Diaphragmatic breathing during virtual reality exposure therapy for aviophobia: functional coping strategy or avoidance behavior? a pilot study

Shiban, Youssef; Diemer, Julia; Müller, Julia; Brütting-Schick, Johanna; Pauli, Paul; Mühlberger, Andreas

doi:10.1186/s12888-016-1181-2

Cited by 42 publications

(36 citation statements)

References 31 publications

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“…Psychological treatments using virtual reality (VR) have shown promising results for different psychopathologies (Riva et al, 2016; Freeman et al, 2017), including specific phobia (Shiban et al, 2017; Meyerbröker et al, 2018), social phobia (Bouchard et al, 2017), PTSD (Rothbaum et al, 2014; Beidel et al, 2017), eating disorders (Manzoni et al, 2016; Ferrer-García et al, 2017), and schizophrenia (du Sert et al, 2018; Pot-Kolder et al, 2018), among others. To date, the most evidence for the efficacy of VR treatments has been shown in phobic disorders (Parsons and Rizzo, 2008; Powers and Emmelkamp, 2008; Opris et al, 2012; Turner and Casey, 2014; Morina et al, 2015), where pioneering studies established VR as a treatment medium as early as the late 1990s (e.g., for claustrophobia treatment, Botella et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure

et al. 2019

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Virtual reality plays an increasingly important role in research and therapy of pathological fear. However, the mechanisms how virtual environments elicit and modify fear responses are not yet fully understood. Presence, a psychological construct referring to the ‘sense of being there’ in a virtual environment, is widely assumed to crucially influence the strength of the elicited fear responses, however, causality is still under debate. The present study is the first that experimentally manipulated both variables to unravel the causal link between presence and fear responses. Height-fearful participants (N = 49) were immersed into a virtual height situation and a neutral control situation (fear manipulation) with either high versus low sensory realism (presence manipulation). Ratings of presence and verbal and physiological (skin conductance, heart rate) fear responses were recorded. Results revealed an effect of the fear manipulation on presence, i.e., higher presence ratings in the height situation compared to the neutral control situation, but no effect of the presence manipulation on fear responses. However, the presence ratings during the first exposure to the high quality neutral environment were predictive of later fear responses in the height situation. Our findings support the hypothesis that experiencing emotional responses in a virtual environment leads to a stronger feeling of being there, i.e., increase presence. In contrast, the effects of presence on fear seem to be more complex: on the one hand, increased presence due to the quality of the virtual environment did not influence fear; on the other hand, presence variability that likely stemmed from differences in user characteristics did predict later fear responses. These findings underscore the importance of user characteristics in the emergence of presence.

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Section: Introductionmentioning

confidence: 99%

Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure

et al. 2019

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“…Physiological measures can also be used to evaluate the progress of the therapy. Shiban et al (2017) created a virtual exposure application for the treatment of aviophobia. Heart rate and skin conductance were measured as indicators for the fear elicited by a virtual airplane flight.…”

Section: Exposure Therapiementioning

confidence: 99%

“…In these studies the independent variable is the number of expositions or sessions and the dependent variable is the physiological measure. This is often done to quantify the progress of a therapy or training (Lee et al, 2015;Shiban et al, 2017) but can, for example, also be used to determine a habituation to cybersickness inducing stimuli (Gavgani et al, 2017). • Correlation: Physiological measures can be used to establish a relationship between the measure and a second variable.…”

Section: High-level Purposesmentioning

confidence: 99%

A Systematic Review of Physiological Measurements, Factors, Methods, and Applications in Virtual Reality

Halbig

Latoschik

2021

Front. Virtual Real.

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Measurements of physiological parameters provide an objective, often non-intrusive, and (at least semi-)automatic evaluation and utilization of user behavior. In addition, specific hardware devices of Virtual Reality (VR) often ship with built-in sensors, i.e. eye-tracking and movements sensors. Hence, the combination of physiological measurements and VR applications seems promising. Several approaches have investigated the applicability and benefits of this combination for various fields of applications. However, the range of possible application fields, coupled with potentially useful and beneficial physiological parameters, types of sensor, target variables and factors, and analysis approaches and techniques is manifold. This article provides a systematic overview and an extensive state-of-the-art review of the usage of physiological measurements in VR. We identified 1,119 works that make use of physiological measurements in VR. Within these, we identified 32 approaches that focus on the classification of characteristics of experience, common in VR applications. The first part of this review categorizes the 1,119 works by field of application, i.e. therapy, training, entertainment, and communication and interaction, as well as by the specific target factors and variables measured by the physiological parameters. An additional category summarizes general VR approaches applicable to all specific fields of application since they target typical VR qualities. In the second part of this review, we analyze the target factors and variables regarding the respective methods used for an automatic analysis and, potentially, classification. For example, we highlight which measurement setups have been proven to be sensitive enough to distinguish different levels of arousal, valence, anxiety, stress, or cognitive workload in the virtual realm. This work may prove useful for all researchers wanting to use physiological data in VR and who want to have a good overview of prior approaches taken, their benefits and potential drawbacks.

