Virtual reality in the assessment, understanding, and treatment of mental health disorders

Abstract

Mental health problems are inseparable from the environment. With virtual reality (VR), computer-generated interactive environments, individuals can repeatedly experience their problematic situations and be taught, via evidence-based psychological treatments, how to overcome difficulties. VR is moving out of specialist laboratories. Our central aim was to describe the potential of VR in mental health, including a consideration of the first 20 years of applications. A systematic review of empirical studies was conducted. In all, 285 studies were identified, with 86 concerning assessment, 45 theory development, and 154 treatment. The main disorders researched were anxiety (n = 192), schizophrenia (n = 44), substance-related disorders (n = 22) and eating disorders (n = 18). There are pioneering early studies, but the methodological quality of studies was generally low. The gaps in meaningful applications to mental health are extensive. The most established finding is that VR exposure-based treatments can reduce anxiety disorders, but there are numerous research and treatment avenues of promise. VR was found to be a much-misused term, often applied to non-interactive and non-immersive technologies. We conclude that VR has the potential to transform the assessment, understanding and treatment of mental health problems. The treatment possibilities will only be realized if – with the user experience at the heart of design – the best immersive VR technology is combined with targeted translational interventions. The capability of VR to simulate reality could greatly increase access to psychological therapies, while treatment outcomes could be enhanced by the technology's ability to create new realities. VR may merit the level of attention given to neuroimaging.

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

“…Although in recent times the popular media has lavishly reported on VR’s potential impact on all elements of our evolving digital culture, and has created the impression that VR is a novel technology, the reality is that VR is not a new concept, and many of its developmental roots are traceable to the 1980s and 1990s (Schnipper et al, 2015). Moreover, since the 1990s a significant scientific literature has evolved, almost under the radar, reporting many positive outcomes across a range of clinical applications that have leveraged the assets provided by VR (Botella, Serrano, Baños, & García-Palacios, 2015; Dascal et al, 2017; Freeman et al, 2017; Hoffman et al, 2011; Howard, 2017; Maples-Keller, Yasinski, Manjin, & Rothbaum, 2017; Morina, Ijntema, Meyerbröker, & Emmelkamp, 2015; Rizzo, 1994; Rizzo et al, 2006; Rizzo, Buckwalter, & van der Zaag, 2002, 2015a; Rizzo et al, 2010, in press, 2017, 2015b; Slater & Sanchez-Vives, 2016). Within that context, the present paper will summarize the ways that researchers and clinicians have employed VR to create relevant simulations that can be applied to the prevention, assessment, and treatment of PTSD.…”

Realidad virtual y sus aplicaciones en trastornos mentales: una revisión

“…En una revisión que buscaba identificar las aplicaciones de RV en trastornos de ansiedad, diagnosticados según entrevista clínica estructurada del DSM-IV, se identificaron n = 127 estudios enfocados en tratamiento, n = 46 en evaluaciones; y solo 19 dedicados a investigar las causas de la ansiedad. Además, en múltiples estudios, enfocados en otros tipos de trastornos mentales, se ha utilizado la ansiedad como variable estresora o como medida sintomática de resultado 13 . Uno de los tratamientos habituales para los trastornos de ansiedad es la terapia cognitivoconductual, en la que los pacientes son expuestos a situaciones de ansiedad, generalmente en la vida real o a través de la exposición imaginaria donde se les pide que imaginen una situación a la cual temen.…”

Head-Mounted Virtual Reality and Mental Health: Critical Review of Current Research (Preprint)

“…As a result established effective psychotherapeutical strategies such as cognitive behavioural therapy are recreated within virtual reality as an exposure technique [11]. This exposure is particularly effective as the goal of VR is to produce an 'illusion of reality' [5], however for the patient, despite knowing the computer environment is not real -a computerised illusion -their brains respond as if it is [1]. Its broad reach has seen VR been used to treat schizophrenia, persecutory delusions, PTSD, social and generalised anxiety disorders, specific phobias, eating disorders, substance abuse, Attention deficit hyperactivity disorder (ADHD), depression/stress as well as being used clinically as part of a wide range of cognitive rehabilitation.…”

“…Immersive VR allows users to interact with a computer-generated world, the users natural sensory perceptions are replaced with a digital three dimensional (3D) alternative [1]. To create an immersive VR system, a computer is used to generate an image, a display system is required to project the image and finally a tracker is needed to update the image based on the user's movements.…”