Slide
Centre Interdisciplinaire
de Recherche et d’Innovation
en Cybersécurité et Société
de Recherche et d’Innovation
en Cybersécurité et Société
1.
Quintana, P.; Bouchard, S.; Botella, C.; Robillard, G.; Serrano, B.; Rodriguez-Ortega, A.; Ernst, M. Torp; Rey, B.; Berthiaume, M.; Corno, G.
In: Journal of Clinical Medicine, vol. 12, no. 13, 2023, ISSN: 20770383 (ISSN), (Publisher: Multidisciplinary Digital Publishing Institute (MDPI)).
Abstract | Links | BibTeX | Tags: adult, anxiety assessment, article, Canada, clinical article, controlled study, cultural differences, ecological validity, exposure, female, generalized social anxiety, human, immersion, male, multicenter study, psychotherapy, self report, social anxiety, social interaction, social phobia, Spain, virtual reality, virtual reality exposure therapy
@article{quintana_engaging_2023,
title = {Engaging in Awkward Social Interactions in a Virtual Environment Designed for Exposure-Based Psychotherapy for People with Generalized Social Anxiety Disorder: An International Multisite Study},
author = {P. Quintana and S. Bouchard and C. Botella and G. Robillard and B. Serrano and A. Rodriguez-Ortega and M. Torp Ernst and B. Rey and M. Berthiaume and G. Corno},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85165033932&doi=10.3390%2fjcm12134525&partnerID=40&md5=7b0f59b46ff7680611d5a64e18909651},
doi = {10.3390/jcm12134525},
issn = {20770383 (ISSN)},
year = {2023},
date = {2023-01-01},
journal = {Journal of Clinical Medicine},
volume = {12},
number = {13},
abstract = {The effectiveness of in virtuo exposure-based treatment of performance-only social anxiety disorder (SAD) has been demonstrated in several studies. However, few studies have validated virtual environments with participants suffering from generalized SAD. The goal of this study is to confirm the potential of a virtual environment in inducing anxiety in adults suffering from generalized SAD, compared to adults without SAD, when engaged in awkward social interactions. Differences between participants from two different countries were also explored. The sample consisted of 15 participants with SAD from Canada, 17 participants without SAD from Canada, 16 participants with SAD from Spain, and 21 participants without SAD from Spain. All participants were immersed in a control virtual environment and in an experimental virtual environment considered potentially anxiety-inducing for individuals with generalized SAD. As hypothesized, results showed that the experimental virtual environment induced a higher level of anxiety than the control environment among participants with SAD compared to those without SAD. The impact on anxiety of each socially threatening task performed during the experimental immersion was statistically significant. In terms of anxiety responses, no significant differences were found between participants from Canada and Spain. However, spatial presence and ecological validity were higher in Canadians than in Spaniards. Unwanted negative side effects induced by immersions in virtual reality were higher in the SAD group. This study highlights the importance for therapists to engage people with SAD in clinically relevant tasks while immersed in VR psychotherapeutic applications. © 2023 by the authors.},
note = {Publisher: Multidisciplinary Digital Publishing Institute (MDPI)},
keywords = {adult, anxiety assessment, article, Canada, clinical article, controlled study, cultural differences, ecological validity, exposure, female, generalized social anxiety, human, immersion, male, multicenter study, psychotherapy, self report, social anxiety, social interaction, social phobia, Spain, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
The effectiveness of in virtuo exposure-based treatment of performance-only social anxiety disorder (SAD) has been demonstrated in several studies. However, few studies have validated virtual environments with participants suffering from generalized SAD. The goal of this study is to confirm the potential of a virtual environment in inducing anxiety in adults suffering from generalized SAD, compared to adults without SAD, when engaged in awkward social interactions. Differences between participants from two different countries were also explored. The sample consisted of 15 participants with SAD from Canada, 17 participants without SAD from Canada, 16 participants with SAD from Spain, and 21 participants without SAD from Spain. All participants were immersed in a control virtual environment and in an experimental virtual environment considered potentially anxiety-inducing for individuals with generalized SAD. As hypothesized, results showed that the experimental virtual environment induced a higher level of anxiety than the control environment among participants with SAD compared to those without SAD. The impact on anxiety of each socially threatening task performed during the experimental immersion was statistically significant. In terms of anxiety responses, no significant differences were found between participants from Canada and Spain. However, spatial presence and ecological validity were higher in Canadians than in Spaniards. Unwanted negative side effects induced by immersions in virtual reality were higher in the SAD group. This study highlights the importance for therapists to engage people with SAD in clinically relevant tasks while immersed in VR psychotherapeutic applications. © 2023 by the authors.
2.
Scholten, W.; Seldenrijk, A.; Hoogendoorn, A.; Bosman, R.; Muntingh, A.; Karyotaki, E.; Andersson, G.; Berger, T.; Carlbring, P.; Furmark, T.; Bouchard, S.; Goldin, P.; Kampmann, I.; Morina, N.; Kocovski, N.; Leibing, E.; Leichsenring, F.; Stolz, T.; Balkom, A. Van; Batelaan, N.
In: JAMA Psychiatry, vol. 80, no. 8, pp. 822–831, 2023, ISSN: 2168622X (ISSN), (Publisher: American Medical Association).
