Slide
Centre Interdisciplinaire
de Recherche et d’Innovation
en Cybersécurité et Société
de Recherche et d’Innovation
en Cybersécurité et Société
1.
Clemmensen, L.; Jørgensen, G.; Gundersen, K. B.; Smith, L. C.; Midtgaard, J.; Bouchard, S.; Thomsen, C. P.; Turgut, L.; Glenthoj, L. B.
In: BMJ Open, vol. 13, no. 9, 2023, ISSN: 20446055, (Publisher: BMJ Publishing Group).
Abstract | Links | BibTeX | Tags: Anxiety disorder, article, Behavior Observation Techniques, behavioral observation, borderline state, clinical effectiveness, clinical outcome, clinical protocol, Coercion, cognitive behavioral therapy, comparative study, Denmark, Depression, feasibility study, health care need, hospital patient, human, Humans, intensive care unit, Intensive Care Units, interpersonal communication, leisure, Leisure Activities, major clinical study, neuroleptic agent, non participant observation, Patient Satisfaction, peer review, pilot study, psychiatric intensive care unit, qualitative analysis, quantitative analysis, schizophrenia spectrum disorder, semi structured interview, virtual reality, virtual reality delivered stress reduction
@article{clemmensen_study_2023,
title = {Study protocol for virtual leisure investigating the effect of virtual reality-delivered stress reduction, entertainment and distraction on the use of coercion and need-based medication and patient satisfaction at a closed psychiatric intensive care unit - A mixed-methods pilot clinical trial},
author = {L. Clemmensen and G. Jørgensen and K. B. Gundersen and L. C. Smith and J. Midtgaard and S. Bouchard and C. P. Thomsen and L. Turgut and L. B. Glenthoj},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85172425765&doi=10.1136%2fbmjopen-2022-070566&partnerID=40&md5=87f1ee7c5b1f4d9245722d461eb9e6d2},
doi = {10.1136/bmjopen-2022-070566},
issn = {20446055},
year = {2023},
date = {2023-01-01},
journal = {BMJ Open},
volume = {13},
number = {9},
abstract = {Introduction The environment at a psychiatric inpatient ward can lead to emotional distress and behavioural deviations in vulnerable individuals potentially resulting in conflicts, increased use of need-based medication and coercive actions, along with low satisfaction with treatment. To accommodate these challenges, recreational and entertaining interventions are recommended. The tested interventions have, however, shown varying effects and demand a high degree of planning and staff involvement while being difficult to adapt to individual needs. Virtual reality (VR) may help overcome these challenges. Methods and analysis The study is a mixed-methods clinical trial with a target sample of 124 patients hospitalised at a closed psychiatric ward in the capital region of Denmark. Outcomes (eg, coercion, need-based medication and perceived stress) for a 12-month period where all patients are offered VR-based recreational experiences during their hospitalisation will be compared with outcomes for a 12-month period where VR is not offered. Feasibility and acceptability will be explored with qualitative interviews supplemented with non-participant observations and focus groups. The study began on 1 January 2023, and we expect to complete data collection by 31 December 2024. Ethics and dissemination The study is registered at Danish Data Protection Agency (j.no P-2022-466) and is approved by the Committee on Health Research Ethics of the capital region of Denmark (j.no 22013313). All patients will be required to provide informed consent. Results from this study will be disseminated via peer-reviewed journals and congress/consortium presentations. Trial registration number NCT05654740. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.},
note = {Publisher: BMJ Publishing Group},
keywords = {Anxiety disorder, article, Behavior Observation Techniques, behavioral observation, borderline state, clinical effectiveness, clinical outcome, clinical protocol, Coercion, cognitive behavioral therapy, comparative study, Denmark, Depression, feasibility study, health care need, hospital patient, human, Humans, intensive care unit, Intensive Care Units, interpersonal communication, leisure, Leisure Activities, major clinical study, neuroleptic agent, non participant observation, Patient Satisfaction, peer review, pilot study, psychiatric intensive care unit, qualitative analysis, quantitative analysis, schizophrenia spectrum disorder, semi structured interview, virtual reality, virtual reality delivered stress reduction},
