scholarly journals The Efficacy of a Virtual Reality Exposure Therapy Treatment for Fear of Flying: A Retrospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Amihai Gottlieb ◽  
Glen M. Doniger ◽  
Yara Hussein ◽  
Shlomo Noy ◽  
Meir Plotnik
Keyword(s):  
Virtual Reality ◽  
Treatment Period ◽  
Outcome Measures ◽  
Large Scale ◽  
Exposure Therapy ◽  
Fear Of Flying ◽  
Efficacy Outcome ◽  
Before And After ◽  
Pre Treatment

Background: Fear of flying (FoF) is a phobia with 10–40% prevalence in the industrialized world. FoF is accompanied by severe economic, social, vocational, and emotional consequences. In recent years, virtual reality (VR)-based exposure therapy (VRET) for FoF has been introduced. Positive long-term efficacy of FoF-VRET has been reported by several studies, which, however, were limited by relatively small, non-representative samples and a lack of comparative pre/post functional efficacy outcome measures. Our objective was to evaluate the efficacy of a VRET treatment utilizing a large-scale VR system, experienced by a representative sample of self-referred individuals.Methods: We conducted a retrospective survey. Of 274 individuals who received the treatment (over a period of 3 years), 209 met inclusion/criteria, and 98 agreed to participate. We mainly collected information regarding flight activity before and after treatment relying on evidence such as boarding passes and flight tickets. The primary outcome measures were (1) number of flights per month (FpM) and (2) number of flight hours per month (FHpM). For each participant, these outcomes were computed for the post-treatment period (≥6 months after FoF-VRET) and the corresponding pre-treatment period.Results: FpM (mean ± SD) increased from 0.04 ± 0.06 to 0.16 ± 14 flights (p < 0.0001). FHpM rose from 0.19 ± 0.35 to 0.79 ± 0.87 h per month (p < 0.0001).Conclusion: These results are indicative of FoF-VRET treatment efficacy. Future studies should evaluate long-term maintenance of the treatment effect and thus identify the optimal frequency for delivery of periodic booster treatments.

scholarly journals The efficacy of a virtual reality exposure therapy treatment for fear of flying: A retrospective study

2020 ◽  
Author(s):  
Amihai Gottlieb ◽  
Glen M. Doniger ◽  
Yara Hussein ◽  
Shlomo Noy ◽  
Meir Plotnik
Keyword(s):  
Virtual Reality ◽  
Treatment Period ◽  
Outcome Measures ◽  
Exposure Therapy ◽  
Medical Center ◽  
Fear Of Flying ◽  
Efficacy Outcome ◽  
Before And After ◽  
Pre Treatment

AbstractBackgroundFear of flying (FoF) is an anxiety disorder classified as a phobia. Its prevalence is estimated at 10–40% in the industrialized world, and it is accompanied by severe economic, social, vocational and emotional consequences. In recent years, virtual reality-based exposure therapy (VRET) for FoF has been introduced. One such FoF-VRET is offered as a paid clinical service at the Center of Advanced Technologies in Rehabilitation (CATR), Sheba Medical Center, Israel. Positive long-term efficacy of FoF-VRET has been found in several studies. However, these studies are limited by relatively small, non-representative samples and a lack of comparative pre/post functional efficacy outcome measures.MethodsTo address these limitations, we conducted a retrospective survey of self-referred individuals treated with FoF-VRET at CATR over the previous four years. The aim of the present study was to evaluate the efficacy of our FoF-VRET in this representative real-world sample. Of 274 individuals who received the treatment, 214 met inclusion/criteria, and 103 agreed to participate. The survey focused mainly on collecting information regarding flight activity before and after treatment. The primary outcome measures were: (1) number of flights per month (FpM); (2) number of flight hours per month (FHpM). For each participant, these outcomes were computed for the post-treatment period (≥6 months after FoF-VRET) and the corresponding pre-treatment period.ResultsFpM (mean±SD) increased from .05±.07 to .16±.07 flights (p<.0001). FHpM rose from.22±.41 to .80±.86 hours per month (p<.0001).ConclusionsThese results are indicative of FoF-VRET treatment efficacy. Future studies should evaluate long-term maintenance of the treatment effect and thus identify the optimal frequency for delivery of periodic booster treatments.