Abstract | Links | BibTeX | Tags: adult, antidepressant agent, Anxiety disorder, article, avoidant personality disorder, clinical outcome, cognitive behavioral therapy, comorbidity, cycloserine, Depression, disease severity, female, hospital admission, human, Humans, Liebowitz Social Anxiety Scale, male, meta analysis, paroxetine, phobia, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, procedures, psychotropic agent, randomized controlled trial (topic), Randomized Controlled Trials as Topic, semi structured interview, Social, social anxiety, social phobia, Structured Clinical Interview for DSM Disorders, symptom, systematic review, treatment response, Waiting Lists
@article{scholten_baseline_2023,
title = {Baseline Severity as a Moderator of the Waiting List-Controlled Association of Cognitive Behavioral Therapy with Symptom Change in Social Anxiety Disorder: A Systematic Review and Individual Patient Data Meta-analysis},
author = {W. Scholten and A. Seldenrijk and A. Hoogendoorn and R. Bosman and A. Muntingh and E. Karyotaki and G. Andersson and T. Berger and P. Carlbring and T. Furmark and S. Bouchard and P. Goldin and I. Kampmann and N. Morina and N. Kocovski and E. Leibing and F. Leichsenring and T. Stolz and A. Van Balkom and N. Batelaan},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166386036&doi=10.1001%2fjamapsychiatry.2023.1291&partnerID=40&md5=c279c8b0ff2d3b4558c6f8803cdda0af},
doi = {10.1001/jamapsychiatry.2023.1291},
issn = {2168622X (ISSN)},
year = {2023},
date = {2023-01-01},
journal = {JAMA Psychiatry},
volume = {80},
number = {8},
pages = {822–831},
abstract = {Importance: Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. Objective: To examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD. Data Sources: For this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial. Study Selection: Inclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD. Data Extraction and Synthesis: Authors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models. Main Outcomes and Measures: The main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS. Results: A total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list-controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = -20.3; 95% CI, -24.9 to -15.6; P <.001; Cohen d = -0.95; 95% CI, -1.16 to -0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = -0.22; 95% CI, -0.39 to -0.06; P =.009), indicating that individuals with severe symptoms had larger waiting list-controlled symptom reductions after CBT (Cohen d = -1.13 [95% CI, -1.39 to -0.88] for patients with very severe SAD; Cohen d = -0.54 [95% CI, -0.80 to -0.29] for patients with mild SAD). Conclusions and Relevance: In this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.. © 2023 American Medical Association. All rights reserved.},
note = {Publisher: American Medical Association},
keywords = {adult, antidepressant agent, Anxiety disorder, article, avoidant personality disorder, clinical outcome, cognitive behavioral therapy, comorbidity, cycloserine, Depression, disease severity, female, hospital admission, human, Humans, Liebowitz Social Anxiety Scale, male, meta analysis, paroxetine, phobia, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, procedures, psychotropic agent, randomized controlled trial (topic), Randomized Controlled Trials as Topic, semi structured interview, Social, social anxiety, social phobia, Structured Clinical Interview for DSM Disorders, symptom, systematic review, treatment response, Waiting Lists},
pubstate = {published},
tppubtype = {article}
}
Importance: Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. Objective: To examine baseline SAD symptom severity as a moderator of the association between CBT and symptom change in patients with SAD. Data Sources: For this systematic review and individual patient data meta-analysis (IPDMA), PubMed, PsycInfo, Embase, and the Cochrane Library were searched from January 1, 1990, to January 13, 2023. Primary search topics were social anxiety disorder, cognitive behavior therapy, and randomized controlled trial. Study Selection: Inclusion criteria were randomized clinical trials comparing CBT with being on a waiting list and using the Liebowitz Social Anxiety Scale (LSAS) in adults with a primary clinical diagnosis of SAD. Data Extraction and Synthesis: Authors of included studies were approached to provide individual-level data. Data were extracted by pairs of authors following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and risk of bias was assessed using the Cochrane tool. An IPDMA was conducted using a 2-stage approach for the association of CBT with change in LSAS scores from baseline to posttreatment and for the interaction effect of baseline LSAS score by condition using random-effects models. Main Outcomes and Measures: The main outcome was the baseline to posttreatment change in symptom severity measured by the LSAS. Results: A total of 12 studies including 1246 patients with SAD (mean [SD] age, 35.3 [10.9] years; 738 [59.2%] female) were included in the meta-analysis. A waiting list-controlled association between CBT and pretreatment to posttreatment LSAS change was found (b = -20.3; 95% CI, -24.9 to -15.6; P <.001; Cohen d = -0.95; 95% CI, -1.16 to -0.73). Baseline LSAS scores moderated the differences between CBT and waiting list with respect to pretreatment to posttreatment symptom reductions (b = -0.22; 95% CI, -0.39 to -0.06; P =.009), indicating that individuals with severe symptoms had larger waiting list-controlled symptom reductions after CBT (Cohen d = -1.13 [95% CI, -1.39 to -0.88] for patients with very severe SAD; Cohen d = -0.54 [95% CI, -0.80 to -0.29] for patients with mild SAD). Conclusions and Relevance: In this systematic review and IPDMA, higher baseline SAD symptom severity was associated with greater (absolute but not relative) symptom reductions after CBT in patients with SAD. The findings contribute to personalized care by suggesting that clinicians can confidently offer CBT to individuals with severe SAD symptoms.. © 2023 American Medical Association. All rights reserved.
