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Just My Take On Things

Recommendations for Use

12/16/2020

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Optical Illusion

12/16/2020

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Virtual Reality for Counselling

12/16/2020

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Is Virtual Reality Effective

11/27/2020

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Test anxiety and virtual reality

11/27/2020

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Test anxiety has been defined as the emotional, physiological and behavioral responses that occur around the potential consequences of negative evaluations or a future test or exam (Zeidner, 1998)
Spielberg and Vagg (1995) have described test anxiety as an element of general anxiety which is composed of processes of cognitive attention that interfere with performance in academic situations or tests. Like Sapp, Durand and Farrel (1995) who consider it as a case of general anxiety disorder related to being tested. Studies about the start, prevalence and incidence indicate that the start of the problem may be very early (7 years), although the major manifestations occur in adolescence, Von Der Embse, N., Barterian, J., & Segool, N. (2013) estimate that between 10 and 40% of the child/adolescent population may suffer from it. Other studies indicate a high incidence, around 48%, on the university access (Kavakci, O., Semiz, M., Kartal, A., Dikici, A., & Kugu, N., 2014).
Systematic desensitization (SD) through exposure is shown to be effective itself to reduce test anxiety (Hembree, 1988) in addition to having a positive effect on academic results and a decrease in overall anxiety and trait status.
The therapeutic approaches that combine SD with cognitive restructuring and study techniques are the ones that show a greater reduction of anxiety before the test (Talbot, 2016).
The virtual reality environments are capable of generating the anxious response that appears because of the test to be able to perform the gradual exposure. In addition, virtual reality is equally effective as exposure by imagination and achieves a greater reduction of avoidance behaviors than exposure by imagination (Gutiérrez-Maldonado, Alsina, Carvallo, Letosa & Magallón, 2007). This may be because virtual reality allows a greater generalization of the coping response learned.
Psious environments allow you to use different techniques of psychological intervention: exposure, cognitive restructuring, systematic desensitization, training in social skills…, use those that are more appropriate to the characteristics of your patient and build on those with greater empirical support to get better results.

References
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  • Ali, M. S., & Mohsin, M. N. (2013). Test Anxiety Inventory (TAI): Factor analysis and psychometric properties. Journal of Humanities and Social Science, 8(1), 73-81
  • Alsina, I., Carvallo, C. y Gutiérrez-Maldonado, J. (2007). Validity of virtual reality as a method of exposure in the treatment of test anxiety. Behavior Research Methods, 39 (4), 844-851. R
  • Botella et al. (2012): La realidad virtual para el tratamiento de los trastornos emocionales: una revisión. Anuario de psicología clínica y de la Salud. Volumen 08 • Pág. 7 a 21 
  • Brown, T. A., DiNardo, P. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV (ADIS-IV), adult version. Albany (NY): Graywind Publications Inc.
  • Cunha, M., & Paiva, M. J. (2012). Text Anxiety in Adolescents: The role of self-criticism and acceptance and mindfulness skills. The Spanish journal of psychology, 15(2), 533
  • Kavakci, O., Semiz, M., Kartal, A., Dikici, A., & Kugu, N. (2014). Test anxiety prevalence and related variables in the students who are going to take the university entrance examination. Dusunen Adam, 27(4), 301.
  • Krijn, et al. (2004) Virtual reality exposure therapy of anxiety disorders: A review, Clinical Psychology Review, Volume 24, Issue 3, Pages 259-281, ISSN 0272-7358, http://dx.doi.org/10.1016/j. cpr.2004.04.001. (http://www.sciencedirect.com/science/article/pii/ S0272735804000418)
  • Liebert, R. M., & Morris, L. W. (1967). Cognitive and emotional components of test anxiety: A distinction and some initial data. Psychological reports, 20(3), 975-978.
  • Mandler, G and Sarason, S B, (1952). A study of anxiety and learning. Journal of Abnormal and Social Psychology, 47, 166–173
  • Gutiérrez-Maldonado, J., Alsina-Jurnet, I., Carvallo-Becíu, C., Letosa Porta, A., y Magallón-Neri, E. (2007). Aplicaciones clínicas de la realidad virtual en el ámbito escolar. Cuadernos de medicina psicosomática y psiquiatría de enlace, 82, 32-51.
  • Heredia, D., Piemontesi, S., Furlan, L., y Pérez, E. (2008). Adaptación de la Escala de Afrontamiento ante la ansiedad e incertidumbre pre examen:(COPEAU). Avaliação psicológica, 7(1), 1-9.
  • Hembree, R. (1988). Correlates, causes, effects, and treatment of test anxiety. Review of educational research, 58(1), 47-77.
  • Hodapp, V., Glanzmann, P., y Laux, L. (1995). Theory and measurement of test anxiety as a situation-specific trait. En Charles Spielberger (Ed). Test anxiety: Theory, assessment, and treatment, (47-58). Philadelphia: Taylor & Francis.
  • Rodríguez, J. O., Alcázar, A. I. R., Caballo, V. E., García-López, L. J., Amorós, M. O., y López-Gollonet, C. (2003). El tratamiento de la fobia social en niños y adolescentes: una revisión meta-analítica. Psicología Conductual, 11, 599-622.
  • Sapp, M., Farrell, W., y Durand, H. (1995). The effect of mathematics, reading, and writing tests in producing worry and emotionality test anxiety with economically and educationally disadvantaged college students. College Student Journal, 29, 122–125.
  • Sarason, I. G. (1972). Experimental approaches to test anxiety: Attention and the uses of information. Anxiety: Current trends in theory and research, 2, 383-403.
  • Spielberger, C.D. (1980). Test Anxiety Inventory Palo Alto, C.A: Consulting Psychologists Press.  
  • Spielberger, C. D & Vagg, P.R. (1995). Test Anxiety: Theory Assessment and Treatment Washington D.C. Taylor Francis, 3-14.
  • Talbot, L. (2016). Test Anxiety: Prevalence, Effects, and Interventions for Elementary School Students. James Madison Undergraduate Research Journal (JMURJ), 3(1), 5.
  • Valero, L. (1999). Evaluación de ansiedad ante exámenes: Datos de aplicación y fiabilidad de un cuestionario CAEX. Anales de psicología, 15(2), 223-231.
  • Von Der Embse, N., Barterian, J., & Segool, N. (2013). Test anxiety interventions for children and adolescents: A systematic review of treatment studies from 2000–2010. Psychology in the Schools, 50(1), 57-71.
  • Zeidner, M. (1998). Test anxiety: The state of the art. Springer Science & Business Media.

