From virtual reality to interreality in the treatment of anxiety disorders

A virtual reality system is a combination of technological devices that allows users to create, explore and interact with 3D environments. In recent years, virtual reality has been increasingly employed in the treatment of anxiety disorders, since it offers the opportunity to carry out exposure-based programs that bypass the limitations that occur during both in vivo exposure and imaginal exposure. The introduction of a new therapeutic approach called interreality has brought us one step further towards e-health. If virtual worlds are considered as ‘closed’ experiences, separated from thoughts and emotions experienced by the patient in the real life, interreality, conversely, is an advanced technological tool whose main novelty is the creation of a hybrid, closed-loop, empowering experience bridging both the physical and virtual worlds. This article will discuss the use of virtual reality and interreality for clinical purposes, and will present the outcomes of different clinical trials that applied these tools in the field of anxiety disorders.

[1]  M. Safir,et al.  Virtual Reality Cognitive Behavior Therapy for Public Speaking Anxiety , 2009, Behavior modification.

[2]  Giuseppe Riva,et al.  Interaction and presence in the clinical relationship: virtual reality (VR) as communicative medium between patient and therapist , 2002, IEEE Transactions on Information Technology in Biomedicine.

[3]  Martijn J. Schuemie,et al.  Do Self-Statements Enhance the Effectiveness of Virtual Reality Exposure Therapy? A Comparative Evaluation in Acrophobia , 2007, Cyberpsychology Behav. Soc. Netw..

[4]  G. Riva,et al.  A Second Life for eHealth: Prospects for the Use of 3-D Virtual Worlds in Clinical Psychology , 2008, Journal of medical Internet research.

[5]  J. Abramowitz,et al.  Cognitive and behavioral treatments for anxiety disorders: a review of meta-analytic findings. , 2004, Journal of clinical psychology.

[6]  Carl Machover,et al.  Virtual reality , 1994, IEEE Computer Graphics and Applications.

[7]  Cristina Botella,et al.  Internet and Virtual Reality as Assessment and Rehabilitation Tools for Clinical Psychology and Neuroscience 3 Virtual Reality and Psychotherapy , 2022 .

[8]  G. Riva,et al.  Biofeedback, virtual reality and mobile phones in the treatment of generalized anxiety disorder (gad): A phase-2 controlled clinical trial , 2009 .

[9]  Albert Rizzo,et al.  Virtual reality for psychotherapy: Current reality and future possibilities. , 2003 .

[10]  Giuseppe Riva,et al.  On feeling (the) present: An evolutionary account of the sense of presence in physical and electronically-mediated environments , 2010 .

[11]  C. Pull,et al.  Recent trends in the study of specific phobias , 2008, Current opinion in psychiatry.

[12]  Giuseppe Riva,et al.  Interreality: A New Paradigm for E-health , 2009, Annual Review of Cybertherapy and Telemedicine.

[13]  Alessandra Grassi,et al.  Interreality in the management of psychological stress: a clinical scenario. , 2010, Studies in health technology and informatics.

[14]  Andrea Gaggioli,et al.  Interreality in Practice: Bridging Virtual and Real Worlds in the Treatment of Posttraumatic Stress Disorders , 2009, Cyberpsychology Behav. Soc. Netw..

[15]  Andrea Gaggioli,et al.  Therapeutic applications of the mobile phone , 2009 .

[16]  E. Winer,et al.  Virtual Reality Exposure Therapy for PTSD symptoms after a road accident: an uncontrolled case series. , 2007, Behavior therapy.

[17]  Gregory A. Gahm,et al.  Virtual reality exposure therapy for active duty soldiers. , 2008, Journal of clinical psychology.

[18]  S. Kosslyn,et al.  Fear selectively modulates visual mental imagery and visual perception , 2010, Quarterly journal of experimental psychology.

[19]  B. Rothbaum,et al.  Exposure therapy for posttraumatic stress disorder. , 2002, American journal of psychotherapy.

[20]  Alessandra Gorini,et al.  Virtual reality as empowering environment for personal change: the contribution of the applied tech , 2009 .

[21]  Francesco Vincelli,et al.  From Imagination to Virtual Reality: The Future of Clinical Psychology , 1999, Cyberpsychology Behav. Soc. Netw..

[22]  H. Hoffman,et al.  Virtual reality exposure therapy for the treatment of posttraumatic stress disorder following September 11, 2001. , 2007, The Journal of clinical psychiatry.

[23]  P. McKenna,et al.  Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials , 2009, Psychological Medicine.

[24]  Daniel Mestre,et al.  Virtual Reality and Claustrophobia: Multiple Components Therapy Involving Game Editor Virtual Environments Exposure , 2008, Cyberpsychology Behav. Soc. Netw..

[25]  Stéphane Bouchard,et al.  Cognitive Mechanisms Underlying Virtual Reality Exposure , 2009, Cyberpsychology Behav. Soc. Netw..

[26]  M Fier,et al.  Panic disorder and agoraphobia. , 1990, New Jersey medicine : the journal of the Medical Society of New Jersey.

[27]  Azucena García-Palacios,et al.  Prolonged Exposure and Virtual Reality-Enhanced Imaginal Exposure for PTSD following a Terrorist Bulldozer Attack: A Case Study , 2010, Cyberpsychology Behav. Soc. Netw..

[28]  Brenda K. Wiederhold,et al.  Exposure Therapy with and without Virtual Reality to Treat PTSD while in the Combat Theater: A Parallel Case Series , 2009, Cyberpsychology Behav. Soc. Netw..