3.
Ørskov, P. T.; Lichtenstein, M. B.; Ernst, M. T.; Fasterholdt, I.; Matthiesen, A. F.; Scirea, M.; Bouchard, S.; Andersen, T. E.
In: Frontiers in Psychiatry, vol. 13, 2022, ISSN: 16640640 (ISSN), (Publisher: Frontiers Media S.A.).
Abstract | Links | BibTeX | Tags: adult, aged, Alcohol Use Disorders Identification Test, anxiety assessment, Anxiety disorder, article, behavior disorder assessment, cognitive behavioral therapy, comparative effectiveness, controlled study, Depression, Drug Use Disorders Identification Test, electrodermal activity, exposure, Fear of Negative Evaluation, follow up, health economics, Heart Rate, human, Leibowitz Anxiety Scale, Machine learning, major clinical study, psychological distress assessment, psychophysiological measurements, randomized controlled trial, Simulator Sickness Questionnaire, social anxiety, Social Interaction Anxiety Scale, social phobia, Subjective Units of Distress Scale, therapy effect, treatment duration, treatment outcome, virtual reality, virtual reality exposure therapy, Working Alliance Inventory
@article{orskov_cognitive_2022,
title = {Cognitive behavioral therapy with adaptive virtual reality exposure vs. cognitive behavioral therapy with in vivo exposure in the treatment of social anxiety disorder: A study protocol for a randomized controlled trial},
author = {P. T. Ørskov and M. B. Lichtenstein and M. T. Ernst and I. Fasterholdt and A. F. Matthiesen and M. Scirea and S. Bouchard and T. E. Andersen},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140322564&doi=10.3389%2ffpsyt.2022.991755&partnerID=40&md5=1dacd4e05081f4790ccd5e0d7224e0ca},
doi = {10.3389/fpsyt.2022.991755},
issn = {16640640 (ISSN)},
year = {2022},
date = {2022-01-01},
journal = {Frontiers in Psychiatry},
volume = {13},
abstract = {Background: Social anxiety disorder (SAD) has a high prevalence and an early onset with recovery taking decades to occur. Current evidence supports the efficacy of cognitive behavioral therapy (CBT) with virtual reality (VR) exposure. However, the evidence is based on a sparse number of studies with predominantly small sample sizes. There is a need for more trials investigating the optimal way of applying VR based exposure for SAD. In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants's anxiety level. Methods: The trial is a randomized controlled, assessor-blinded, parallel-group superiority trail. The study has two arms: (1) CBT including exposure in vivo (CBT-Exp), (2) CBT including exposure therapy using individually tailored VR-content and a system to track anxiety levels (CBT-ExpVR). Treatment is individual, manual-based and consists of 10 weekly sessions with a duration of 60 min. The study includes 90 participants diagnosed with SAD. Assessments are carried out pre-treatment, mid-treatment and at follow-up (6 and 12 months). The primary outcome is the mean score on the Social Interaction Anxiety Scale (SIAS) with the primary endpoint being post-treatment. Discussion: The study adds to the existing knowledge by assessing the efficacy of CBT with adaptive VR exposure. The study has high methodological rigor using a randomized controlled trial with a large sample size that includes follow-up data and validated measures for social anxiety outcomes. Clinical trial registration: ClinicalTrials.gov, identifier: NCT05302518. Copyright © 2022 Ørskov, Lichtenstein, Ernst, Fasterholdt, Matthiesen, Scirea, Bouchard and Andersen.},
note = {Publisher: Frontiers Media S.A.},
keywords = {adult, aged, Alcohol Use Disorders Identification Test, anxiety assessment, Anxiety disorder, article, behavior disorder assessment, cognitive behavioral therapy, comparative effectiveness, controlled study, Depression, Drug Use Disorders Identification Test, electrodermal activity, exposure, Fear of Negative Evaluation, follow up, health economics, Heart Rate, human, Leibowitz Anxiety Scale, Machine learning, major clinical study, psychological distress assessment, psychophysiological measurements, randomized controlled trial, Simulator Sickness Questionnaire, social anxiety, Social Interaction Anxiety Scale, social phobia, Subjective Units of Distress Scale, therapy effect, treatment duration, treatment outcome, virtual reality, virtual reality exposure therapy, Working Alliance Inventory},
pubstate = {published},
tppubtype = {article}
}
Background: Social anxiety disorder (SAD) has a high prevalence and an early onset with recovery taking decades to occur. Current evidence supports the efficacy of cognitive behavioral therapy (CBT) with virtual reality (VR) exposure. However, the evidence is based on a sparse number of studies with predominantly small sample sizes. There is a need for more trials investigating the optimal way of applying VR based exposure for SAD. In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants's anxiety level. Methods: The trial is a randomized controlled, assessor-blinded, parallel-group superiority trail. The study has two arms: (1) CBT including exposure in vivo (CBT-Exp), (2) CBT including exposure therapy using individually tailored VR-content and a system to track anxiety levels (CBT-ExpVR). Treatment is individual, manual-based and consists of 10 weekly sessions with a duration of 60 min. The study includes 90 participants diagnosed with SAD. Assessments are carried out pre-treatment, mid-treatment and at follow-up (6 and 12 months). The primary outcome is the mean score on the Social Interaction Anxiety Scale (SIAS) with the primary endpoint being post-treatment. Discussion: The study adds to the existing knowledge by assessing the efficacy of CBT with adaptive VR exposure. The study has high methodological rigor using a randomized controlled trial with a large sample size that includes follow-up data and validated measures for social anxiety outcomes. Clinical trial registration: ClinicalTrials.gov, identifier: NCT05302518. Copyright © 2022 Ørskov, Lichtenstein, Ernst, Fasterholdt, Matthiesen, Scirea, Bouchard and Andersen.
