Acceptability and Perceived Utility of Virtual Reality among People who are Incarcerated who use Drugs: A Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Kasey Claborn ◽  
Fiona Conway ◽  
Katlyn Brinkley ◽  
Regan Hill ◽  
Sanjana Kalvakuntla ◽  
...  
Keyword(s):  
Substance Use ◽  
Virtual Reality ◽  
Stress Response ◽  
Mixed Models ◽  
Repeated Measures ◽  
Stress Reactivity ◽  
Qualitative Interviews ◽  
Skills Training ◽  
Perceived Utility ◽  
Environmental Trigger

UNSTRUCTURED Virtual reality (VR) allows a platform to create common scenarios of environmental trigger situations to elicit drug cravings. We know little about acceptability of VR among people who are incarcerated who use drugs. Mixed methods explored VR perspectives and stress response among 20 inmates with a substance use disorder at a county jail. Cardiovascular data were collected to determine if exposure to the VR environment provoked a stress response. Repeated measures mixed models were used to assess stress reactivity measured by three heart rate variability indices (HR, RMSSD, and HF-HRV). Qualitative interviews assessed acceptability and perceived utility on VR in the jail setting. Cardiovascular data analyses showed no significant increase in stress reactivity for HR (b = -3.14, t(18) = -3.85, p < .01 ), RMSSD (b = -0.06, t(18) = -1.06, p = 0.30 ) and HF-HRV (b = -0.21, t(18) = -1.71, p = 0.10). Qualitative data indicate high levels of acceptability and potential utility in the following thematic areas: (1) mental health and substance use interventions; (2) community re-entry skills training; and (3) communication and conflict resolution skills. Results demonstrated high acceptability and no significant stress response of VR among people who are incarcerated who use drugs.

scholarly journals Associations between Longitudinal Patterns of Substance Use and Anxiety and Depression Symptoms among a Sample of Canadian Secondary School Students

2021 ◽  
Vol 18 (19) ◽  
pp. 10468
Author(s):  
Gillian C. Williams ◽  
Karen A. Patte ◽  
Mark A. Ferro ◽  
Scott T. Leatherdale
Keyword(s):  
Substance Use ◽  
Mixed Models ◽  
Repeated Measures ◽  
Latent Class ◽  
Treatment Strategies ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Cigarette Use ◽  
School Students ◽  
Relevant Covariates

The objective of this study is to examine the longitudinal associations between latent classes of substance use and anxiety and depression scores among youth who use substances. This study uses data from three waves (Wave 1: 2017/18, Wave 2: 2018/19, and Wave 3: 2019/20) of the COMPASS study. Students in grades 9 and 10 who reported substance use at baseline (n = 738) report their substance use (alcohol, cannabis, cigarettes, and e-cigarettes) and anxiety and depression symptoms at each wave. A Repeated Measures Latent Class Analysis (RMLCA) is used to determine substance use classes, and mixed models are used to examine the associations between substance use classes and anxiety and depression. We identify three classes of substance use: (1) occasional alcohol and e-cigarette use, (2) escalating poly-substance use, and (3) consistent poly-substance use. After controlling for relevant covariates, consistent poly-substance use is associated with depression (Female OR: 1.24 [95%CI: 0.46, 2.02]; Male OR 1.13 [95%CI: 0.38, 1.87]) but not anxiety. Escalating poly-substance use is associated with depression among males (OR 0.72 [95%CI: 0.10, 1.33]). These findings should be taken into consideration when creating prevention programming and treatment strategies for adolescents. Substance use programming should be comprehensive, consider multiple substances, and be cognizant of symptoms of mental illness, particularly depression.

scholarly journals Virtual Reality Meditation Among Youth Experiencing Homelessness: Pilot Randomized Controlled Trial of Feasibility (Preprint)

