Mental health problems are inseparable from the environment. With virtual reality (VR), computer-generated interactive environments, individuals can repeatedly experience their problematic situations and be taught, via evidence-based psychological treatments, how to overcome difficulties. VR is moving out of specialist laboratories. Our central aim was to describe the potential of VR in mental health, including a consideration of the first 20 years of applications. A systematic review of empirical studies was conducted. In all, 285 studies were identified, with 86 concerning assessment, 45 theory development, and 154 treatment. The main disorders researched were anxiety (n = 192), schizophrenia (n = 44), substance-related disorders (n = 22) and eating disorders (n = 18). There are pioneering early studies, but the methodological quality of studies was generally low. The gaps in meaningful applications to mental health are extensive. The most established finding is that VR exposure-based treatments can reduce anxiety disorders, but there are numerous research and treatment avenues of promise. VR was found to be a much-misused term, often applied to non-interactive and non-immersive technologies. We conclude that VR has the potential to transform the assessment, understanding and treatment of mental health problems. The treatment possibilities will only be realized if - with the user experience at the heart of design - the best immersive VR technology is combined with targeted translational interventions. The capability of VR to simulate reality could greatly increase access to psychological therapies, while treatment outcomes could be enhanced by the technology's ability to create new realities. VR may merit the level of attention given to neuroimaging.

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Virtual reality in the assessment, understanding, and treatment of mental health disorders.

Following the idea of using virtual environments (VEs) as mood induction procedures (MIPs), this study set out to examine whether five different virtual park scenarios would each elicit a specific affective state (i.e., joy, sadness, boredom, anger and anxiety). Within this main objective, a subset of two additional goals was identified: first, to analyze whether the sense of presence would differ across emotionally charged VEs, and second, to examine the link between a more objective measure of affective arousal, electrodermal activity (EDA), and presence. Following a between-subject design, 120 students were randomly assigned to one of the five VEs. Results show that almost all of the five virtual park scenarios were able to elicit the intended emotion. Additionally, presence levels were the same across all VEs suggesting that presence did not confound the emotional reaction to the VEs. Furthermore, EDA seems to be a poor indicator of presence as it is not significantly correlated with self-reported presence. The implications of these findings for both future research and practice are addressed in a comprehensive discussion. Four virtual park scenarios elicited the intended emotional states.Presence levels were the same across different virtual environments.Skin conductance level seems to be a poor indicator of presence.

Is virtual reality emotionally arousing? Investigating five emotion inducing virtual park scenarios

http://diposit.ub.edu/dspace/bitstream/2445/153940/1/601098.pdf

The use of virtual reality in the study, assessment, and treatment of body image in eating disorders and nonclinical samples: a review of the literature.

Obesity and eating disorders are usually considered unrelated problems with different causes. However, various studies identify unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse), induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. But how might negative body image—common to most adolescents, not only to medical patients—be behind the development of obesity and eating disorders? In this paper, I review the “allocentric lock theory” of negative body image as the possible antecedent of both obesity and eating disorders. Evidence from psychology and neuroscience indicates that our bodily experience involves the integration of different sensory inputs within two different reference frames: egocentric (first-person experience) and allocentric (third-person experience). Even though functional relations between these two frames are usually limited, they influence each other during the interaction between long- and short-term memory processes in spatial cognition. If this process is impaired either through exogenous (e.g., stress) or endogenous causes, the egocentric sensory inputs are unable to update the contents of the stored allocentric representation of the body. In other words, these patients are locked in an allocentric (observer view) negative image of their body, which their sensory inputs are no longer able to update even after a demanding diet and a significant weight loss. This article discusses the possible role of virtual reality in addressing this problem within an integrated treatment approach based on the allocentric lock theory.

/pdf/the-key-to-unlocking-the-virtual-body-virtual-reality-in-the-3h7nltsh06.pdf

The Key to Unlocking the Virtual Body: Virtual Reality in the Treatment of Obesity and Eating Disorders

Can a virtual supermarket bring realism into the lab? Comparing shopping behavior using virtual and pictorial store representations to behavior in a physical store