pubstate = {published},
tppubtype = {article}
}
Introduction The environment at a psychiatric inpatient ward can lead to emotional distress and behavioural deviations in vulnerable individuals potentially resulting in conflicts, increased use of need-based medication and coercive actions, along with low satisfaction with treatment. To accommodate these challenges, recreational and entertaining interventions are recommended. The tested interventions have, however, shown varying effects and demand a high degree of planning and staff involvement while being difficult to adapt to individual needs. Virtual reality (VR) may help overcome these challenges. Methods and analysis The study is a mixed-methods clinical trial with a target sample of 124 patients hospitalised at a closed psychiatric ward in the capital region of Denmark. Outcomes (eg, coercion, need-based medication and perceived stress) for a 12-month period where all patients are offered VR-based recreational experiences during their hospitalisation will be compared with outcomes for a 12-month period where VR is not offered. Feasibility and acceptability will be explored with qualitative interviews supplemented with non-participant observations and focus groups. The study began on 1 January 2023, and we expect to complete data collection by 31 December 2024. Ethics and dissemination The study is registered at Danish Data Protection Agency (j.no P-2022-466) and is approved by the Committee on Health Research Ethics of the capital region of Denmark (j.no 22013313). All patients will be required to provide informed consent. Results from this study will be disseminated via peer-reviewed journals and congress/consortium presentations. Trial registration number NCT05654740. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
2.
Belleville, G.; Ouellet, M. -C.; Békés, V.; Lebel, J.; Morin, C. M.; Bouchard, S.; Guay, S.; Bergeron, N.; Ghosh, S.; Campbell, T.; Macmaster, F. P.
In: Behavior Therapy, vol. 54, no. 2, pp. 230–246, 2023, ISSN: 00057894 (ISSN), (Publisher: Elsevier Inc.).
Abstract | Links | BibTeX | Tags: adult, Anxiety, article, clinical effectiveness, clinical feature, cognitive behavioral therapy, controlled study, Depression, disaster, Disasters, disease severity, e-mental health, female, human, Humans, insomnia, Internet-Based Intervention, major clinical study, male, Middle Aged, natural disaster, physical disability, Post-Traumatic, posttraumatic stress disorder, psychotherapist, PTSD, randomized controlled trial, risk factor, Sleep Initiation and Maintenance Disorders, Stress Disorders, telepsychotherapy, treatment outcome, wildfire
@article{belleville_efficacy_2023,
title = {Efficacy of a Therapist-Assisted Self-Help Internet-Based Intervention Targeting PTSD, Depression, and Insomnia Symptoms After a Disaster: A Randomized Controlled Trial},
author = {G. Belleville and M. -C. Ouellet and V. Békés and J. Lebel and C. M. Morin and S. Bouchard and S. Guay and N. Bergeron and S. Ghosh and T. Campbell and F. P. Macmaster},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140981202&doi=10.1016%2fj.beth.2022.08.004&partnerID=40&md5=261383919bbdaa149ac0eeb6d3317fc0},
doi = {10.1016/j.beth.2022.08.004},
issn = {00057894 (ISSN)},
year = {2023},
date = {2023-01-01},
journal = {Behavior Therapy},
volume = {54},
number = {2},
pages = {230–246},
abstract = {This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128},
note = {Publisher: Elsevier Inc.},
keywords = {adult, Anxiety, article, clinical effectiveness, clinical feature, cognitive behavioral therapy, controlled study, Depression, disaster, Disasters, disease severity, e-mental health, female, human, Humans, insomnia, Internet-Based Intervention, major clinical study, male, Middle Aged, natural disaster, physical disability, Post-Traumatic, posttraumatic stress disorder, psychotherapist, PTSD, randomized controlled trial, risk factor, Sleep Initiation and Maintenance Disorders, Stress Disorders, telepsychotherapy, treatment outcome, wildfire},
pubstate = {published},
tppubtype = {article}
}
This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128
3.
