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Virtual Reality Exposure Treatment in Phobias: a Systematic Review

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Abstract

We compare the relative efficacy of virtual reality therapy exposure (VRET) versus in vivo therapy exposure among individuals suffering from phobias. A systematic search was completed up to 03 April 2020, using the following databases: ACM Digital Library, ResearchGate, IEEE, Science Direct, MIT PressJournals, Center for Direct Scientific Communication (CCSD) and Mary Ann Liebert Publishers. Five authors searched the databases using the following terms: Virtual Reality, Phobia, Mental health, Computing, Therapy, HMD, CAVE, Virtual ambient, in virtuo, Avoidance, Exposure, VRET, in vivo, Anxiety, Agoraphobia, Social Phobia, Stimuli, Cognitive–behaviour. All studies that evaluate the effect of in virtuo exposure towards phobia rehabilitation were selected. By reviewing the article, each author then applied the inclusion and exclusion criteria, and 30 articles were selected. Data extracted included the number of samples, amount of sessions, study variables that may affect the final outcome, therapy technology. The data provided was synthesized using a meta-analysis based on the results. The results demonstrated a positive outcome of Virtual Reality Exposure Treatment in the treatment of most phobias. In contrast, some of these treatments did not work for a few specific phobias in which the standard procedures were more effective. The findings suggest that for some specific phobias treatment, Virtual Reality Exposure Treatment does not reach the in vivo exposure level of immersion and presence. Further research is needed to perform studies with higher-dimension samples, since many papers report a low sample size and that is probably why many of them have inconclusive results.

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Notes

  1. Exposure therapy generally used for treating individuals with phobias, obsessive-compulsive disorder, and other anxiety disorders, in which the client directly experiences anxiety-provoking situations or stimuli in real-world conditions [5].

  2. extreme anxiety, panic attacks...

References

  1. American Psychiatric Association, https://www.psychiatry.org/. Consulted on March 27, 2020.

  2. National Institute of Mental Health, https://www.nimh.nih.gov/index.shtml. Consulted on March 27, 2020.

  3. A. Carmosino, Facts About Phobias. Psych Central, from https://psychcentral.com/lib/facts-about-phobias/. Consulted on March 27, 2020, 2020.

  4. Phobias - treatment. (2016, January 14), http://www.nhs.uk/Conditions/Phobias/Pages/Treatment.aspx. Consulted on April 3, 2020.

  5. American Psychological Association, https://dictionary.apa.org/in-vivo-exposure. Consulted on March 26, 2020.

  6. Snowball Sampling, from https://en.wikipedia.org/wiki/Snowballsampling. Consulted 1 April, 2020.

  7. American Psychological Association. (2011, June). Psychologist identifies what may trigger claustrophobia [Press release] http://www.apa.org/monitor/2011/06/claustrophobia.aspx. Consulted 3 April, 2020.

  8. S Bouchard, Could virtual reality be effective in treating children with phobias?. Expert review of neurotherapeutics. 11. 207-13. https://doi.org/10.1586/ern.10.196. Consulted on March 20 2020, 2011.

  9. G-P Azucena, H Hoffman, A Carlin, T Furness, and C Botella, Virtual reality in the treatment of spider phobia: A controlled study, Behav Res Therapy 40 (2002), 983–93. https://doi.org/10.1016/S0005-7967(01)00068-7. Consulted on March 20, 2020.

  10. P Emmelkamp, M Bruynzeel, L Drost, and C Mast, Virtual reality treatment in acrophobia: A comparison with exposure in vivo, Cyberpsychology, Behavior : The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society 4 (2001), 335–9. https://doi.org/10.1089/109493101300210222. Consulted on March 20, 2020.

  11. B Rothbaum, L Hodges, S Smith, J Lee, and L Price, A controlled study of virtual reality exposure therapy for fear of flying, J Consult Clin Psychol 68 (2001), 1020–6. https://doi.org/10.1037//0022-006X.68.6.1020. Consulted on March 20, 2020.

  12. E Klinger, S Bouchard, P Légeron, F Lauer, I Chemin, and P Nugues, Virtual reality therapy versus cognitive behavior therapy for social phobia: A preliminary controlled study, Cyberpsychol Behav 8 (2005), 76–88. https://doi.org/10.1089/cpb.2005.8.76. Consulted on March 20, 2020.

