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Özgül Fobilerde Sanal Gerçeklik ile Maruz Bırakma Terapisinin Etkinliği: Sistematik Bir Gözden Geçirme

Year 2023, Volume: 15 Issue: 4, 562 - 576, 25.12.2023
https://doi.org/10.18863/pgy.1192543

Abstract

Özgül fobi, günlük yaşamı ve işlevselliği önemli derecede olumsuz etkileyen belirli nesne ya da duruma yönelik belirgin ve sürekli bir korku olarak tanımlanmaktadır. Aynı zamanda, en sık görülen psikolojik bozukluklar arasında olduğu bildirilmektedir. Özgül fobilerin tedavisinde maruz bırakma temelli müdahalelerin yaygın olarak kullanıldığı bilinmekle birlikte standart yöntemlerin bazı sınırlılıklarının bulunması farklı yaklaşımlara ihtiyaç duyulduğuna işaret etmektedir. Bu çerçevede, son yıllarda psikoterapi bağlamında sanal gerçeklik teknolojisinin kullanımı giderek yaygınlaşmış ve maruz bırakma terapisi ile bütünleştirilmiştir. Bilgisayar tarafından oluşturulan üç boyutlu ortamla çeşitli teknolojik araçlar aracılığıyla gerçek zamanlı etkileşim sağlayan sanal gerçekliğin, maruz bırakma terapisi ile kullanımının özellikle özgül fobiler gibi psikopatolojilerin tedavisinde önemli bir müdahale yöntemi haline geldiği görülmektedir. Bu çalışma kapsamında, özgül fobilerin tedavisinde sanal gerçeklik ile maruz bırakma müdahaleleri sistematik olarak gözden geçirilmiştir. PRISMA yöntemi izlenerek APA (PsycINFO), EBSCO, PubMed, Scopus, Web of Science, Science Direct, Ulakbim ve TRDizin veri tabanlarında yapılan taramada dahil etme ölçütleri kapsamında; özgül fobi tanı kriterlerini karşılayan yetişkin katılımcıların yer aldığı, sanal gerçeklik ile maruz bırakma terapisinin kontrol grubuna kıyasla etkinliğinin incelendiği ve tam metnine ulaşılabilen 10 seçkisiz kontrollü çalışma bu sistematik derlemeye dahil edilmiştir. Dahil edilen makaleler örneklem özellikleri, temel ölçüm araçları, araştırma deseni, müdahalenin özellikleri ve etkisi açısından değerlendirilmiştir. Bulgular, sanal gerçeklik ile maruz bırakma terapisinin, özgül fobi belirtilerini azaltmadaki etkinliğine işaret etmektedir. Yapılan izlem çalışmaları tedavi sonuçlarının uzun vadede korunduğuna yönelik destek sağlamaktadır.

Supporting Institution

Destekleyen kurum bulunmamaktadır.

Project Number

Çalışma bir proje kapsamında yürütülmemiştir.