Treatment of Storm Fears Using Virtual Reality and Progressive Muscle Relaxation

2017 ◽  
Vol 46 (2) ◽  
pp. 251-256 ◽  
Author(s):  
Jessica Lima ◽  
Hanna McCabe-Bennett ◽  
Martin M. Antony
Keyword(s):  
Virtual Reality ◽  
Treatment Group ◽  
Exposure Therapy ◽  
Clinical Sample ◽  
Muscle Relaxation ◽  
Post Treatment ◽  
Progressive Muscle Relaxation ◽  
Exposure Condition ◽  
Pre Treatment

Background: The present study examined the efficacy of virtual reality (VR) exposure therapy for treating individuals with storm fears by comparing a one-session VR exposure treatment with a one-session progressive muscle relaxation (PMR) and psychoeducation session. Aims: It was predicted that there would be a reduction in storm-related fear post-treatment for individuals in both conditions, but that this reduction would be greater for those in the VR exposure condition. It was predicted that improvements would be maintained at 30-day follow-up only for those in the VR exposure condition. Method: Thirty-six participants each received one of the two treatment conditions. Those in the PMR treatment group received approximately 30 minutes of PMR and approximately 15 minutes of psychoeducation regarding storms. Those in the VR treatment group received approximately 1 hour of VR exposure. Additionally, participants were asked to complete a pre-treatment and post-treatment 5-minute behavioural approach test to assess changes in storm fears. They were also asked to complete a measure assessing storm phobia. Results: There was a significant interaction between treatment group and self-reported fear at post-treatment, such that fear decreased for both groups, although the reduction was stronger in the VR group. Results also showed that reductions in storm fear were maintained at 30-day follow-up for both groups. Conclusions: Although this study used a small non-clinical sample, these results offer preliminary support for the use of VR exposure therapy in the treatment of storm-related fear.

Effects of open field testing and associated handling v. handling alone on the adrenocortical reactivity of piglets around weaning

2002 ◽  
Vol 74 (3) ◽  
pp. 485-491 ◽  
Author(s):  
M. S. Herskin ◽  
K. H. Jensen
Keyword(s):  
Blood Sample ◽  
Open Field ◽  
Field Testing ◽  
Blood Sampling ◽  
Cortisol Response ◽  
Temporal Development ◽  
Novel Object ◽  
Before And After ◽  
Pre Treatment

AbstractEffects of open field testing and associated handling (including blood sampling) v. handling (with blood sampling) alone on adrenocortical reactivity were investigated in piglets around weaning. After weaning at day 28, piglets were mixed to form eight replicates with three litter each and kept on slatted floors. Treatments were open field/novel object testing and associated handling (OFT + H) v. handling alone (H) (no. = 40). Testing took place on the following days (weaning day 0): -4, 0, 1, 4 and 8 (no. = 16). The open field/novel object test lasted 10 min and blood was sampled by venipuncture before and after the test and/or handling procedures. In the first blood sample, plasma concentration of cortisol did not differ between OFT + H and H piglets. In the second blood sample, however, OFT + H piglets had a higher concentration of cortisol and a larger increase in cortisol than H piglets (P < 0·01). In the first blood sample the concentration of cortisol was affected by day (P < 0·05), with concentration on day -4 being lower than those on day 0, 1, and 4 and the concentration on day 8 was lower than the concentration on day 0 as well. However, no differences were found between days for the second blood sample nor the adrenocortical reactivity. In conclusion, the increase in pre-treatment cortisol in the first 4 days after weaning as well as the lack of changes in the adrenocortical reactivity after weaning suggest that the temporal development of HPA activity and reactivity in piglets after weaning are comparable with other, more standardized long-term stressors. Exposure to an open field/novel object test and associated handling results in higher adrenocortical reactivity than handling alone but the latter (including blood sampling) in itself accounts for proportionately 0·74 of the cortisol response.

INFLUENCE OF LOW DOSE OESTROGEN ON CIRCULATING PROLACTIN, LH AND FSH LEVELS IN POST-MENOPAUSAL WOMEN

1976 ◽  
Vol 83 (1) ◽  
pp. 9-14 ◽  
Author(s):  
C. Robyn ◽  
M. Vekemans
Keyword(s):  
Breast Cancer ◽  
Treatment Period ◽  
Prolactin Level ◽  
Low Dose ◽  
Serum Prolactin ◽  
Blood Samples ◽  
Menopausal Women ◽  
Pre Treatment ◽  
Post Menopausal

ABSTRACT The effect on serum prolactin, LH and FSH levels of 25 μg ethinyloestradiol administered daily per os during 27 consecutive days was investigated in 5 post-menopausal women aged 52-78. Blood samples were collected before, during and after treatment. The hormones were assayed in serum by radioimmunological methods. Both LH and FSH decreased progressively and significantly from 120 and 115 mIU/ml before treatment to 52 and 51 mIU/ml, respectively after three weeks of oestrogen administration. Two weeks after interruption of treatment, LH (90 mIU/ml) and FSH (112 mIU/ml) were significantly higher than during the last week of treatment. Mean prolactin level increased from 127 μU/ml before treatment to 237 μU/ml after 10 days of oestrogen administration (P < 0.001). This increase was significant after 4 to 8 days and the levels remained about twice as high as the control values for the rest of the treatment period. Two weeks after interruption of treatment, serum prolactin had fallen (136 μU/ml) to the pre-treatment levels. Such results raise the question of possible effects of elevated levels of this hormone during long term oestrogen medication in post-menopausal women on the development of breast cancer.

