VIRTUAL REALITY CUE EXPOSURE THERAPY FOR THE TREATMENT OF TOBACCO DEPENDENCE.

Researchers and clinicians have recently begun using Virtual Reality (VR) to create immersive and interactive cue exposure paradigms. The current study aimed to assess the effectiveness of individual cue exposure therapy (CET), using smoking-related VR cues (smoking-VR) as a smoking cessation treatment compared to a placebo-VR (neutral cue) treatment. The sample consisted of healthy treatment-seeking cigarette smokers, who underwent bi-weekly cognitive behavioral group therapy (CBT) plus either smoking-VR CET or placebo-VR CET (random assignment). Smoking-VR CET participants had a higher quit rate than placebo-VR CET participants (P = 0.015). Smoking-VR CET treated participants also reported smoking significantly fewer cigarettes per day at the end of treatment than placebo-VR CET treated participants (P = 0.034). These data indicate that smoking-related VR CET may prove useful in enhancing the efficacy of CBT treatment for tobacco dependence.

[1]  Y. Shaham,et al.  The reinstatement model of drug relapse: history, methodology and major findings , 2003, Psychopharmacology.

[2]  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.

[3]  D. Abrams,et al.  Cue exposure treatment for smoking relapse prevention: a controlled clinical trial. , 1999, Addiction.

[4]  Hilary L. Copp,et al.  Assessing reactivity to virtual reality alcohol based cues. , 2008, Addictive behaviors.

[5]  R. Katzev,et al.  Factors involved in the rapid elimination of avoidance behavior. , 1972, Behaviour research and therapy.

[6]  A. Finlayson.  The Tobacco Dependence Treatment Handbook: A Guide to Best Practices , 2004 .

[7]  A. Jansen,et al.  Context-dependency of cue-elicited urge to smoke. , 2005, Addiction.

[8]  M. Jarvik,et al.  Nicotine Blood Levels and Subjective Craving for Cigarettes , 2000, Pharmacology Biochemistry and Behavior.

[9]  D J Rohsenow,et al.  Naltrexone and cue exposure with coping and communication skills training for alcoholics: treatment process and 1-year outcomes. , 2001, Alcoholism, clinical and experimental research.

[10]  P M Monti,et al.  Reactivity to high risk situations and smoking cessation outcome. , 1989, Journal of substance abuse.

[11]  D J Rohsenow,et al.  Smokers' reactions to interpersonal interaction and presentation of smoking cues. , 1992, Addictive behaviors.

[12]  M. A. van den Hout,et al.  Smokers can learn to influence their urge to smoke. , 2000, Addictive behaviors.

[13]  S. Tiffany,et al.  The production of smoking urges through an imagery manipulation: psychophysiological and verbal manifestations. , 1991, Addictive behaviors.

[14]  J. Gray,et al.  Postwithdrawal exposure treatment to prevent relapse in opiate addicts: a pilot study. , 1991, The International journal of the addictions.

[15]  Brenda K. Wiederhold,et al.  Experimental Application of Virtual Reality for Nicotine Craving through Cue Exposure , 2003, Cyberpsychology Behav. Soc. Netw..

[16]  Edythe D. London,et al.  Methamphetamine craving induced in an online virtual reality environment , 2010, Pharmacology Biochemistry and Behavior.

[17]  Brenda K. Wiederhold,et al.  Nicotine Craving and Cue Exposure Therapy by Using Virtual Environments , 2004, Cyberpsychology Behav. Soc. Netw..

[18]  R. Ehrman,et al.  Integrating systemic cue exposure with standard treatment in recovering drug dependent patients. , 1990, Addictive behaviors.

[19]  A. Wikler,et al.  Dynamics of drug dependence. Implications of a conditioning theory for research and treatment. , 1973, Archives of general psychiatry.

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

[21]  J. Gray,et al.  Does post-withdrawal cue exposure improve outcome in opiate addiction? A controlled trial. , 1993, Addiction.

[22]  Hilary L. Copp,et al.  Utilizing virtual reality to standardize nicotine craving research: a pilot study. , 2004, Addictive behaviors.

