Abstract
Exposure Therapy (ET) is one of the most widely-used methods for treating Specific Phobias, and, over the past few years, Virtual Reality (VR) has contributed significantly in this field, since the birth of what we call “Virtual Reality ET” (VRET). However, VR systems used in VRET so far do not fully integrate ET characteristics; the reason behind this is that they do not provide sufficient, or occasionally not any at all, interaction with the feared stimulus, which is a key factor for full ET implementation. Objective: The aim of our study is to propose a way to include natural interaction between the patient and the system during the treatment procedure. Method: We propose an addition to current session protocols for mental health professionals through which they can apply ET in full extent with the use of motion tracking sensors. Specifically, we added a Motion Recognition Camera, which tracks the patient’s movements and places their physical body within the virtual environment, increasing their feeling of presence and making the system more immersive. Therefore, clinicians can assign interactive tasks for their patients to practice within a controlled virtual environment. Results: We present the feedback we received regarding the system’s potential utility and efficiency by a group of psychiatry professionals who tried the system. Impact: With real-time interaction and VRET, patients stand a better chance to truly acquire the necessary skills to overcome their phobias.
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Change history
03 August 2019
The original version of this chapter was published without the reference “Anxiety detection from Electrodermal Activity Sensor with movement & interaction during Virtual Reality Simulation”, https://ieeexplore.ieee.org/document/8717170, which has now been included. The correction chapter has been updated with the changes.
References
American psychiatric association: diagnostic and statistical manual of mental disorders, 5th edn. (2013)
National Institute of Mental Health: Anxiety Disorder
National Institute of Mental Health: Mental Illness
Bandelow, B., Michaelis, S.: Epidemiology of anxiety disorders in the 21st century. Dialogues Clin. Neurosci. 17(3), 327–335 (2015)
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., Walters, E.E.: Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch. Gen. Psychiatry 62, 293–602 (2005)
Stinson, F.S.: The epidemiology of DSM-IV specific phobia in the USA: results from the national epidemiologic survey on alcohol and related conditions. Psychol. Med. 37(March), 1047–1059 (2007)
Öst, L.G.: One-session treatment for specific phobias. Behav. Res. Ther. 27, 1–7 (1989)
Scott, J., Beck, A.T.: Cognitive behavioural therapy. In: Essential Psychiatry, 4th edn. (2008)
Mayo-Wilson, E., Montgomery, P.: Media-delivered cognitive behavioural therapy and behavioural therapy (self-help) for anxiety disorders in adults. Cochrane Database Syst. Rev. (2013)
Treatment - (ADAA) Anxiety and Depression Association of America. https://www.adaa.org/finding-help/treatment
Otte, C.: Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin. Neurosci. 13(4), 413–421 (2011)
Wittchen, H.-U., Mühlig, S., Beesdo, K.: Mental disorders in primary care. Dialogues Clin. Neurosci. 5(2), 115–128 (2003)
Kerns, C.M., Read, K.L., Klugman, J., Kendall, P.C.: Cognitive behavioral therapy for youth with social anxiety: differential short and long-term treatment outcomes. J. Anxiety Disord. 27(2), 210–215 (2013)
Riddle-Walker, L.: Cognitive behaviour therapy for specific phobia of vomiting (Emetophobia): a pilot randomized controlled trial. J. Anxiety Disord. 43, 14–22 (2016)
Krebs, G.: Long-term outcomes of cognitive-behavioral therapy for adolescent body dysmorphic disorder. Behav. Ther. 48(4), 462–473 (2017)
Rozental, A.: A randomized controlled trial of internet-based cognitive behavior therapy for perfectionism including an investigation of outcome predictors. Behav. Res. Ther. 95, 79–86 (2017)
Warwick, H.: Complete recovery from anxiety disorders following cognitive behavior therapy in children and adolescents: a meta-analysis. Clin. Psychol. Rev. 52, 77–91 (2017)
Peñate, W., Fumero, A., Viña, C., Herrero, M., Marrero, R.J., Rivero, F.: A meta-analytic review of neuroimaging studies of specific phobia to small animals. Eur. J. Psychiatry 31, 1–44 (2017)
Twomey, C., O’Reilly, G., Meyer, B.: Effectiveness of an individually-tailored computerised CBT programme (Deprexis) for depression: a meta-analysis. Psychiatry Res. 256, 371–377 (2017)
Ollendick, T.H., Öst, L.G., Ryan, S.M., Capriola, N.N., Reuterskiöld, L.: Harm beliefs and coping expectancies in youth with specific phobias. Behav. Res. Ther. 91, 51–57 (2017)
Shiban, Y., Schelhorn, I., Pauli, P., Mühlberger, A.: Effect of combined multiple contexts and multiple stimuli exposure in spider phobia: a randomized clinical trial in virtual reality. Behav. Res. Ther. 71, 45–53 (2015)
Treanor, M., Craske, M.G.: Exposure therapy. In: Encyclopedia of Mental Health, 2nd edn. (2015)
Rothbaum, B.O., Rizzo, A.S., McDaniel, D.D., Zanov, M.V.: Virtual reality exposure therapy. In: Encyclopedia of Mental Health, 2nd edn. (2015)
Society of Clinical Psychology: What is Exposure Therapy?. American Psychological Association: Division, vol. 12 (2013)
Waters, A.M.: Augmenting one-session treatment of children’s specific phobias with attention training to positive stimuli. Behav. Res. Ther. 62, 107–119 (2014)
Rizzo, A., Hartholt, A., Grimani, M., Leeds, A., Liewer, M.: Virtual reality exposure therapy for combat-related posttraumatic stress disorder. In: Computer, Long Beach California (2014)
