scholarly journals New Developments in Virtual Reality-Assisted Treatment of Aggression in Forensic Settings: The Case of VRAPT

2022 ◽  
Vol 2 ◽  
Author(s):  
Fernando Renee González Moraga ◽  
Stéphanie Klein Tuente ◽  
Sean Perrin ◽  
Pia Enebrink ◽  
Kristina Sygel ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Psychological Treatment ◽  
Behavioral Therapy ◽  
Ecological Validity ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Real Life ◽  
Evidence Base ◽  
Theoretical Background ◽  
Lessons Learned

Aggression is a known problem in individuals being cared for in forensic settings, yet the evidence base for its treatment is scarce. Virtual Reality (VR) has been proposed as a promising addition to interventions in forensic settings, as it may increase the motivation among participants, bridge the gap between real life, therapeutic and laboratory experiences, and increase the ecological validity of psychological research. Recently, a new treatment for aggression using VR as the treatment environment, Virtual Reality Aggression Prevention Training (VRAPT), was developed to provide realistic and safe environments for participants to practice aggression management. In its current revised version, VRAPT is conceptualized as a form of cognitive behavioral therapy with its theoretical background in the General Aggression Model. Its purpose is to increase awareness of, and improve control over, one’s own aggression and that of others through social interactions in individually tailored virtual environments. This manuscript describes how the lessons learned from the first randomized controlled trial of VRAPT have been applied to further develop the method and discusses challenges and future directions for VR-assisted treatment of aggression in forensic settings. VRAPT is a new psychological treatment for aggression and the coming years will provide expanded scientific evidence for further developments and adaptations.

scholarly journals Automated virtual reality (VR) cognitive therapy for patients with psychosis: study protocol for a single-blind parallel group randomised controlled trial (gameChange)

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031606 ◽  
Author(s):  
Daniel Freeman ◽  
Ly-Mee Yu ◽  
Thomas Kabir ◽  
Jen Martin ◽  
Michael Craven ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Psychiatric Symptoms ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Real Life ◽  
Activity Levels ◽  
Physical And Mental Health ◽  
Social Situations ◽  
Treatment As Usual ◽  
South Central

IntroductionMany patients with psychosis experience everyday social situations as anxiety-provoking. The fears can arise, for example, from paranoia, hallucinations, social anxiety or negative-self beliefs. The fears lead patients to withdraw from activities, and this isolation leads to a cycle of worsening physical and mental health. Breaking this cycle requires highly active treatment directly in the troubling situations so that patients learn that they can safely and confidently enter them. However patients with psychosis seldom receive such life-changing interventions. To solve this problem we have developed an automated psychological treatment delivered in virtual reality (VR). It allows patients to experience computer simulations of the situations that they find anxiety-provoking. A virtual coach guides patients, using cognitive techniques, in how to overcome their fears. Patients are willing to enter VR simulations of anxiety-provoking situations because they know the simulations are not real, but the learning made transfers to the real world.Methods and analysis432 patients with psychosis and anxious avoidance of social situations will be recruited from National Health Service (NHS) secondary care services. In the gameChange trial, they will be randomised (1:1) to the six-session VR cognitive treatment added to treatment as usual or treatment as usual alone. Assessments will be conducted at 0, 6 (post-treatment) and 26 weeks by a researcher blind to allocation. The primary outcome is avoidance and distress in real-life situations, using a behavioural assessment task, at 6 weeks. The secondary outcomes are psychiatric symptoms, activity levels and quality of life. All main analyses will be intention-to-treat. Moderation and mediation will be tested. An economic evaluation will be conducted.Ethics and disseminationThe trial has received ethical approval from the NHS South Central - Oxford B Research Ethics Committee (19/SC/0075). A key output will be a high-quality automated VR treatment for patients to overcome anxious avoidance of social situations.Trial registration numberISRCTN17308399.

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 A 7-year follow-up of antenatal depression treatment with cognitive behavioral therapy: A case report of maternal and child outcomes

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984146
Author(s):  
Laura S Bleker ◽  
Jeannette Milgrom ◽  
Alan W Gemmill ◽  
Tessa J Roseboom ◽  
Susanne R de Rooij
Keyword(s):  
Case Report ◽  
Cognitive Behavioral Therapy ◽  
Treatment Effectiveness ◽  
Psychological Treatment ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Child Outcomes ◽  
Antenatal Depression ◽  
Cognitive Behavioral