Aardema, F.; Bouchard, S.; Koszycki, D.; Lavoie, M. E.; Audet, J. -S.; O'Connor, K.
In: Psychotherapy and Psychosomatics, vol. 91, no. 5, pp. 348–359, 2022, ISSN: 00333190 (ISSN), (Publisher: S. Karger AG).
Abstract | Links | BibTeX | Tags: adult, aged, appraisal based cognitive behavioral therapy, article, clinical effectiveness, clinical evaluation, clinical outcome, clinical trial, cognitive behavioral therapy, Cognitive-behavioral therapy, controlled study, disease severity, female, human, Humans, inference based cognitive behavioral therapy, Inference-based approach, intermethod comparison, major clinical study, male, mindfulness, mindfulness-based stress reduction, multicenter study, obsessive compulsive disorder, Obsessive-Compulsive Disorder, patient dropout, procedures, randomized controlled trial, remission, treatment outcome, treatment refusal, Yale Brown Obsessive Compulsive Scale
@article{aardema_evaluation_2022,
title = {Evaluation of Inference-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Multicenter Randomized Controlled Trial with Three Treatment Modalities},
author = {F. Aardema and S. Bouchard and D. Koszycki and M. E. Lavoie and J. -S. Audet and K. O'Connor},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85131012874&doi=10.1159%2f000524425&partnerID=40&md5=ff9a6095068e094c394e952eca4ca318},
doi = {10.1159/000524425},
issn = {00333190 (ISSN)},
year = {2022},
date = {2022-01-01},
journal = {Psychotherapy and Psychosomatics},
volume = {91},
number = {5},
pages = {348–359},
abstract = {Introduction: Inference-based cognitive-behavioral therapy (I-CBT) is a specialized psychological treatment for obsessive-compulsive disorder (OCD) without deliberate and prolonged exposure and response prevention (ERP) that focuses on strengthening reality-based reasoning and correcting the dysfunctional reasoning giving rise to erroneous obsessional doubts and ideas. Objective: The present study aimed to evaluate the effectiveness of I-CBT through a comparison with appraisal-based cognitive behavioral therapy (A-CBT) and an adapted mindfulness-based stress reduction (MBSR) intervention. Methods: This was a two-site, parallel-arm randomized controlled trial (RCT) comparing I-CBT with A-CBT. The MBSR intervention acted as a non-specific active control condition. Following formal evaluation, 111 participants diagnosed with OCD were randomly assigned. The principal outcome measure was the Yale-Brown Obsessive-Compulsive Scale. Results: All treatments significantly reduced general OCD severity and specific symptom dimensions without a significant difference between treatments. I-CBT was associated with significant reductions in all symptom dimensions at post-test. Also, I-CBT led to significantly greater improvement in overvalued ideation, as well as significantly higher rates of remission as compared to MBSR at mid-test. Conclusions: I-CBT and MBSR appear to be effective, alternative treatment options for those with OCD that yield similar outcomes as A-CBT. I-CBT may have an edge in terms of the rapidity by which patients reach remission, its generalizability across symptom dimension, its potentially higher level of acceptability, and effectiveness for overvalued ideation. Future research is needed to assess whether additional alternative treatments options can help to increase the number of people successfully treated. © 2022 The Author(s). Published by S. Karger AG, Basel.},
note = {Publisher: S. Karger AG},
keywords = {adult, aged, appraisal based cognitive behavioral therapy, article, clinical effectiveness, clinical evaluation, clinical outcome, clinical trial, cognitive behavioral therapy, Cognitive-behavioral therapy, controlled study, disease severity, female, human, Humans, inference based cognitive behavioral therapy, Inference-based approach, intermethod comparison, major clinical study, male, mindfulness, mindfulness-based stress reduction, multicenter study, obsessive compulsive disorder, Obsessive-Compulsive Disorder, patient dropout, procedures, randomized controlled trial, remission, treatment outcome, treatment refusal, Yale Brown Obsessive Compulsive Scale},
pubstate = {published},