  13. MM North, SM North, and JR Coble, Effectiveness of virtual environment desensitization in the treatment of agoraphobia, Presence: Teleoper Virtual Environ 5 (1996), no. 3, 346–352. https://doi.org/10.1162/pres.1996.5.3.346. Consulted on March 20, 2020.

  14. E Salehi, M Mehrabi, F Fatehi, and A Salehi, Virtual reality therapy for social phobia: a scoping review. Consulted on March 20, 2020, 2020.

  15. M Clemente, B Rey, M Alcañiz Raya, A Rodríguez-Pujadas, A Barrós-Loscertales, C Avila, J Bretón-López, C Botella, and R Baños, fMRI assessment of small animals’ phobia using virtual reality as stimulus. 344-347. https://doi.org/10.4108/icst.pervasivehealth.2013.252180. Consulted on March 26, 2020, 2013.

  16. S Côté and S Bouchard, Virtual reality exposure for phobias: A critical review, J Cyber Ther Rehabil 1 (2008), 75–92. Consulted on March 30, 2020.

  17. B Wiederhold, M Mendoza, T Nakatani, AH Bullinger, and M Wiederhold, VR for blood-injection-injury phobia, Ann Rev Cyber Therapy Tele 3 (2005), 109–116. Consulted on March 30, 2020.

  18. M Krijn, PMG Emmelkamp, RP Olafsson, and R Biemond, Virtual reality exposure therapy of anxiety disorders: A review. Consulted on March 30, 2020, 2004.

  19. R Baños, C Botella, C Perpiñá, RA Mariano, Jose Lozano, Jorge Osma, and Myriam Gallardo, Virtual reality treatment of flying phobia, IEEE Trans Inf Technol Biomed A Publ IEEE Eng Med Biol Soc 6 (2002), 206–12. https://doi.org/10.1109/TITB.2002.802380. Consulted on March 30, 2020.

  20. BO Rothbaum, LF Hodges, D Ready, K Graap, and RD Alarcon, Virtual reality exposure therapy for Vietnam veterans with post traumatic stress disorder, J Clin Psych 62 (2001), 617–6. Consulted on March 30, 2020.

  21. LM Dewis, KC Kirkby, F Martin, BA Daniels, LJ Gilroy, and RG Menzie, Computer-aided vicarious exposure versus live graded exposure for spider phobia in children, J Behav Ther Exp Psychiatry 32 (2001), 17–27. Consulted on March 30, 2020.

  22. YH Choi, DP Jang, JH Ku, MB Shin, and SI Kim, Short-term treatment of acrophobia with virtual reality therapy (VRT): A case report, Cyberpsychology and Behavior 4 (2001), 349–354. Consulted on March 30, 2020.

  23. M North, SM North, and JR Coble, Virtual Reality Therapy: an Effective Treatment for the Fear of Public Speaking (Riva et al., eds.), IOS Press, Amsterdam, 1998. Consulted on March 31, 2020.

  24. K Gujjar, R Sharma, and AD Jongh, Virtual reality exposure therapy for treatment of dental phobia, Dental update 44 (2017), 423–4. https://doi.org/10.12968/denu.2017.44.5.423. Consulted on March 30, 2020.

  25. C aBotella, RM Baños, H Villa, P Conxa, and G Azucena, Virtual reality in the treatment of claustrophobic fear: A controlled, multiple-baseline design. Consulted March 30, 2020, 2000.

  26. A Bullinger, Treating acrophobia in a virtual enviroment. In wiederhold, B., Riva, G. and Bullinger. Consulted 30 March 2020, 2005.

  27. DP Jang, JH Ku, MB Shin, YH Choi, and SI Kim, Objective validation of the effectiveness of virtual reality psychotherapy, Cyberpsy Behav 3 (2000), 369–3. Consulted March 31, 2020.

  28. DG Walshe, EJ Lewis, SI Kim, K O’Sullivan, BK Wiederhold, and MBA Bcia, Exploring the use of computer games and virtual reality in exposure therapy for fear of driving following a motor vehicle accident. Consulted 31 March 2020.

