SAFEvR MentalVeRse.app: Development of a Free Immersive Virtual Reality Exposure Therapy for Acrophobia and Claustrophobia.

Background: Specific phobias impact over 400 million people worldwide. Digitalizing mental health could alleviate the burden. Still, although the corporate-driven Metaverse is expanding rapidly, there needs to be more momentum in harnessing virtual reality exposure therapy uptake. Objective: This study aims to conceptualize, develop, and deploy a free Virtual Reality Exposure Therapy (VRET) application specifically designed for treating acrophobia and claustrophobia. This pilot study, which holds the promise of a future where mental health is more accessible and effective, explores the feasibility of leveraging transdisciplinary collaboration among specialists to create a safe, accessible, and effective VRET solution. Methods: We conducted a Delphi heuristic approach involving bioethicists, neuroscientists, and tech developers. Second, we reviewed the existing psychological theories and therapeutic strategies for addressing phobias in VR. Third, we conceptualized a thematic analysis-derived framework for a safe, adaptive-gamified free exposure to virtual reality acrophobia and claustrophobia (SAFEvR ACT). Finally, we provide an overview of the iterative improvements made during 12 workshops and 76 weekly briefings on developmental implementations. Results: We developed the SAFEvR ACT into a proof-of-concept application freely deployed on the MentalVerse app platform. Our safety-focused approach can benefit from prevalidation perspectives within future randomized control trials. Conclusions: The resulting application derived from the SAFEvR ACT framework represents a blueprint to counter the current lack of iVR mental health uptake by offering a free VRET alternative. Future research should aim towards developing similar free platforms to lessen mental health burdens and gather quantitative data. We conclude with a call to action to researchers to fine-tune our current approach and take a stand for free digital mental health within MentalVeRse.app.

Real-Time Classification of Anxiety in Virtual Reality Therapy Using Biosensors and a Convolutional Neural Network.

Virtual Reality Exposure Therapy is a method of cognitive behavioural therapy that aids in the treatment of anxiety disorders by making therapy practical and cost-efficient. It also allows for the seamless tailoring of the therapy by using objective, continuous feedback. This feedback can be obtained using biosensors to collect physiological information such as heart rate, electrodermal activity and frontal brain activity. As part of developing our objective feedback framework, we developed a Virtual Reality adaptation of the well-established emotional Stroop Colour-Word Task. We used this adaptation to differentiate three distinct levels of anxiety: no anxiety, mild anxiety and severe anxiety. We tested our environment on twenty-nine participants between the ages of eighteen and sixty-five. After analysing and validating this environment, we used it to create a dataset for further machine-learning classification of the assigned anxiety levels. To apply this information in real-time, all of our information was processed within Virtual Reality. Our Convolutional Neural Network was able to differentiate the anxiety levels with a 75% accuracy using leave-one-out cross-validation. This shows that our system can accurately differentiate between different anxiety levels.

Estratégias de terapias de exposição à realidade virtual: uma revisão discutida sob a ótica analítico-comportamental / Virtual reality exposure therapy strategies: a review discussed under the behavior-analytic perspective / Estrategias de terapias de exposición a la realidad virtual: una revisión discuto en la perspectiva analítico conductual

A tecnologia de realidade virtual parece trazer vantagens para as intervenções psicoterapêuticas de transtornos de ansiedade como as fobias. Este artigo revisou a bibliografia sobre terapia de exposição à realidade virtual (VRET) de cinco tipos de fobias (agorafobia, aracnofobia,

The virtual reality technology seems to bring advantages to the psychotherapeutic interventions of anxiety disorders like phobias. This paper reviews the literature about virtual reality exposure therapy (VRET) of five forms of phobias (agoraphobia, arachnophobia, claustrophobia, katsaridaphobia, fear of driving), describes the therapeutic procedures, and compared them with procedures used in behavioral-analytic psychotherapy. A search using the keywords therapy, virtual reality, phobia, was performed using the Boolean operator AND, from 2006 to 2015. The studies that reported the therapeutic procedure of the five phobias specified were eight of agoraphobia, 10 of acrophobia, one of claustrophobia, two of katsaridaphobia, and two of fear of driving. The treatment procedures consisted of preprogramed pretreatment sessions, virtual reality exposure, and follow-up. Most of them (22 of 23 studies) reported a fixed number of therapeutic sessions, and in 18 of them, the exposure hierarchy was preprogrammed. The results show that VRET and analytical-behavioral therapy have similarity in basic structure and differences in fixing or not exposure hierarchies and conducting or not functional analysis of the behaviors.

La tecnología de realidad virtual parece traer ventajas significativas a las intervenciones psicoterapéuticas de los trastornos de ansiedad como las fobias. Este artículo revisa la literatura sobre la terapia de exposición de realidad virtual (VRET) de cinco tipos de fobias (agorafobia, aracnofobia, claustrofobia, entomofobia y fobia de conducir) para describir el procedimiento terapéutico adoptado, y compararlos con los procedimientos usados en la psicoterapia analítica-conductual. Se realizó una búsqueda usando las palabras-clave therapy, virtual reality, phobia, con el operador booleano AND, desde 2006 hasta 2015. Los estudios que informaron el procedimiento terapéutico de las cinco fobias especificadas eran ocho de la agorafobia, 10 de la acrofobia, uno de la claustrofobia, dos de la entomofobia, y dos de lo miedo a conducir. Los procedimientos de tratamiento consistieron en sesiones de pre-tratamiento pre-programados, la exposición a la realidad virtual, y el seguimiento. La mayoría de ellos (22 de 23 estudios) informaron un número fijo de sesiones terapéuticas y en 18 de ellos, la jerarquía de la exposición fue pre-programado. Los resultados indican que la VRET y la terapia analítica-conductual tienen semejanza en la estructura básica y diferencias en la fijación o no de jerarquías de exposición y de la realización o no de análisis funcionales los comportamientos.