Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: a block randomized controlled trial.
Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: a block randomized controlled trial.
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DOI：
10.2196/jmir.3235
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发表时间：
2014-07-08
影响因子：
7.4
通讯作者：
Riva G
中科院分区：
文献类型：
--
作者：
Gaggioli A;Pallavicini F;Morganti L;Serino S;Scaratti C;Briguglio M;Crifaci G;Vetrano N;Giulintano A;Bernava G;Tartarisco G;Pioggia G;Raspelli S;Cipresso P;Vigna C;Grassi A;Baruffi M;Wiederhold B;Riva G
最近技术和医学的融合为行为保健提供了创新的方法和工具。其中，一种新兴的方法是在基于暴露的方案中使用虚拟现实(VR)来治疗焦虑症，特别是创伤后应激障碍。然而，还没有系统测试的VR方案可用于管理心理压力。我们的目标是评估一种新的技术范式InterReality在管理和预防心理压力方面的有效性。InterReality的主要特征是通过体验式虚拟场景(完全由治疗师控制，用于学习应对技能和提高自我效能)和使用先进技术(虚拟世界、可穿戴生物传感器和智能手机)进行实时监控和支持(识别危急情况和评估临床变化)，实现虚拟世界和现实世界之间的双重联系。这项研究被设计为一项随机分组对照试验，涉及121名参与者，他们来自两个高度暴露于心理压力的不同工作人群-教师和护士。参与者是在米兰招聘的教师样本(第1组：n=61)和在意大利梅西纳招聘的护士样本(第2组：n=60)。每个区块的参与者被随机分配到(1)试验组(EG)：n=40；B1=20，B2=20，接受基于交互现实范式的5周治疗；(2)对照组(CG)：n=42，B1=22，B2=20，接受基于认知行为疗法(CBT)的5周传统压力管理训练；(3)等待名单组(WL)：N=39，B1=19，B2=20，在初始评估5周后重新评估并与其他两组进行比较。尽管两种治疗方法都能比WL更好地显著减少感知到的压力，但只有EG参与者报告了慢性“特质”焦虑的显著减少(EG=12%比CG=0.5%)。在应对技能上也发现了类似的模式：两种治疗方法都能够显著提高大多数应对技能，但只有实验组参与者报告在情感支持技能方面有显著提高(EG=14%对CG=0.3%)。我们的发现提供了初步证据，表明交互现实方案产生的结果比传统上接受的心理压力治疗的黄金标准：CBT更好。因此，这些发现为今后继续研究技术强化的心理压力管理方案的重要性奠定了坚实的基础和理论基础。ClinicalTrials.gov：nct01683617；http://clinicaltrials.gov/show/NCT01683617(由网站http://www.webcitation.org/6QnziHv3h).存档
The recent convergence between technology and medicine is offering innovative methods and tools for behavioral health care. Among these, an emerging approach is the use of virtual reality (VR) within exposure-based protocols for anxiety disorders, and in particular posttraumatic stress disorder. However, no systematically tested VR protocols are available for the management of psychological stress. Our goal was to evaluate the efficacy of a new technological paradigm, Interreality, for the management and prevention of psychological stress. The main feature of Interreality is a twofold link between the virtual and the real world achieved through experiential virtual scenarios (fully controlled by the therapist, used to learn coping skills and improve self-efficacy) with real-time monitoring and support (identifying critical situations and assessing clinical change) using advanced technologies (virtual worlds, wearable biosensors, and smartphones). The study was designed as a block randomized controlled trial involving 121 participants recruited from two different worker populations—teachers and nurses—that are highly exposed to psychological stress. Participants were a sample of teachers recruited in Milan (Block 1: n=61) and a sample of nurses recruited in Messina, Italy (Block 2: n=60). Participants within each block were randomly assigned to the (1) Experimental Group (EG): n=40; B1=20, B2=20, which received a 5-week treatment based on the Interreality paradigm; (2) Control Group (CG): n=42; B1=22, B2=20, which received a 5-week traditional stress management training based on cognitive behavioral therapy (CBT); and (3) the Wait-List group (WL): n=39, B1=19, B2=20, which was reassessed and compared with the two other groups 5 weeks after the initial evaluation. Although both treatments were able to significantly reduce perceived stress better than WL, only EG participants reported a significant reduction (EG=12% vs CG=0.5%) in chronic “trait” anxiety. A similar pattern was found for coping skills: both treatments were able to significantly increase most coping skills, but only EG participants reported a significant increase (EG=14% vs CG=0.3%) in the Emotional Support skill. Our findings provide initial evidence that the Interreality protocol yields better outcomes than the traditionally accepted gold standard for psychological stress treatment: CBT. Consequently, these findings constitute a sound foundation and rationale for the importance of continuing future research in technology-enhanced protocols for psychological stress management. ClinicalTrials.gov: NCT01683617; http://clinicaltrials.gov/show/NCT01683617 (Archived by WebCite at http://www.webcitation.org/6QnziHv3h).
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影响因子：
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作者：
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通讯作者：
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