Der Einsatz von Virtueller Realität in der Psychotherapeutischen Praxis: Aktueller Forschungsstand, Chancen, Risiken und Herausforderungen

ZusammenfassungIn den letzten Jahren sind durch die Fortschritte der Digitalisierung neue psychotherapeutische Behandlungsmöglichkeiten und Unterstützungsangebote entstanden. Während sich bestimmte Innovationen wie die Videotherapie im letzten Jahr stark verbreitet haben, sind andere Formate wie z. B. Psychotherapieanwendungen in der Virtuellen Realität (VR) zwar sehr gut wissenschaftlich untersucht, aber dennoch kaum in die (tägliche) Praxis implementiert worden.Der folgende Artikel gibt einen Überblick über den aktuellen Forschungsstand zum Einsatz von VR im Kontext Psychotherapie. Hierbei wird auf zwei wichtige (kognitiv-verhaltenstherapeutische) Interventionsmethoden fokussiert, bei denen VR oft eingesetzt und untersucht wurde: (1) Behaviorale Exposition bei Angsterkrankungen und (2) Modifikation von Informationsverarbeitungsprozessen (Cognitive Bias Modification, CBM). Es werden aktuelle Studien zur Wirksamkeit sowie weitere aktuelle Ergebnisse zur Nutzung und dem Einsatz diskutiert. Weiterhin beschreibt der Artikel die grundsätzliche Nutzung der Virtuellen Realität und definiert wichtige Begriffe und Anwendungen.

The Time-Course of Induced Interpretive Biases in Healthy Individuals Varying in Depressive Symptoms

<p>Cognitive theories of depression posit that after a negative event or mood state, those vulnerable to the disorder automatically impose negative interpretations on ambiguous information. However, empirical research on depression-linked interpretive biases has yielded mixed results, likely due to flawed experimental paradigms and statistical techniques that do not adequately control for anxiety. Cognitive Bias Modification for Interpretation (CBM-I) is an innovative research paradigm that involves inducing interpretive biases in an experimentally controlled manner. The current study is the first to assess whether cognitive bias modification influences interpretation differently according to vulnerability to depression. Individuals scoring lower and higher on a depression inventory judged the relatedness of either neutrally valenced (e.g. book-read) or negatively valenced (e.g. sick-vomit) word-pairs. They then made judgements about homophone word-pairs, in which the first word could be interpreted as either neutral in meaning (e.g. dye-ink) or negative in meaning (e.g. die-death). At the later stages of processing all individuals, regardless of depression scores, resolved ambiguous word-pairs in a training-congruent manner, consistent with previous CBM-I studies. However, in the early stages of processing, those scoring higher, but not lower in the depression inventory, were uniquely receptive to negative context training, such that they were more likely to interpret ambiguous word-pairs in a negative as opposed to neutral manner. This finding is crucially important, as it helps to clarify theoretical debate in the literature.</p>

The Time-Course of Induced Interpretive Biases in Healthy Individuals Varying in Depressive Symptoms

<p>Cognitive theories of depression posit that after a negative event or mood state, those vulnerable to the disorder automatically impose negative interpretations on ambiguous information. However, empirical research on depression-linked interpretive biases has yielded mixed results, likely due to flawed experimental paradigms and statistical techniques that do not adequately control for anxiety. Cognitive Bias Modification for Interpretation (CBM-I) is an innovative research paradigm that involves inducing interpretive biases in an experimentally controlled manner. The current study is the first to assess whether cognitive bias modification influences interpretation differently according to vulnerability to depression. Individuals scoring lower and higher on a depression inventory judged the relatedness of either neutrally valenced (e.g. book-read) or negatively valenced (e.g. sick-vomit) word-pairs. They then made judgements about homophone word-pairs, in which the first word could be interpreted as either neutral in meaning (e.g. dye-ink) or negative in meaning (e.g. die-death). At the later stages of processing all individuals, regardless of depression scores, resolved ambiguous word-pairs in a training-congruent manner, consistent with previous CBM-I studies. However, in the early stages of processing, those scoring higher, but not lower in the depression inventory, were uniquely receptive to negative context training, such that they were more likely to interpret ambiguous word-pairs in a negative as opposed to neutral manner. This finding is crucially important, as it helps to clarify theoretical debate in the literature.</p>

Cognitive-bias modification intervention to improve physical activity in patients following a rehabilitation programme: protocol for the randomised controlled IMPACT trial

IntroductionBeing physically active is associated with a wide range of health benefits in patients. However, many patients do not engage in the recommended levels of physical activity (PA). To date, interventions promoting PA in patients mainly rely on providing knowledge about the benefits associated with PA to develop their motivation to be active. Yet, these interventions focusing on changing patients’ conscious goals have proven to be rather ineffective in changing behaviours. Recent research on automatic factors (eg, automatic approach tendencies) may provide additional targets for interventions. However, the implementation and evaluation of intervention designed to change these automatic bases of PA are rare. Consequently, little is known about whether and how interventions that target automatically activated processes towards PA can be effective in changing PA behaviours. The Improving Physical Activity (IMPACT) trial proposes to fill this knowledge gap by investigating the effect of a cognitive-bias modification intervention aiming to modify the automatic approach towards exercise-related stimuli on PA among patients.Methods and analysisThe IMPACT trial is a single-centre, placebo (sham controlled), triple-blinded, phase 3 randomised controlled trial that will recruit 308 patients enrolled in a rehabilitation programme in the Division of General Medical Rehabilitation at the University Hospital of Geneva (Switzerland) and intends to follow up them for up to 1 year after intervention. Immediately after starting a rehabilitation programme, patients will be randomised (1:1 ratio) to receive either the cognitive-bias modification intervention consisting of a 12-session training programme performed over 3 weeks or a control condition (placebo). The cognitive-bias modification intervention aims to improve PA levels through a change in automatic approach tendencies towards PA and sedentary behaviours. The primary outcome is the sum of accelerometer-based time spent in light-intensity, moderate-intensity and vigorous-intensity PA over 1 week after the cognitive-bias modification intervention (in minutes per week). Secondary outcomes are related to changes in (1) automatic approach tendencies and self-reported motivation to be active, (2) physical health and (3) mental health. Sedentary behaviours and self-reported PA will also be examined. The main time point of the analysis will be the week after the end of the intervention. These outcomes will also be assessed during the rehabilitation programme, as well as 1, 3, 6 and 12 months after the intervention for secondary analyses.Ethics and disseminationThe study will be conducted in accordance with the Declaration of Helsinki. This trial was approved by the Ethics Committee of Geneva Canton, Switzerland (reference number: CCER2019-02257). All participants will give an informed consent to participate in the study. Results will be published in relevant scientific journals and be disseminated in international conferences.Trial registration detailsThe clinical trial was registered at the German clinical trials register (reference number: DRKS00023617); Pre-results.

Computergestütztes Training (CBM) während der stationären Alkohol-Entzugsbehandlung

Computergestützte Trainings, „Cognitive-bias-modification“-Programme (CBM), zielen darauf ab, Verzerrungen in der kognitiven Verarbeitung zu verändern und wurden für unterschiedliche psychische Erkrankungen entwickelt. Bei einer Alkoholabhängigkeit wird davon ausgegangen, dass bestimmte alkoholbezogene Hinweisreize das Verlangen nach Alkohol steigern und somit die Gefahr eines Rückfalls erhöhen. Bei CBM-Trainings werden die Teilnehmenden angehalten, auf Bilder auf einem Computerbildschirm mittels Joystick in einer bestimmten Art und Weise zu reagieren. Neutrale, nicht alkoholassoziierte Stimuli sollen damit verstärkt werden.