References

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  • APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington D.C., American Psychiatric Association.
  • APA Presidential Task Force on Evidence-Based Practice (2006) Evidence-based practice in psychology. Am Psychol, 61:271-285.
  • Anderson PL, Rothbaum BO, Hodges L (2001) Virtual reality: using the virtual world to improve quality of life in the real world. Bull Menninger Clin, 65:78-91.
  • Antony MM, Barlow DH (2002) Specific phobias. In Anxiety and its Disorders - The Nature and Treatment of Anxiety and Panic (Ed. DH Barlow): 380-417. London, Guilford Press.
  • Barlow DH, Conklin LR, Bentley KH (2015) Psychological treatments for panic disorders, phobias, and social and generalized anxiety disorders. In A Guide to Treatments That Work (Eds PE Nathan, JM Gorman): 409-461. New York, Oxford University Press.
  • Boeldt D, McMahon E, McFaul M, Greenleaf W (2019) Using virtual reality exposure therapy to enhance treatment of anxiety disorders: identifying areas of clinical adoption and potential obstacles. Front Psychiatry, 10:773.
  • Botella C, Fernández-Álvarez J, Guillén V, García-Palacios A, Baños R (2017) Recent progress in virtual reality exposure therapy for phobias: a systematic review. Curr Psychiatry Rep, 19:42.
  • Chambless DL, Baker MJ, Baucom DH, Beutler LE, Calhoun KS, Daiuto A (1998) Update on empirically validated therapies, II. Clin Psychol, 51:3-16.
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  • Cohen DC (1977) Comparison of self-report and overt-behavioral procedures for assessing acrophobia. Behav Ther, 8:17-23.
  • Depp C, Lebowitz BD (2007) Clinical trials: bridging the gap between efficacy and effectiveness. Int Rev Psychiatry, 19:531-539.
  • Dickinson ER, Adelson, JL, Owen J (2012) Gender balance, representativeness, and statistical power in sexuality research using undergraduate student samples. Arch Sex Behav, 41:325-327.
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  • Ertan T (2008) Psikiyatrik bozukluklarin epidemiyolojisi. Türkiye'de Sık Karşılaşılan Psikiyatrik Hastalıklar Sempozyumu (Eds M Uğur, İ Balcıoğlu, N Kocabaşoğlu):25-30. İstanbul, İstanbul Üniversitesi.
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  • Grenier S, Forget H, Bouchard S, Isere S, Belleville S, Potvin O et al. (2015) Using virtual reality to improve the efficacy of cognitive-behavioral therapy (CBT) in the treatment of late-life anxiety: preliminary recommendations for future research. Int Psychogeriatr, 27:1217-1225.
  • Gujjar KR, van Wijk A, Kumar R, de Jongh A (2019) Efficacy of virtual reality exposure therapy for the treatment of dental phobia in adults: a randomized controlled trial. J Anxiety Disord, 62:100-108.
  • Hofmann SG, Smits JA (2008) Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry, 69:621-632.
  • Hood HK, Antony MM (2012) Evidence-based assessment and treatment of specific phobias in adults. In Intensive One-Session Treatment of Specific Phobias (Eds TE Davis III, TH Ollendick, LG Öst): 19-41. New York, NY, Springer.
  • Humphris GM, Morrison T, Lindsay SJE (1995) The modified dental anxiety scale: validation and United Kingdom norms. Community Dent Health, 12:143-50.
  • Jiang MY, Upton E, Newby JM (2020) A randomised wait-list controlled pilot trial of one-session virtual reality exposure therapy for blood-injection-injury phobias. J Affect Disord, 276:636-645.
  • Karlsson P, Bergmark A (2015) Compared with what? an analysis of control‐group types in cochrane and campbell reviews of psychosocial treatment efficacy with substance use disorders. Addiction, 110:20-428.
  • Kaussner Y, Kuraszkiewicz AM, Schoch S, Markel P, Hoffmann S, Baur-Streubel R et al. (2020) Treating patients with driving phobia by virtual reality exposure therapy - a pilot study. PLoS One, 15:e0226937.
  • Kendler KS, Myers J, Prescott CA (2002) The etiology of phobias: an evaluation of the stress-diathesis model. Arch Gen Psychiatry, 59:242-248.
  • Kessler RC, Petukhova M, Sampson, NA, Zaslavsky AM, Wittchen HU (2012) Twelve‐month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res, 21:169-184.
  • Kristman V, Manno M, Côté P (2004) Loss to follow-up in cohort studies: how much is too much?. Eur J Epidemiol, 19:751-760.
  • Krzystanek M, Surma S, Stokrocka M, Romańczyk M, Przybyło J, Krzystanek N et al. (2021) Tips for effective implementation of virtual reality exposure therapy in phobias - a systematic review. Front Psychiatry, 12:737351.
  • Llewellyn-Bennett R, Bowman L, Bulbulia R (2016) Post-trial follow-up methodology in large randomized controlled trials: a systematic review protocol. Syst Rev, 5:214.
  • Magee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC (1996) Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Arch Gen Psychiatry 53:159-168.
  • Maples-Keller JL, Bunnell BE, Kim SJ, Rothbaum BO (2017) The use of virtual reality technology in the treatment of anxiety and other psychiatric disorders. Harv Rev Psychiatry, 25:103-113.
  • Marks IM (1978) Behavioral psychotherapy of adult neurosis. In Handbook of Psychotherapy and Behavior Change (Eds SL Garfield, AE Bergin):493-547). Chichester, Wiley.
  • Michaliszyn D, Marchand A, Bouchard S, Martel MO, Poirier-Bisson J (2010) A randomized, controlled clinical trial of in virtuo and in vivo exposure for spider phobia. Cyberpsychol Behav Soc Netw, 13:689-695.
  • Miloff A, Lindner P, Dafgård P, Deak S, Garke M, Hamilton W et al. (2019) Automated virtual reality exposure therapy for spider phobia vs. in-vivo onesession treatment: a randomized non-inferiority trial. Behav Res Ther, 118:130-140.
  • Mineka S, Sutton J (2006) Contemporary learning theory perspectives on the etiology of fears and phobias. Fear and Learning: From Basic Processes to Clinical Implications (Eds MG Craske, D Hermans, D Vansteenwegen): 75-97). Washington DC, American Psychological Association.
  • Minns, S, Levihn-Coon A, Carl E, Smits JA, Miller W, Howard D et al. (2019) Immersive 3D exposure-based treatment for spider fear: a randomized controlled trial. J Anxiety Disord, 61:37-44.
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Efficacy of Virtual Reality Exposure Therapy in the Treatment of Specific Phobias: A Systematic Review