tppubtype = {article}
}
Introduction: Inference-based cognitive-behavioral therapy (I-CBT) is a specialized psychological treatment for obsessive-compulsive disorder (OCD) without deliberate and prolonged exposure and response prevention (ERP) that focuses on strengthening reality-based reasoning and correcting the dysfunctional reasoning giving rise to erroneous obsessional doubts and ideas. Objective: The present study aimed to evaluate the effectiveness of I-CBT through a comparison with appraisal-based cognitive behavioral therapy (A-CBT) and an adapted mindfulness-based stress reduction (MBSR) intervention. Methods: This was a two-site, parallel-arm randomized controlled trial (RCT) comparing I-CBT with A-CBT. The MBSR intervention acted as a non-specific active control condition. Following formal evaluation, 111 participants diagnosed with OCD were randomly assigned. The principal outcome measure was the Yale-Brown Obsessive-Compulsive Scale. Results: All treatments significantly reduced general OCD severity and specific symptom dimensions without a significant difference between treatments. I-CBT was associated with significant reductions in all symptom dimensions at post-test. Also, I-CBT led to significantly greater improvement in overvalued ideation, as well as significantly higher rates of remission as compared to MBSR at mid-test. Conclusions: I-CBT and MBSR appear to be effective, alternative treatment options for those with OCD that yield similar outcomes as A-CBT. I-CBT may have an edge in terms of the rapidity by which patients reach remission, its generalizability across symptom dimension, its potentially higher level of acceptability, and effectiveness for overvalued ideation. Future research is needed to assess whether additional alternative treatments options can help to increase the number of people successfully treated. © 2022 The Author(s). Published by S. Karger AG, Basel.
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.
Sert, O. P.; Potvin, S.; Lipp, O.; Dellazizzo, L.; Laurelli, M.; Breton, R.; Lalonde, P.; Phraxayavong, K.; O'Connor, K.; Pelletier, J. -F.; Boukhalfi, T.; Renaud, P.; Dumais, A.
Virtual reality therapy for refractory auditory verbal hallucinations in schizophrenia: A pilot clinical trial Journal Article
In: Schizophrenia Research, vol. 197, pp. 176–181, 2018, ISSN: 09209964, (Publisher: Elsevier B.V.).
Abstract | Links | BibTeX | Tags: adult, article, auditory hallucination, auditory verbal hallucination, clinical article, clinical effectiveness, computer assisted therapy, Computer-Assisted, controlled study, Cross-Over Studies, crossover procedure, disease severity, distress syndrome, female, follow up, Follow-Up Studies, hallucination, Hallucinations, human, Humans, male, Middle Aged, neuroleptic agent, outcome assessment, Outcome Assessment (Health Care), phase 2 clinical trial, physiology, Pilot Projects, pilot study, priority journal, procedures, psychotherapy, quality of life, randomized controlled trial, schizophrenia, Speech Perception, symptom, Therapy, therapy delay, therapy effect, treatment duration, treatment response, virtual reality, virtual reality exposure therapy
@article{du_sert_virtual_2018,
title = {Virtual reality therapy for refractory auditory verbal hallucinations in schizophrenia: A pilot clinical trial},
author = {O. P. Sert and S. Potvin and O. Lipp and L. Dellazizzo and M. Laurelli and R. Breton and P. Lalonde and K. Phraxayavong and K. O'Connor and J. -F. Pelletier and T. Boukhalfi and P. Renaud and A. Dumais},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85042420594&doi=10.1016%2fj.schres.2018.02.031&partnerID=40&md5=fe98669ecfdfb69d05cc9ebb58fecdcc},
doi = {10.1016/j.schres.2018.02.031},
issn = {09209964},
year = {2018},
date = {2018-01-01},
journal = {Schizophrenia Research},
volume = {197},
pages = {176–181},