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Stress & trauma

11/27/2020

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Sport performance and virtual reality

11/27/2020

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Somatic & related,and virtual reality

11/27/2020

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Somatic Symptom Disorder (SSD) includes the diagnosis of somatic symptom disorder, illness anxiety disorder, con­version disorder (functional neurological symptom disorder), psychological factors affect­ing other medical conditions, factitious disorder and other related disorders. It is important to note that some other mental disorders may initially manifest with primarily somatic symptoms (e.g., major depressive disorder, panic disorder). Such diagnoses may account for the somatic symptoms, or they may occur alongside one of the somatic symptoms and related disorders. (adapted from APA, 2013).
Somatic symptom disorder (SSD) is characterized by an extreme focus on physical symptoms — such as pain or fatigue — that causes major emotional distress and problems functioning. The patient may or may not have another diagnosed medical condition associated with these symptoms, but the person’s reaction to the symptoms is excessive. People diagnosed with IAD strongly believe they have a serious or life-threatening illness despite having no, or only mild, symptoms. Yet IAD patients’ concerns are to them very real. Even if they go to doctors and no illnesses are found, they are generally not reassured, or they only do it for a short time,  and their obsessive worry continues. IAD can also trigger worries in people who do have a physical illness that they are sicker than they really are. The disorder is not about the presence or absence of illness, but the psychological reaction (adapted from Mayo and Cleveland Clinics).
Cognitive Behavior Therapy (CBT) is the best established treatment for a variety of somatoform disorders, with some benefit also demonstrated for a consultation letter to the primary care physician ( Kroenke, K., 2007). 
Psious’ “Somatic and Related” therapeutic area tools were grouped to help therapists on somatic symptoms assessment and treatment, especially for somatic symptoms and illness anxiety disorders.  These tools can help for somatic symptomatology treatment using CBT evidence-based techniques: exposure and response prevention (Hedman, E., et al 2016 ), relaxation training and cognitive–behavioral therapy (Bauer, M.,et al  2014), Mindfulness (Fjorback, L. O.,et al  2013, Hedman, E., et al 2016 ).

