Mothers' and Fathers' Perspectives on the Causes of Their Child's Disorder.

BACKGROUND: Parental beliefs about the cause of their child's illness are thought to affect parents' help-seeking behaviors, treatment decisions, and the child's health outcomes. Yet, research on parental beliefs about disease causation is still scarce. While a small number of studies assesses parental cause attributions for singular disorders (e.g., neurodevelopmental disorders), no study has compared disorders with differing physical versus mental conditions or with mixed comorbidities in children and adolescents or their caregivers. Furthermore, most pediatric research suffers from a lack of data on fathers. OBJECTIVE: Hence, the objective of the current study was to test for possible differences in mothers' and fathers' perceptions about the etiology of their child's illness. METHODS: Forty-two parent couples (overall N = 84) whose child had been diagnosed either with Attention Deficit Hyperactivity-Disorder (ADHD) or Autism Spectrum Disorder (ASD) (category "neurodevelopmental disorder") or with a primary physical illness and a comorbid mental disorder, e.g. depression (category "psychosomatic disorder") were asked to rate possible causes of their child's illness using a modified version of the revised Illness Perception Questionnaire (IPQ) Cause scale. RESULTS: A two-way ANOVA showed that psychosomatic disorders were significantly more strongly attributed to be caused by medical and environmental stressors than neurodevelopmental disorders. A significant parent × illness category interaction revealed that this effect was more pronounced in fathers. CONCLUSIONS: By providing first insights into parental beliefs about the etiology of their children's neurodevelopmental versus psychosomatic disorders, this study paves ground for future research and tailored counseling of affected families.

Virtual reality exposure therapy for posttraumatic stress disorder (PTSD): a meta-analysis.

Contrary to specific phobias, for which Virtual Reality Exposure Therapy (VRET) constitutes an effective treatment, uncertainty still exists regarding the usefulness of VRET for posttraumatic stress disorder (PTSD). Therefore, this meta-analysis investigated the efficacy of VRET for PTSD as compared to waitlist and active comparators. A literature search yielded nine controlled studies encompassing 296 participants (124 VRET, 172 controls). The differences between conditions regarding the primary outcome of PTSD symptom severity and the secondary outcome of depressive and anxiety symptoms post-treatment were calculated using Hedges' g. Compared to waitlist controls, VRET showed a significantly better outcome for PTSD symptoms (g = 0.62, p = .017) and depressive symptoms (g = 0.50, p = .008). There was no significant difference between VRET and active comparators regarding PTSD symptoms (g = 0.25, p = .356) and depressive symptoms (g = 0.24, p = .340) post-treatment. No significant effects emerged for anxiety symptoms. These findings suggest that VRET may be as effective as active comparators for PTSD patients. However, the results must be interpreted with caution due to the limited number of trials and the substantial number of - predominantly male - military service members studied. Additional controlled trials, considering a wider range of trauma types and balanced gender, are required to strengthen the evidence.

Al contrario de las fobias específicas, para las cuales la Terapia de Exposición de Realidad Virtual (VRET en sus siglas en inglés) constituye un tratamiento efectivo, existe todavía incertidumbre con respecto a la utilidad de la VRET para el trastorno de estrés postraumático (TEPT). Por lo tanto, este meta-análisis investigó la efectividad de la VRET para el TEPT en comparación con la lista de espera y los comparadores activos. Una búsqueda de literatura arrojó nueve estudios controlados involucrando a 296 participantes (124 VRET, 172 controles). Las diferencias entre las condiciones con respecto al resultado principal de la severidad de los síntomas del TEPT y el resultado secundario de los síntomas depresivos y ansiosos luego del tratamiento, fueron calculados usando la g de Hedges. En comparación a los controles de lista de espera, la VRET mostró un resultado significativamente mejor para los síntomas del TEPT (g=0.62, p=.017) y los síntomas depresivos (g=0.50, p=.008). No hubo diferencias significativas entre la VRET y los comparadores activos con respecto a los síntomas del TEPT (g=0.25, p=.356) y los síntomas depresivos (g=0.24, p=.340) luego del tratamiento. No surgieron efectos significativos para los síntomas ansiosos. Estos hallazgos sugieren que la VRET podría ser tan efectiva como los comparadores activos para los pacientes con TEPT. Sin embargo, los resultados deben ser interpretados con cautela debido al número limitado de ensayos y el sustancial número de miembros del servicio militar ­predominantemente hombres- estudiados. Ensayos controlados adicionales, que consideren un rango más amplio de tipos de trauma y balanceados en género, son requeridos para fortalecer la evidencia.

Virtual social support buffers stress response: An experimental comparison of real-life and virtual support prior to a social stressor.

BACKGROUND AND OBJECTIVES: Face-to-face and text-based social support have been shown to attenuate stress responses in past studies. Yet as social interactions increasingly take place online by means of virtual humans, our objective was to examine whether different forms of social support (virtual vs. real) prior to the Trier Social Stress Test (TSST) would also decrease stress. Additionally, the effect on subsequent real-life social behaviors (helping and approach) was evaluated while controlling for affective states and social presence. METHODS: 56 participants were either supported by an avatar, an agent, a real human or received no support before completing the TSST and two subsequent social behavior tasks (pen task and seating task). RESULTS: Results show no difference in agency regarding social presence. Yet, participants with agent support and no support had significantly higher heart rates during the TSST and reported to be more worried. Also, they were more irritated and showed significantly slower helping reactions (picking up pens). LIMITATIONS: A limitation to this study is that only emotional verbal and non-verbal support were provided by a stranger. Different forms of support as well as a different source (i.e., a friend) may have a more pronounced effect on stress buffering. CONCLUSIONS: Virtual social support is as effective as face-to-face support in terms of stress buffering, as long as the recipient has the impression that it is provided by another human (via an avatar). This has wide ranging implications not only for health-related application in prevention and treatment but also for further research.

Agency and Gender Influence Older Adults' Presence-Related Experiences in an Interactive Virtual Environment.

While virtual humans are increasingly used to benefit the elderly, considerably little is still known about older adults' virtual experiences. However, due to age-related changes, older adults' perceptions of virtual environments (VEs) may be unique. Hence, our objective was to examine possible gender differences in immersion, flow, and emotional states as well as physical and social presence in elderly males and females interacting either with a computer-controlled agent or a human-controlled avatar. Seventy-eight German-speaking older adults were randomly assigned to an avatar or an agent condition and were exposed to a brief social encounter in a virtual café. Results indicate no overall gender differences, but a significant effect of agency on social presence, physical presence, immersion, and flow. Participants in the avatar condition reported higher levels in all measures, except for involvement. Furthermore, significant gender × agency interactions were found, with females showing more social presence, spatial presence, and flow when interacting with a human-controlled avatar and more realism when conversing with an agent. Also, all participants showed significant changes in their affect post exposure. In sum, older adults' virtual experiences seem to follow unique patterns, yet, they do not preclude the elderly from successfully participating in VEs.