abstract = {Schizophrenia is a chronic and severe mental illness that poses significant challenges. While many pharmacological and psychosocial interventions are available, many treatment-resistant schizophrenia patients continue to suffer from persistent psychotic symptoms, notably auditory verbal hallucinations (AVH), which are highly disabling. This unmet clinical need requires new innovative treatment options. Recently, a psychological therapy using computerized technology has shown large therapeutic effects on AVH severity by enabling patients to engage in a dialogue with a computerized representation of their voices. These very promising results have been extended by our team using immersive virtual reality (VR). Our study was a 7-week phase-II, randomized, partial cross-over trial. Nineteen schizophrenia patients with refractory AVH were recruited and randomly allocated to either VR-assisted therapy (VRT) or treatment-as-usual (TAU). The group allocated to TAU consisted of antipsychotic treatment and usual meetings with clinicians. The TAU group then received a delayed 7 weeks of VRT. A follow-up was ensured 3 months after the last VRT therapy session. Changes in psychiatric symptoms, before and after TAU or VRT, were assessed using a linear mixed-effects model. Our findings showed that VRT produced significant improvements in AVH severity, depressive symptoms and quality of life that lasted at the 3-month follow-up period. Consistent with previous research, our results suggest that VRT might be efficacious in reducing AVH related distress. The therapeutic effects of VRT on the distress associated with the voices were particularly prominent (d = 1.2). VRT is a highly novel and promising intervention for refractory AVH in schizophrenia. © 2018},
note = {Publisher: Elsevier B.V.},
keywords = {adult, article, auditory hallucination, auditory verbal hallucination, clinical article, clinical effectiveness, computer assisted therapy, Computer-Assisted, controlled study, Cross-Over Studies, crossover procedure, disease severity, distress syndrome, female, follow up, Follow-Up Studies, hallucination, Hallucinations, human, Humans, male, Middle Aged, neuroleptic agent, outcome assessment, Outcome Assessment (Health Care), phase 2 clinical trial, physiology, Pilot Projects, pilot study, priority journal, procedures, psychotherapy, quality of life, randomized controlled trial, schizophrenia, Speech Perception, symptom, Therapy, therapy delay, therapy effect, treatment duration, treatment response, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Schizophrenia is a chronic and severe mental illness that poses significant challenges. While many pharmacological and psychosocial interventions are available, many treatment-resistant schizophrenia patients continue to suffer from persistent psychotic symptoms, notably auditory verbal hallucinations (AVH), which are highly disabling. This unmet clinical need requires new innovative treatment options. Recently, a psychological therapy using computerized technology has shown large therapeutic effects on AVH severity by enabling patients to engage in a dialogue with a computerized representation of their voices. These very promising results have been extended by our team using immersive virtual reality (VR). Our study was a 7-week phase-II, randomized, partial cross-over trial. Nineteen schizophrenia patients with refractory AVH were recruited and randomly allocated to either VR-assisted therapy (VRT) or treatment-as-usual (TAU). The group allocated to TAU consisted of antipsychotic treatment and usual meetings with clinicians. The TAU group then received a delayed 7 weeks of VRT. A follow-up was ensured 3 months after the last VRT therapy session. Changes in psychiatric symptoms, before and after TAU or VRT, were assessed using a linear mixed-effects model. Our findings showed that VRT produced significant improvements in AVH severity, depressive symptoms and quality of life that lasted at the 3-month follow-up period. Consistent with previous research, our results suggest that VRT might be efficacious in reducing AVH related distress. The therapeutic effects of VRT on the distress associated with the voices were particularly prominent (d = 1.2). VRT is a highly novel and promising intervention for refractory AVH in schizophrenia. © 2018
6.
Bouchard, S.; Robillard, G.; Giroux, I.; Jacques, C.; Loranger, C.; St-Pierre, M.; Chrétien, M.; Goulet, A.