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.

scholarly journals Virtual Reality (VR)-Based Environmental Enrichment in Older Adults with Mild Cognitive Impairment (MCI) and Mild Dementia

2021 ◽  
Vol 11 (8) ◽  
pp. 1103
Author(s):  
Waleed Riaz ◽  
Zain Yar Khan ◽  
Ali Jawaid ◽  
Suleman Shahid
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Environmental Enrichment ◽  
Mental Wellbeing ◽  
Mild Dementia ◽  
Error Ratio ◽  
Before And After ◽  
Vr Training ◽  
Input Error

Background: Despite an alarming rise in the global prevalence of dementia, the available modalities for improving cognition and mental wellbeing of dementia patients remain limited. Environmental enrichment is an experimental paradigm that has shown promising anti-depressive and memory-enhancing effects in pre-clinical studies. However, its clinical utility has remained limited due to the lack of effective implementation strategies. Objective: The primary objective of this study was to evaluate the usability (tolerability and interactivity) of a long-term virtual reality (VR)- based environmental enrichment training program in older adults with mild cognitive impairment (MCI) and mild dementia. A secondary objective was to assess the effect of VR-based environmental enrichment on stabilization of cognitive functioning and improvement of mental wellbeing in older adults with MCI and mild dementia. Methods: A total of seven participants (four patients with MCI and three with mild dementia) received biweekly VR-based environmental enrichment over a course of 6 months. The tolerability and interactivity of the participants in the VR training was serially assessed via virtual reality sickness questionnaire (VRSQ) and recording of input-error ratio. Cognitive functioning was assessed through Montreal cognitive assessment (MoCA) before and after the study. Mental wellbeing was assessed through Warwick-Edinburgh Mental Well Being Scale (WEMWBS). Results: VR-based environmental enrichment was well-tolerated by the patients with significant decrease in VRSQ scores (p < 0.01) and input-error ratio (p < 0.001) overtime. VR training was also effective in stabilization of MoCA scores over the course of therapy (non-significant difference in the MoCA scores before and after the therapy) and was associated with a trend (p < 0.1) towards improvement in WEMWBS scores between the first and the last assessments. Qualitative observations by the care-givers further corroborated a noticeable improvement in mental wellbeing of patients. Conclusions: This pilot study shows that VR can be a feasible, tolerable, and potentially effective tool in long-term support of older adults with MCI and mild dementia.

scholarly journals Virtual reality-based sensorimotor adaptation shapes subsequent spontaneous and naturalistic stimulus-driven brain activity

2021 ◽  
Author(s):  
Meytal Wilf ◽  
Celine Dupuis ◽  
Davide Nardo ◽  
Diana Huber ◽  
Sibilla Sander ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Large Scale ◽  
Right Hemisphere ◽  
Functional Neuroimaging ◽  
Brain Activity ◽  
Visual Response ◽  
Spatial Shift ◽  
Before And After ◽  
Behavioural Tests ◽  
The Right

Our everyday life summons numerous novel sensorimotor experiences, to which our brain needs to adapt in order to function properly. However, tracking plasticity of naturalistic behaviour and associated brain modulations is challenging. Here we tackled this question implementing a prism adaptation training in virtual reality (VRPA) in combination with functional neuroimaging. Three groups of healthy participants (N=45) underwent VRPA (with a spatial shift either to the left/right side, or with no shift), and performed fMRI sessions before and after training. To capture modulations in free-flowing, task-free brain activity, the fMRI sessions included resting state and free viewing of naturalistic videos. We found significant decreases in spontaneous functional connectivity between large-scale cortical networks, namely attentional and default mode/fronto-parietal networks, only for adaptation groups. Additionally, VRPA was found to bias visual representations of naturalistic videos, as following rightward adaptation, we found upregulation of visual response in an area in the parieto-occipital sulcus (POS) in the right hemisphere. Notably, the extent of POS upregulation correlated with the size of the VRPA induced after-effect measured in behavioural tests. This study demonstrates that a brief VRPA exposure is able to change large-scale cortical connectivity and correspondingly bias the representation of naturalistic sensory inputs.

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