2020 ◽  
Author(s):  
Laura Johnson Chavez ◽  
Kelly Kelleher ◽  
Natasha Slesnick ◽  
Eugene Holowacz ◽  
Ellison Luthy ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Virtual Reality ◽  
Outcome Measures ◽  
Effect Size ◽  
Homeless Youth ◽  
Skills Training ◽  
Significant Group ◽  
Web Based ◽  
Mindfulness Skills

BACKGROUND Homelessness among youth is devastating, with high rates of substance use disorders and mental health comorbidity. Mindfulness-based interventions that include meditation and mindfulness skills training reduce stress and symptoms of anxiety or depression. However, engaging high-risk youth in interventions is challenging. Virtual reality is a more flexible platform for delivering meditation and may be appealing to youth. OBJECTIVE The study objectives were to evaluate the feasibility of delivering virtual reality meditation and of collecting outcome measures, including anxiety and physiologic stress. METHODS A sample of 30 youth experiencing homelessness was enrolled in the study. Youth were randomized to receive 10 minutes of one of three interventions: (1) virtual reality meditation, (2) audio meditation (through a web-based platform), or (3) virtual reality imagery of historical pictures and text. Subjects who consented to the study attended two research visits. The first visit collected survey measures of demographics, mental health, and substance use, and oriented subjects to the intervention platforms. The second visit (1-3 days later) delivered the intervention and collected pre and post outcome measures of anxiety and physiologic stress (salivary cortisol). Changes in anxiety and cortisol at the second visit were compared across groups using a linear regression model in which the primary analysis compared virtual reality meditation to audio meditation and secondary analyses compared virtual reality meditation to virtual reality imagery. RESULTS Anxiety scores decreased in all groups, with a larger reduction among the virtual reality meditation group (difference=10.8) compared to the web-based meditation or virtual reality images groups (difference=5.8 and 5.0, respectively). After controlling for baseline values, there were no significant group differences in changes in anxiety scores or cortisol levels. In comparing virtual reality meditation and audio meditation, the effect size for anxiety was moderate (Cohen <i>d</i>=0.58) while the effect size for cortisol was small (Cohen <i>d</i>=0.08). CONCLUSIONS Preliminary results suggest that virtual reality meditation has a moderate benefit for anxiety but not physiologic stress. Future research is needed to confirm these results in a larger sample and to investigate whether the effects are sustained or increase with repeated use of virtual reality mediation. Virtual reality meditation appears feasible to deliver among homeless youth and merits further study. CLINICALTRIAL ClinicalTrials.gov NCT04004520; https://clinicaltrials.gov/ct2/show/NCT04004520

scholarly journals Virtual Reality Meditation Among Youth Experiencing Homelessness: Pilot Randomized Controlled Trial of Feasibility

10.2196/18244 ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. e18244
Author(s):  
Laura Johnson Chavez ◽  
Kelly Kelleher ◽  
Natasha Slesnick ◽  
Eugene Holowacz ◽  
Ellison Luthy ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Virtual Reality ◽  
Outcome Measures ◽  
Effect Size ◽  
Homeless Youth ◽  
Skills Training ◽  
Significant Group ◽  
Web Based ◽  
Mindfulness Skills