Year 2023, Volume: 15 Issue: 4, 562 - 576, 25.12.2023
https://doi.org/10.18863/pgy.1192543

Abstract

Specific phobia is defined as a notable and continuous fear of a certain object or a situation that particularly impairs daily life and functioning. It is also one of the most common psychological disorders. Exposure-based interventions are commonly used in the treatment of specific phobias. However, some limitations of the standard methods require the need for alternative approaches. In light of this, the use of virtual reality technology in psychotherapy has become increasingly widespread in recent years and is now integrated with exposure therapy. Virtual reality provides real-time interaction using the computer-generated three-dimensional environment via variety oftechnological tools. Applications of virtual reality in exposure therapy have proven to be an important intervention method, especially in the psychopathologies such as specific phobias. In this study, virtual reality exposure therapy for the treatment of specific phobias is systematically reviewed. Inclusion criteria were taken into account in the scanning performed in APA (PsycINFO), EBSCO, PubMed, Scopus, Web of Science, Science Direct, Ulakbim ve TRDizin databses following the PRISMA method. Following that, ten randomized controlled trials, which included adult participants meeting the diagnostic criteria for specific phobia, examined the efficacy of virtual reality and exposure therapy compared to the control group, and the ones with full text could be accessed, were included in this systematic review. The included studies were evaluated in terms of sample attributes, primary measurement tools, research design, characteristics of the intervention and its efficacy. In general, the findings indicate the efficacy of virtual reality exposure therapy in reducing specific phobia symptoms. Follow-up studies support the long-term maintenance of the results.

Project Number

Çalışma bir proje kapsamında yürütülmemiştir.