References


  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. Arlington, VA: American Psychiatric Association.
  • Kroenke, K. (2007). Efficacy of treatment for somatoform disorders: A review of randomized controlled trials. Psychosomatic Medicine, 69(9), 881–888. https://doi.org/10.1097/PSY.0b013e31815b00c
  • Bauer, M., Hersey, D., Kasuba, J., Lauridsen, A., Stewart, A., B. (2014). Somatic symptom disorder: Effective techniques for diagnosing and managing this complex condition in primary care practices. Consultant, 54(9), 1–12.
  • Fjorback, L. O., Arendt, M., Ørnbøl, E., Walach, H., Rehfeld, E., Schröder, A., & Fink, P. (2013). Mindfulness therapy for somatization disorder and functional somatic syndromes – Randomized trial with one-year follow-up. Journal of Psychosomatic Research, 74(1), 31–40. https://doi.org/10.1016/j.jpsychores.2012.09.006
  • Hedman, E., Axelsson, E., Andersson, E., Lekander, M., & Ljótsson, B. (2016). Exposure-based cognitive–behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial. British Journal of Psychiatry, 209(5), 407–413. https://doi.org/10.1192/bjp.bp.116.181396
  • Hinz, A., Ernst, J., Glaesmer, H., Brähler, E., Rauscher, F. G., Petrowski, K., & Kocalevent, R. D. (2017). Frequency of somatic symptoms in the general population: Normative values for the Patient Health Questionnaire-15 (PHQ-15). Journal of Psychosomatic Research, 96, 27–31. https://doi.org/10.1016/j.jpsychores.2016.12.017
  • Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2002). The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64(2), 258–266. https://doi.org/10.1097/00006842-200203000-00008
  • Salkovskis, P.M., Rimes, K.A., Warwick, H.M.C. & Clark, D. . (2002). The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, Vol. 32, 843-853. Psychological Medi, 843-853, 843–853.


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Social anxiety and virtual reality

11/27/2020

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The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), replaces the old term of social phobia with Social Anxiety Disorder. This modification represents a change in the conceptualization of the disorder, in which it is understood that the condition exists in a variety of social settings.
Virtual Reality (VR) is a beneficial tool for the treatment of Social Phobia, as it exposes the patient to social interactions, cognitive restructuring, social skills training and allows to train the patient on relaxation techniques. Moreover, the virtual exposure can be applied in an anxiogenic or unfavorable situation (seated, noisy, mid-conversation, etc), which is useful to design the exposure to the patient’s needs.

References


  • García-López, L. J., Olivares, J., Hidalgo, M. D., Beidel, D. C., & Turner, S. M. (2001). Psychometric properties of the social phobia and anxiety inventory, the Social Anxiety Scale for Adolescents, the Fear of Negative Evaluation Scale, and the Social Avoidance and Distress Scale in an adolescent Spanish-speaking sample. Journal of Psychopathology and behavioral assessment, 23(1), 51-59.
  • Gebara, C., Barros-Neto, T., Gertsenchstein, L., Lotufo-Neto, F. (2015). Virtual reality exposure using three-dimensional images for the treatment of social phobia. 
  • Hartanto, D., Kampmann, I.L., Morina, N., Emmelkamp, P.G., Neerincx, M.A. y Brinkman, W. (2014). Controlling social stress in virtual reality environments. PLos ONE, 9(3), 1-17-. doi: 10.1371/journal. pone.0092804
  • Herbelin, B., Vexo, F. y Thalmann, D. (2002). Sense of presence in virtual reality exposure therapy. Virtual Reality Laboratory, Federal Institute of Technology (EPFL). Recuperado de: http://citeseerx.ist.psu. edu/viewdoc/download?doi=10.1.1.9.9590&rep=rep1&type=pdf
  • Klinger, E., Bouchard, S., Légeron, P., Roy, S., Lauer, F., Chemin, I. y Nugues, P. (2005). Virtual Reality Therapy versus Cognitive Behavior Therapy for Social Phobia: A preliminary controlled study. CyberPsychology & Behavior, 8(1):76-88. DOI: 10.1089/cpb.2005.8.76 
  • McNeil, D.W. y Randall, C.L. (2014). Conceptualizing and describing Social Anxiety and its disorders. En S.G. Hofmann y P.M. DiBartolo (Eds.), Social Anxiety. Clinical, developmental, and social perspectives (pp. 3-21). Londres: Elsevier.
  • Morrison, J. (2015). DSM-5: Guía para el diagnóstico clínico. México, D.F.: El Manual Moderno
  • Nichols, A. L., & Webster, G. D. (2015). Designing a brief measure of social anxiety: Psychometric support for a three-item version of the Interaction Anxiousness Scale (IAS-3). Personality and Individual Differences, 79, 110-115.
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Sleep-wake disorders

11/27/2020

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Relaxation and virtual reality

11/27/2020

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With Psious training in relaxation techniques is easy and fast thanks to Virtual Reality (VR), in a few sessions, the patient will be able to generalize the use of the techniques learned and apply them in their day to day.
Relaxation techniques useful for anxiety reduction. Useful for the treatment of Post-traumatic Stress Disorder (PTSD ), Generalized Anxiety Disorder (GAD), eating disorders, substance related disorders , addictive disorders and others. 
We recommend the following steps to have a successful training:
  1. Practice the techniques in relaxation environments
    • Visual and audio support
  1. Practice the techniques in the anxiogenic environment
    • Audio support
    • No audio
For more details on training, please refer to point 3 of the manual. The relaxation techniques and virtual environments offered by Psious are presented below.
Exercises and Techniques
Diaphragmatic BreathingIts goal is to induce parasympathetic activation and promote a relaxed state, reducing stress and other symptoms caused by excessive activation.
Progressive Muscle RelaxationThrough the tension-relaxation cycle, Jacobson’s technique teaches to control the voluntary musculature in order to reach a state of relaxation.
All the environments of Psious have two audios, in the relax section, that allow to put in practice both techniques.