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“…Therefore, music may be useful only in certain phases of therapy. Shiban et al 44 used diaphragmatic breathing to augment VRE for flying phobia. At both 1 week and 1 year after intervention, a significant reduction of fear was confirmed by a self-report measure in both intervention and control groups, and there was no significant difference between groups.…”

Section: Others (N = 9)mentioning

confidence: 99%

Recent developments in the intervention of specific phobia among adults: A rapid review.

et al. 2020

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F1000 Faculty Reviews are written by members of the prestigious . They are F1000 Faculty commissioned and are peer reviewed before publication to ensure that the final, published version is comprehensive and accessible. The reviewers who approved the final version are listed with their names and affiliations. AbstractSpecific phobia is highly prevalent worldwide. Although the body of intervention studies is expanding, there is a lack of reviews that summarise recent progress and discuss the challenges and direction of research in this area. Hence, this rapid review seeks to systematically evaluate the available evidence in the last five years in the treatment of specific phobias in adults. Studies published between January 2014 to December 2019 were identified through searches on the electronic databases of Medline and PsychINFO. In total, 33 studies were included. Evidence indicates that psychotherapy, and in particular cognitive behaviour therapy, when implemented independently or as an adjunctive, is a superior intervention with large effect sizes. Technology-assisted therapies seem to have a beneficial effect on alleviating fears and are described to be more tolerable than exposure therapy. Pharmacological agents are investigated in vivo solely as adjuncts to exposure therapy, but the effects are inconsistent; propranolol and glucocorticoid may be promising. A handful of cognitive-based therapies designed to alter fear arousal and activation pathways of phobias have presented preliminary, positive outcomes. Challenges remain with the inherent heterogeneity of specific phobia as a disorder and the accompanying variability in outcome measures and intervention approaches to warrant a clear conclusion on efficacy. A Randomized, Controlled Trial With a 6-Month Follow-Up. J Arthroplasty. 2018; 33(3): 704-10. PubMed Abstract | Publisher Full Text | F1000 Recommendation 12. Soravia LM, Heinrichs M, Winzeler L, et al.: Glucocorticoids enhance in vivo exposure-based therapy of spider phobia. Depress Anxiety. 2014; 31(5): 429-35. PubMed Abstract | Publisher Full Text | F1000 Recommendation 13. Rouhe H, Salmela-Aro K, Toivanen R, et al.: Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience--a randomised controlled trial. J Psychosom Obstet Gynaecol. 2015; 36(1): 1-9. PubMed Abstract | Publisher Full Text 14. Dumville JC, Torgerson DJ, Hewitt CE: Reporting attrition in randomised controlled trials. BMJ. 2006; 332(7547): 969-71. PubMed Abstract | Publisher Full Text | Free Full Text 15. Klabbers GA, Wijma K, Paarlberg KM, et al.: Haptotherapy as a new intervention for treating fear of childbirth: a randomized controlled trial. J Psychosom Obstet Gynaecol. 2019; 40(1): 38-47. PubMed Abstract | Publisher Full Text | F1000 Recommendation 16. Rondung E, Ekdahl J, Hildingsson I, et al.: Heterogeneity in childbirth related fear or anxiety. Scand J Psychol. 2018; 59(6): 634-43. PubMed Abstract | Publisher Full Text | F1000 Recommendation 17. Tellez M, Potter CM...

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Diaphragmatic breathing during virtual reality exposure therapy for aviophobia: functional coping strategy or avoidance behavior? a pilot study

Cited by 42 publications

References 31 publications

Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure

Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure

A Systematic Review of Physiological Measurements, Factors, Methods, and Applications in Virtual Reality

Recent developments in the intervention of specific phobia among adults: A rapid review.

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