References

  • Albakri G, Bouaziz R, Alharthi W, Kammoun S, Al-Sarem M, Saeed F et al. (2022) Phobia exposure therapy using virtual and augmented reality: a systematic review. Appl Sci, 12:1672.
  • APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington D.C., American Psychiatric Association.
  • APA Presidential Task Force on Evidence-Based Practice (2006) Evidence-based practice in psychology. Am Psychol, 61:271-285.
  • Anderson PL, Rothbaum BO, Hodges L (2001) Virtual reality: using the virtual world to improve quality of life in the real world. Bull Menninger Clin, 65:78-91.
  • Antony MM, Barlow DH (2002) Specific phobias. In Anxiety and its Disorders - The Nature and Treatment of Anxiety and Panic (Ed. DH Barlow): 380-417. London, Guilford Press.
  • Barlow DH, Conklin LR, Bentley KH (2015) Psychological treatments for panic disorders, phobias, and social and generalized anxiety disorders. In A Guide to Treatments That Work (Eds PE Nathan, JM Gorman): 409-461. New York, Oxford University Press.
  • Boeldt D, McMahon E, McFaul M, Greenleaf W (2019) Using virtual reality exposure therapy to enhance treatment of anxiety disorders: identifying areas of clinical adoption and potential obstacles. Front Psychiatry, 10:773.
  • Botella C, Fernández-Álvarez J, Guillén V, García-Palacios A, Baños R (2017) Recent progress in virtual reality exposure therapy for phobias: a systematic review. Curr Psychiatry Rep, 19:42.
  • Chambless DL, Baker MJ, Baucom DH, Beutler LE, Calhoun KS, Daiuto A (1998) Update on empirically validated therapies, II. Clin Psychol, 51:3-16.
  • Choy Y, Fyer AJ, Lipsitz JD (2007) Treatment of specific phobia in adults. Clin Psychol Rev, 27:266-286.
  • Cohen DC (1977) Comparison of self-report and overt-behavioral procedures for assessing acrophobia. Behav Ther, 8:17-23.
  • Depp C, Lebowitz BD (2007) Clinical trials: bridging the gap between efficacy and effectiveness. Int Rev Psychiatry, 19:531-539.
  • Dickinson ER, Adelson, JL, Owen J (2012) Gender balance, representativeness, and statistical power in sexuality research using undergraduate student samples. Arch Sex Behav, 41:325-327.
  • Dinh HQ, Walker N, Hodges LF, Song C, Kobayashi A (1999) Evaluating the importance of multi-sensory input on memory and the sense of presence in virtual environments (p. 222-228). IEEE Comput Soc, Houston.
  • Donker T, Cornelisz I, Van Klaveren C, Van Straten A, Carlbring P, Cuijpers P et al. (2019) Effectiveness of self-guided app-based virtual reality cognitive behavior therapy for acrophobia: a randomized clinical trial. JAMA Psychiatry, 76:682-690.
  • Dunsmoor JE, Ahs F, Zielinski DJ, LaBar KS (2014) Extinction in multiple virtual reality contexts diminishes fear reinstatement in humans. Neurobiol Learn Mem, 113:157-164.
  • Eaton WW, Bienvenu OJ, Miloyan B (2018) Specific phobias. Lancet Psychiatry, 5:678-686.
  • Eaton WW, Dryman A, Weissman MM (1991) Panic and phobia. In Psychiatric Disorders in America: The Epidemiologic Catchment Area Study (Eds LA Robins, DA Regier):155-179. Los Angeles, CA, Free Press.
  • Elkins DN (2012) Toward a common focus in psychotherapy research. Psychotherapy, 49:450-454.
  • Ertan T (2008) Psikiyatrik bozukluklarin epidemiyolojisi. Türkiye'de Sık Karşılaşılan Psikiyatrik Hastalıklar Sempozyumu (Eds M Uğur, İ Balcıoğlu, N Kocabaşoğlu):25-30. İstanbul, İstanbul Üniversitesi.
  • Freitas JRS, Velosa VHS, Abreu LTN, Jardim RL, Santos JAV, Peres B et al. (2021) Virtual reality exposure treatment in phobias: a systematic review. Psychiatr Q, 92:1685-1710.
  • Garcia-Palacios A, Botella C, Hoffman H, Fabregat S (2007) Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias. Cyberpsychol Behav, 10:722-724.
  • Garcia-Palacios A, Hoffman HG, See SK, Tsai A, Botella C (2001) Redefining therapeutic success with virtual reality exposure therapy. Cyberpsychol Behav, 4:341-348.
  • Garcia-Palacios A, Hoffman H, Carlin A, Furness III TA, Botella C (2002) Virtual reality in the treatment of spider phobia: a controlled study. Behav Res Ther, 40:983-993.
  • Geraets CN, Van der Stouwe EC, Pot-Kolder R, Veling W (2021) Advances in immersive virtual reality interventions for mental disorders: a new reality?. Curr Opin Psychol, 41:40-45.
  • Götestam KG (2002) One session group treatment of spider phobia by direct or modelled exposure. Cogn Behav Ther, 31:18-24.
  • Grenier S, Forget H, Bouchard S, Isere S, Belleville S, Potvin O et al. (2015) Using virtual reality to improve the efficacy of cognitive-behavioral therapy (CBT) in the treatment of late-life anxiety: preliminary recommendations for future research. Int Psychogeriatr, 27:1217-1225.