References
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  • Ansgar, C. & Walton, R. (2007). Muscle relaxation therapy for anxiety disorders: it works but how?. Journal of Anxiety Disorders, 21(3), 243-264. Recuperado de: http://www.sciencedirect.com.sire.ub.edu/science/article/pii/S0887618506001174 
  • Mazoni, G., Pagnini, F., Castelnuovo & G., Molinari, E. (2008). Relaxation training for anxiety: a ten-years systematic review with metaanalysis. BMC Psychiatry, june. Recuperado de: http://link.springer.com/article/10.1186/1471-244X-8-41/fulltext. html#copyrightInformation
  • Richard, D. & Lauterbach, D. (2007). Handbook of exposure therapies. San Diego, CA: Elsevier. 
  • Serrano, V., Baños, R. & Botella, C. (2016). Virtual reality and stimulation of touch and smell for inducing relaxation: A randomized controlled trial. Computers in Human Behavior, 55(A), 1-8. Recuperado de: http://ac.els-cdn.com.sire.ub.edu/S0747563215300856/1-s2.0-S0747563215300856- main.pdf?_tid=592d5014-e60b-11e5-9676-00000aacb35e&acdnat=1457537392_38be 8d967a7bf04c27d4b027990429b4
  • Spira, J.L., Pyne, J.M., Wiederhold, B., Wiederhold, M., Graap, K. & Rizzo, A. (2006). Virtual reality and other experiential therapies for combat-related posttraumatic stress disorder. Primary Psychiatry, 13(3), 58-64. Recuperado de: http://www.researchgate.net/profile/James_Spira/publication/228387636_Virtual_ reality_and_other_experiential_therapies_for_combat-related_posttraumatic_ stress_disorder/links/00463518c81d4ac9d1000000.pd



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Public speaking and virtual reality

11/27/2020

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Pain managementand virtual reality

11/27/2020

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OCD and virtual reality

11/27/2020

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Neurodevelopmental Disorders and Virtual Reality

11/27/2020

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Mindfulness and virtual reality

11/27/2020

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Mindfulness is defined as the consciousness that emerges through paying attention on purpose, in the present moment, and without being critical, to the development of the moment-by-moment experience (Kabat-Zinn, 2003, cited in Boettcher et al., 2014). However, it is more than a type of meditation, since it is considered a state of consciousness by nature (Shapiro, Carlson, Astin & Freedman, 2006) that involves consciously paying attention to the personal experience of “moment by moment”.
Through the use of meditation practices (both formal and informal), in combination with components of other therapies such as the cognitive behavioral intervention with mindfulness aims to help patients become more aware of problematic patterns of thinking, feelings, and action. In addition, it helps them develop a better acceptance relationship with their unwanted internal experiences (Morgan, Danitz, Roemer and Orsillo, 2016).
The concept of Mindfulness is essentially transdiagnostic (Boettcher et al., 2014), therefore, its use in the field of psychological therapy is justified from a broad theoretical framework in which it is considered that individuals with mental disorders share behavioral processes and specific cognitive factors that contribute to the development and maintenance of said disorders (Barlow et al., 2004 and Mansell et al., 2009, cited in Boettcher et al., 2014). These are processes such as selective attention both internal and external, avoidance of attention, interpretation biases, recurrent negative thoughts and avoidance and safety behaviors (Harvey, Watkins, Mansell, & Shafran, 2004, cited in Boettcher et al., 2014). Therefore, through the practice of Mindfulness it is not intended to treat specific aspects of a specific disorder, but to treat certain aspects common to different disorders.