  29. K Raghav, AJ Van Wijk, F Abdullah, MN Islam, M Bernatchez, and A De Jongh, Efficacy of virtual reality exposure therapy for treatment of dental phobia: a randomized control trial, BMC Oral Health 16 (2016), 25. https://doi.org/10.1186/s12903-016-0186-z. Consulted 31 March 2020.

  30. R Chad, S Emaan, and O Jillian, Effect of virtual reality headset for pediatric fear and pain distraction during immunization, Pain Manag 8 (2018), no. 3, 175–1. https://doi.org/10.2217/pmt-2017-0040. Consulted 31 March 2020.

  31. JH Kwon, A Chalmers, S Czanner, G Czanner, and John Powell, A study of visual perception: social anxiety and virtual realism. In: Proceedings of the 25th Spring Conference on Computer Graphics (SCCG ’09). Association for Computing Machinery, New York, NY, USA, 167–172. https://doi.org/10.1145/1980462.1980495. Consulted 31 March 2020, 2009.

  32. S Bouchard, J St-Jacques, G Robillard, and P Renaud, Effectiveness of an exposure-based treatment for arachnophobia in children using virtual reality: a pilot study, J Thér Comport Cogn 17 (2007), no. 3, 101–108. Consulted 1 April 2020.

  33. J Gutiérrez-Maldonado, E Magallon-Neri, M Rus-Calafell, and C Penaloza-Salazar, Virtual reality exposure therapy for school phobia, Anuario de Psicologia 40 (2009), no. 2, 223–236. Consulted 1 April 2020.

  34. F Doré and S Bouchard, Using virtual reality to treat social anxiety disorders in adolescents, 2006.

  35. S Bouchard, S Côté, J St-Jacques, and G Robillard, Effectiveness of virtual reality exposure in the treatment of arachnophobia using 3D games. Consulted 1 April 2020.

  36. M Bruce and H Regenbrecht, A Virtual Reality Claustrophobia Therapy System – Implementation and Test, Consulted 1 April 2020.

  37. H Hoffman, A Garcia-Palacios, A Carlin, and C Botella, Interfaces That Heal: Coupling real and virtual objects to treat spider phobia, Int J Human-Comput Inter 16 (2003), 283–3. https://doi.org/10.1207/S15327590IJHC160208. Consulted 1 April 2020.

  38. RT da Costa1, MR de Carvalho, P Ribeiro, and AE Nardi, Virtual reality exposure therapy for fear of driving: analysis of clinical characteristics, physiological response, and sense of presence. Consulted 1 April 2020.

  39. J Wald and S Taylor, Efficacy of virtual reality exposure therapy to treat driving phobia: A case report, J Behav Therapy Exper Psych 31 (2000), 249–57. https://doi.org/10.1016/S0005-7916(01)00009-X. Consulted 1 April 2020.

  40. BO Rothbaum, L Hodges, BA Watson, and GD DanOpdyke, Virtual reality exposure therapy in the treatment of fear of flying: a case report. Consulted 1 April 2020, 1996.

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Authors and Affiliations

  1. University of Madeira, Funchal, Portugal

    José Rúben Silva Freitas, Vitor Hugo Silva Velosa, Leonardo Tadeu Nunes Abreu, Ricardo Lucas Jardim, João Artur Vieira Santos & Pedro F. Campos

  2. ITI/LARSyS, Lisbon, Portugal

    Beatriz Peres

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Correspondence to Pedro F. Campos.

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All authors state that there are no known conflicts of interest. This research did not involve any human participants and/or animals. Consequently, there was no need for informed consent. Moreover, all authors certify that they accept responsibility for the conduct of the study and for the analysis and interpretation of the data. All helped write the manuscript and agree with the decisions about it, meeting the definition of an author as stated by the International Committee of Medical Journal Editors, and they have seen and approved the final manuscript.

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Freitas, J.R.S., Velosa, V.H.S., Abreu, L.T.N. et al. Virtual Reality Exposure Treatment in Phobias: a Systematic Review. Psychiatr Q 92, 1685–1710 (2021). https://doi.org/10.1007/s11126-021-09935-6

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