BMC Psychiatry | |
Is virtual reality always an effective stressors for exposure treatments? some insights from a controlled trial | |
Giuseppe Riva2  Andrea Gaggioli3  Marco Villamira1  Stefano Triberti3  Cinzia Vigna3  Silvia Serino3  Alessandra Grassi2  Simona Raspelli3  Pietro Cipresso3  Federica Pallavicini3  | |
[1] Iulm University, Milan, Italy;Department of Psychology, Catholic University of Milan, Milan, Italy;Istituto Auxologico Italiano IRCCS, Applied Technology for Neuro-Psychology Laboratory, Milan, Italy | |
关键词: Virtual reality; Emotion elicitation; Stress; | |
Others : 1124141 DOI : 10.1186/1471-244X-13-52 |
|
received in 2012-07-18, accepted in 2013-02-07, 发布年份 2013 | |
【 摘 要 】
Background
Several research studies investigating the effectiveness of the different treatments have demonstrated that exposure-based therapies are more suitable and effective than others for the treatment of anxiety disorders. Traditionally, exposure may be achieved in two manners: in vivo, with direct contact to the stimulus, or by imagery, in the person’s imagination. However, despite its effectiveness, both types of exposure present some limitations that supported the use of Virtual Reality (VR). But is VR always an effective stressor? Are the technological breakdowns that may appear during such an experience a possible risk for its effectiveness?
Methods
To answer these questions we compared changes following the exposure to an academic examination, one of the most universal examples of real-life stressors, in a sample of 39 undergraduate students. The same experience was offered using text (TX), audio (AU), video (VD), and VR. However, in the virtual environment we manipulated the experience introducing technological breakdowns. The Post Media Questionnaire (PMQ) and the Slater-Usoh-Steed Presence Questionnaire (SUS) were administered to each participant in order to evaluated self-report measures of anxiety and relaxation and the level of presence experience during media exposure. Electrocardiogram (ECG), Thoracic Respiration Signal (RSP) and Facial corrugator supercilii muscle Electromyography (EMG) were recorded in order to obtain objective measures of subjects’ emotional state.
Results
Analyses conducted on PMQ showed a significant increase in anxiety scores and a mirror decrease in relax scores after all our emotional procedures, showing that all the condition were effective in inducing a negative emotional response. Psychometric scores and psychophysiological indexes showed that VR was less effective than other procedures in eliciting stress responses. Moreover, we did not observe significative difference in SUS scores: VR induced a sense of presence similar to that experienced during the exposition to other media.
Conclusions
Technological breakdowns significantly reduce the possibility of VR eliciting emotions related to complex real-life stressors. Without a high sense of presence, the significant advantages offered by VR disappear and its emotional induction abilities are even lower than the ones provided by much cheaper media.
Trial registration
Trial registration number:NCT01683617
【 授权许可】
2013 Pallavicini et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150216062045314.pdf | 773KB | download | |
Figure 3. | 72KB | Image | download |
Figure 2. | 66KB | Image | download |
Figure 1. | 90KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
【 参考文献 】
- [1]Deacon BJ, Abramowitz JS: Cognitive and behavioral treatments for anxiety disorders: a review of meta-analytic findings. J Clin Psychol 2004, 60(4):429-441.
- [2]Emmelkamp PM: Behavior therapy in adults. In Handbook of psychotherapy and behavior change. 5th edition. Edited by Lambert M. New York: Wiley; 2003:393-446.
- [3]Rothbaum BO, Schwartz AC: Exposure therapy for posttraumatic stress disorder. Am J Psychother 2002, 56(1):59-75.
- [4]Asukai N, Saito A, Tsuruta N, Kishimoto J, Nishikawa T: Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study. J Trauma Stress 2010, 23(6):744-750.
- [5]Barlow JH, Ellard DR, Hainsworth JM, Jones FR, Fisher A: A review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders. Acta Psychiatr Scand 2005, 111(4):272-285.
- [6]Craske M, Barlow D: Panic disorder and agoraphobia. In Clinical handbook of psychological disorders: A step-by-step treatment manual. 4th edition. Edited by Barlow DH. New York: Guilford; 2007:1-64.
- [7]Landon TM, Barlow DH: Cognitive-behavioral treatment for panic disorder: current status. J Psychiatr Pract 2004, 10(4):211-226.