References



  • Boettcher, J., Aström, V., Pahlsson, D., Schenström, O., Andersson, G. & Carlbring, P. (2014). Internet-Based Mindfulness Treatment for Anxiety Disorders: A Randomized Controlled Trial. Behavior Therapy, 45(2), 241- 253. doi:10.1016/j.beth.2013.11.003
  • Delgado, L. C. (2009). Correlatos psicofisiológicos de mindfulness y la preocupación. Eficacia de un entrenamiento en habilidades mindfulness. (Gr. 1989-2009). Universidad de Granada. Granada.
  • Morgan, L. P. K., Danitz, S. B., Roemer, L. & Orsillo, S. M. (2016). Mindfulness approaches to psychological disorders. En Encyclopedia of mental health (pp. 148-155). San Diego, CA: Elsevier.
  • Richard, D. & Lauterbach, D. (2007). Handbook of exposure therapies. San Diego, CA: Elsevier.
  • Shapiro, S. L., Carlson, L. E., Astin, J. A. & Freedman, B. (2006). Mechanisms of Mindfulness. Journal of Clinical Psychology, 62(3), 373- 386. Recuperado de: http://www.mindfulnessstudies.com/wp-content/ uploads/2014/01/2-Shapiro-M-echanismsOfMindfulness2006.pdf
  • Spira, J.L., Pyne, J.M., Wiederhold, B., Wiederhold, M., Graap, K. & Rizzo, A. (2006). Virtual reality and other experiential therapies for combat-related posttraumatic stress disorder. Primary Psychiatry, 13(3), 58-64. Recuperado de: http://www.researchgate.net/profile/James_Spira/publication/2283876 36_Virtual_reality_and_other_experiential_therapies_for_combatrelated_posttraumatic_stress_disorder/links/00463518c81d4ac9d10000 00.pdf
  • Vøllestad, J., Sivertsen, B. y Nielsen, G.H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49(4), 281-288. Recuperado de: http://www.sciencedirect.com/science/article/ pii/S0005796711000246
  • Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness Interventions with Youth: A Meta-Analysis. Mindfulness, 6(2), 290–302. https://doi.org/10.1007/s12671-013-0260-4
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Medical Procedures and Virtual Reality

11/27/2020

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The fear of blood is a phobia classified on current mental disorders diagnosis systems as a specific Blood-Injection-Injury type of phobia (BII). Some sort of fear towards blood is common and, in fact, it is considered that the amount of people that experience this fear may exceed 10%. Yet recent studies point out that about 2-3% of the population suffers from BII phobia.
This data is significant; not only because of its prevalence, but also due to the negative consequences that blood phobia can have on the quality of life of those who suffer from it. These people tend to avoid medical interventions that are key to health or pregnancies, as well as quitting on graduate school (e.g. medical school, nursing school), or avoid visiting hospitalized relatives, and so on.
Blood phobia, unlike the rest of phobias, is characterized by a biphasic anxiety response. That is to say, even though during the first seconds of exposure to the feared stimulus an elevated physiological activity takes place (tachycardia, palpitations, sweating, etc.), immediately followed by a rapid drop (blood pressure drops, cardiac rhythm can drop to between 35 to 40 beats per minute, etc). This can lead to dizziness, pallor, and, sometimes, even fainting.
In addition to the fear of fainting, among the most common fears are: the possibility of losing control, having a panic attack, fear of making a fool of oneself, or fear that the needle will break and stay inside the body. The feeling of disgust when seeing stimuli related to blood is also common.
In regard to the treatment of blood phobia, it is not usually recommended to use relaxation techniques during the exposure to the feared situation (though these are useful during the first phase of the biphasic response). On the contrary, it is considered more adequate to use Applied Tension techniques, with the aim of balancing out the physiological drop and so preventing fainting.
In the last few years, Virtual Reality (VR) and Augmented Reality (AR) have shown great clinical efficiency in the treatment of specific phobias. These technologies provide the ideal context to play the situations feared by the patient , in a controlled safe way. In the case of blood phobia, for instance, these technologies allow for blood analysis to be carried out any day of the year, without prior appointment, and offer the chance to set the parameters that are considered suitable and without even leaving the practice.

References
  • Chapman, L. K., & DeLapp, R. C. (2013). Nine session treatment of a blood–injection–injury phobia with manualized cognitive behavioral therapy: An adult case example. Clinical Case Studies. Retrieved October 26, 2014, from http://ccs.sagepub.com/content/ early/2013/10/28/1534650113509304
  • Marks, I. M. (1988). Blood-injury phobia: A review. American Journal of Psychiatry, 145, 1207- 13.
  • Marks, I. M. y Mathews, A. M. (1979). Case histories and shorter communications. Brief stan- dard self-rating for phobic patients. Behaviour Research and Therapy, 30, 425-434.
  • Mas, M. B., Jiménez, A. M. L., & San Gregorio, M. Á. P. (2010). Blood-injection Phobia Inventory (BIPI): Development, reliability and validity.[Inventario de fobia a la sangre (BIPI): Desarrollo, fiabilidad y validez]. Anales de Psicología/Annals of Psychology, 26(1), 58-71.
  • Wiederhold, B.K., Mendoza, M., Nakatani, T. Bulinger, A.H. & Wiederhold, M.D. (2005). VR for blood-injection-injury phobia. Annual Review of CyberTherapy and Telemedicine, 3, 109-116.
  • Wolf, J.J. & Symons, F.J. (2013). An evaluation of multi-component exposure treatment of needle phobia in an adult with autism and intellectual disability. Journal of Applied Research in Intellectual Disabilities, 26(4), 344-348.
  • Ritz, T.M., Meuret, A.E. & ALvord, M.K. (2014). Blood-injection injury-phobia. In Grossman, L. & Walfish, S. (Ed.): Translating psychological research into practice (pp. 295-301). New York, NY, US: Springer Publishing Co, 609. 