Cardoş, R.A.I., David, O.A., David, D.O.: Virtual reality exposure therapy in flight anxiety: a quantitative meta-analysis. Comput. Hum. Behav. 72, 371–380 (2017)
Bun, P., Gorski, F., Grajewski, D., Wichniarek, R., Zawadzki, P.: Low - cost devices used in virtual reality exposure therapy. Procedia Comput. Sci. 104, 445–451 (2016)
Yiasemidou, M., Siqueira, J., Tomlinson, J., Glassman, D., Stock, S., Gough, M.: Take-home’ box trainers are an effective alternative to virtual reality simulators. J. Surg. Res. 213, 69–74 (2017)
Blakey, S.M., Abramowitz, J.S.: The effects of safety behaviors during exposure therapy for anxiety: critical analysis from an inhibitory learning perspective. Clin. Psychol. Rev. 49, 1–15 (2016)
Krijn, M., Emmelkamp, P.M.G., Biemond, R., Schuemie, M.J., Van Der Mast, C.A.P.G.: Treatment of acrophobia in virtual reality: The role of immersion and presence. Behav. Res. Ther. 42, 229–239 (2004)
Emmelkamp, P.M.G., Krijn, M., Hulsbosch, A.M., Vries, S., Schuemie, M.J.: Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia. Behav. Res. Ther. 40, 509–516 (2002)
Carlin, A.S., Hoffman, H.G., Weghorst, S.: Virtual reality and tactile augmentation in the treatment of spider phobia: a case report. Behav. Res. Ther. 35, 153–158 (1997)
Freeman, D.: Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial. Lancet Psychiatry 5, 625–632 (2018)
Price, M., Anderson, P.: The role of presence in virtual reality exposure therapy. J. Anxiety Disord. 21, 742–751 (2007)
Morina, N., Brinkman, W.-P., Hartanto, D., Emmelkamp, P.M.G.: Sense of presence and anxiety during virtual social interactions between a human and virtual humans. PeerJ 2, e337 (2014)
Rudaz, M., Ledermann, T., Margraf, J., Becker, E.S., Craske, M.G.: The moderating role of avoidance behavior on anxiety over time: is there a difference between social anxiety disorder and specific phobia? PLoS ONE 12, e0180298 (2017)
Da Gama, A.E.F., de Menezes Chaves, T., Fallavollita, P., Figueiredo, L.S., Teichrieb, V.: Rehabilitation motion recognition based on the international biomechanical standards. Expert Syst. Appl. 116, 396–409 (2019)
Wang, X., Yan, K.: Immersive human-computer interactive virtual environment using large-scale display system. Future Gener. Comput. Syst. 96, 649–659 (2017)
Chen, J., Qiu, J., Ahn, C.: Construction worker’s awkward posture recognition through supervised motion tensor decomposition. Autom. Constr. 77, 67–81 (2017)
Maples-Keller, J.L., Bunnell, B.E., Kim, S.J., Rothbaum, B.O.: The use of virtual reality technology in the treatment of anxiety and other psychiatric disorders. Harvard Rev. Psychiatry 25, 103 (2017)
Morina, N., Ijntema, H., Meyerbröker, K., Emmelkamp, P.M.G.: Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments. Behav. Res. Ther. 74, 18–24 (2015)
Turner, W.A., Casey, L.M.: Outcomes associated with virtual reality in psychological interventions: where are we now? Clin. Psychol. Rev. 34, 634–644 (2014)
Suh, A., Prophet, J.: The state of immersive technology research: a literature analysis. Comput. Hum. Behav. 86, 77–90 (2018)
Freeman, D.: Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychol. Med. 47(14), 2393–2400 (2017)
Kritikos, J., Tzannetos, G., Zoitaki, C., Poulopoulou, S., Koutsouris, D.: Anxiety detection from Electrodermal Activity Sensor with movement & interaction during Virtual Reality Simulation. In: 9th International IEEE EMBS Conference on Neural Engineering, San Francisco, CA, USA, 20–23 March 2019, pp. 571–576 (2019). https://ieeexplore.ieee.org/document/8717170
Acknowledgements
We would like to thank the executive managers and members of the stuff of the General and Oncology Hospital of Kifissia for agreeing to provide the opportunity to present our work to them and receive their feedback.
At this point, we would like to discuss the expertise of the healthcare facility members we used as evaluators of our system a bit further. The medical staff of the facility we chose consists of experienced, well-trained, highly educated psychiatrists and healthcare attendants, who agreed to test our proposed system and provide their substantial feedback on its efficiency, as well as methods of enhancing it in the future. All of the members have graduated from reputable medical universities and have frequently assisted patients in treating their obsessive/irrational thought and behavioral patterns through exposure therapy sessions. Another important aspect of our preference in this particular psychiatric department is their constant quest for innovative diagnostic and therapeutic techniques. Our system and method are quite original; subsequently, they were highly interested in the new methods in which ET can be enhanced through VR technology. Taking the aforementioned facts into consideration, it is clear that our choice in this particular psychiatric department was everything but coincidental; we strongly believe that the clinic’s specialists were the most fitting to evaluate the efficacy of our system in view of their experience and education.
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Kritikos, J., Poulopoulou, S., Zoitaki, C., Douloudi, M., Koutsouris, D. (2019). Full Body Immersive Virtual Reality System with Motion Recognition Camera Targeting the Treatment of Spider Phobia. In: Cipresso, P., Serino, S., Villani, D. (eds) Pervasive Computing Paradigms for Mental Health. MindCare 2019. Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering, vol 288. Springer, Cham. https://doi.org/10.1007/978-3-030-25872-6_18
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