4.
Clemmensen, L.; Bouchard, S.; Rasmussen, J.; Holmberg, T. T.; Nielsen, J. H.; Jepsen, J. R. Mø.; Lichtenstein, M. B.
In: BMC Psychiatry, vol. 20, no. 1, 2020, ISSN: 1471244X, (Publisher: BioMed Central).
Abstract | Links | BibTeX | Tags: adult, Anxiety, article, clinical effectiveness, cognitive behavioral therapy, controlled study, exposure, follow up, health program, human, Humans, in vivo study, outcome assessment, phobia, psychologist, questionnaire, randomized controlled trial, relaxation training, Social, Social Interaction Anxiety Scale, social phobia, treatment outcome, virtual reality, virtual reality exposure therapy, Young Adult
@article{clemmensen_study_2020,
title = {Study protocol: Exposure in virtual reality for social anxiety disorder-a randomized controlled superiority trial comparing cognitive behavioral therapy with virtual reality based exposure to cognitive behavioral therapy with in vivo exposure},
author = {L. Clemmensen and S. Bouchard and J. Rasmussen and T. T. Holmberg and J. H. Nielsen and J. R. Mø. Jepsen and M. B. Lichtenstein},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85078711155&doi=10.1186%2fs12888-020-2453-4&partnerID=40&md5=28b076f10bf189f7c90b8bed4c719200},
doi = {10.1186/s12888-020-2453-4},
issn = {1471244X},
year = {2020},
date = {2020-01-01},
journal = {BMC Psychiatry},
volume = {20},
number = {1},
abstract = {Background: Social Anxiety Disorder (SAD) is characterized by an intense fear of negative judgement by others. Cognitive Behavioral Therapy (CBT) is recommended for treatment, but a substantial part of individuals with SAD either do not seek treatment or drop-out. CBT with Virtual Reality (VR)-based exposure has several advantages compared to traditional exposure methods, mainly due to increased control of situational elements. The aim of the current study is to develop a CBT program containing VR-based exposure. The intervention is targeted to adult patients suffering from SAD and treatment effect will be assessed by changes in SAD symptoms. Methods: This article describes the study protocol of a Randomized Controlled Trial with three arms: 1) CBT with VR exposure based on 360° videos 2) CBT with in vivo exposure and 3) VR relaxation therapy. There will be 30 participants in each arm with a crossover at the end of the treatment period during which the participants in the third group will be randomly re-Allocated to one of the two former groups. The treatment program consists of 10 weekly individual sessions with a psychologist, and a six month follow-up consisting of a questionnaire. The primary outcome measure is reduction in SAD symptoms which will be assessed with the Social Interaction Anxiety Scale (SIAS). Discussion: There are currently no published studies on CBT with VR exposure based on 360° videos for SAD treatment. Furthermore, the current study will be the first Danish SAD treatment program that includes VR technology. Trial registration: clinicaltrials.gov (NCT03973541) June 3rd 2019. © 2020 The Author(s).},
note = {Publisher: BioMed Central},
keywords = {adult, Anxiety, article, clinical effectiveness, cognitive behavioral therapy, controlled study, exposure, follow up, health program, human, Humans, in vivo study, outcome assessment, phobia, psychologist, questionnaire, randomized controlled trial, relaxation training, Social, Social Interaction Anxiety Scale, social phobia, treatment outcome, virtual reality, virtual reality exposure therapy, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Background: Social Anxiety Disorder (SAD) is characterized by an intense fear of negative judgement by others. Cognitive Behavioral Therapy (CBT) is recommended for treatment, but a substantial part of individuals with SAD either do not seek treatment or drop-out. CBT with Virtual Reality (VR)-based exposure has several advantages compared to traditional exposure methods, mainly due to increased control of situational elements. The aim of the current study is to develop a CBT program containing VR-based exposure. The intervention is targeted to adult patients suffering from SAD and treatment effect will be assessed by changes in SAD symptoms. Methods: This article describes the study protocol of a Randomized Controlled Trial with three arms: 1) CBT with VR exposure based on 360° videos 2) CBT with in vivo exposure and 3) VR relaxation therapy. There will be 30 participants in each arm with a crossover at the end of the treatment period during which the participants in the third group will be randomly re-Allocated to one of the two former groups. The treatment program consists of 10 weekly individual sessions with a psychologist, and a six month follow-up consisting of a questionnaire. The primary outcome measure is reduction in SAD symptoms which will be assessed with the Social Interaction Anxiety Scale (SIAS). Discussion: There are currently no published studies on CBT with VR exposure based on 360° videos for SAD treatment. Furthermore, the current study will be the first Danish SAD treatment program that includes VR technology. Trial registration: clinicaltrials.gov (NCT03973541) June 3rd 2019. © 2020 The Author(s).