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Generalized anxiety and virtual reality

11/27/2020

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The main objective in the treatment of generalized anxiety disorder (GAD) is to get the complete and prolonged remission of symptoms, as well as the restoration of the operational level of presymptomatic (Dilbaz, Cavus Y Darcin, 2011). However, not all patients respond well to treatment of choice: Cognitive Behavioural Therapy. Which can be combined with training on relaxation techniques and/or pharmacological treatment. 
Research conducted about this topic shows that treatment with Virtual Reality (VR) is a good alternative for people with GAD (Gorini & Riva, 2008). Mainly because it eases the learning process as well as the creation of a relaxing mood. particularly complicated in people with chronically raised voltage as in the case of this disorder.
Moreover, Psious virtual environments specially designed for the treatment of GAD, are very useful as the therapist can carry out exposure to the patient’s worrying in two different environments: a house and subway.
References
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  • Bados, A. (2005). Trastorno de ansiedad generalizada. Recuperado de la web del depósito digital de la Universidad de Barcelona: http:// diposit.ub.edu/dspace/bitstream/2445/357/1/116.pdf 
  • Bastida de Miguel, A.M. (2012). Tratamiento cognitivo-conductual aplicado a un caso de insomnio severo comórbido con ansiedad generalizada. Revista de Psiquiatría, 16(3), 2-36. Recuperado de http://www.psiquiatria.com/revistas/index.php/psiquiatriacom/ article/viewFile/1395/1266/
  • Brown, T.A., O’Leary, T.A. y Barlow, D.H. (2001). Generalized Anxiety Disorder. En D.H. Barlow (Ed.), Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual (pp. 154-208). Nueva York: The Guilford Press.
  • Chorpita, B.F., Tracey, S.A., Brown, T.A., Collica, T.J. y Barlow, D.H. (1997). Assessment of worry in children and adolescents: An adaptation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 35, 569-581.
  • Dilbaz, N., Cavus, S.Y. y Darcin, A.E. (2011). Treatment resistant Generalized Anxiety Disorder. En S. Selek (Ed.), Different views of Anxiety Disorders (pp. 219-232). Rijeka: InTech.
  • Dugas, M., Savard, P., Gaudet, A., Turcotte, J., Laugesen, N., Robichaud, M., Francis, K. y Koerner, N. (2007). Can the components of a cognitive model predict the severity of generalized anxiety disorder? Behavior Therapy, 38, 169-178. 
  • Gorini, A., Pallavicini, F., Algeri, D., Repetto, C., Gaggioli, A. y Riva, G. (2010). Virtual Reality in the treatment of Generalized Anxiety Disorders. En B.K. Wiederhold, G. Riva y S.I. Kim (Eds.), Annual Review of Cybertherapy and Telemedicine (pp. 39-43). Amsterdam: IOS Press. Wittchen, H.U. y Hoyer, J. (2001). Generalized Anxiety Disorder: nature and course. Journal of Clinical Psychiatry, 62(11), 15-19. Recuperado de http://psychologie.tu-dresden.de/i2/klinische/mitarbeiter/ publikationen/hoyer/Pdf/504.pdf
  • Meyer, T.J., Miller, M.L., Metzger, R.L. y Borkovec, T.D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487-495.
  • Spitzer, R.L,, Kroenke, K., Williams, J.B.W. y Löwe, B. (2006). A brief measure for assessing Generalized Anxiety Disorder. Archives of Internal Medicine, 166, 1092-1097.
  • Tallis, F., Davey, G.C.L. y Bond, A. (1994). The Worry Domains Questionnaire. En G.C.L. Davey y F. Tallis (Eds.),Worrying: Perspectives in theory, assessment and treatment (pp. 285-297). Nueva York: Wiley.
  • Wittchen, H.U. (2002). Generalized Anxiety Disorder: prevalence, burden, and cost to society. Depression and Anxiety, 16(4), 162-171. doi: 10.1002/da.10065





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Fear of the Dark and Virtual Reality

