AUGMENTED%20REALITY

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Case Study
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• CASE STUDY
• Exposure treatment One hour.
• The patient interacted with the cockroach in the
  container, and also with the cockroach outside
  the container.
• The patient killed four cockraches.

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AUGMENTED REALITY

• Treatment outcomes were maintained at one-month
  follow-up.
• Reports of high Reality judgment and Presence.

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Case Series Study

• Participants 10 patients so far (9 women and 1
  man)
• Four with spider phobia
• Six with cockroach phobia

Treatment Adaptation of the one-session exposure
program developed by Öst delivered with Augmented
Reality.
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Results BAT (0-12)
PATIENTS BASELINE PRE-TEST POST-TEST
1 5 5 12
2 6 6 12
3 6 6 12
4 7 7 12
5 5 5 12
6 0 0 12
7 0 0 12
8 5 5 12
9 0 0 12
10 5 5 12
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Results Self-report (0-126)
PATIENTS PRE-TEST POST-TEST
1 114 19
2 91 68
3 95 40
4 60 35
5 111 86
6 95 45
7 95 48
8 71 34
9 95 39
10 121 43
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Preference IN VIVO vs AR (0-7)
PATIENTS 1 2 3 4 5 6 7 8 9 10
Willingness of getting involved in a treatment with AR exposure 7 4 7 7 7 7 6 7 7 7
Willingness of getting involved in a treatment with in vivo exposure 6 4 4 5 4 2 4 4 5 5
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Satisfaction (0-10)
PATIENTS 1 2 3 4 5 6 7 8 9 10
Do you think the procedure is logic? 9 9 10 10 10 10 10 10 10 10
Your level of satisfaction with the procedure 10 9 9 8 8 8 10 10 10 10
Would you recommended it to a friend? 10 9 10 9 9 10 10 10 10 10
Do you think it could be useful for treating other psychological problems? 10 9 10 10 8 10 10 10 10 10
Do you find the treatment aversive? 2 7 7 1 5 7 1 7 9 0
Do you think the treatment has been useful in treating your problem? 10 7 10 7 7 7 9 10 10 10
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Conclusions

• AR Efficacious in the treatment of specific
  phobia.
• Significant reduction in objective and
  subjective measures of fear and avoidance.
• Patients preferred AR rather than in vivo
  exposure.
• Patients were satisfied with the treatment.

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Controlled Studies n gt 8
Fear of Driving
Author Country Year of Pts Tx Grps
Berger U.S. 1999 16 PC VR, Phobics, Non-Phobics
Kim Korea 1999 9 PC VR, WLC
Wiederhold U.S. 2001 9 VR, In vivo
Jang Korea 2002 11 Driving vs. Flying
Walshe Ireland 2003 14 ECT, CBT, WLC
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• Types of VR equipment used clinically

Head Mounted Display
Multiple Screens
Regular Desktop
Full Car
Automobile Seat
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Driving Study 9 participants (Wiederhold BK,
Jang DP, Kim SI, Wiederhold MD, 2001)
Treatment Success
Specific Phobia PDA PTSD
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Fear of Driving Movie Clip
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Social Phobia
Patient wearing a HMD while engaging in the
virtual party
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Controlled Studies n gt 8
Social Phobia
Author Country Year of Pts Tx Grps
Slater U.K. 2003 10 Neutral, demanding
Lègeron France 2003 36 VR, CBT
Roy France 2003 10 VR, CBT, WLC
Klinger France 2005 36 VR, CBT
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Social Phobia(Klinger, Bouchard et al., 2004)
N 36, 12 sessions. CBT in group.
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SOCIAL PHOBIA
(Klinger et al., 2005)

• Sample Population 18 participants
• 10 females and 8 males
• Mean age 30.5 5.06
• On average, participants have been suffering from
  social phobia for 14.5 years
• 9 participants were also displayed symptoms of
  major depression
• (all information based only on the VRT group)

