In the Journals

Virtual reality promising for mental health treatment, more research needed

A recent review indicated that virtual reality-based treatment was effective for numerous psychiatric disorders, including panic disorder and agoraphobia, addiction and schizophrenia, but current literature for some disorders is lacking.

“Virtual reality is potentially a powerful tool for the psychiatric community,” Jessica L. Maples-Keller, PhD, of Emory University School of Medicine, said in a press release. “It allows providers to create computer-generated environments in a controlled setting, which can be used to create a sense of presence and immersion in the feared environment for individuals suffering from anxiety disorders.”

To assess utility of virtual reality technologies for the treatment of psychiatric disorders, researchers reviewed available literature on efficacy of incorporating virtual reality within the treatment of various psychiatric disorders.

The review indicated numerous studies that showed efficacy of virtual reality-based CBT for treatment of specific phobias. Many studies were randomized controlled trials with adequate sample sizes that indicated large treatment effects.

Data further suggested treatment benefits were maintained for years following treatment completion.

Analysis indicated fewer studies on effects of virtual reality for social anxiety disorder compared with specific phobias. However, data thus far showed that virtual reality may be useful for individuals with social anxiety, particularly adjunctive to CBT.

Current literature on virtual reality exposure treatment for PTSD was promising, according to researchers, but many had small sample sizes, did not use randomization or lacked comparison to an active treatment condition.

Studies on virtual reality-based exposure for panic disorder and agoraphobia utilized rigorous study design and methodology that indicated efficacy for treating the disorders.

Researchers found a shortage of studies on virtual reality for treatment of generalized anxiety disorder, potentially due to difficulty of creating a standardized scenario that address the various and individualized worries of individuals with generalized anxiety disorder. Thus, they suggested that virtual reality programs could focus on some common anxieties, such as healthy anxiety or something happening to a loved one.

A number of studies assessed virtual reality for treatment of obsessive-compulsive disorder (OCD), but researchers noted that the technology may not be necessary considering many feared stimuli may be accessible in the environment. Nevertheless, virtual reality may be useful for individuals with OCD whose obsessions are not feasible or appropriate for traditional exposure therapy.

Existing research on virtual reality treatment for schizophrenia was limited but preliminary findings were promising, according to researchers.

Findings showed virtual reality plus standard pharmacological pain management was more effective than standard analgesia alone for reducing subjective pain severity. Further, virtual reality may help individuals with chronic pain learn and practice pain-management techniques, such as mindfulness.

Regarding addiction, current studies showed virtual reality-based environments were effective in inducing cue reactivity and craving in different substance-dependent patient populations and could be incorporated into repeated cue-exposure treatment.

There was preliminary support for incorporating virtual reality into treatment for different types of eating pathology and weight problems and findings suggested virtual reality treatment effects may lead to greater improvement in some specific outcomes.

Preliminary findings for autism showed feasibility and efficacy of incorporating virtual reality into psychiatric treatment for autism spectrum disorders.

“Overall, meta-analyses have indicated that [virtual reality] is an efficacious tool, compares favorably to existing treatments, and has lasting effects that generalize to the real world,” the researchers wrote. “Problems have been noted in the existing research, however, including small sample sizes, lack of methodological rigor, and lack of comparison groups. With the cost of head-mounted displays coming down and with smaller smartphone applications being developed, it is likely that [virtual reality] applications will proliferate. It will be important that these are treated as tools and that therapists are properly trained in their applications.” – by Amanda Oldt

Disclosure: Maples-Keller reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.

A recent review indicated that virtual reality-based treatment was effective for numerous psychiatric disorders, including panic disorder and agoraphobia, addiction and schizophrenia, but current literature for some disorders is lacking.

“Virtual reality is potentially a powerful tool for the psychiatric community,” Jessica L. Maples-Keller, PhD, of Emory University School of Medicine, said in a press release. “It allows providers to create computer-generated environments in a controlled setting, which can be used to create a sense of presence and immersion in the feared environment for individuals suffering from anxiety disorders.”

To assess utility of virtual reality technologies for the treatment of psychiatric disorders, researchers reviewed available literature on efficacy of incorporating virtual reality within the treatment of various psychiatric disorders.

The review indicated numerous studies that showed efficacy of virtual reality-based CBT for treatment of specific phobias. Many studies were randomized controlled trials with adequate sample sizes that indicated large treatment effects.

Data further suggested treatment benefits were maintained for years following treatment completion.

Analysis indicated fewer studies on effects of virtual reality for social anxiety disorder compared with specific phobias. However, data thus far showed that virtual reality may be useful for individuals with social anxiety, particularly adjunctive to CBT.

Current literature on virtual reality exposure treatment for PTSD was promising, according to researchers, but many had small sample sizes, did not use randomization or lacked comparison to an active treatment condition.

Studies on virtual reality-based exposure for panic disorder and agoraphobia utilized rigorous study design and methodology that indicated efficacy for treating the disorders.

Researchers found a shortage of studies on virtual reality for treatment of generalized anxiety disorder, potentially due to difficulty of creating a standardized scenario that address the various and individualized worries of individuals with generalized anxiety disorder. Thus, they suggested that virtual reality programs could focus on some common anxieties, such as healthy anxiety or something happening to a loved one.

A number of studies assessed virtual reality for treatment of obsessive-compulsive disorder (OCD), but researchers noted that the technology may not be necessary considering many feared stimuli may be accessible in the environment. Nevertheless, virtual reality may be useful for individuals with OCD whose obsessions are not feasible or appropriate for traditional exposure therapy.

Existing research on virtual reality treatment for schizophrenia was limited but preliminary findings were promising, according to researchers.

Findings showed virtual reality plus standard pharmacological pain management was more effective than standard analgesia alone for reducing subjective pain severity. Further, virtual reality may help individuals with chronic pain learn and practice pain-management techniques, such as mindfulness.

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Regarding addiction, current studies showed virtual reality-based environments were effective in inducing cue reactivity and craving in different substance-dependent patient populations and could be incorporated into repeated cue-exposure treatment.

There was preliminary support for incorporating virtual reality into treatment for different types of eating pathology and weight problems and findings suggested virtual reality treatment effects may lead to greater improvement in some specific outcomes.

Preliminary findings for autism showed feasibility and efficacy of incorporating virtual reality into psychiatric treatment for autism spectrum disorders.

“Overall, meta-analyses have indicated that [virtual reality] is an efficacious tool, compares favorably to existing treatments, and has lasting effects that generalize to the real world,” the researchers wrote. “Problems have been noted in the existing research, however, including small sample sizes, lack of methodological rigor, and lack of comparison groups. With the cost of head-mounted displays coming down and with smaller smartphone applications being developed, it is likely that [virtual reality] applications will proliferate. It will be important that these are treated as tools and that therapists are properly trained in their applications.” – by Amanda Oldt

Disclosure: Maples-Keller reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.