- [8]Olatunji BO, Cisler JM, Deacon BJ: Efficacy of cognitive behavioral therapy for anxiety disorders: a review of meta-analytic findings. Psychiatr Clin North Am 2010, 33(3):557-577.
- [9]Franklin M, Foa E: Obsessive compulsive disorder. In Clinical handbook of psychological disorders: A step-by-step treatment manual. 4th edition. Edited by Barlow DH. New York: Guilford; 2007:164-215.
- [10]Borst G, Kosslyn SM: Fear selectively modulates visual mental imagery and visual perception. Q J Exp Psychol (Colchester) 2010, 63(5):833-839.
- [11]Krijn M, Emmelkamp PM, Olafsson RP, Biemond R: Virtual reality exposure therapy of anxiety disorders: a review. Clin Psychol Rev 2004, 24(3):259-281.
- [12]Krijn M, Emmelkamp PMG, Olafsson RP, Biemond R: Virtual reality exposure therapy of anxiety disorders: A review. Clin Psychology Rev 2004, 24(3):259-281.
- [13]Opris D, Pintea S, Garcia-Palacios A, Botella C, Szamoskozi S, David D: Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depress Anxiety 2012, 29(2):85-93.
- [14]Riva G: Virtual reality in psychotherapy: review. Cyberpsychol Behav 2005, 8(3):220-230. discussion 231–240
- [15]Repetto C, Riva G: From virtual reality to interreality in the treatment of anxiety disorders. Neuropsychiatry 2011, 1(1):31-43.
- [16]Riva G, Waterworth JA, Waterworth EL, Mantovani F: From intention to action: The role of presence. New Ideas in Psychology 2011, 29(1):24-37.
- [17]Waterworth JA, Waterworth EL, Mantovani F, Riva G: On Feeling (the) Present: An evolutionary account of the sense of presence in physical and electronically-mediated environments. J Conscious Stud 2010, 17(1–2):167-178.
- [18]Villani D, Riva G: Does interactive media enhance the management of stress? Suggestions from a controlled study. Cyberpsychol Behav Soc Netw 2012, 15(1):24-30.
- [19]Botella C, GarcÌa-Palacios A, Villa H, Baños RM, Quero M, Alcañiz M, Riva G: Virtual reality exposure in the treatment of panic disorder and agoraphobia: A controlled study. Clin Psychol Psychother 2007, 14(3):164-175.
- [20]Parsons TD, Rizzo AA: Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: a meta-analysis. J Behav Ther Exp Psychiatry 2008, 39(3):250-261.
- [21]Powers MB, Emmelkamp PMG: Virtual reality exposure therapy for anxiety disorders: A meta-analysis. J Anxiety Disord 2008, 22(3):561-569.
- [22]Gorini A, Griez E, Petrova A, Riva G: Assessment of the emotional responses produced by exposure to real food, virtual food and photographs of food in patients affected by eating disorders. Ann Gen Psychiatry 2010, 9:30. Online: http://www.annals-general-psychiatry.com/content/39/31/30 webcite BioMed Central Full Text
- [23]Riva G, Gaggioli A, Grassi A, Raspelli S, Cipresso P, Pallavicini F, Vigna C, Gagliati A, Gasco S, Donvito G: NeuroVR 2-- a free virtual reality for the assessment and treatment in behavioral health care. Stud Health Technol Inform 2011, 163:493-495.
- [24]Villani D, Repetto C, Cipresso P, Riva G: May I experience more presence in doing the same thing in virtual reality than in reality? An answer from a simulated job interview. Interacting with Computer 2012.
- [25]Hartanto D, Kang N, Brinkman WP, Kampmann IL, Morina N, Emmelkamp PMG, Neerincx MA: Automatic Mechanisms for Measuring Subjective Unit of Discomfort. Annu Rev Cybertherapy Telemed 2012, 181:192-196.
- [26]Riva G, Mantovani F: From the body to the tools and back: a general framework for presence in mediated interactions. Interacting with Computers 2012, 24(4):203-210.
- [27]Gorini A, Capideville CS, De Leo G, Mantovani F, Riva G: The role of immersion and narrative in mediated presence: the virtual hospital experience. Cyberpsychol Behav Soc Netw 2011, 14(3):99-105.
