AUGMENTED REALITY Case Study AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

Case StudyCase Study

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

AUGMENTED REALITY

CASE STUDYCASE STUDY Exposure treatment: One hour. The patient interacted with the cockroach in the container, and also with the cockroach outside the container. The patient killed four cockraches.

AUGMENTED REALITY

Treatment outcomes were maintained at one-month follow-up.

Reports of high Reality judgment and Presence.

AUGMENTED REALITY

Participants: 10 patients so far (9 women and 1 man)

Four with spider phobia Six with cockroach phobia

AUGMENTED REALITY

Case Series StudyCase Series Study

Treatment:Treatment: Adaptation of the one-session Adaptation of the one-session exposure program developed by Öst delivered with exposure program developed by Öst delivered with Augmented Reality.Augmented Reality.

AUGMENTED REALITY

Results: BAT (0-12)Results: BAT (0-12)PATIENTS BASELINE PRE-TEST POST-TEST

1 5 5 12

2 6 6 12

3 6 6 12

4 7 7 12

5 5 5 12

6 0 0 12

7 0 0 12

8 5 5 12

9 0 0 12

10 5 5 12

AUGMENTED REALITY

Results: Self-report (0-126)Results: Self-report (0-126)PATIENTS PRE-TEST POST-TEST

1 114 19

2 91 68

3 95 40

4 60 35

5 111 86

6 95 45

7 95 48

8 71 34

9 95 39

10 121 43

AUGMENTED REALITY

Preference: IN VIVO vs AR (0-7)Preference: IN VIVO vs AR (0-7)

PATIENTSPATIENTS 1 2 3 4 5 6 7 8 9 10

Willingness of getting involved in a treatment with AR exposure

7 4 7 7 7 7 6 7 7 7

Willingness of getting involved in a treatment with in vivo exposure

6 4 4 5 4 2 4 4 5 5

AUGMENTED REALITY

Satisfaction (0-10)Satisfaction (0-10)PATIENTSPATIENTS 1 2 3 4 5 6 7 8 9 10

Do you think the procedure is logic?

9 9 10 10 10 10 10 10 10 10

Your level of satisfaction with the procedure

10 9 9 8 8 8 10 10 10 10

Would you recommended it to a friend?

10 9 10 9 9 10 10 10 10 10

Do you think it could be useful for treating other psychological problems?

10 9 10 10 8 10 10 10 10 10

Do you find the treatment aversive?

2 7 7 1 5 7 1 7 9 0

Do you think the treatment has been useful in treating your problem?

10 7 10 7 7 7 9 10 10 10

AUGMENTED REALITY

ConclusionsConclusions

AR: Efficacious in the treatment of specific AR: Efficacious in the treatment of specific phobia.phobia.

Significant reduction in objective and Significant reduction in objective and subjective measures of fear and avoidance.subjective measures of fear and avoidance.

Patients preferred AR rather than in vivo Patients preferred AR rather than in vivo exposure.exposure.

Patients were satisfied with the treatment.Patients were satisfied with the treatment.

Controlled Studies: n > 8Controlled Studies: n > 8

AuthorAuthor CountryCountry YearYear # of Pts# of Pts Tx GrpsTx Grps

BergerBerger U.S.U.S. 19991999 1616 PC VR, Phobics, Non-PhobicsPC VR, Phobics, Non-Phobics

KimKim KoreaKorea 19991999 99 PC VR, WLCPC VR, WLC

WiederholdWiederhold U.S.U.S. 20012001 99 VR, VR, In vivoIn vivo

JangJang KoreaKorea 20022002 1111 Driving vs. FlyingDriving vs. Flying

WalsheWalshe IrelandIreland 20032003 1414 ECT, CBT, WLCECT, CBT, WLC

Fear of DrivingFear of Driving

Types of VR equipment used clinically:

Regular DesktopHead Mounted

DisplayMultiple Screens

Full Car

Automobile Seat

Driving Study: 9 participants (Wiederhold BK, Jang DP, Kim SI, Wiederhold MD, 2001)

88%

12%

0%

20%

40%

60%

80%

100%

Type 1 Type 2 Type 3 Type 4

Based on Framework Type

Success

Treatment SuccessTreatment Success

Specific PhobiaPDAPTSD

Fear of Driving Movie Clip

Social Phobia

Patient wearing a HMD while engaging in the virtual party

Controlled Studies: n > 8Controlled Studies: n > 8

AuthorAuthor CountryCountry YearYear # of Pts# of Pts Tx GrpsTx Grps

SlaterSlater U.K.U.K. 20032003 1010 Neutral, demandingNeutral, demanding

LLègeronègeron FranceFrance 20032003 3636 VR, CBTVR, CBT

RoyRoy FranceFrance 20032003 1010 VR, CBT, WLCVR, CBT, WLC

KlingerKlinger FranceFrance 20052005 3636 VR, CBTVR, CBT

Social PhobiaSocial Phobia

Social Phobia(Klinger, Bouchard et al., 2004)

0

20

40

60

80

100

Pre Post

Liebowitz (total)

in VR CBT

0

2

4

6

8

10

12

Pre Post

Hamilton Anxiety

in VR CBT

-30

-25

-20

-15

-10

-5

0

Pre Post

Rathus (assertiveness)

in VR CBT

N = 36, 12 sessions. CBT in group.