11/27/2020

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​This Psious Virtual Reality environment (VR) will assist you in the intervention and evaluation of children and adults who are showing signs of fear of darkness and or storms. With the help of the events and the environment settings provided in the platform each environment can be adapted to the therapeutic procedure requirements.
For example, a behavioral approach test or alike, can be carried out (Orgilés, Méndez y Espada, 2005) or the psychological intervention through procedures that have demonstrated stronger observational, in this instance multicomponent programs (systematic desensitization, exposure, modelling, token economy approach, parents training…). Amongst them, one worthy of mention is that of Mikulas y Coffman (1989) and the “emotive performances technique” ( EPT) by Méndez (1986) that suggested using EPT as an alternative to emotive imagery by Lazarus y Abramovitz (1979). Furthermore, an environment can be used to carry out gradual exposure, psychoeducation, cognitive reconstruction, relaxation… 
Lastly, let’s focus on the advantages that VR brings to this type of intervention and denote that VR has already demonstrated to be very effective as a treatment in phobias (Capafons, J.I, 2001). With respect to darkness phobia in children, as already indicated, multicomponent programs have shown greater effectiveness than other intervention techniques. For example, in the emotive performances technique counterconditioning components are clearly combined (a child being introduced to a game should be sufficiently attractive to offset the effects of the feared stimulus) with other operant conditioning techniques, not only the strengthening of approach behaviors to the phobic stimulus, but also the elimination of possible conduct behaviors that parents or adults involved in the treatment could apply.The control that the therapist acquires in addition to the gradual process that patients undergoes, on the one hand, facilitates the transition from the simulated environment to the real environment, delivering greater levels of accuracy, and on the other hand, due to the fact that this type of coaching encourages acceptance of the intervention. Thereby, favoring the coaching of parents through observation during the visit and lastly, allowing us to easily “gamify” the intervention. 
When it comes to storm phobias, VR provides the solution to solving one of the major drawbacks to in vivo exposure: unpredictability and the lack of frequency. Exposures in Psious can be exposed to patients systemically and the levels of anxiety can be adjusted accordingly to the degree of: night or day, amount of light, intensity of rain or storms. 
Ultimately, it combines your knowledge with the tools that you are provided with by Psious, thus enhancing user experiences and achieving better results.
References
  • Antony, M.M., Craske, M.G. y Barlow, D.H. (2006). Mastering your fears and phobias: Client workbook (2a ed.). Londres Oxford University Press.
  • Arrindell, W. A. Dimensional structure and psychopathology correlates of the fear survey schedule (FSS-III) in a phobic population: A factorial definition of agoraphobia, Behaviour Research and Therapy, Volume 18, Issue 4, 1980, Pages 229-242, ISSN 0005-7967 
  • Brown, T. A., DiNardo, P. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV (ADIS-IV), adult version. Albany (NY): Graywind Publications Inc.http://www.libreriaolejnik.com/ventana. php?codig=31669
  • Carrobles, J.A. (1986). Cuestionario de Temores de Wope y Lang, FSS-III-122. En J.A.I. Carrobles, P. Bartolomé, P.T. Costa y T del Ser. La práctica de la terapia de conducta: Valencia: Promolibro. 
  • Craske, M.G., Antony, M.M. y Barlow, D.H. (2006). Mastering your fears and phobias: Therapist guide (2a ed.). Londres: Oxford University Press.
  • Gutiérrez, C. et al.(2012): Características psicométricas del inventario de Miedos de Ollendick. CUaDERNos HisPaNoaMERiCaNos DE PsiCología, Vol 12 No 1, 85-93  
  • Mikulas, W. L. y Coffman, M. G. (1989). Home-based treatment of children’s fear of the dark. En C.E. Schaefer y J.M. Briesmeister (Eds.), Handbook of parent training (pp. 179-202). Nueva York: John Wiley and Sons. 
  • Matesanz, L. (2006): Datos para la adaptación castellana de la Escala de Temores (FSS). Análisis y Modificación de Conducta. Vol. 32, Nº 144. 
  • Méndez, X. , Orgilés, A. y Espada, J.P. (2003). Escenificaciones emotivas para la fobia a la oscuridad: un ensayo controlado. International Journal of Clinical and Health Psychology. ISSN 1697-2600 2004, Vol. 4, No 3, pp. 505-520 
  • Méndez, X., Orgilés, A. y Rosa, A. I. (2005). Los tratamientos psicológicos en la fobia a la oscuridad: Una revisión cuantitativa. Anales de psicología. Vol. 21, no 1 (junio), 73-82 
  • Muris, P., Merckelbach, H., Ollendick, T. H., King, N. J., & Bogie, N. (2001). Children’s nighttime fears: Parent-child ratings of frequency, content, origins, coping behaviors and severity. Behaviour Research and Therapy, 39(1), 13-28. doi: 10.1016/S0005-7967(99)00155-2
  • Lazarus, A. y Abramovitz, A. (1979). The use of “emotive imagery” in the treatment of children’s phobias. En H.J. Eysenck (Ed.), Experimentos en terapia de conducta: experimentación con niños (vol. 3) (pp. 37-45). Madrid: Fundamentos
  • Olivares, J., Y Méndez, F.X. (2001).Técnicas de modificación de conducta. Madrid: Biblioteca Nueva.
  • Ollendick, T. H. (1979). Fear reduction techniques with children. En M. Hersen, R. M. Eisler y P. M. Miller (Eds.), Progress in behavior modification: Vol. 8 (pp. 127-168). Nueva York: Academic Press. 
  • Ollendick, T. H. (1983). Reliability and validity of the revised fear survey schedule for children (FSSC-R), Behaviour Research and Therapy, VolumeZ21, Issue 6, 1983, Pages 685-692, ISSN 0005-7967.
  • Orgilés, A., Méndez, X. , y Espada, J.P. (2005)Tratamiento de la fobia a la oscuridad mediante entrenamiento a padres. Psicothema. Psicothema 2005. Vol. 17, no 1, pp. 9-14 
  • Sardinero, E., Pedreira J.L. y Muñiz J.: El cuestionario CBCL de Achenbach: Adaptación española y aplicaciones clínico-epidemiológicas: http://www.copmadrid.org/webcopm/publicaciones/clinica/1997/Vol8/Arti3. Htm
  • Silverman, W.K, M, Albano, A.M y Sandín, B (2003): ADIS-IV: Entrevista para el diagnóstico de los trastornos de ansiedad en niños según el DSM IV : entrevista para el niño = (anxiety disorders interview schedule for DSM-IV: child version : child interview schedule). Ed. Klinik, 2003. España