- [28]Raspelli S, Pallavicini F, Grassi A, Cipresso P, Balgera A, Meazzi D, Gaggioli A, Villamira M, Riva G: Validation of a narrative as an emotional-induction technique through different non-invasive psychophysiological monitoring devices: preliminary results. J Cybertherapy Rehabil 2011, 4(2):261.
- [29]Lang PJ, Davis M, Öhman A: Fear and anxiety: animal models and human cognitive psychophysiology. J Affect Disord 2000, 61(3):137-159.
- [30]Sinha R: Imaging stress-and cue-induced drug and alcohol craving: association with relapse and clinical implications. Drug Alcohol Rev 2007, 26(1):25-31.
- [31]Sinha R, Garcia M, Paliwal P, Kreek MJ: Stress-induced cocaine craving and hypothalamic-pituitary-adrenal responses are predictive of cocaine relapse outcomes. Ann N Y Acad Sci 2004, 1032:254-257.
- [32]Gross JJ, Levenson RW: Emotion elicitation using films. Cognit Emot 1995, 9(1):87-108.
- [33]Rottenberg J, Ray RD, Gross JJ: Emotion elicitation using films. In The Handbook of Emotion Elicitation and Assessment. 9th edition. Edited by Coan JA, Allen JJB. New York: Oxford University Press; 2007:9-28.
- [34]Slater M, Usoh M, Steed A: Depth of presence in virtual environments. Presence: Teleoperators and Virtual Environments 1994, 1(3):130-144.
- [35]Ahuja ND, Agarwal AK, Mahajan NM, Mehta NH, Kapadia HN: GSR and HRV: its application in clinical diagnosis. Computer-Based Medical Systems 16th IEEE Symposium: 2003 2003, 279-283.
- [36]Barbieri R, Triedman JK, Saul JP: Heart rate control and mechanical cardiopulmonary coupling to assess central volume: a systems analysi. Am J Physiol Regul Integr Comp Physiol 2002, 283:1210-1220.
- [37]Mauri M, Magagnin V, Cipresso P, Mainardi L, Brown EN: Psychophysiological signals associated with affective states. Annual International Conference of the IEEE Engineering in Medicine and Biology Society 2010 2010, 3563-3566.
- [38]Lewicki RJ, Tomlinson EC, Gillespie N: Models of interpersonal trust development: Theoretical approaches, empirical evidence, and future directions. J Manag 2006, 32:991-1022.
- [39]Malik M, Bigger JT, Camm AJ, Kleiger R, Malliani A: Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 1996, 93:1043-1065.
- [40]Magagnin V, Mauri M, Cipresso P, Mainardi L, Brown EN: Heart Rate Variability and Respiratory Sinus Arrhythmia Assessment of Affective States by Bivariate Autoregressive Spectral analysis. Comput Cardiol 2010, 37:145-148.
- [41]Gerrig RJ: Experiencing narrative worlds: on the psychological activity of reading. New Haven and London: Yale University Press; 1993.
- [42]Michaud M, Bouchard S, Dumoulin S, Zhong XW, Renaud P: Manipulating presence and its impact on anxiety. Cyberpsychol Behav 2004, 7(3):297-298.
- [43]Riva G, Mantovani F, Capideville CS, Preziosa A, Morganti F, Villani D, Gaggioli A, Botella C, Alcaniz M: Affective interactions using virtual reality: the link between presence and emotions. Cyberpsychol Behav 2007, 10(1):45-56.
- [44]Serino S, Cipresso P, Tartarisco G, Baldus G, Corda D, Pioggia G, Gaggioli A, Riva G: An Event-Driven Psychophysiological Assessment for Health Care. In 2nd International Workshop on Computing Paradigms for Mental Health: 669 2002. : SciTe Press; 2012:25-34.
- [45]Gutierrez-Maldonado J, Ferrer-Garcia M, Caqueo-Urizar A, Moreno E: The validity of virtual environments for eliciting emotional responses in patients with eating disorders and in controls. Behaviour Modification 2009, 33:830-854.
- [46]Slater M, Spanlang B, Sanchez-Vives MV, Blanke O: First person experience of body transfer in virtual reality. PLoS One 2010, 5(5):e10564.