Background Homelessness among youth is devastating, with high rates of substance use disorders and mental health comorbidity. Mindfulness-based interventions that include meditation and mindfulness skills training reduce stress and symptoms of anxiety or depression. However, engaging high-risk youth in interventions is challenging. Virtual reality is a more flexible platform for delivering meditation and may be appealing to youth. Objective The study objectives were to evaluate the feasibility of delivering virtual reality meditation and of collecting outcome measures, including anxiety and physiologic stress. Methods A sample of 30 youth experiencing homelessness was enrolled in the study. Youth were randomized to receive 10 minutes of one of three interventions: (1) virtual reality meditation, (2) audio meditation (through a web-based platform), or (3) virtual reality imagery of historical pictures and text. Subjects who consented to the study attended two research visits. The first visit collected survey measures of demographics, mental health, and substance use, and oriented subjects to the intervention platforms. The second visit (1-3 days later) delivered the intervention and collected pre and post outcome measures of anxiety and physiologic stress (salivary cortisol). Changes in anxiety and cortisol at the second visit were compared across groups using a linear regression model in which the primary analysis compared virtual reality meditation to audio meditation and secondary analyses compared virtual reality meditation to virtual reality imagery. Results Anxiety scores decreased in all groups, with a larger reduction among the virtual reality meditation group (difference=10.8) compared to the web-based meditation or virtual reality images groups (difference=5.8 and 5.0, respectively). After controlling for baseline values, there were no significant group differences in changes in anxiety scores or cortisol levels. In comparing virtual reality meditation and audio meditation, the effect size for anxiety was moderate (Cohen d=0.58) while the effect size for cortisol was small (Cohen d=0.08). Conclusions Preliminary results suggest that virtual reality meditation has a moderate benefit for anxiety but not physiologic stress. Future research is needed to confirm these results in a larger sample and to investigate whether the effects are sustained or increase with repeated use of virtual reality mediation. Virtual reality meditation appears feasible to deliver among homeless youth and merits further study. Trial Registration ClinicalTrials.gov NCT04004520; https://clinicaltrials.gov/ct2/show/NCT04004520

Virtual reality interventions to improve cognitive functioning in adults with major psychiatric disorders: A narrative systematic review (Preprint)

2021 ◽  
Author(s):  
Donna Monbourquette ◽  
Sadiq Vali ◽  
Sara Harvey ◽  
Kawkab Mahmud ◽  
Miguel Jose ◽  
...  
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Virtual Reality ◽  
Psychiatric Disorders ◽  
Real World ◽  
Cognitive Skills ◽  
Social Cognitive ◽  
Skills Training ◽  
Cognitive Outcomes ◽  
Remediation Strategies

BACKGROUND Cognitive dysfunction is an impairing and difficult to treat feature of psychiatric illnesses. Virtual Reality (VR) has shown promise in improving cognition in neurologic disorders, but its role in improving cognitive outcomes in adults with major psychiatric disorders is unclear. OBJECTIVE To conduct a review of the efficacy and usability of VR interventions to improve cognitive functioning in psychiatric disorders. METHODS Following PRISMA guidelines, a systematic review of controlled and uncontrolled English-language studies that assessed changes in cognition following an immersive or non-immersive VR intervention, in adults with a mood, psychotic, anxiety, or substance use disorder was conducted. Studies were searched on MEDLINE, EMBASE, PsychINFO, and Web of Science until May 2021. RESULTS Thirteen studies were included [primary psychotic disorder (n=10), substance use disorder (n=2) and major depressive disorder (n=1)]. Intervention strategies included cognitive remediation (i.e. repeated practice of targeted skills, n=2), social cognitive/skills training (n=5), real world simulations (n=3) and vocational training (n=3). VR social cognitive/skills training resulted in improvements in social cognition, while the other remediation strategies resulted in generalized improvements across multiple cognitive domains. Both immersive and non-immersive VR appeared to be effective. In studies with an active control group (n=5), VR treatment resulted in equivalent or greater cognitive improvements versus therapist led training. Changes in real-world functioning were inconsistently reported. CONCLUSIONS Preliminary evidence suggests VR interventions can improve cognitive outcomes in psychiatric disorders; however, significant variability in study design and outcome measures, small sample sizes and a focus on primary psychotic disorders limit the literature. More rigorous assessment of long-term cognitive and functional outcomes, and the comparative utility of immersive versus non-immersive modalities and different remediation strategies, is required.