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Fear of flying and virtual reality

11/27/2020

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Virtual Reality (VR) is a less complex, cheaper alternative to in vivo exposure for 2.2. Going to the airport 2.3. Boarding Gate 2.4. The Plane the treatment of flying phobia. This technology does not require a high imagination capacity on the patient as the case of the typical exposure techniques. Also, the exposure can be modified to the patients needs when using VR, as the therapist can control different parameters such as duration of the flight, weather conditions, people on the flight,etc.
Many studies demonstrate the efficiency of VR as a treatment for specific phobias. A systematic review about the use of VR as a treatment of flying phobia showed that Cognitive Behavioral Therapy (CBT) combined with relaxation techniques and VR exposure is effective for the treatment of flying phobia (Costa et al. 2008). Also, a study by Botella (2004), demonstrated the efficiency of VR as the only line of treatment for flying phobia at short and long term.

References
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  • Bornas Agustí, F., Tortella-Feliu, M., García de la Banda García, G., Fullana Rivas, M., & Llabrés, J. (1999). Validación factorial del cuestionario de miedo a volar. Análisis y Modificación de Conducta.
  • Botella, C., Osma, J., García-Palacios, A., Quero, S. & Baños, R.M. (2004). Treatment of Flying Phobia using Virtual Reality: Data from a 1-Year Follow-up using a Multiple Baseline Design. Clinical Psychology & Psychotherapy, 11(5), 311-323.
  • Bretón-López, J., Tortella-Feliu, M., Del Amo, A. R., Baños, R., Llabrés, J., Gelabert, J. M., & Botella, C. (2015). Patients’ preferences regarding three computer based exposure treatments for fear of flying. Behavioral Psychology/ Psicologia Conductual.
  • Da Costa, R.T., Sardinha, A. & Nardi, A.E. (2008). Virtual reality exposure in the treatment of fear of flying. Aviation, Space, and Environmental Medicine, 79(9), 899-903.
  • Haug, T., Brenne, L., Johnsen, D. H., Brentzen, D., Götestam, K. G., & Hughdal, K. (1987). A three systems analysis of fear of flying: A comparison of a consonant versus a non-consonant treatment method. Behaviour Research and Therapy, 25, 187-194. doi:10.1016/0005-7967(87)90045-3
  • Hirsch, J.A. (2012). Virtual reality exposure therapy and hypnosis for flying phobia in a treatment resistant patient: A case report. American Journal of Clinical Hypnosis, 55(2), 168-173.
  • Tortella-Feliu, M., Botella, C., Llabrés, J., Bretón-López, J. M., del Amo, A. R., Baños, R. M., & Gelabert, J. M. (2011). Virtual reality versus computer-aided exposure treatments for fear of flying. Behavior Modification. https://doi.org/10.1177/0145445510390801
  • Wallach, H.S. & Bar-Zvi, M. (2007). Virtual-reality-assisted treatment of flight phobia. Israel Journal of Psychiatry and Related Sciences, 44(1), 29-32.
  • Wiederhold, B.K., Jang, D.P., Gervirtz, R.G., Kim, S.I., Kim, I.Y. & Wiederhold, M.D. (2002). The Treatment of Fear of Flying: A Controlled Study of Imaginal and Virtual Reality Graded Exposure Therapy. IEEE Transactions on Information Technology in Biomedicine, 6(3), 218-223.

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