• Sample Population = 18 participants– 10 females and 8 males– Mean age: 30.5 ± 5.06– On average, participants have been suffering from

social phobia for 14.5 years– 9 participants were also displayed symptoms of

major depression(all information based only on the VRT group)

SOCIAL PHOBIA

(Klinger et al., 2005)(Klinger et al., 2005)

• Measures– The Short Beck Depression Inventory (BDI-13)– The Liebowitz Social Anxiety Scale (LSAS)– The Rathus Assertiveness Schedule– The Zigmond and Snaith Hospital Anxiety

Depression Scale (HAD)

SOCIAL PHOBIA

(Klinger et al., 2005)(Klinger et al., 2005)

• Protocol – for VRT only– Overview

• 12 sessions of VRT• 45 minutes each• Exposed to virtual environments for either assessment

or therapy• Virtual exposure lasts less than 20 minutes per session

SOCIAL PHOBIA

(Klinger et al., 2005)(Klinger et al., 2005)

• Protocol (cont’d)– Virtual environments included 4 situations that

social phobic patients felt were the most threatening:

• Performance• Intimacy • Scrutiny• Assertiveness

SOCIAL PHOBIA

(Klinger et al., 2005)(Klinger et al., 2005)

• Protocol (cont’d)– Session 1

• Therapist presents virtual world to patient• Patient familiarizes the virtual world and tools in a

neutral environment– Session 2-9

• 2 sessions devoted to each of the 4 virtual environments

– Assessment, expose patient to VR environment, 2 phases of “therapy” exposure to the environment

SOCIAL PHOBIA

(Klinger et al., 2005)(Klinger et al., 2005)

• Protocol (cont’d)– Session 10-12

• 3 sessions devoted to more focused and detailed work on one or two of the four environments that gave the patient the most trouble

• 12th session = conclusion to therapy and introduction of a personal program to carry out beyond the therapy

SOCIAL PHOBIA

(Klinger et al., 2005)(Klinger et al., 2005)

SOCIAL PHOBIA

(Klinger et al., 2005)(Klinger et al., 2005)

• Conclusion:– Based on the LSAS, VRT would illustrate a better form of

treatment over CBT– The differences between the two groups, however, are not

significant– For VRT to be significantly better than CBT in terms of social

phobia symptoms, experiment participants would have to be increased to 200-300

– Participants should be increased to a sample of 3,000 in order to find a significant difference in performance anxiety

– In order to further confirm the efficacy of virtual reality for the treatment of social phobia, additional outcome studies could be conducted with the inclusion of a third control condition such as a placebo or a waiting list

SOCIAL PHOBIA

(Klinger et al., 2005)(Klinger et al., 2005)

Social Phobia Movie Clip

Internet-based Worlds

www.there.com

www.secondlife.com

SOCIAL PHOBIA

Online Worlds to Help with Social PhobiaOnline Worlds to Help with Social Phobia

Human Avatars

Animal Avatars

Controlled Studies: n > 8

RivaRiva ItalyItaly 20022002 4545 PC VR, PC VR, In vivoIn vivo, WLC, WLC

WiederholdWiederhold U.S.U.S. 20022002 4545 PC VR, PC VR, In vivo, In vivo, WLCWLC

BouchardBouchard CanadaCanada 20022002 4545 PC VR, PC VR, In vivo, In vivo, WLCWLC

KimKim KoreaKorea 20022002 4545 PC VR, PC VR, In vivo, In vivo, WLCWLC

Panic Disorder with AgoraphobiaPanic Disorder with Agoraphobia

Multi-center Controlled StudyMulti-center Controlled Study

AuthorAuthor CountryCountry YearYear # of Pts# of Pts Tx GrpsTx Grps

NorthNorth U.S.U.S. 19981998 3030 PC VR, WLCPC VR, WLC

KimKim KoreaKorea 19991999 99 PC VR, WLCPC VR, WLC

BotellaBotella SpainSpain 20022002 1010 PC VR, PC VR, In vivoIn vivo

WiederholdWiederhold U.S.U.S. 20022002 99 Non-phobics in PDA environ.Non-phobics in PDA environ.

BotellaBotella SpainSpain 20032003 3636 VRE, VRE, In vivo, In vivo, WLCWLC

Agoraphobia: 12 participants(Vincelli, Anolli, Bouchard, Wiederhold, Zurloni, & Riva, 2003)

Patient TreatmentPatient Treatment VR-CBTVR-CBT CBTCBT WLCWLC

DesignDesign VR-CBT 8 sessionsVR-CBT 8 sessions CBT 12 sessionsCBT 12 sessions

ResultsResults VR-CBT produced same or VR-CBT produced same or

better results using 33% better results using 33% fewer sessions than CBTfewer sessions than CBT

MeasuresMeasures Beck Depression Beck Depression

InventoryInventory State Trait Anxiety State Trait Anxiety

InventoryInventory Agoraphobic Cognitions Agoraphobic Cognitions

QuestionnaireQuestionnaire Fear QuestionnaireFear Questionnaire

Agoraphobia: 12 participants(Vincelli, Anolli, Bouchard, Wiederhold, Zurloni, & Riva, 2003)

0

0.5

1

1.5

Pre Rx Post Rx

Panic attack frequency

CBT-VR CBT

0

10

20

30

40

50

60

Pre Rx Post Rx

Fear Questionnaire

CBT-VR CBT

0

5

10

15

20

25

Pre Rx Post Rx

BDI-II

CBT-VR CBT

“The Mall”

“The Room”