[29]  D. Ellard,et al.  A review of self‐management interventions for panic disorders, phobias and obsessive‐compulsive disorders , 2005, Acta psychiatrica Scandinavica.

[30]  Dong Pyo Jang,et al.  The treatment of fear of flying: a controlled study of imaginal and virtual reality graded exposure therapy , 2002, IEEE Transactions on Information Technology in Biomedicine.

[31]  Jürgen Margraf,et al.  Epidemiology of anxiety disorders , 2004 .

[32]  C. Pull Current status of virtual reality exposure therapy in anxiety disorders: editorial review. , 2005, Current opinion in psychiatry.

[33]  G. Riva,et al.  The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project , 2009, Journal of visualized experiments : JoVE.

[34]  Sanjay T. Menon,et al.  Psychological Empowerment: Definition, Measurement, and Validation , 1999 .

[35]  M. Krijn,et al.  Fear of flying treatment methods: virtual reality exposure vs. cognitive behavioral therapy. , 2007, Aviation, space, and environmental medicine.

[36]  Brenda K. Wiederhold,et al.  Cost Effectiveness of Virtual Reality Graded Exposure Therapy with Physiological Monitoring for the Treatment of Combat Related Post Traumatic Stress Disorder , 2009, Annual Review of Cybertherapy and Telemedicine.

[37]  Pedro Gamito,et al.  PTSD Elderly War Veterans: A Clinical Controlled Pilot Study , 2009, Cyberpsychology Behav. Soc. Netw..

[38]  Barbara O. Rothbaum,et al.  Comparing Virtual Reality Exposure Therapy to Present-Centered Therapy with 11 U.S. Vietnam Veterans with PTSD , 2010, Cyberpsychology Behav. Soc. Netw..

[39]  David H Barlow,et al.  Cognitive-Behavioral Treatment for Panic Disorder: Current Status , 2004, Journal of psychiatric practice.

[40]  Debra A. Hope,et al.  Cognitive behavioral group treatment for social phobia: Comparison with a credible placebo control , 1990, Cognitive Therapy and Research.

[41]  J. Wolpe,et al.  Psychotherapy by reciprocal inhibition , 1958, Conditional reflex.

[42]  R. Baños,et al.  Virtual reality exposure in the treatment of panic disorder and agoraphobia: A controlled study , 2007 .

[43]  J. Abramowitz,et al.  Obsessive-compulsive disorder , 2006, The Lancet.

[44]  Andrea Gaggioli,et al.  NeuroVR 1.5 in Practice: Actual Clinical Applications of the Open Source VR System , 2009, Annual Review of Cybertherapy and Telemedicine.

[45]  T. Nishikawa,et al.  Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study. , 2010, Journal of traumatic stress.

[46]  Rosa María Baños,et al.  An Adaptive Display for the Treatment of Diverse Trauma PTSD Victims , 2009, Cyberpsychology Behav. Soc. Netw..

[47]  Grigore C. Burdea,et al.  Treating Psychological and Physical Disorders with VR , 2022 .

[48]  Andrea Gaggioli,et al.  NeuroVR 1.5 - A Free Virtual Reality Platform for the Assessment and Treatment in Clinical Psychology and Neuroscience , 2009, MMVR.

[49]  Stéphane Bouchard,et al.  Is virtual reality effective to motivate and raise interest in phobic children toward therapy? A clinical trial study of in vivo with in virtuo versus in vivo only treatment exposure. , 2010, The Journal of clinical psychiatry.

[50]  G. Riva,et al.  From intention to action: The role of presence , 2011 .

[51]  G. Riva,et al.  Virtual reality in the treatment of generalized anxiety disorders. , 2010, Studies in health technology and informatics.

[52]  E. Foa,et al.  Treatment of obsessive compulsive disorder. , 2011, Annual review of clinical psychology.

[53]  A. Rizzo,et al.  Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: a meta-analysis. , 2008, Journal of behavior therapy and experimental psychiatry.

[54]  A. Damasio,et al.  Subcortical and cortical brain activity during the feeling of self-generated emotions , 2000, Nature Neuroscience.

[55]  M. Krijn,et al.  Virtual reality exposure therapy of anxiety disorders: a review. , 2004, Clinical psychology review.

[56]  Ranjan Roy,et al.  Cognitive-behavioral therapy. , 2008 .

[57]  R. Baños,et al.  Virtual reality interoceptive exposure for the treatment of panic disorder and agoraphobia. , 2010, Studies in health technology and informatics.

[58]  Jonathan Steuer,et al.  Defining virtual reality: dimensions determining telepresence , 1992 .

[59]  Josh M Cisler,et al.  Efficacy of cognitive behavioral therapy for anxiety disorders: a review of meta-analytic findings. , 2010, The Psychiatric clinics of North America.

[60]  Albert A. Rizzo,et al.  VR PTSD Exposure Therapy Results with Active Duty OIF/OEF Combatants , 2009, MMVR.

[61]  Mark B. Powers,et al.  Virtual reality exposure therapy for anxiety disorders: A meta-analysis. , 2008, Journal of anxiety disorders.

[62]  G. Robillard,et al.  Using virtual humans to alleviate social anxiety: preliminary report from a comparative outcome study. , 2010, Studies in health technology and informatics.

[63]  Giuseppe Riva,et al.  Virtual reality: an experiential tool for clinical psychology , 2009 .

[64]  K. Ressler,et al.  Virtual reality exposure therapy using a virtual Iraq: case report. , 2008, Journal of traumatic stress.

[65]  Stéphane Bouchard,et al.  Documenting the Efficacy of Virtual RealityExposure with Psychophysiological andInformation Processing Measures , 2005, Applied psychophysiology and biofeedback.