View
32
Download
0
Category
Tags:
Preview:
DESCRIPTION
At the end of the 6th session. Relapse prevention : what have you learned ? what are your high risk situations ? lapse vs relapse : a lapse is a source of information about what went wrong… and your reaction could turn a lapse into a relapse. From virtual to physical reality : - PowerPoint PPT Presentation
Citation preview
At the end of the 6th session Relapse prevention :
what have you learned ? what are your high risk situations ? lapse vs relapse :
a lapse is a source of information about what went wrong… and your reaction could turn a lapse into a relapse.
From virtual to physical reality : Plan self-exposure homework in necessary.
Fostering Presence / Anxiety
Talk in «non virtual» terms.«Walk toward the table and then please close the door».
Highlight useful virtual stimuli.«Ouch, it’s a big spider… its legs are so long… and its looking at you». «Let the spider walk on the wall behind you».
Give the participant some «story line».«Somebody collects spiders in that apartment and we’ll visit it for awhile».
Suggest sensations when you talk.«It feels cold in here … bend over if you don’t want to hit your head on the lamp».
Aviophobia: 30 phobics (Wiederhold BK, Wiederhold MD, 1999)
3 groupsVR Exposure with NO physiological
feedbackVR Exposure WITH physiological feedbackImaginal exposure therapy (VIZ)
2 sessions breathing retraining6 sessions of exposure
Behavioral Outcome – 3 month Behavioral Outcome – 3 month follow-upfollow-up
0123456789
10
# of
Par
ticip
ants
Flying without meds
VR + PhysioVR AloneVIZ
Behavioral Outcome – 3 year Behavioral Outcome – 3 year follow-upfollow-up
0123456789
10
# of
Par
tici
pan
ts
Flying without meds
VR + PhysioVR AloneVIZ
Controlled Studies: n > Controlled Studies: n > 88
AuthorAuthor CountryCountry YearYear # of Pts# of Pts Tx GrpsTx Grps
WiederholdWiederhold U.S.U.S. 19991999 3030 VR w/Fdbk, VR no Fdbk, VIZVR w/Fdbk, VR no Fdbk, VIZ
RothbaumRothbaum U.S.U.S. 20002000 4949 PC VR, PC VR, In vivo, In vivo, WLCWLC
BotellaBotella SpainSpain 20022002 1111 PC VR w/AnticipatoryPC VR w/Anticipatory
MaltbyMaltby U.S.U.S. 20022002 4545 VRE, VRE, In vivoIn vivo
WiederholdWiederhold U.S.U.S. 20022002 3030 VRGETno, VRGETpm, IETVRGETno, VRGETpm, IET
JangJang KoreaKorea 20022002 1111 Driving vs. FlyingDriving vs. Flying
WiederholdWiederhold U.S.U.S. 20022002 5858 Phobic, non-phobicPhobic, non-phobic
RothbaumRothbaum U.S.U.S. 20022002 4949 VR, SE, WLCVR, SE, WLC
WiederholdWiederhold U.S.U.S. 20032003 3030 VRGETno, VRGETpm, IETVRGETno, VRGETpm, IET
MuhlbergerMuhlberger GermanyGermany 20032003 4545 VRCBT, WLCVRCBT, WLC
BotellaBotella SpainSpain 20042004 99 Multiple baseline Multiple baseline
AviophobiaAviophobia
Controlled Studies: n > 8Controlled Studies: n > 8
Fear of Public SpeakingFear of Public Speaking
AuthorAuthor CountryCountry YearYear # of Pts# of Pts Test GroupsTest Groups
NorthNorth U.S.U.S. 19981998 1616 PC VR, WLCPC VR, WLC
BotellaBotella SpainSpain 20012001 88 Internet-based PC VRInternet-based PC VR
PertaubPertaub U.K.U.K. 20012001 4343 Phobic, non-phobicPhobic, non-phobic
HarrisHarris U.S.U.S. 20022002 1414 VRT, WLCVRT, WLC
SlaterSlater U.K. U.K. 20042004 4040 Phobic, non-phobicPhobic, non-phobic
People React to Avatars’ Behaviors(Pertaub, Slater, & Barker, 2001, 2002)
Static audience
Positive audience
Negative audience
Subjects : 43 fear of public speaking patients - Randomly assigned to one of three
groups, distinguished by the type of virtual audience - Subjects have to talk in front of the virtual audience, at least twice.Scenario : 8 formally dressed avatars, seated around a tableThree variables :
2 designed to assess the degree of self-reported anxiety generated by experienceThe other to measure the speaker’s assessment of their performance.(With a modified form of the Personal Report of Confidence as a Speaker - MPRCS)
Pertaub, Slater & Barker (2001, 2002)
AnovaType of audience, p < .05Neutral > Positive = Negative, p < .05
0102030405060708090
100
Satis
fact
ion
tow
ards
the
perfo
rman
ce
Neutral Positive Negative
Type of audience
0
2
4
6
8
10
12
14
MP
RC
S
Neutral Positive Negative
Type of audience
ANCOVA (estimated from data in the paper)Type of audience, p < .05Negative > positive = neutral.