Background: Many researchers and clinicians have proposed using virtual reality (VR) in adjunct to in vivo exposure therapy to provide an innovative form of exposure to patients suffering from different psychological disorders. The rationale behind the 'virtual approach' is that real and virtual exposures elicit a comparable emotional reaction in subjects, even if, to date, there are no experimental data that directly compare these two conditions. To test whether virtual stimuli are as effective as real stimuli, and more effective than photographs in the anxiety induction process, we tested the emotional reactions to real food (RF), virtual reality (VR) food and photographs (PH) of food in two samples of patients affected, respectively, by anorexia (AN) and bulimia nervosa (BN) compared to a group of healthy subjects. The two main hypotheses were the following: (a) the virtual exposure elicits emotional responses comparable to those produced by the real exposure; (b) the sense of presence induced by the VR immersion makes the virtual experience more ecological, and consequently more effective than static pictures in producing emotional responses in humans. Methods: In total, 10 AN, 10 BN and 10 healthy control subjects (CTR) were randomly exposed to three experimental conditions: RF, PH, and VR while their psychological (Stait Anxiety Inventory (STAI-S) and visual analogue scale for anxiety (VAS-A)) and physiological (heart rate, respiration rate, and skin conductance) responses were recorded. Results: RF and VR induced a comparable emotional reaction in patients higher than the one elicited by the PH condition. We also found a significant effect in the subjects' degree of presence experienced in the VR condition about their level of perceived anxiety (STAI-S and VAS-A): the higher the sense of presence, the stronger the level of anxiety. Conclusions: Even though preliminary, the present data show that VR is more effective than PH in eliciting emotional responses similar to those expected in real life situations. More generally, the present study suggests the potential of VR in a variety of experimental, training and clinical contexts, being its range of possibilities extremely wide and customizable. In particular, in a psychological perspective based on a cognitive behavioral approach, the use of VR enables the provision of specific contexts to help patients to cope with their diseases thanks to an easily controlled stimulation.

/pdf/assessment-of-the-emotional-responses-produced-by-exposure-2copg7sic0.pdf

Assessment of the emotional responses produced by exposure to real food, virtual food and photographs of food in patients affected by eating disorders

Real – time digestion of type I collagen molecules by bacterial collagenase from Clostridium histolyticum has been monitored using Dynamic Light Scattering method. Time dependencies for translation diffusion coefficient ( D t ) and hydrodynamic radius ( R H ) on were obtained for pure  “ collagen + collagenase” Tris–HCl buffer solution at different temperatures and for solutions with added CaCl 2 , ZnCl 2  and MgCl 2  and EDTA. It was shown that digestion of type I collagen molecules by bacterial collagenase is the first-order reaction. Reaction rate coefficients were calculated.

/pdf/influence-of-activators-and-inhibitors-on-the-collagenase-11j6t6bnjb.pdf

Influence of activators and inhibitors on the collagenase with collagen interaction monitored by dynamic light scattering in solutions

The pH dependences of the translational diffusion coefficient $$D_{t}$$
 and hydrodynamic radius $$R_{h}$$
 in buffer solutions of collagen and collagenase in the presence of calcium, zinc, and chromium ions have been studied using the method of dynamic light scattering. An insignificant influence of metal ions on the studied molecules has been revealed. The time dependences of $$D_{t}$$
 and $$R_{h}$$
 in solutions of collagen and collagenase in the presence of an activator (Ca
 $${}^{2+}$$
 ) and tanning agent (Cr
 $${}^{3+}$$
 ) are measured, and the rate constants of protein cleavage are calculated. It has been found that the addition of chromium ions slows the collagenolysis process by 70
 $$\%$$
 (or 3.3 times) (
 $$k_{1}=0.006$$
 min
 $${}^{-1}$$
 ), compared to pure solution collagen and collagenase (
 $$k_{1}=0.02$$
 min
 $${}^{-1}$$
 ). In turn, the presence of calcium ions accelerates the reaction by 250
 $$\%$$
 (or 3.5 times) (
 $$k_{1}=0.07$$
 min
 $${}^{-1}$$
 ). However, prechromated collagen is less susceptible to biodegradation by activated collagenase (
 $$k_{1}=0.009$$
 min
 $${}^{-1}$$
 ).

The Features of Interaction of Collagen and Collagenase Molecules in the Presence of Chromium and Calcium Ions in Solutions by Dynamic Light Scattering

Anna Petrova

Papers

Assessment of the emotional responses produced by exposure to real food, virtual food and photographs of food in patients affected by eating disorders

Influence of activators and inhibitors on the collagenase with collagen interaction monitored by dynamic light scattering in solutions

The Features of Interaction of Collagen and Collagenase Molecules in the Presence of Chromium and Calcium Ions in Solutions by Dynamic Light Scattering