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SOCIAL PHOBIA
(Klinger et al., 2005)

• Measures
• The Short Beck Depression Inventory (BDI-13)
• The Liebowitz Social Anxiety Scale (LSAS)
• The Rathus Assertiveness Schedule
• The Zigmond and Snaith Hospital Anxiety
  Depression Scale (HAD)

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SOCIAL PHOBIA
(Klinger et al., 2005)

• Protocol for VRT only
• Overview
• 12 sessions of VRT
• 45 minutes each
• Exposed to virtual environments for either
  assessment or therapy
• Virtual exposure lasts less than 20 minutes per
  session

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(Klinger et al., 2005)

• Protocol (contd)
• Virtual environments included 4 situations that
  social phobic patients felt were the most
  threatening
• Performance
• Intimacy
• Scrutiny
• Assertiveness

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SOCIAL PHOBIA
(Klinger et al., 2005)

• Protocol (contd)
• Session 1
• Therapist presents virtual world to patient
• Patient familiarizes the virtual world and tools
  in a neutral environment
• Session 2-9
• 2 sessions devoted to each of the 4 virtual
  environments
• Assessment, expose patient to VR environment, 2
  phases of therapy exposure to the environment

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SOCIAL PHOBIA
(Klinger et al., 2005)

• Protocol (contd)
• Session 10-12
• 3 sessions devoted to more focused and detailed
  work on one or two of the four environments that
  gave the patient the most trouble
• 12th session conclusion to therapy and
  introduction of a personal program to carry out
  beyond the therapy

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SOCIAL PHOBIA
(Klinger et al., 2005)
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SOCIAL PHOBIA
(Klinger et al., 2005)

• Conclusion
• Based on the LSAS, VRT would illustrate a better
  form of treatment over CBT
• The differences between the two groups, however,
  are not significant
• For VRT to be significantly better than CBT in
  terms of social phobia symptoms, experiment
  participants would have to be increased to
  200-300
• Participants should be increased to a sample of
  3,000 in order to find a significant difference
  in performance anxiety
• In order to further confirm the efficacy of
  virtual reality for the treatment of social
  phobia, additional outcome studies could be
  conducted with the inclusion of a third control
  condition such as a placebo or a waiting list

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Social Phobia Movie Clip
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Internet-based Worlds
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SOCIAL PHOBIA
Online Worlds to Help with Social Phobia

• www.there.com
• www.secondlife.com

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Human Avatars
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Animal Avatars
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Controlled Studies n gt 8
Panic Disorder with Agoraphobia
Author Country Year of Pts Tx Grps
North U.S. 1998 30 PC VR, WLC
Kim Korea 1999 9 PC VR, WLC
Botella Spain 2002 10 PC VR, In vivo
Wiederhold U.S. 2002 9 Non-phobics in PDA environ.
Botella Spain 2003 36 VRE, In vivo, WLC
Multi-center Controlled Study
Riva Italy 2002 45 PC VR, In vivo, WLC
Wiederhold U.S. 2002 45 PC VR, In vivo, WLC
Bouchard Canada 2002 45 PC VR, In vivo, WLC
Kim Korea 2002 45 PC VR, In vivo, WLC
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Agoraphobia 12 participants(Vincelli, Anolli,
Bouchard, Wiederhold, Zurloni, Riva, 2003)

• Patient Treatment
• VR-CBT
• CBT
• WLC
• Design
• VR-CBT 8 sessions
• CBT 12 sessions
• Results
• VR-CBT produced same or better results using 33
  fewer sessions than CBT

• Measures
• Beck Depression Inventory
• State Trait Anxiety Inventory
• Agoraphobic Cognitions Questionnaire
• Fear Questionnaire

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Agoraphobia 12 participants(Vincelli, Anolli,
Bouchard, Wiederhold, Zurloni, Riva, 2003)
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The Mall
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The Room