Controlled Studies: n > 8Controlled Studies: n > 8
Needle PhobiaNeedle Phobia
AuthorAuthor CountryCountry YearYear # of Pts# of Pts Test GroupsTest Groups
HamzaHamza South South AfricaAfrica
20002000 1616 Needle phobicNeedle phobic
Virtual Environment
Polar view of the Polar view of the layout of the virtual layout of the virtual student healthstudent health
Virtual ScenarioSimulation of a doctor’s
appointment Two types of exposure to
the injectionInjection lying on the
further end of the doctor’s desk
Simulation of the injecting procedure:Doctor applies a virtual
swab to the avatar's arm and injects the needle
Highest Mean heart rate is when the injection is moving closer to the arm (i.e., situation INJ2 = 95.08 beats per minute)
Decrease in heart rate in INJ3
Mean Heart rate for the first 6 situations did not vary much
Heart Rate at Various StagesHeart Rate at Various Stages140140
120120
100100
6060
4040
8080
Mean Heart Mean Heart RateRate
Various StagesVarious Stages
Desk1 Desk3Desk2
SwabArmUp INJ3INJ1
INJ2
SUDS at Various Stages
Various StagesVarious Stages
Mean Mean
SUDSSUDS
88
77
66
55
44
33
22
11
• As patients moved As patients moved closer to the needle, closer to the needle, mean SUD increasedmean SUD increased
• Mean SUDS Mean SUDS decreased between decreased between when the patient has when the patient has raised his/her arm and raised his/her arm and after swab is applied after swab is applied
3.65
4.6
Desk1Desk1Desk2Desk2
Desk3Desk3ArmUpArmUp
SwabSwabINJ1INJ1
INJ2INJ2INJ3INJ3
5.175.05
4.5
5.716.0
4.41
Controlled Studies: Controlled Studies: n > 8n > 8
AuthorAuthor CountryCountry YearYear # of Pts# of Pts Tx GrpsTx Grps
Hodges, NorthHodges, North U.S.U.S. 19951995 1717 SG VR, WLCSG VR, WLC
LamsonLamson U.S.U.S. 19951995 99 SG VR, WLCSG VR, WLC
BullingerBullinger SwitzerlandSwitzerland 19971997 88 SG VR, SG VR, In vivoIn vivo
HuangHuang U.S.U.S. 19981998 1010 CAVE, CAVE, In vivoIn vivo
EmmelkampEmmelkamp NetherlandsNetherlands 19991999 1010 PC VR, PC VR, In vivoIn vivo
EmmelkampEmmelkamp NetherlandsNetherlands 20022002 3333 PC VR, PC VR, In vivoIn vivo
EmmelkampEmmelkamp NetherlandsNetherlands 20022002 3737 PC VR , CAVE, WLCPC VR , CAVE, WLC
BouchardBouchard CanadaCanada 20022002 88 VideogameVideogame VR VR
SirbuSirbu U.S.U.S. 20042004 3030 Stroop Physio, VR Physio, Stroop Physio, VR Physio, In vivoIn vivo
AcrophobiaAcrophobia
Physiological Differentiation in Participants with High and Low Fear Scores Exposed to a VR Heights
Environment (Wiederhold, Wilhelm, Nguyen, Kim, & Gross)
Protocol Participants stood on a platform in a darkened room 5-minute baseline
Viewed neutral film through HMD 15-minute VR exposure Post-exposure, participants completed self-report
questionnaires to identify a number of physiological sensations and emotions
Measures
Self-Reported Anxiety HR: Heart Rate MAP: Mean Arterial Blood
Pressure FPA: Finger Pulse Amplitude FPTT: Finger Pulse Transit
Time EPA: Ear Pulse Amplitude
EPTT: Ear Pulse Transit Time
TEMP: Peripheral Skin Temperature
SCL: Skin Conductance Levels
RR: Respiratory Rate TV: Tidal Volume ACT: Somatic Activity
Acrophobia: Fear of Heights
Self-Reported Anxiety
0
1
2
3
4
5
6
7
8
0 2 4 6 8 10 12 14
Minute
An
xiet
y R
atin
g (
0-10
)
High Acrophobia
Low Acrophobia
70
75
80
85
90
95
100
0 2 4 6 8 10 12 14
Minute
Hea
rt R
ate
High Acrophobia
Low Acrophobia
Heart RateHeart Rate
Acrophobia: Fear of Heights
SUDS = 0-10
Skin Conductance
5
6
7
8
9
10
11
12
0 2 4 6 8 10 12 14
Minute
SC
L
High Acrophobia
Low Acrophobia
Desynchrony/Discordance: HR & Self-Report
0
1
2
3
4
5
6
7
8
0 2 4 6 8 10 12 14
Minute
An
xiet
y R
atin
g (
0-10
)
High Acrophobia
Low Acrophobia
70
75
80
85
90
95
100
0 2 4 6 8 10 12 14
Minute
Hea
rt R
ate
High Acrophobia
Low Acrophobia
Acrophobia: Fear of Heights
Synchrony/Concordance: Skin Conductance & Self-Report
0
1
2
3
4
5
6
7
8
0 2 4 6 8 10 12 14
Minute
An
xiet
y R
atin
g (
0-10
)
High Acrophobia
Low Acrophobia
5
6
7
8
9
10
11
12
0 2 4 6 8 10 12 14
Minute
SC
L
High Acrophobia
Low Acrophobia
Acrophobia: Fear of Heights
Mean Arterial Blood Pressure
80
85
90
95
100
105
0 2 4 6 8 10 12 14
Minute
Mea
n A
rter
ial B
loo
d P
ress
ure
High Acrophobia
Low Acrophobia
190
195
200
205
210
215
220
0 2 4 6 8 10 12 14
Minute
EP
TT
High Acrophobia
Low Acrophobia
Ear Pulse Transit Time
Acrophobia: Fear of Heights
Summary Results
Self-reported Anxiety Blood pressure Skin conductance Somatic activity Respiration rate
(both)
Ear pulse transit time (indicative of greater sympathetic activation)
Heart Rate (result of compensatory changes driven by the blood pressure changes?)
Increased:Increased: Decreased:Decreased:
Acrophobia: Fear of Heights
Recommended