An adaptive display to treat stress-related disorders: EMMA's World

ABSTRACT Most of the virtual environments currently available in the field of psychological treatments were designed to solve a specific problem. Our research group has developed a versatile virtual reality system (an adaptive display) called ‘EMMA's world’, which can address a wide range of problems. It was designed to assist in clinical situations where a person has suffered a stressful experience, for example post-traumatic stress disorder, adjustment disorder, and pathological grief. To accomplish therapeutic goals, a series of emotional virtual elements are used and personalised so that they are meaningful to the user and contain the fundamental emotional elements that the person must …

Detection and distraction effects for threatening information in social phobia and change after treatment.

This work examines differences in the detection and distraction by social-threatrelated information between a social phobia group (SP; N533) and a normal control group (NC; N532). The change obtained after psychological treatment is also studied for the SP group. A paper-and-pencil visual search task is used, in which the emotional valence of the ‘‘target’’ (social threat, physical threat, and neutral words) and ‘‘distractor’’ (social threat, physical threat, neutral, and nonsense words) verbal stimuli is manipulated. Results indicate that there are no differences in the detection of social-threat targets between SP and NC participants. However, the performance of SP individuals is more imp…

Virtual reality treatment of flying phobia.

Flying phobia (FP) might become a very incapacitating and disturbing problem in a person's social, working, and private areas. Psychological interventions based on exposure therapy have proved to be effective, but given the particular nature of this disorder they bear important limitations. Exposure therapy for FP might be excessively costly in terms of time, money, and efforts. Virtual reality (VR) overcomes these difficulties as different significant environments might be created, where the patient can interact with what he or she fears while in a totally safe and protected environment, the therapist's consulting room. This paper intends, on one hand, to show the different scenarios desig…

Corrigendum: Elena+ Care for COVID-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol

Positive mood induction and well being

The aim of this study is to test the role of consecutive positive mood induction virtual procedures on satisfaction of life of people with subclinical levels of sadness and/or anxiety. This is a work in progress and positive effects of mood induction on satisfaction and well being are expected.

An Internet-Based Self-Help Program for the Treatment of Fear of Public Speaking: A Case Study

ABSTRACT This article discusses the development of the first totally self-administered online CBT program for the treatment of a specific social phobia (fear of public speaking) called talk to me. The online program includes three parts. The assessment protocol gives the patient information about the problem, including impairment, severity, and the degree of fear and avoidance regarding the main feared situations. The structured treatment protocol ensures that the patient does not skip any steps in the treatment. The treatment protocol is a CBT program that provides exposure to the feared situation using videos of real audiences. Finally, the control protocol assesses treatment efficacy, no…

Zwischenergebnisse zum Online-Programm „Healthy Teens @ School“ zur Prävention von Essstörungen und Adipositas im Schulsetting

Efficacy and cost-effectiveness of a blended cognitive behavioral therapy for depression in Spanish primary health care:Study protocol for a randomised non-inferiority trial

Background: Data from primary health care in Spain show a high prevalence of the major depressive disorder. Blended treatment (combination of face-to-face and online components) seems to be a very promising tool for the optimization and dissemination of psychological treatments in a cost-effective form. Although there is growing data that confirm the advantages of blended therapies, few studies have analyzed their application in regular clinical practice. The objective of the present paper is to describe the protocol for a clinical study aimed at exploring the clinical and cost-effectiveness of a blended cognitive behavioral therapy (b-CBT) for depression, compared to treatment as usual (TA…

The Social Phobia and Anxiety Inventory: Psychometric Properties in a Spanish Sample

This study is a validation of the Spanish version of the Social Phobia and Anxiety Inventory using a nonclinical sample (198 participants) and a clinical sample (72 participants with social phobia). The factor structure and concurrent validity with Fear of Negative Evaluation and Social Avoidance and Distress scales were analyzed. The Social Phobia and Anxiety Inventory demonstrated good concurrent validity, showing statistically significant relationships with Fear of Negative Evaluation and Social Avoidance and Distress. Results confirmed the rationale for the division of the SPAI into two subscales. Results also demonstrated the utility of the Social Phobia and Anxiety Inventory for diff…

A VR-based serious game for studying emotional regulation in adolescents

[EN] We all use more or less adapted strategies to confront adverse emotional situations in our lives without being psychologically affected. Emotional Regulation (ER) strategies that we use determine the way in which we feel, express and behave. Moreover, ER strategies are particularly important in adolescents, a population in the age when the deficits of ER strategies can be linked to the appearance of numerous mental health disorders such as depression or anxiety, or disruptive behaviors. Thus, the early detection of dysfunctional ER strategies and the training in adaptive ER strategies will help us to prevent the future occurrence of possible behavioral and psychosocial disorders. In th…