56. Proficiency at the end of practice predicts retention of a technical clinical skills

2007 ◽  
Vol 30 (4) ◽  
pp. 59
Author(s):  
H. Carnahan ◽  
E. Hagemann ◽  
A. Dubrowski
Keyword(s):  
Virtual Reality ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Technical Skills ◽  
Skills Training ◽  
Retention Performance ◽  
Specific Criterion ◽  
Practice Trials ◽  
Practice Time ◽  
Criterion Time

A debate is emerging regarding the efficacy of proficiency based versus duration based training of technical skills. It is not clear whether the performance level attained at the end of practice (i.e., proficiency criteria), or the overall amount of practice performed during learning will best predict the retention of a technical clinical skill. The skill learned was the single-handed double square-knot. Forty two trainees learned the skill through video-based instruction and were divided into three groups (14 participants per group) each with a specific criterion time to tie the knot (10, 15, and 20 seconds). Practice continued until participants completed the knot within their criterion time. The total number of trials, and the overall practice time required to obtain each respective criterion were recorded during practice. Participants returned one-week later for a timed retention test consisting of one trial of the knot tying skill with no video instruction. A multiple regression analysis tested whether the amount of practice, the total practice time, or the criterion reached at the end of practice was the best predictor of the time taken to perform the skill during retention. This analysis showed that the number of practice trials was highly correlated with total practice time (r = .82, p = .01), therefore total practice time was withdrawn as a predictor variable from the subsequent analysis. The regression showed that the only significant predictor of retention performance was the criterion reached at the end of practice (p = .03). The number of practice trials was not found to significantly predict the retention performance (p = .87). The results support the notion that proficiency based training results in better retention of a technical clinical skill in comparison to duration based approaches. This provides evidence for the introduction of proficiency based educational approaches in technical skills curricula. Jowett N, LeBlanc V, Xeroulis G, MacRae H, Dubrowski A. Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg. 2007; 193(2):237-42. Gallagher AG, Ritter EM, Champion H, Higgins G, Fried MP, Moses G, Smith CD, Satava RM. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg. 2005; 241(2):364-72. Van Sickle KR, Ritter EM, McClusky DA, Lederman A, Baghai M, Gallagher AG, Smith CD. Attempted establishment of proficiency levels for laparoscopic performance on a national scale using simulation: the results from the 2004 SAGES Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) learning center study. Surg Endosc. 2007; 21(1):5-10.

Virtual reality in social skills training programs for people with schizophrenia: A systematic review and focus group

2021 ◽  
pp. 030802262110113
Author(s):  
Catarina Oliveira ◽  
Raquel Simões de Almeida ◽  
António Marques
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Virtual Reality ◽  
Social Skills ◽  
Focus Group ◽  
Social Skills Training ◽  
Occupational Therapists ◽  
Skills Training ◽  
Training Programme ◽  
Cochrane Library

Introduction This study aims to determine the guidelines for the design of a social skills training programme for people with schizophrenia using virtual reality. Methods This article encompasses two studies: Study 1, a systematic review of five articles indexed in the databases B-on, PubMed, Clinical trials and Cochrane Library (2010–2020); Study 2, a focus group of occupational therapists trained in mental health and multimedia professionals, in which they discussed the outline of such a programme. Results A set of guidelines were identified as central and consensual which should be included in the programme. It must have multilevel logic and gradual learning, with simulations of everyday situations, in which it is possible to practise the skills of conversation and communication. Virtual reality provides people with schizophrenia with unlimited opportunities, enhancing a personalized intervention. Conclusion Social skills training could be part of the treatment for people with schizophrenia, and virtual reality is a promising tool to complement traditional training, although still little implemented in mental health services. Occupational therapists have a prominent role in the development and application of this because of their knowledge of activity analysis and their ability to facilitate the generalization of skills in different contexts.

scholarly journals Clinical characterization of dysautonomia in long COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicolas Barizien ◽  
Morgan Le Guen ◽  
Stéphanie Russel ◽  
Pauline Touche ◽  
Florent Huang ◽  
...  
Keyword(s):  
Mixed Models ◽  
Repeated Measures ◽  
Physical Medicine ◽  
Persistent Symptoms ◽  
Index Changes ◽  
Changes Over Time ◽  
And Control ◽  
Testing Group ◽  
Over Time

AbstractIncreasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. 39 participants were included from December 2020 to January 2021 for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200 pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. A significant NOL index dissociation over time between long COVID-19 participants with fatigue and control participants was observed (p = 0.046). A trend towards significant NOL index dissociation over time was observed between long COVID-19 participants without fatigue and control participants (p = 0.109). No difference over time was observed between the two groups of long COVID-19 participants (p = 0.904). Long COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia. Trial registration: The study was approved by the Foch IRB: IRB00012437 (Approval Number: 20-12-02) on December 16, 2020.

scholarly journals Intimate Partner Violence and Structural Violence in the Lives of Incarcerated Women: A Mixed-Method Study in Rural New Mexico

2021 ◽  
Vol 18 (12) ◽  
pp. 6185
Author(s):  
Shilo St. Cyr ◽  
Elise Trott Jaramillo ◽  
Laura Garrison ◽  
Lorraine Halinka Malcoe ◽  
Stephen R. Shamblen ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Substance Use ◽  
New Mexico ◽  
Rural Communities ◽  
Interpersonal Relationships ◽  
Rural Women ◽  
Partner Violence ◽  
Qualitative Interviews ◽  
Incarcerated Women ◽  
Intimate Partner

Intimate partner violence (IPV) is a common feature in the lives of incarcerated women returning to rural communities, enhancing their risk of mental ill-health, substance use, and recidivism. Women’s experiences of IPV intersect with challenges across multiple social–ecological levels, including risky or criminalizing interpersonal relationships, geographic isolation, and persistent gender, racial, and economic inequities. We conducted quantitative surveys and qualitative interviews with 99 incarcerated women in New Mexico who were scheduled to return to micropolitan or non-core areas within 6 months. Quantitative and qualitative data were analyzed separately and then triangulated to identify convergences and divergences in data. The findings underscore how individual and interpersonal experiences of IPV, substance use, and psychological distress intersect with broad social inequities, such as poverty, lack of supportive resources, and reluctance to seek help due to experiences of discrimination. These results point to the need for a more proactive response to the mutually constitutive cycle of IPV, mental distress, incarceration, and structures of violence to improve reentry for women returning to rural communities. Policy and treatment must prioritize socioeconomic marginalization and expand community resources with attention to the needs of rural women of color.

Changes in multiple sclerosis symptoms are associated with changes in work productivity of people living with multiple sclerosis

2021 ◽  
pp. 135245852199455
Author(s):  
Barnabas Bessing ◽  
Mohammad A Hussain ◽  
Suzi B Claflin ◽  
Jing Chen ◽  
Leigh Blizzard ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Mixed Models ◽  
Repeated Measures ◽  
Work Productivity ◽  
Annual Change ◽  
Individual Variations ◽  
Unit Increase ◽  
The Mean ◽  
Employment Rates ◽  
Study Participants

Background: While employment rates have increased in people with multiple sclerosis (PwMS), little is known about the longitudinal trends of work productivity. Objective: To describe the longitudinal patterns of work productivity and examine the factors associated with annual change of work productivity of PwMS. Methods: Study participants were employed participants of the Australian MS Longitudinal Study (AMSLS) followed from 2015 to 2019 with at least two repeated measures ( n = 2121). We used linear mixed models to examine if the within-individual variations in MS symptoms are associated with changes in work productivity. Results: The mean annual change in work productivity between 2015 and 2019 was −0.23% ( SD = 18.68%). Not the actual severity of symptoms but rather the changes in severity of symptoms that are associated with change in work productivity in the same year. In a multivariable model, every unit increase in mean annual change in ‘pain and sensory symptoms’, ‘feelings of anxiety and depression’, and ‘fatigue and cognitive symptoms’ were independently associated with 2.43%, 1.55% and 1.01% annual reductions in work productivity, respectively. Conclusion: Individual changes in work productivity are largely driven by the changes in symptom severity rather than the absolute severity. Stabilising/improving MS symptoms might improve work productivity.

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