature.

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Feeling Stressed and Ugly? Leave the City and Visit Nature! An Experiment on Self- and Other-Perceived Stress and Attractiveness Levels

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228519 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8519

Author(s):

Claudia Menzel ◽

Fiona Dennenmoser ◽

Gerhard Reese

Keyword(s):

Perceived Stress ◽

Urban Environments ◽

Natural Environments ◽

Body Appreciation ◽

Short Term ◽

Self And Other ◽

Before And After ◽

The Face ◽

Stressful Experience ◽

The City

Natural environments, compared to urban environments, usually lead to reduced stress and positive body appreciation. We assumed that walks through nature and urban environments affect self- and other-perceived stress and attractiveness levels. Therefore, we collected questionnaire data and took photographs of male participants’ faces before and after they took walks. In a second step, female participants rated the photographs. As expected, participants felt more restored and attractive, and less stressed after they walked in nature compared to an urban environment. A significant interaction of environment (nature, urban) and time (pre, post) indicated that the men were rated by the women as being more stressed after the urban walk. Other-rated attractiveness levels, however, were similar for both walks and time points. In sum, we showed that the rather stressful experience of a short-term urban walk mirrors in the face of men and is detectable by women.

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