There are few studies of cognitive behavioral therapy for women with antenatal depression including qualitative and quantitative data, and yet, individual cases can provide valuable information on personal experiences of treatment effectiveness and acceptability. The purpose of this case report is to explore the long-term qualitative outcomes following cognitive behavioral therapy for antenatal depression. A pregnant woman with a Diagnostic and Statistical Manual of Mental Disorders diagnosis of depression was allocated to receive seven sessions of cognitive behavioral therapy in a randomized controlled trial. We describe her experiences and mood during treatment, at 12 weeks, 9 months, 2 years, and 7 years postpartum, as well as markers of her child’s development. The woman’s mood symptoms were dramatically improved after treatment and remained in the mild to moderate range until 7 years postpartum. Her child showed overall age-appropriate development, with strengths highlighted in his nonverbal and problem-solving ability. Relative weaknesses were in the communication domain and his processing speed. This case report suggests that psychological treatment for depression during pregnancy can be both acceptable to women and potentially protective in the long term.

scholarly journals Virtual reality as a clinical tool in mental health research and practice

2020 ◽  
Vol 22 (2) ◽  
pp. 169-177 ◽  
Keyword(s):  
Mental Health ◽  
Virtual Reality ◽  
Virtual Worlds ◽  
Ecological Validity ◽  
Evidence Base ◽  
Mental Health Research ◽  
Clinical Settings ◽  
Clinical Tool ◽  
Ethical Implications ◽  
Controlled Environments

Virtual reality (VR) is a potentially powerful technology for enhancing assessment in mental health. At any time or place, individuals can be transported into immersive and interactive virtual worlds that are fully controlled by the researcher or clinician. This capability is central to recent interest in how VR might be harnessed in both treatment and assessment of mental health conditions. The current review provides a summary of the advantages of using VR for assessment in mental health, focusing on increasing ecological validity of highly controlled environments, enhancing personalization and engagement, and capturing real-time, automated data in real-world contexts. Considerations for the implementation of VR in research and clinical settings are discussed, including current issues with cost and access, developing evidence base, technical challenges, and ethical implications. The opportunities and challenges of VR are important to understand as researchers and clinicians look to harness this technology to improve mental health outcomes.

scholarly journals Experimental Outcomes of the Mediterranean Diet: Lessons Learned from the Predimed Randomized Controlled Trial

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2991 ◽  
Author(s):  
Dicle Kargin ◽  
Laura Tomaino ◽  
Lluís Serra-Majem
Keyword(s):  
Mediterranean Diet ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Olive Tree ◽  
Energy Restriction ◽  
Lessons Learned ◽  
Long Term Effects ◽  
Beneficial Effects ◽  
The Mediterranean ◽  
Predimed Study

The Mediterranean Diet (MD) is, culturally and historically, the nutritional pattern shared by people living in the olive-tree growing areas of the Mediterranean basin. It is of great importance for its potential preventive effect against cardiovascular diseases (CVDs). The PREvención con DIeta MEDiterránea (PREDIMED) study, a Spanish multicentre randomised controlled trial (RCT), was designed to assess the long-term effects of the MD, without any energy restriction, on the incidence of CVD in individuals at high cardiovascular (CV) risk. Since its inception, it gave a great contribution to the available literature on the issue. It is well known that, in the field of the health sciences, RCTs provide the best scientific evidence. Thus, the aim of the present review is to analyse the results of the RCTs performed within the frame of the PREDIMED study. Our findings showed that MD has beneficial effects in the primary prevention of CVDs, diabetes and in the management of metabolic syndrome.

Real-life memory and spatial navigation in patients with focal epilepsy: Ecological validity of a virtual reality supermarket task

2014 ◽  
Vol 31 ◽  
pp. 57-66 ◽  
Author(s):  
P. Grewe ◽  
D. Lahr ◽  
A. Kohsik ◽  
E. Dyck ◽  
H.J. Markowitsch ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Focal Epilepsy ◽  
Ecological Validity ◽  
Spatial Navigation ◽  
Real Life

scholarly journals Effectiveness of a stand-alone, smartphone-based virtual reality exposure app to reduce fear of heights in real-life: a randomized trial

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Dorothée Bentz ◽  
Nan Wang ◽  
Merle K. Ibach ◽  
Nathalie S. Schicktanz ◽  
Anja Zimmer ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Controlled Trial ◽  
Phase 1 ◽  
Real Life ◽  
Phase 2 ◽  
Parallel Group ◽  
Real Life Situation ◽  
Repeated Use ◽  
Virtual Reality Exposure ◽  
Fear Of Heights

