Virtual Reality and Cognitive-Behavioral Therapy for Driving Anxiety and Aggression in Veterans: A Pilot Study

Zinzow, Heidi M.; Brooks, Johnell O.; Rosopa, Patrick J.; Jeffirs, Stephanie M.; Jenkins, Casey; Seeanner, Julia; McKeeman, Alyssa; Hodges, Larry F.

doi:10.1016/j.cbpra.2017.09.002

Cited by 40 publications

(39 citation statements)

References 37 publications

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“…Gamification is a widely used approach that has shown effectiveness with anxiety and other mental health problems, such as depression and PTSD for military personnel [82] , [83] , and aggression for veterans [84] . Combining game elements and knowledge on game players’ behaviors with known mental health care management methods is an interesting approach that can result in the creation of effective anxiety apps.…”

Section: Resultsmentioning

confidence: 99%

An analysis on self-management and treatment-related functionality and characteristics of highly rated anxiety apps

Drissi

Ouhbi

Idrissi

et al. 2020

International Journal of Medical Informatics

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Highlights Selected apps addressed multiple anxiety issues as well as other health issues. Selected apps adopted various anxiety self-management and treatment approaches. 51% of the selected anxiety apps use gamification to motivate and engage users. Only few apps (19%) reported mental health professionals involvement in their design. 64% of the apps were updated in early 2020, which may be linked to COVID-19 outbreak.

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Section: Resultsmentioning

confidence: 99%

An analysis on self-management and treatment-related functionality and characteristics of highly rated anxiety apps

Drissi

Ouhbi

Idrissi

et al. 2020

International Journal of Medical Informatics

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“…Zinzow et al 62 used a driving simulator to place military populations with aggressive driving problems in personalized VR-driving scenarios. They led a pilot study on eight veterans using their eight-session intervention combining VR exposure to CBT.…”

Section: Resultsmentioning

confidence: 99%

“…Such a holistic approach will be able to be more inclusive of the difficulties that must be treated in violent youth with schizophrenia. In all, current literature suggests that an immersive VR therapy combining elements of AT 74–76 for hallucinatory symptom reduction with exposition to at-risk situations that may trigger perceived threat, as well as allow skill training 46,47,49,50,62,63 used to manage negative emotions, impulsivity, and violence should be the next few steps. More specifically, such VR therapies will enable young offenders to learn and practice relevant skills in real time with the therapist to reduce violence.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive review on virtual reality for the treatment of violence: implications for youth with schizophrenia

et al. 2019

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Youth violence is a complex and multifactorial issue that has severe health and social consequences. While treatment options exist to treat/reduce violence in at-risk populations such as schizophrenia, there remains limitations in the efficacy of current interventions. Virtual reality (VR) appears to be a unique possibility to expose offenders and to train coping skills in virtual situations that are capable of eliciting aggression‐relevant behavior without threatening others. The focus of this paper is to provide a comprehensive review of studies using VR to manage violence across several at-risk populations, with a particular emphasis on youth with schizophrenia. Despite the encouraging success of VR applications for the treatment of different mental health problems, no studies have explored the usability of VR to specifically treat violence in patients with schizophrenia. A limited number of studies have focused on violence risk factors in other mental health problems (i.e., emotion regulation in individual suffering from post-traumatic disorders) that may be targeted in treatments to reduce the risk of violence. The preliminary studies using VR as a therapeutic element have shown reductions in anger, improvements in conflict-resolution skills as well as in empathy levels, and decreases in aggression. Possible applications of these interventions in youth with schizophrenia will be discussed.

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“…The results could have been different if a longer intervention had been designed and if complementary teaching methods were employed, such as virtual reality technology. A pilot study conducted by Zinzow et al [32] on U.S. veterans who presented with signs of driving phobia, hyperarousal, anxiety/anger related thoughts and behaviors, risky driving, and PTSD symptoms has shown great effectiveness in managing a decline in hyperarousal in driving situations and aggressive and risky driving with the use of virtual reality and cognitive behavioral intervention in multiple sessions.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Testing the Effectiveness of a Mixed-Method Pilot Intervention in Reducing Risky Driving Due to Aggression and Stress

Papadakaki

Stamou

Bessas

et al. 2020

Safety

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The study aimed at testing the effectiveness of a mixed-method pilot intervention in reducing risky self-reported driving performance, upon addressing stress and aggression while driving. The study recruited individuals who had performed these behaviors during the year preceding the study and allocated them into an intervention (n = 10) and a control group (n = 30). A pre-and postintervention evaluation design was employed to explore changes in risky self-reported driving behaviors, 12 months after the intervention. The intervention involved 2 h of experiential instruction and 1 h of cognitive restructuring using a driving simulator and scenarios appropriate for the processing of driving stress, aggression, and risk. The intervention group displayed significant improvements in the scales of “Hazard Monitoring” (p = 0.037) and “Covered Violations” (p = 0.049) at the postintervention level. No statistically significant differences were identified in terms of self-reported driving performance between the intervention and the control group at postintervention level. Launching large-scale experimental surveys with broadened cognitive restructuring approaches seems important to deepen our understanding of the behavioral change processes and increase the effectiveness of future interventions.

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Virtual Reality and Cognitive-Behavioral Therapy for Driving Anxiety and Aggression in Veterans: A Pilot Study

Cited by 40 publications

References 37 publications

An analysis on self-management and treatment-related functionality and characteristics of highly rated anxiety apps

An analysis on self-management and treatment-related functionality and characteristics of highly rated anxiety apps

Comprehensive review on virtual reality for the treatment of violence: implications for youth with schizophrenia

Testing the Effectiveness of a Mixed-Method Pilot Intervention in Reducing Risky Driving Due to Aggression and Stress

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