  • Gujjar KR, van Wijk A, Kumar R, de Jongh A (2019) Efficacy of virtual reality exposure therapy for the treatment of dental phobia in adults: a randomized controlled trial. J Anxiety Disord, 62:100-108.
  • Hofmann SG, Smits JA (2008) Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry, 69:621-632.
  • Hood HK, Antony MM (2012) Evidence-based assessment and treatment of specific phobias in adults. In Intensive One-Session Treatment of Specific Phobias (Eds TE Davis III, TH Ollendick, LG Öst): 19-41. New York, NY, Springer.
  • Humphris GM, Morrison T, Lindsay SJE (1995) The modified dental anxiety scale: validation and United Kingdom norms. Community Dent Health, 12:143-50.
  • Jiang MY, Upton E, Newby JM (2020) A randomised wait-list controlled pilot trial of one-session virtual reality exposure therapy for blood-injection-injury phobias. J Affect Disord, 276:636-645.
  • Karlsson P, Bergmark A (2015) Compared with what? an analysis of control‐group types in cochrane and campbell reviews of psychosocial treatment efficacy with substance use disorders. Addiction, 110:20-428.
  • Kaussner Y, Kuraszkiewicz AM, Schoch S, Markel P, Hoffmann S, Baur-Streubel R et al. (2020) Treating patients with driving phobia by virtual reality exposure therapy - a pilot study. PLoS One, 15:e0226937.
  • Kendler KS, Myers J, Prescott CA (2002) The etiology of phobias: an evaluation of the stress-diathesis model. Arch Gen Psychiatry, 59:242-248.
  • Kessler RC, Petukhova M, Sampson, NA, Zaslavsky AM, Wittchen HU (2012) Twelve‐month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res, 21:169-184.
  • Kristman V, Manno M, Côté P (2004) Loss to follow-up in cohort studies: how much is too much?. Eur J Epidemiol, 19:751-760.
  • Krzystanek M, Surma S, Stokrocka M, Romańczyk M, Przybyło J, Krzystanek N et al. (2021) Tips for effective implementation of virtual reality exposure therapy in phobias - a systematic review. Front Psychiatry, 12:737351.
  • Llewellyn-Bennett R, Bowman L, Bulbulia R (2016) Post-trial follow-up methodology in large randomized controlled trials: a systematic review protocol. Syst Rev, 5:214.
  • Magee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC (1996) Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Arch Gen Psychiatry 53:159-168.
  • Maples-Keller JL, Bunnell BE, Kim SJ, Rothbaum BO (2017) The use of virtual reality technology in the treatment of anxiety and other psychiatric disorders. Harv Rev Psychiatry, 25:103-113.
  • Marks IM (1978) Behavioral psychotherapy of adult neurosis. In Handbook of Psychotherapy and Behavior Change (Eds SL Garfield, AE Bergin):493-547). Chichester, Wiley.
  • Michaliszyn D, Marchand A, Bouchard S, Martel MO, Poirier-Bisson J (2010) A randomized, controlled clinical trial of in virtuo and in vivo exposure for spider phobia. Cyberpsychol Behav Soc Netw, 13:689-695.
  • Miloff A, Lindner P, Dafgård P, Deak S, Garke M, Hamilton W et al. (2019) Automated virtual reality exposure therapy for spider phobia vs. in-vivo onesession treatment: a randomized non-inferiority trial. Behav Res Ther, 118:130-140.
  • Mineka S, Sutton J (2006) Contemporary learning theory perspectives on the etiology of fears and phobias. Fear and Learning: From Basic Processes to Clinical Implications (Eds MG Craske, D Hermans, D Vansteenwegen): 75-97). Washington DC, American Psychological Association.
  • Minns, S, Levihn-Coon A, Carl E, Smits JA, Miller W, Howard D et al. (2019) Immersive 3D exposure-based treatment for spider fear: a randomized controlled trial. J Anxiety Disord, 61:37-44.
  • Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M et al. (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev, 4:1.
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There are 76 citations in total.

Details

Primary Language English
Subjects Psychology
Journal Section Review
Authors

Merve Demir 0000-0001-5762-4373

Tolga Köskün 0000-0002-7843-7355

Project Number Çalışma bir proje kapsamında yürütülmemiştir.
Publication Date December 25, 2023
Acceptance Date January 15, 2023
Published in Issue Year 2023 Volume: 15 Issue: 4

Cite

AMA Demir M, Köskün T. Efficacy of Virtual Reality Exposure Therapy in the Treatment of Specific Phobias: A Systematic Review. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. December 2023;15(4):562-576. doi:10.18863/pgy.1192543

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