AbstractSmartphone-based virtual reality (VR) applications (apps) might help to counter low utilization rates of available treatments for fear of heights. Demonstration of effectiveness in real-life situations of such apps is crucial, but lacking so far. Objective of this study was to develop a stand-alone, smartphone-based VR exposure app—Easy Heights—and to test its effectiveness in a real-life situation. We performed a single-blind, parallel group, randomized controlled trial. We recruited 70 participants with fear of heights, aged 18–60 years. Primary outcome was performance in a real-life Behavioral Avoidance Test (BAT) on a lookout tower after a single 1-h app use (phase 1) and after additional repeated (6 × 30 min) app use at home (phase 2). After phase 2, but not phase 1, participants in the Easy Heights condition showed significantly higher BAT scores compared to participants in the control condition (Cohen’s d = 1.3, p = 0.0001). Repeated use of our stand-alone, smartphone-based VR exposure app reduces avoidance behavior and fear, providing a low-threshold treatment for fear of heights.

scholarly journals Validation of the Virtual Reality Everyday Assessment Lab (VR-EAL): An immersive virtual reality neuropsychological battery with enhanced ecological validity

2021 ◽  
Author(s):  
Panagiotis Kourtesis ◽  
Simona Collina ◽  
Leonidas A. A. Doumas ◽  
Sarah E. MacPherson
Keyword(s):  
Virtual Reality ◽  
Cognitive Functions ◽  
Ecological Validity ◽  
Pearson Correlation ◽  
Real Life ◽  
Performance Outcomes ◽  
Immersive Virtual Reality ◽  
Neuropsychological Battery ◽  
Administration Time ◽  
Paper And Pencil

Objective: The assessment of cognitive functions such as prospective memory, episodic memory, attention, and executive functions benefits from an ecologically valid approach to better understand how performance outcomes generalize to everyday life. Immersive virtual reality (VR) is considered capable of simulating real-life situations to enhance ecological validity. The present study attempted to validate the Virtual Reality Everyday Assessment Lab (VR-EAL), an immersive VR neuropsychological battery, against an extensive paper-and-pencil neuropsychological battery. Methods: Forty-one participants (21 females) were recruited: 18 gamers and 23 non-gamers who attended both an immersive VR and a paper-and-pencil testing session. Bayesian Pearson correlation analyses were conducted to assess construct and convergent validity of the VR-EAL. Bayesian t-tests were performed to compare VR and paper-and-pencil testing in terms of administration time, similarity to real life tasks (i.e., ecological validity), and pleasantness. Results: VR-EAL scores were significantly correlated with their equivalent scores on the paper-and-pencil tests. The participants’ reports indicated that the VR-EAL tasks were significantly more ecologically valid and pleasant than the paper-and-pencil neuropsychological battery. The VR-EAL battery also had a shorter administration time. Conclusion: The VR-EAL appears as an effective neuropsychological tool for the assessment of everyday cognitive functions, which has enhanced ecological validity, a highly pleasant testing experience, and does not induce cybersickness.

Significance of Virtual Reality-Based Rehabilitation in Acquired Brain Injury

2018 ◽  
pp. 1586-1601
Author(s):  
Artemisa R. Dores ◽  
Liliana Mendes ◽  
Irene P. Carvalho ◽  
Sandra Guerreiro ◽  
Isabel Almeida ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Injury ◽  
Neural Plasticity ◽  
Ecological Validity ◽  
Real Life ◽  
Acquired Brain Injury ◽  
Immediate Feedback ◽  
Daily Life Activities ◽  
Neurocognitive Rehabilitation ◽  
Independent Functioning

Recent research has shown the potential of Virtual Reality (VR) in the field of rehabilitation, namely neurocognitive rehabilitation. This technology will certainly revolutionize the rehabilitation of the future. Its advantages include greater ecological validity than conventional rehabilitation methods, provision of safe contexts for learning/training, the possibility of programs to be contingent on patient performance, with increasing levels of task difficulty and provision of immediate feedback, and the use of a “game factor” that promotes motivation for participation. These are important aspects in the rehabilitation of patients with acquired brain injury. Patients with this and other types of neurological injuries endure cognitive deficits that cause difficulties in independent functioning and daily-life activities. Their rehabilitation calls for systematic intervention programs that are theoretically grounded and use innovative approaches to their advantage. In this paper we present a review about the advantages of VR in the generalization of acquired skills to real-life contexts, to promote patients' functionality and quality of life, and propose an innovative program of neurocognitive rehabilitation. Research in the field shows positive effects of VR programs, but urges progress in terms of the development of techniques (e.g., facial synthesis and of more research on the impact of these interventions. Future studies should also explore the existence of neuro-anatomical correlates of behavioral changes, contributing to the investigation of the relationship between neural plasticity and behavior and providing evidence for clinical practice.

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