CASE STUDY Exposure treatment: One hour. The patient interacted with the cockroach in the container, and also with the cockroach outside the container. The patient killed four cockraches. AUGMENTED REALITY
Treatment outcomes were maintained at one-month follow-up. Reports of high Reality judgment and Presence. AUGMENTED REALITY
Participants: 10 patients so far (9 women and 1 man) Four with spider phobia Six with cockroach phobia AUGMENTED REALITY Case Series Study Treatment: Adaptation of the one-session exposure program developed by Öst delivered with Augmented Reality.
AUGMENTED REALITY Preference: IN VIVO vs AR (0-7) PATIENTS 12345678910 Willingness of getting involved in a treatment with AR exposure 7477776777 Willingness of getting involved in a treatment with in vivo exposure 6445424455
AUGMENTED REALITY Satisfaction (0-10) PATIENTS 12345678910 Do you think the procedure is logic? 9910 Your level of satisfaction with the procedure 1099888 Would you recommended it to a friend? 109 99 Do you think it could be useful for treating other psychological problems? 109 8 Do you find the treatment aversive? 2771571790 Do you think the treatment has been useful in treating your problem? 107 7779
AUGMENTED REALITYConclusions AR: Efficacious in the treatment of specific phobia. Significant reduction in objective and subjective measures of fear and avoidance. Patients preferred AR rather than in vivo exposure. Patients were satisfied with the treatment.
Controlled Studies: n > 8 AuthorCountryYear # of Pts Tx Grps BergerU.S.199916 PC VR, Phobics, Non-Phobics KimKorea19999 PC VR, WLC WiederholdU.S.20019 VR, In vivo JangKorea200211 Driving vs. Flying WalsheIreland200314 ECT, CBT, WLC Fear of Driving
Types of VR equipment used clinically: Regular Desktop Head Mounted Display Multiple Screens Full Car Automobile Seat
Driving Study: 9 participants (Wiederhold BK, Jang DP, Kim SI, Wiederhold MD, 2001) Treatment Success Specific Phobia PDA PTSD
Social Phobia Patient wearing a HMD while engaging in the virtual party
Controlled Studies: n > 8 AuthorCountryYear # of Pts Tx Grps SlaterU.K.200310 Neutral, demanding Lègeron France200336 VR, CBT RoyFrance200310 VR, CBT, WLC KlingerFrance200536 VR, CBT Social Phobia
Social Phobia (Klinger, Bouchard et al., 2004) N = 36, 12 sessions. CBT in group.
Sample Population = 18 participants – 10 females and 8 males – Mean age: 30.5 ± 5.06 – On average, participants have been suffering from social phobia for 14.5 years – 9 participants were also displayed symptoms of major depression (all information based only on the VRT group) SOCIAL PHOBIA (Klinger et al., 2005)
Measures – The Short Beck Depression Inventory (BDI-13) – The Liebowitz Social Anxiety Scale (LSAS) – The Rathus Assertiveness Schedule – The Zigmond and Snaith Hospital Anxiety Depression Scale (HAD) SOCIAL PHOBIA (Klinger et al., 2005)
Protocol – for VRT only – Overview 12 sessions of VRT 45 minutes each Exposed to virtual environments for either assessment or therapy Virtual exposure lasts less than 20 minutes per session SOCIAL PHOBIA (Klinger et al., 2005)
Protocol (cont’d) – Virtual environments included 4 situations that social phobic patients felt were the most threatening: Performance Intimacy Scrutiny Assertiveness SOCIAL PHOBIA (Klinger et al., 2005)
Protocol (cont’d) – Session 1 Therapist presents virtual world to patient Patient familiarizes the virtual world and tools in a neutral environment – Session 2-9 2 sessions devoted to each of the 4 virtual environments – Assessment, expose patient to VR environment, 2 phases of “therapy” exposure to the environment SOCIAL PHOBIA (Klinger et al., 2005)
Protocol (cont’d) – Session 10-12 3 sessions devoted to more focused and detailed work on one or two of the four environments that gave the patient the most trouble 12 th session = conclusion to therapy and introduction of a personal program to carry out beyond the therapy SOCIAL PHOBIA (Klinger et al., 2005)
Conclusion: – Based on the LSAS, VRT would illustrate a better form of treatment over CBT – The differences between the two groups, however, are not significant – For VRT to be significantly better than CBT in terms of social phobia symptoms, experiment participants would have to be increased to 200-300 – Participants should be increased to a sample of 3,000 in order to find a significant difference in performance anxiety – In order to further confirm the efficacy of virtual reality for the treatment of social phobia, additional outcome studies could be conducted with the inclusion of a third control condition such as a placebo or a waiting list SOCIAL PHOBIA (Klinger et al., 2005)
Controlled Studies: n > 8RivaItaly200245 PC VR, In vivo, WLC WiederholdU.S.200245 BouchardCanada200245 KimKorea200245 Panic Disorder with Agoraphobia Multi-center Controlled Study AuthorCountryYear # of Pts Tx Grps NorthU.S.199830 PC VR, WLC KimKorea19999 BotellaSpain200210 PC VR, In vivo WiederholdU.S.20029 Non-phobics in PDA environ. BotellaSpain200336 VRE, In vivo, WLC
Agoraphobia: 12 participants (Vincelli, Anolli, Bouchard, Wiederhold, Zurloni, & Riva, 2003) Patient Treatment VR-CBT CBT WLC Design VR-CBT 8 sessions CBT 12 sessions Results VR-CBT produced same or better results using 33% fewer sessions than CBT Measures Beck Depression Inventory State Trait Anxiety Inventory Agoraphobic Cognitions Questionnaire Fear Questionnaire