5.
Jacques, C.; Cloutier, V.; Bouchard, S.
In: Annual Review of CyberTherapy and Telemedicine, vol. 2018, no. 16, pp. 148–152, 2018, ISSN: 15548716, (Publisher: Interactive Media Institute).
Abstract | Links | BibTeX | Tags: adult, article, autism, human, male, pilot study, psychoeducation, social cognition, social competence, social interaction, social interaction test, social learning, social phobia, virtual reality
@article{jacques_decoding_2018,
title = {The “Decoding of social interactions in virtual reality” tasks for autism spectrum people: Development of an intervention protocol and pilot testing},
author = {C. Jacques and V. Cloutier and S. Bouchard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85067871545&partnerID=40&md5=e33888550b28cf41db490b1f1d716097},
issn = {15548716},
year = {2018},
date = {2018-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {2018},
number = {16},
pages = {148–152},
abstract = {Virtual reality (VR) could provide an opportunity to engage people with autism in complex social interactions and improve their social skills. Our team developed a psychoeducationl program, named the Decoding Social Interaction Task in VR (DSITinVR), and this pilot study aims at exploring whether people with autism can improve their social cognition with DSITinVR as well as improving their social skills. Three AS adult males without intellectual disability were immersed in a 6-wall CAVE-Like system. Pre-and post-application of the program was assessed by the interviewer, participants and parents to document social decoding, social skills and social anxiety. Following exposition to DSITinVR, participants showed improvement in decoding social interactive situations. However, they showed less change in social skills and social anxiety. Based on the assessment of participants, parents and the interviewer, suggestions for modifying the program are proposed, including more situations dedicated to social-skills teaching, planned practice of skills between sessions, and reframing increase in awareness to avoid sensitization. © 2018, Interactive Media Institute. All rights reserved.},
note = {Publisher: Interactive Media Institute},
keywords = {adult, article, autism, human, male, pilot study, psychoeducation, social cognition, social competence, social interaction, social interaction test, social learning, social phobia, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Virtual reality (VR) could provide an opportunity to engage people with autism in complex social interactions and improve their social skills. Our team developed a psychoeducationl program, named the Decoding Social Interaction Task in VR (DSITinVR), and this pilot study aims at exploring whether people with autism can improve their social cognition with DSITinVR as well as improving their social skills. Three AS adult males without intellectual disability were immersed in a 6-wall CAVE-Like system. Pre-and post-application of the program was assessed by the interviewer, participants and parents to document social decoding, social skills and social anxiety. Following exposition to DSITinVR, participants showed improvement in decoding social interactive situations. However, they showed less change in social skills and social anxiety. Based on the assessment of participants, parents and the interviewer, suggestions for modifying the program are proposed, including more situations dedicated to social-skills teaching, planned practice of skills between sessions, and reframing increase in awareness to avoid sensitization. © 2018, Interactive Media Institute. All rights reserved.
6.
Bouchard, S.
Author’s reply: Journal Article
In: British Journal of Psychiatry, vol. 213, no. 4, pp. 617, 2018, ISSN: 00071250 (ISSN), (Publisher: Cambridge University Press).
Links | BibTeX | Tags: cost effectiveness analysis, gold standard, hospital admission, human, Humans, letter, Liebowitz Social Anxiety Scale, phobia, self report, Social, social phobia, speech, virtual reality
@article{bouchard_authors_2018,
title = {Author’s reply:},
author = {S. Bouchard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85054728668&doi=10.1192%2fbjp.2018.192&partnerID=40&md5=11905e8a9bb8578e1df964a26b9930d4},
doi = {10.1192/bjp.2018.192},
issn = {00071250 (ISSN)},
year = {2018},
date = {2018-01-01},
journal = {British Journal of Psychiatry},
volume = {213},
number = {4},
pages = {617},
note = {Publisher: Cambridge University Press},
keywords = {cost effectiveness analysis, gold standard, hospital admission, human, Humans, letter, Liebowitz Social Anxiety Scale, phobia, self report, Social, social phobia, speech, virtual reality},
pubstate = {published},
tppubtype = {article}
}
7.
Ikic, V.; Bélanger, C.; Bouchard, S.; Gosselin, P.; Langlois, F.; Labrecque, J.; Dugas, M. J.; Marchand, A.
Reduction in costs after treating comorbid panic disorder with agoraphobia and generalized anxiety disorder Journal Article
In: Journal of Mental Health Policy and Economics, vol. 20, no. 1, pp. 11–20, 2017, ISSN: 10914358, (Publisher: ICMPE).