[23]  D. Abrams,et al.  Reactivity to smoking cues and relapse: two studies of discriminant validity. , 1988, Behaviour research and therapy.

[24]  N Heather,et al.  Cue exposure as a practical treatment for addictive disorders: why are we waiting? , 1990, Addictive behaviors.

[25]  E. Nestler,et al.  Relapse to drug-seeking: neural and molecular mechanisms. , 1998, Drug and alcohol dependence.

[26]  M. Bouton.  Context, time, and memory retrieval in the interference paradigms of Pavlovian learning. , 1993, Psychological bulletin.

[27]  S. Baumann,et al.  Smoking cues in a virtual world provoke craving in cigarette smokers. , 2006, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[28]  L. Kozlowski,et al.  The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. , 1991, British journal of addiction.

[29]  Ken Graap,et al.  A preliminary report on the use of virtual reality technology to elicit craving and cue reactivity in cocaine dependent individuals. , 2006, Addictive behaviors.

[30]  D J Rohsenow,et al.  Relevance of cue reactivity to understanding alcohol and smoking relapse. , 1988, Journal of abnormal psychology.

[31]  K. Fagerström,et al.  Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. , 1978, Addictive behaviors.

[32]  D J Rohsenow,et al.  Cue exposure with coping skills training and communication skills training for alcohol dependence: 6- and 12-month outcomes. , 2001, Addiction.

[33]  N. Mackintosh.  The psychology of animal learning , 1974 .

[34]  D. Drummond,et al.  What does cue-reactivity have to offer clinical research? , 2000, Addiction.

[35]  S. Shiffman,et al.  The relevance and treatment of cue-induced cravings in tobacco dependence. , 2009, Journal of substance abuse treatment.

[36]  D. Abrams,et al.  Responses to smoking-related stimuli and early relapse to smoking. , 1989, Addictive behaviors.

[37]  Erik W. Moody,et al.  Memory processes in classical conditioning , 2004, Neuroscience & Biobehavioral Reviews.

[38]  S. Tiffany,et al.  Applying extinction research and theory to cue-exposure addiction treatments. , 2002, Addiction.

[39]  Jeremy C. Brooks,et al.  Virtual Reality Cue Reactivity Assessment in Cigarette Smokers , 2005, Cyberpsychology Behav. Soc. Netw..

[40]  S. Higgins,et al.  The validity of the reinstatement model of craving and relapse to drug use , 2003, Psychopharmacology.

[41]  I. Franken,et al.  Cue reactivity and effects of cue exposure in abstinent posttreatment drug users. , 1999, Journal of substance abuse treatment.

[42]  N. Heather,et al.  Cue exposure in the treatment of drug dependence: the potential of a new method for preventing relapse. , 1990, Drug and alcohol review.

[43]  Matthew L. Ho,et al.  Brain metabolic changes during cigarette craving. , 2002, Archives of general psychiatry.

[44]  P M Monti,et al.  Psychosocial stress and coping in smokers who relapse or quit. , 1987, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[45]  Brenda K. Wiederhold,et al.  A Functional Magnetic Resonance Imaging (fMRI) Study of Cue-Induced Smoking Craving in Virtual Environments , 2005, Applied psychophysiology and biofeedback.

[46]  C. Conklin.  Environments as cues to smoke: implications for human extinction-based research and treatment. , 2006, Experimental and clinical psychopharmacology.

[47]  M. Hamilton,et al.  Development of a rating scale for primary depressive illness. , 1967, The British journal of social and clinical psychology.

[48]  R Hammersley.  Cue exposure and learning theory. , 1992, Addictive behaviors.

[49]  M F Kuntze,et al.  Immersive Virtual Environments in Cue Exposure , 2001, Cyberpsychology Behav. Soc. Netw..

[50]  Jang-Han Lee,et al.  Cue-Exposure Therapy to Decrease Alcohol Craving in Virtual Environment , 2007, Cyberpsychology Behav. Soc. Netw..