The Intelligent e-Therapy system: a new paradigm for telepsychology and cybertherapy

ABSTRACT One of the main drawbacks of computer-assisted psychology tools developed up to now is related to the real time customisation and adaptation of the content to each patient depending on his/her activity. In this paper we propose a new approach for mental e-health treatments named Intelligent e-Therapy (eIT) with capabilities for ambient intelligence and ubiquitous computing. From a technical point of view, an eIT system is based on four fundamental axes: ambient intelligence for capturing physiological, psychological and contextual information of the patient; persuasive computing for changing/reinforcing behaviours; ubiquitous computing for using the system at any place, and at any …

Psychological Variables and Reality Judgment in Virtual Environments: The Roles of Absorption and Dissociation

Literature on virtual reality (VR) and psychology has focused on the influence that some basic psychological processes have on VR. Although psychological processes may be defined as common to all humans, there are individual differences that might make it difficult to provide the same VR experience for everyone. Of the several personality and psychological variables that might be relevant to the VR field, this study focuses on two: absorption and dissociation. Both psychological dimensions are deeply interrelated and might play an important role in the immersion of subjects in virtual environments and in the reality attributions they make. Thus, the purpose of this study was to ascertain pe…

A low-intensity internet-based intervention focused on the promotion of positive affect for the treatment of depression in Spanish primary care: Secondary analysis of a randomized controlled trial

Background: A large number of low-intensity Internet-based interventions (IBIs) for the treatment of depression have emerged in Primary Care

Clinical utility of cognitive-behavioural treatment for panic disorder. results obtained in different settings: a research centre and a public mental health care unit

Cognitive-Behavioural programmes have become the treatment of choice for Panic Disorder (PD). However, although its effectiveness has been widely demonstrated, there are still some limitations regarding the possibility of offering this type of treatment to all panic sufferers. Some researchers are studying ways to make these programmes more available. This study deals with the application and testing of treatment programmes for PD in sites where patients usually look for help for their psychological problems, i.e. mental health care centres. Our work follows a strategy of benchmarking, and the results obtained after applying the treatment in habitual clinical contexts are compared with the …

An Augmented Reality System for Treating Psychological Disorders: Application to Phobia to Cockroaches

Augmented reality has been used in many fields, but it has not been used to treat psychological disorders. Augmented reality presents several advantages respect to: the traditional treatment of psychological disorders and virtual reality treatments. In this paper we present the first augmented reality system for the treatment of phobia to cockroaches. Our system has been developed using ARToolkit software. It has been tested with one patient and the results have been very satisfactory. At first of the exposure session the patient was not able to approach to a real cockroach and after the exposure session using our augmented reality system, the patient was able to approach to a real cockroac…

Working Alliance Inventory for Online Interventions-Short Form (WAI-TECH-SF): The Role of the Therapeutic Alliance between Patient and Online Program in Therapeutic Outcomes.

Background: Therapeutic alliance (TA) between the patient and therapist has been related to positive therapeutic outcomes. Because Internet-based interventions are increasingly being implemented, a tool is needed to measure the TA with Internet-based self-guided programs. The Working Alliance Inventory for online interventions (WAI-TECH-SF) was adapted based on the WAI Short Form (Hatcher &amp

Using an adaptive display for the treatment of emotional disorders

A preliminary study on the use of an adaptive display for treating emotional disorders is presented. This adaptive display (named EMMA) varies the contents that are presented depending on the emotions of the user at each moment. The application has been designed to help in the treatment of Post-Traumatic Stress Disorder (PTSD) and Adjustment Disorder (AD). The specific objective of the present work is to test the effectiveness of this adaptive display, specifically the acceptance of the treatment by patients. EMMA's tools are compared with the standard of care for PTSD and AD. Results showed differences only for the variable aversiveness. Participants in the EMMA condition evaluated the tre…

Body Image and Virtual Reality in Eating Disorders: Is Exposure to Virtual Reality More Effective than the Classical Body Image Treatment?