Abstract | Links | BibTeX | Tags: adult, agoraphobia, Anxiety disorder, Anxiety Disorders, article, cognitive behavioral therapy, cognitive therapy, comorbidity, controlled study, dysthymia, economics, female, follow up, generalized anxiety disorder, health care cost, Health Care Costs, human, Humans, major clinical study, major depression, male, Mental health, obsessive compulsive disorder, panic, Panic Disorder, phobia, posttraumatic stress disorder, procedures, Quebec, social phobia, statistics and numerical data
@article{ikic_reduction_2017,
title = {Reduction in costs after treating comorbid panic disorder with agoraphobia and generalized anxiety disorder},
author = {V. Ikic and C. Bélanger and S. Bouchard and P. Gosselin and F. Langlois and J. Labrecque and M. J. Dugas and A. Marchand},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85018690998&partnerID=40&md5=0d0600e6dd4e2a381f733ac063d639dc},
issn = {10914358},
year = {2017},
date = {2017-01-01},
journal = {Journal of Mental Health Policy and Economics},
volume = {20},
number = {1},
pages = {11–20},
abstract = {Background: Panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) are impairing and costly disorders that are often misdiagnosed and left untreated despite multiple consultations. These disorders frequently co-occur, but little is known about the costs associated with their comorbidity and the impact of cognitive-behavioral therapy (CBT) on cost reduction. Aims of the Study: The first objective of this study was to assess the mental health-related costs associated with the specific concomitance of PDA and GAD. The second aim was to determine whether there is a reduction in direct and indirect mental healthrelated costs following conventional CBT for the primary disorder only (PDA or GAD) or combined CBT adapted to the comorbidity (PDA and GAD). Methods: A total of 123 participants with a double diagnosis of PDA and GAD participated in this study. Direct and indirect mental health-related costs were assessed and calculated from a societal perspective at the pre-Test, the post-Test, and the three-month, sixmonth and one-year follow-ups. Results: At the pre-Test, PDA-GAD comorbidity was found to generate a mean total cost of CAD2,000.48 (SD = 2,069.62) per participant over a three-month period. The indirect costs were much higher than the direct costs. Both treatment modalities led to significant and similar decreases in all cost categories from the pretest to the post-Test. This reduction was maintained until the oneyear follow-up. Discussion: Methodological choices may have underestimated cost evaluations. Nonetheless, this study supports the cost offset effects of both conventional CBT for primary PDA or GAD and combined CBT for PDA-GAD comorbidity. Implications for Healthcare Provision and Use: Treatment of comorbid and costly disorders with evidence-based treatments such as CBT may lead to considerable economic benefits for society. Implications for Health Policies: Considering the limited resources of healthcare systems, it is important to make choices that will lead to better accessibility of quality services. The application of CBT for PDA, GAD or both disorders and training mental health professionals in this therapeutic approach should be encouraged. Additionally, it would be favorable for insurance plans to reimburse employees for expenses associated with psychological treatment for anxiety disorders. Implications for Further Research: In addition to symptom reduction, it would be of great pertinence to explore which factors can contribute to reducing direct and indirect mental health-related costs. © 2017 ICMPE.},
note = {Publisher: ICMPE},
keywords = {adult, agoraphobia, Anxiety disorder, Anxiety Disorders, article, cognitive behavioral therapy, cognitive therapy, comorbidity, controlled study, dysthymia, economics, female, follow up, generalized anxiety disorder, health care cost, Health Care Costs, human, Humans, major clinical study, major depression, male, Mental health, obsessive compulsive disorder, panic, Panic Disorder, phobia, posttraumatic stress disorder, procedures, Quebec, social phobia, statistics and numerical data},
pubstate = {published},
tppubtype = {article}
}
Background: Panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) are impairing and costly disorders that are often misdiagnosed and left untreated despite multiple consultations. These disorders frequently co-occur, but little is known about the costs associated with their comorbidity and the impact of cognitive-behavioral therapy (CBT) on cost reduction. Aims of the Study: The first objective of this study was to assess the mental health-related costs associated with the specific concomitance of PDA and GAD. The second aim was to determine whether there is a reduction in direct and indirect mental healthrelated costs following conventional CBT for the primary disorder only (PDA or GAD) or combined CBT adapted to the comorbidity (PDA and GAD). Methods: A total of 123 participants with a double diagnosis of PDA and GAD participated in this study. Direct and indirect mental health-related costs were assessed and calculated from a societal perspective at the pre-Test, the post-Test, and the three-month, sixmonth and one-year follow-ups. Results: At the pre-Test, PDA-GAD comorbidity was found to generate a mean total cost of CAD2,000.48 (SD = 2,069.62) per participant over a three-month period. The indirect costs were much higher than the direct costs. Both treatment modalities led to significant and similar decreases in all cost categories from the pretest to the post-Test. This reduction was maintained until the oneyear follow-up. Discussion: Methodological choices may have underestimated cost evaluations. Nonetheless, this study supports the cost offset effects of both conventional CBT for primary PDA or GAD and combined CBT for PDA-GAD comorbidity. Implications for Healthcare Provision and Use: Treatment of comorbid and costly disorders with evidence-based treatments such as CBT may lead to considerable economic benefits for society. Implications for Health Policies: Considering the limited resources of healthcare systems, it is important to make choices that will lead to better accessibility of quality services. The application of CBT for PDA, GAD or both disorders and training mental health professionals in this therapeutic approach should be encouraged. Additionally, it would be favorable for insurance plans to reimburse employees for expenses associated with psychological treatment for anxiety disorders. Implications for Further Research: In addition to symptom reduction, it would be of great pertinence to explore which factors can contribute to reducing direct and indirect mental health-related costs. © 2017 ICMPE.
