Virtual Reality as a Tool for Delivering PTSD Exposure Therapy and Stress Resilience Training

Rizzo, Albert; John, Bruce; Newman, Brad; Williams, Josh; Hartholt, Arno; Lethin, Clarke; Buckwalter, J. Galen

doi:10.1080/21635781.2012.721064

Cited by 48 publications

(37 citation statements)

References 35 publications

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“…However, only 2 had over 10 participants, and most of the original papers provide little detail regarding the game. Hence an alternative example, that of Virtual Iraq for PTSD (34) is given in Table 2. Promising findings from VR interventions, including non-game-based VR interventions (40) along with the popularity of commercial AR games, suggest promise in this area.…”

Section: Types Of Applied Gamesmentioning

confidence: 99%

Serious Games and Gamification for Mental Health: Current Status and Promising Directions

et al. 2017

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Computer games are ubiquitous and can be utilized for serious purposes such as health and education. “Applied games” including serious games (in brief, computerized games for serious purposes) and gamification (gaming elements used outside of games) have the potential to increase the impact of mental health internet interventions via three processes. First, by extending the reach of online programs to those who might not otherwise use them. Second, by improving engagement through both game-based and “serious” motivational dynamics. Third, by utilizing varied mechanisms for change, including therapeutic processes and gaming features. In this scoping review, we aim to advance the field by exploring the potential and opportunities available in this area. We review engagement factors which may be exploited and demonstrate that there is promising evidence of effectiveness for serious games for depression from contemporary systematic reviews. We illustrate six major categories of tested applied games for mental health (exergames, virtual reality, cognitive behavior therapy-based games, entertainment games, biofeedback, and cognitive training games) and demonstrate that it is feasible to translate traditional evidence-based interventions into computer gaming formats and to exploit features of computer games for therapeutic change. Applied games have considerable potential for increasing the impact of online interventions for mental health. However, there are few independent trials, and direct comparisons of game-based and non-game-based interventions are lacking. Further research, faster iterations, rapid testing, non-traditional collaborations, and user-centered approaches are needed to respond to diverse user needs and preferences in rapidly changing environments.

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Section: Types Of Applied Gamesmentioning

confidence: 99%

Serious Games and Gamification for Mental Health: Current Status and Promising Directions

et al. 2017

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“…Additionally, it puts patients in a potentially distressing situation, where they need to face the real threat or embarrassment related to some public aspects of in vivo treatment (Rizzo et al, 2007 ). On the other hand, during imaginal ET some patients are reluctant, or find it difficult to mentally visualize the fear-inducing stimuli, or are hesitant to verbally engage with the therapist in imaginal ET (Rothbaum and Hodges, 1999 ; Garcia-Palacios et al, 2002 ; Rothbaum et al, 2006 ; Rizzo et al, 2013 ). Furthermore, in anxiety disorders or Post-traumatic Stress Disorder (PTSD) some patients are unwilling or unable to sufficiently engage emotionally during the therapy and visualize or recall the anxiogenic stimuli or traumatic event (Rothbaum and Hodges, 1999 ; Rizzo et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Within- and Between-Session Prefrontal Cortex Response to Virtual Reality Exposure Therapy for Acrophobia

Landowska

Roberts

Eachus

et al. 2018

Front. Hum. Neurosci.

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Exposure Therapy (ET) has demonstrated its efficacy in the treatment of phobias, anxiety and Post-traumatic Stress Disorder (PTSD), however, it suffers a high drop-out rate because of too low or too high patient engagement in treatment. Virtual Reality Exposure Therapy (VRET) is comparably effective regarding symptom reduction and offers an alternative tool to facilitate engagement for avoidant participants. Neuroimaging studies have demonstrated that both ET and VRET normalize brain activity within a fear circuit. However, previous studies have employed brain imaging technology which restricts people’s movement and hides their body, surroundings and therapist from view. This is at odds with the way engagement is typically controlled. We used a novel combination of neural imaging and VR technology—Functional Near-Infrared Spectroscopy (fNIRS) and Immersive Projection Technology (IPT), to avoid these limitations. Although there are a few studies that have investigated the effect of VRET on a brain function after the treatment, the present study utilized technologies which promote ecological validity to measure brain changes after VRET treatment. Furthermore, there are no studies that have measured brain activity within VRET session. In this study brain activity within the prefrontal cortex (PFC) was measured during three consecutive exposure sessions. N = 13 acrophobic volunteers were asked to walk on a virtual plank with a 6 m drop below. Changes in oxygenated (HbO) hemoglobin concentrations in the PFC were measured in three blocks using fNIRS. Consistent with previous functional magnetic resonance imaging (fMRI) studies, the analysis showed decreased activity in the DLPFC and MPFC during first exposure. The activity increased toward normal across three sessions. The study demonstrates potential efficacy of a method for measuring within-session neural response to virtual stimuli that could be replicated within clinics and research institutes, with equipment better suited to an ET session and at fraction of the cost, when compared to fMRI. This has application in widening access to, and increasing ecological validity of, immersive neuroimaging across understanding, diagnosis, assessment and treatment of, a range of mental disorders such as phobia, anxiety and PTSD or addictions.

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“…'Serious games' (Michael and Chen, 2006) are designed to improve human lives by helping people learn new information and skills (Williamson et al, 2005) and overcome psychological challenges (e.g. PTSD (Rizzo et al, 2013), ADHD (Rizzo et al, 2000), and phobias (Walshe et al, 2003)) as well as physical challenges (e.g. weight loss (Göbel et al, 2010) and stroke recovery (Burke et al, 2009)).…”

Section: Methodsmentioning

confidence: 99%

Concepts and practice in the emerging use of games for marine education and conservation

Colleton

Lakshman

Flood

et al. 2016

Aquatic Conservation

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ABSTRACT1. Mobilizing marine conservation on a global scale is a tremendous challenge, especially as it involves motivating people who may have no physical connection to marine areas to experience and understand them.2. Game technology through virtual means, enables players anywhere at anytime, to explore areas they may not otherwise experience, and experience numerous scenarios for the benefit of global engagement in marine conservation action.3. New game platforms are being developed to teach science, and better connect people to nature, specifically marine environments.4. Infinite Scuba enables players to explore the ocean virtually with Mission Blue Founder, Sylvia Earle. 5. Planet3 is developing a game that will present marine and freshwater ecosystems in the greater context of the Earth system. 6. Games have the potential to play a key role in mobilizing knowledge and conservation action in the future.

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Virtual Reality as a Tool for Delivering PTSD Exposure Therapy and Stress Resilience Training

Cited by 48 publications

References 35 publications

Serious Games and Gamification for Mental Health: Current Status and Promising Directions

Serious Games and Gamification for Mental Health: Current Status and Promising Directions

Within- and Between-Session Prefrontal Cortex Response to Virtual Reality Exposure Therapy for Acrophobia

Concepts and practice in the emerging use of games for marine education and conservation

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