Body image (BI) disturbances are considered to be central in eating disorders (ED) psychopathology. There are few studies focused on the treatment of BI disturbances in ED, and most of them have used "traditional methods." The purpose of the present study was to probe the effectiveness of one specific component in the assessment and treatment of BI in ED by means of virtual reality (VR). Two treatment conditions were applied: (a) The Standard Body Image Treatment Condition (SBIT) and (b) the VR Condition. Thirteen eating disordered patients were randomly assigned to one of those conditions. No differences between both conditions were found in general ED measures, but patients treated in the…

The acceptability of an Internet-based self-help treatment for fear of public speaking

ABSTRACT Several randomised controlled studies have shown the efficacy of Internet-based self-help treatments. These studies have centred their attention on axis I (efficacy) of the Guidelines for Empirically Validated Treatments, although there are a few studies that also take into account axis II (effectiveness). The aim of the present work was to test the acceptability of an Internet-based self-help program for fear of public speaking and to compare its acceptability with the same treatment administered by a therapist. Fifty-two participants suffering from social phobia were randomly selected to take part in one of these treatments. All participants reported being satisfied with the trea…

Elena+ Care for COVID-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol

Background: The current COVID-19 coronavirus pandemic is an emergency on a global scale, with huge swathes of the population required to remain indoors for prolonged periods to tackle the virus. In this new context, individuals' health-promoting routines are under greater strain, contributing to poorer mental and physical health. Additionally, individuals are required to keep up to date with latest health guidelines about the virus, which may be confusing in an age of social-media disinformation and shifting guidelines. To tackle these factors, we developed Elena+, a smartphone-based and conversational agent (CA) delivered pandemic lifestyle care intervention.Methods: Elena+ utilizes varied…

Understanding the Influence of Eating Patterns on Binge Drinking: A Mediation Model

Background: Binge drinking is an important health problem, and it has been related to binge eating and fat intake in animal models, but this relationship has not been tested in humans. The first objective of this study was to analyze whether binge eating and fat intake are related to binge drinking in a youth sample. The second objective was to analyze whether binge eating and fat intake mediate the relationship between individual factors associated with binge eating and fat intake (sex, body mass index (BMI), drive for thinness, body dissatisfaction, eating styles, impulsivity, and food addiction) and binge drinking. Methods: A sample of 428 undergraduate students filled out several questi…

Efficacy of Three Low-Intensity, Internet-Based Psychological Interventions for the Treatment of Depression in Primary Care: Randomized Controlled Trial

Background: Primary care is a major access point for the initial treatment of depression, but the management of these patients is far from optimal The lack of time in primary care is one of the major difficulties for the delivery of evidence-based psychotherapy. During the last decade, research has focused on the development of brief psychotherapy and cost-effective internet-based interventions mostly based on cognitive behavioral therapy (CBT). Very little research has focused on alternative methods of treatment for depression using CBT. Thus, there is a need for research into other therapeutic approaches. Objective: This study aimed to assess the effectiveness of 3 low-intensity, internet…

Physical activity in anorexia nervosa: How relevant is it to therapy response?

AbstractObjectiveElevated physical activity has been observed in some patients with anorexia nervosa (AN) despite their emaciated condition. However, its effects on treatment outcome remain unclear. This study aimed to examine objectively measured physical activity in this clinical population and how it might be related to a partial hospitalization therapy response, after considering potential confounders.MethodThe sample comprised 88 AN patients consecutively enrolled in a day hospital treatment program, and 116 healthy-weight controls. All participants were female and a baseline assessment took place using an accelerometer (Actiwatch AW7) to measure physical activity, the Eating Disorders…

The VEPSY UPDATED Project: Clinical Rationale and Technical Approach.

More than 10 years ago, Tart (1990) described virtual reality (VR) as a technological model of consciousness offering intriguing possibilities for developing diagnostic, inductive, psychotherapeutic, and training techniques that can extend and supplement current ones. To exploit and understand this potential is the overall goal of the "Telemedicine and Portable Virtual Environment in Clinical Psychology"--VEPSY UPDATED--a European Community-funded research project (IST-2000-25323, www.cybertherapy.info). Particularly, its specific goal is the development of different PC-based virtual reality modules to be used in clinical assessment and treatment of social phobia, panic disorders, male sexu…

Exploring the Heterogeneity and Trajectories of Positive Functioning Variables, Emotional Distress, and Post-traumatic Growth During Strict Confinement Due to COVID-19

Abstract  COVID-19 pandemic-related confinement may be a fruitful opportunity to use individual resources to deal with it or experience psychological functioning changes. This study aimed to analyze the evolution of different psychological variables during the first coronavirus wave to identify the different psychological response clusters, as well as to keep a follow-up on the changes among these clusters. The sample included 459 Spanish residents (77.8% female, Mage = 35.21 years, SDage = 13.00). Participants completed several online self-reported questionnaires to assess positive functioning variables (MLQ, Steger et al. in J Loss Trauma 13(6):511–527, 2006. 10.1080/15325020802173660; GQ…