8.
Bouchard, S.; Dumoulin, S.; Robillard, G.; Guitard, T.; Klinger, E.; Forget, H.; Loranger, C.; Roucaut, F. X.
Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: A three-arm randomised controlled trial Journal Article
In: British Journal of Psychiatry, vol. 210, no. 4, pp. 276–283, 2017, ISSN: 00071250, (Publisher: Royal College of Psychiatrists).
Abstract | Links | BibTeX | Tags: adult, article, avoidance behavior, clinical outcome, cognitive therapy, comparative effectiveness, comparative study, computer interface, controlled study, cost, devices, female, hospital admission, human, Humans, Implosive Therapy, in vivo study, major clinical study, male, Middle Aged, outcome assessment, Outcome Assessment (Health Care), phobia, procedures, randomized controlled trial, Social, social phobia, User-Computer Interface, virtual reality, virtual reality exposure therapy
@article{bouchard_virtual_2017,
title = {Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: A three-arm randomised controlled trial},
author = {S. Bouchard and S. Dumoulin and G. Robillard and T. Guitard and E. Klinger and H. Forget and C. Loranger and F. X. Roucaut},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85018214603&doi=10.1192%2fbjp.bp.116.184234&partnerID=40&md5=245751bf4ef3f8ae014a9c5816a585c3},
doi = {10.1192/bjp.bp.116.184234},
issn = {00071250},
year = {2017},
date = {2017-01-01},
journal = {British Journal of Psychiatry},
volume = {210},
number = {4},
pages = {276–283},
abstract = {Background: People with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive-behavioural therapy (CBT), could be an answer. Aims: To show that conducting VR exposure in CBT for SAD is effective and is more practical for therapists than conducting exposure in vivo. Method: Participants were randomly assigned to either VR exposure (n =17), in vivo exposure (n=22) or waiting list (n= 20). Participants in the active arms received individual CBT for 14 weekly sessions and outcome was assessed with questionnaires and a behaviour avoidance test. (Trial registration number ISRCTN99747069.) Results: Improvements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list. Conducting exposure in VR was more effective at post-treatment than in vivo on the primary outcome measure and on one secondary measure. Improvements were maintained at the 6-month follow-up. VR was significantly more practical for therapists than in vivo exposure. Conclusions: Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure. Declaration of interest S.B. and G.R. are consultants to and own equity in Cliniques et Développement In Virtuo, which develops virtual environments; however, Cliniques et Développement In Virtuo did not create the virtual environments used in this study. The terms of these arrangements were reviewed and approved by Universitédu Québec en Outaouais, in accordance with its policy on conflicts of interest. © The Royal College of Psychiatrists 2017.},
note = {Publisher: Royal College of Psychiatrists},
keywords = {adult, article, avoidance behavior, clinical outcome, cognitive therapy, comparative effectiveness, comparative study, computer interface, controlled study, cost, devices, female, hospital admission, human, Humans, Implosive Therapy, in vivo study, major clinical study, male, Middle Aged, outcome assessment, Outcome Assessment (Health Care), phobia, procedures, randomized controlled trial, Social, social phobia, User-Computer Interface, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Background: People with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive-behavioural therapy (CBT), could be an answer. Aims: To show that conducting VR exposure in CBT for SAD is effective and is more practical for therapists than conducting exposure in vivo. Method: Participants were randomly assigned to either VR exposure (n =17), in vivo exposure (n=22) or waiting list (n= 20). Participants in the active arms received individual CBT for 14 weekly sessions and outcome was assessed with questionnaires and a behaviour avoidance test. (Trial registration number ISRCTN99747069.) Results: Improvements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list. Conducting exposure in VR was more effective at post-treatment than in vivo on the primary outcome measure and on one secondary measure. Improvements were maintained at the 6-month follow-up. VR was significantly more practical for therapists than in vivo exposure. Conclusions: Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure. Declaration of interest S.B. and G.R. are consultants to and own equity in Cliniques et Développement In Virtuo, which develops virtual environments; however, Cliniques et Développement In Virtuo did not create the virtual environments used in this study. The terms of these arrangements were reviewed and approved by Universitédu Québec en Outaouais, in accordance with its policy on conflicts of interest. © The Royal College of Psychiatrists 2017.
9.
Baus, O.; Bouchard, S.
Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: A review Journal Article
In: Frontiers in Human Neuroscience, vol. 8, no. MAR, 2014, ISSN: 16625161, (Publisher: Frontiers Media S. A.).
