Real-time monitoring of brain activity in patients with specific phobia during exposure therapy, employing a stereoscopic virtual environment.

Exposure therapy is a behavioral technique that is reported to be the most effective, long-lasting treatment for patients suffering from specific phobia. During the performance in enclosed spaces, the patients show a strong psychophysiological response to the phobic stimulus that is normally avoided. This psychophysiological response changes characteristically during the course of exposure. We implemented an electroencephalographic monitoring focusing on event-related potentials to resolve the modulation of preattentive information processing by the anxiety state of the subject. Therefore, mismatch-negativity (MMN) was chosen as parameter using a passive auditory oddball paradigm that does not interfere with performance in the virtual environment. The results of this neurophysiological monitoring are demonstrated in one patient suffering from claustrophobia.

Immersive virtual environments in cue exposure.

Cue reactivity to drug-related stimuli is a frequently observed phenomenon in drug addiction. Cue reactivity refers to a classical conditioned response pattern that occurs when an addicted subject is exposed to drug-related stimuli. This response consists of physiological and cognitive reactions. Craving, a subjective desire to use the drug of choice, is believed to play an important role in the occurrence of relapse in the natural setting. Besides craving, other subjective cue-elicited reactions have been reported, including withdrawal symptoms, drug-agonistic effects, and mood swings. Physiological reactions that have been investigated include skin conductance, heart rate, salivation, and body temperature. Conditioned reactivity to cues is an important factor in addiction to alcohol, nicotine, opiates, and cocaine. Cue exposure treatment (CET) refers to a manualized, repeated exposure to drug-related cues, aimed at the reduction of cue reactivity by extinction. In CET, different stimuli are presented, for example, slides, video tapes, pictures, or paraphernalia in nonrealistic, experimental settings. Most often assessments consist in subjective ratings by craving scales. Our pilot study will show that immersive virtual reality (IVR) is as good or even better in eliciting subjective and physiological craving symptoms as classical devices.

[Predictive value of psychiatric symptoms in the preschool age for adjustment in school age]. / Zum Vorhersagewert kinderpsychiatrischer Symptome im Vorschulalter für das Anpassungsverhalten im Schulater.

This paper derives from a prospective cohort study conducted in Freiburg (Federal Republic of Germany) from 1979 to 1987 with 209 (follow-up outcome: 172) 3- to 5-year-olds. The "Behaviour-Screening Questionnaire," the "Children's Global Assessment Scale" and a thorough semi-standardized interview were used to identify behavior problems in the children. The results were analyzed in relation to life events, sex and socioeconomic status. They were compared with the findings in other studies. Most of the variables examined proved to be of low predictive value. The mood changes common in preschool and kindergarten children with behavior problems were no longer in evidence 7 years later.

[Treatment of acrophobia in a virtual environment]. / Die Behandlung der Höhenangst in einer virtuellen Umgebung.

Specific phobias are one of the most frequent mental health problems and can lead to years of personal suffering. The most effective treatment is exposure therapy. Our aim was to proof the feasibility and efficacy of virtual environments in treating acrophobia patients using a manually guided exposure therapy. Our pilot study was designed as a crossover intervention with a waiting list condition as a control group. After treatment, our results show that exposure in virtual environments is a feasible technique, can provoke anxiety, and leads to a therapeutic effect.