[Development of virtual reality as an exposure technique]. / Die Entwicklung virtueller Realität als Expositionsverfahren.

BACKGROUND: Virtual reality (VR) has been investigated as a medium for exposure therapy of anxiety disorders for 20 years. Various meta-analyses have provided convincing evidence of the therapeutic efficacy of exposure therapy in VR. OBJECTIVE: In recent years VR technology and its applications have considerably improved. Therefore, the current state of the art of VR exposure therapy is presented. MATERIAL AND METHODS: This article provides a narrative review of current research on VR exposure therapy for anxiety disorders and major directions of development in this area. RESULTS: After an almost exclusive focus on specific phobias in the early days, research on more complex anxiety disorders (particularly on social anxiety disorder) is increasing. In addition, VR has become established as an experimental method to probe psychopathological processes and to elucidate the mechanism of action of (VR) exposure therapy. CONCLUSION: There is still a need for more research into VR exposure therapy, especially in complex anxiety disorders (e. g. panic disorder, agoraphobia and social anxiety disorder) and trauma-related disorders. Furthermore, VR has become established as a research tool. The rapid technological development gives reason to expect a continuing increase in VR research, in clinical as well as basic research.

Virtual environments as an assessment modality with pediatric ASD populations: a brief report.

Virtual environments (VEs) have demonstrated promise as a neuropsychological assessment modality and may be well suited for the evaluation of children suspected of having an autism spectrum disorder (ASD). Some recent studies indicate their potential for enhancing reliability, ecologically validity, and sensitivity over traditional neuropsychological evaluation measures. Although research using VEs with ASD is increasing to the degree that several reviews of the literature have been conducted, the reviews to date lack rigor and are not necessarily specific to cognitive or neuropsychological assessment as many focus on intervention. The aim of this project was to comprehensively examine the current literature status of neuropsychological assessment in pediatric ASD using VEs by conducting a systematic review. Specifically, psychometric comparisons of VEs to traditional neuropsychological assessment measures that examined reliability, validity, and/or diagnostic accuracy for pediatric individuals, age 18 and below, with ASD were sought. The search using key words yielded 899 manuscripts, 894 of which were discarded for not meeting inclusion criteria. The remaining five met exclusion criteria. Therefore, the systematic review was modified to a brief report. These findings (or lack thereof) indicate a significant gap in the literature in that psychometric comparisons of these tools for the neuropsychological assessment of pediatric individuals with ASD are lacking. An important future direction of research will be extending the demonstrated incremental validity of VE neuropsychological assessment with other neurodevelopmental (e.g., attention-deficit/hyperactivity disorder) and adult populations to pediatric ASD populations.

Functional assessment in mental health: lessons from occupational therapy.

Occupational therapists have been conducting functional assessments since World War I, and this accumulated experience has taught us several critical lessons. First, a comprehensive profile of a patient's functioning requires multiple assessment methods. Second, assessment content and measurement constructs must change with the times. Third, technology can enhance and extend functional assessment. Fourth, performance-based assessments of everyday activities can also be used to measure body functions/impairments. However, while deconstructing activities into body functions/impairments is possible, the results do not reflect patients' abilities to integrate the cognitive, motor, sensory and affective functions necessary to complete a complex activity. Finally, the differential complexity of everyday activities that a patient can master or successfully complete can also provide a ruler with which to measure progress.

Los terapeutas ocupacionales han realizado evaluaciones funcionales desde la Primera Guerra Mundial, y esta experiencia acumulada nos ha enseñado algunas lecciones importantes. Primero, un perfil comprensivo del funcionamiento de un paciente requiere de mùltiples métodos de evaluación. Segundo, el contenido de la evaluación y los constructos de medición deben cambiar con los tiempos. Tercero, la tecnología puede reforzar y ampliar la evaluación funcional. Cuarto, las evaluaciones basadas en el desempeño de las actividades diarias también se pueden emplear para medir las funciones y deterioros corporales. Sin embargo, aunque es posible la deconstrucción de las actividades en funciones y deterioros corporales, los resultados no reflejan las capacidades de los pacientes para integrar las funciones cognitivas, motoras, sensoriales y afectivas necesarias para completar una actividad compleja. Por último, la complejidad diferencial de las actividades diarias que un paciente puede dominar o completar exitosamente también puede aportar una regla con la cual medir el progreso.

Les ergothérapeutes ont mené des évaluations fonctionnelles depuis la première guerre mondiale et cette accumulation d'expérience nous a enseigné plusieurs leçons essentielles. Tout d'abord, de nombreuses méthodes d'évaluation sont nécessaires pour établir le profil complet du fonctionnement d'un patient. Deuxièmement, le contenu de l'évaluation et les méthodes de mesure doivent évoluer avec le temps. Troisièmement, la technologie peut améliorer et élargir l'évaluation fonctionnelle. Quatrièmement, les évaluations basées sur la performance des activités quotidiennes peuvent aussi être utilisées pour mesurer le fonctionnement du corps (ou les troubles du fonctionnement). Toutefois, bien qu'il soit possible de décomposer les activités du quotidien par fonction, les résultats obtenus ne reflètent pas la manière dont les patients sont capables de coordonner leurs fonctions cognitives, motrices, sensorielles et affectives pour effectuer une activité complexe. Enfin, différents niveaux de complexité des diverses activités quotidiennes qu'un patient peut maîtriser ou exécuter avec succès peuvent aussi fournir une règle permettant de mesurer le progrès.

Future Directions: How Virtual Reality Can Further Improve the Assessment and Treatment of Eating Disorders and Obesity.

Transdisciplinary efforts for further elucidating the etiology of eating and weight disorders and improving the effectiveness of the available evidence-based interventions are imperative at this time. Recent studies indicate that computer-generated graphic environments-virtual reality (VR)-can integrate and extend existing treatments for eating and weight disorders (EWDs). Future possibilities for VR to improve actual approaches include its use for altering in real time the experience of the body (embodiment) and as a cue exposure tool for reducing food craving.