The following article is part of conference coverage from the 2019 American Psychiatric Association Annual Meeting (APA 2019) in San Francisco, CA. Psychiatry Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in psychiatry. Check back for the latest news from APA 2019.


SAN FRANCISCO — The Mental Health Innovation Zone at the American Psychiatric Association Annual Meeting, held May 18-22, 2019, in San Francisco, California, hosted presentations on new technologies and developments in existing technologies that can be leveraged in psychiatry. Among these, a presentation by Limbix VR provided clinicians with an overview of the range of uses of virtual reality (VR) and how to integrate the technology in usual care.

Research indicates that VR can be as effective as exposure therapy for the treatment of specific phobias. For example, VR technology is useful to treat the fear of flying, which is difficult to address using real-life exposure therapy, particularly since individuals are afraid of a specific part of the flying experience (eg, take off). With VR, a person can virtually witness this aspect of the experience that induces fear over and over again, but with a clinician present.

In addition, VR was found to be more effective — both immediately after and 12 months later — than in vivo exposure therapy and patients waiting to receive therapy. Among several exposure programs created by Limbix, 1 provides the experience of a job interview and includes several gradations of intensity in the attitude of the interviewer. The experience can be adapted based on changes in the patient’s voice and responses.

Addiction behavior can be elicited by common everyday triggers associated with cravings. In this context, VR therapy allows patients to practice refusal skills upon virtual presentation of triggers in the presence of a mental health professional while attending a rehabilitation facility.

Psychoeducation — the first step of cognitive behavioral therapy — was found to be more effective when using VR than in the absence of it, as the technology provides an interactive experience and allows the user to block out outside distractions. Researchers at Limbix created immersive educational content for the management of depression, anxiety, and trauma, as well as content on mindfulness. In the latter, the individual mindfully attends to specific aspects of the environment and is able to transform it. For example, in an experience that was created, the user is taught diaphragmatic breathing in a 360-degree starscape, the colors of which change with inhalation and with exhalation.

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Promising research that leverages neuroplasticity for the management of depression in adolescents was translated into an immersive VR experience. In this study, a single session intervention during which patients were taught to adopt a “growth” mindset and shown that their emotions, behaviors, and personality are not fixed, led to a clinically significant reduction in depression at 3, 6, and 9 months.

VR can also be leveraged as a distraction tool for acute pain (eg, for wound changing in patients with severe burns), as attention is known to modulate the perception of pain. VR is now widely used in children’s hospitals, particularly in perioperative pain departments. Successful use of VR for these applications requires the technology to be hands-free, simple, and devoid of “fail states” so as to avoid breaks in the experience that would bring attention back to a procedure.

Although the use of VR requires extensive research for successfully leveraging its use for the management of chronic pain, the technology was found to effectively enhance the efficacy of guided imagery. Avenues explored for leveraging VR in patients with chronic pain included an experience in which the patient looks at the body area(s) where they experience pain, and use a “virtual wand” to dissipate the pain. The patient would then see the pain dissipate, as indicated by the area changing colors from a “hot” red to a “cold” blue hue. A feasibility study of this concept is underway.

For more information, visit Limbix.com.

For more coverage of APA 2019, click here.

Reference

Caruso K, Guina J, Ritchie E. Brain changers: Integration and differentiation of PTSD and TBI in clinical and disability evaluations. American Psychiatric Association Annual Meeting; May 18-22, 2019; San Francisco, CA.