Abstract | Links | BibTeX | Tags: augmented reality exposure based therapy, behavior therapy, clinical effectiveness, Fear, history of medicine, human, intermethod comparison, phobia, review, safety, social phobia, virtual reality, virtual reality exposure therapy
@article{baus_moving_2014,
title = {Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: A review},
author = {O. Baus and S. Bouchard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84897016348&doi=10.3389%2ffnhum.2014.00112&partnerID=40&md5=daae74386678a753194f5b127b852140},
doi = {10.3389/fnhum.2014.00112},
issn = {16625161},
year = {2014},
date = {2014-01-01},
journal = {Frontiers in Human Neuroscience},
volume = {8},
number = {MAR},
abstract = {This paper reviews the move from virtual reality exposure-based therapy to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although, the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the twentieth century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed safely to the object(s) of their fear, without the costs associated with programing complete VEs. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper covers some less well-known aspects of the history of AR, raises some ARET related issues, and proposes potential avenues to be followed. These include the type of measures to be used to qualify the user's experience in an augmented reality environment, the exclusion of certain AR-type functionalities from the definition of AR, as well as the potential use of ARET to treat non-small animal phobias, such as social phobia. © 2014 Baus and Bouchard.},
note = {Publisher: Frontiers Media S. A.},
keywords = {augmented reality exposure based therapy, behavior therapy, clinical effectiveness, Fear, history of medicine, human, intermethod comparison, phobia, review, safety, social phobia, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
This paper reviews the move from virtual reality exposure-based therapy to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although, the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the twentieth century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed safely to the object(s) of their fear, without the costs associated with programing complete VEs. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper covers some less well-known aspects of the history of AR, raises some ARET related issues, and proposes potential avenues to be followed. These include the type of measures to be used to qualify the user's experience in an augmented reality environment, the exclusion of certain AR-type functionalities from the definition of AR, as well as the potential use of ARET to treat non-small animal phobias, such as social phobia. © 2014 Baus and Bouchard.
10.
Katzman, M. A.; Bleau, P.; Blier, P.; Chokka, P.; Kjernisted, K.; Ameringen, M. Van; Antony, M. M.; Bouchard, S.; Brunet, A.; Flament, M.; Rabheru, K.; Grigoriadis, S.; Richter, P. M. A.; Mendlowitz, S.; O'Connor, K.; Robichaud, M.; Walker, J. R.; Asmundson, G.; Klassen, L. R.; Lam, R. W.; McIntyre, R. S.; Szpindel, I.
Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders Journal Article
In: BMC Psychiatry, vol. 14, no. SUPPL.1, 2014, ISSN: 1471244X (ISSN), (Publisher: BioMed Central Ltd.).
Abstract | Links | BibTeX | Tags: agoraphobia, Anxiety disorder, Anxiety Disorders, benzodiazepine derivative, buspirone, Canada, clinical trial, clomipramine, comorbidity, duloxetine, escitalopram, fluoxetine, fluvoxamine, fluvoxamine maleate, GAD, generalized anxiety disorder, guidelines, human, Humans, obsessive compulsive disorder, Obsessive-Compulsive Disorder, OCD, panic, Panic Disorder, paroxetine, periodic medical examination, pharmacotherapy, Post-Traumatic, posttraumatic stress disorder, practice guideline, Practice Guidelines as Topic, psychotherapy, PTSD, recommendations, review, sertraline, social anxiety disorder, social phobia, special populations, Specific phobia, Stress Disorders, venlafaxine
@article{katzman_canadian_2014,
title = {Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders},
author = {M. A. Katzman and P. Bleau and P. Blier and P. Chokka and K. Kjernisted and M. Van Ameringen and M. M. Antony and S. Bouchard and A. Brunet and M. Flament and K. Rabheru and S. Grigoriadis and P. M. A. Richter and S. Mendlowitz and K. O'Connor and M. Robichaud and J. R. Walker and G. Asmundson and L. R. Klassen and R. W. Lam and R. S. McIntyre and I. Szpindel},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84903778611&doi=10.1186%2f1471-244X-14-S1-S1&partnerID=40&md5=4787fc6f97c204c1428770a5e4a57a00},
doi = {10.1186/1471-244X-14-S1-S1},
issn = {1471244X (ISSN)},
year = {2014},
date = {2014-01-01},
journal = {BMC Psychiatry},
volume = {14},
number = {SUPPL.1},
abstract = {Background: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.Methods: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.Results: These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Conclusions: Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. © 2014 Katzman et al.},
note = {Publisher: BioMed Central Ltd.},
keywords = {agoraphobia, Anxiety disorder, Anxiety Disorders, benzodiazepine derivative, buspirone, Canada, clinical trial, clomipramine, comorbidity, duloxetine, escitalopram, fluoxetine, fluvoxamine, fluvoxamine maleate, GAD, generalized anxiety disorder, guidelines, human, Humans, obsessive compulsive disorder, Obsessive-Compulsive Disorder, OCD, panic, Panic Disorder, paroxetine, periodic medical examination, pharmacotherapy, Post-Traumatic, posttraumatic stress disorder, practice guideline, Practice Guidelines as Topic, psychotherapy, PTSD, recommendations, review, sertraline, social anxiety disorder, social phobia, special populations, Specific phobia, Stress Disorders, venlafaxine},
pubstate = {published},
tppubtype = {article}
}
Background: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.Methods: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.Results: These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Conclusions: Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. © 2014 Katzman et al.