Using virtual reality in the treatment of gambling disorder: The development of a new tool for cognitive behavior therapy Journal Article
In: Frontiers in Psychiatry, vol. 8, no. FEB, 2017, ISSN: 16640640, (Publisher: Frontiers Research Foundation).
Abstract | Links | BibTeX | Tags: adult, age distribution, article, clinical effectiveness, cognitive behavioral therapy, controlled study, craving, DSM-5, ethnic difference, female, high risk population, human, major clinical study, male, outcome assessment, pathological gambling, pilot study, program feasibility, safety, sex difference, treatment duration, treatment outcome, virtual reality exposure therapy
@article{bouchard_using_2017,
title = {Using virtual reality in the treatment of gambling disorder: The development of a new tool for cognitive behavior therapy},
author = {S. Bouchard and G. Robillard and I. Giroux and C. Jacques and C. Loranger and M. St-Pierre and M. Chrétien and A. Goulet},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85014229849&doi=10.3389%2ffpsyt.2017.00027&partnerID=40&md5=27df5ef448fec9e2ac3498cd76632899},
doi = {10.3389/fpsyt.2017.00027},
issn = {16640640},
year = {2017},
date = {2017-01-01},
journal = {Frontiers in Psychiatry},
volume = {8},
number = {FEB},
abstract = {Virtual reality (VR) can be used in the treatment of gambling disorder to provide emotionally charged contexts (e.g., induce cravings) where patients can practice cognitive behavior therapy (CBT) techniques in the safety of the therapist's office. This raises practical questions, such as whether the cravings are sufficient to be clinically useful but also manageable enough to remain clinically safe. Pilot data are also needed to test the development of a treatment manual and prepare large randomized control trials. This paper reports on three studies describing (a) cravings induced in VR compared to real gambling and a control game of skill with no money involved (N = 28 frequent gamblers and 36 infrequent gamblers); (b) the usefulness of a treatment protocol with only two CBT sessions using VR (N = 34 pathological gamblers); and (c) the safety of a four-session treatment program of CBT in VR (N = 25 pathological gamblers). Study 1 reveals that immersions in VR can elicit desire and a positive anticipation to gamble in frequent gamblers that are (a) significantly stronger than for infrequent gamblers and for playing a control game of skill and (b) as strong as for gambling on a real video lottery terminal. Study 2 documents the feasibility of integrating VR in CBT, its usefulness in identifying more high-risk situations and dysfunctional thoughts, how inducing cravings during relapse prevention exercises significantly relates to treatment outcome, and the safety of the procedure in terms of cybersickness. Results from Study 3 confirm that, compared to inducing urges to gamble in imagination, using VR does not lead to urges that are stronger, last longer, or feel more out of control. Outcome data and effect sizes are reported for both randomized control pilot trials conducted in inpatient settings. Suggestions for future research are provided, including on increasing the number of VR sessions in the treatment program. © 2017 Bouchard, Robillard, Giroux, Jacques, Loranger, St-Pierre, Chrétien and Goulet.},
note = {Publisher: Frontiers Research Foundation},
keywords = {adult, age distribution, article, clinical effectiveness, cognitive behavioral therapy, controlled study, craving, DSM-5, ethnic difference, female, high risk population, human, major clinical study, male, outcome assessment, pathological gambling, pilot study, program feasibility, safety, sex difference, treatment duration, treatment outcome, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Virtual reality (VR) can be used in the treatment of gambling disorder to provide emotionally charged contexts (e.g., induce cravings) where patients can practice cognitive behavior therapy (CBT) techniques in the safety of the therapist's office. This raises practical questions, such as whether the cravings are sufficient to be clinically useful but also manageable enough to remain clinically safe. Pilot data are also needed to test the development of a treatment manual and prepare large randomized control trials. This paper reports on three studies describing (a) cravings induced in VR compared to real gambling and a control game of skill with no money involved (N = 28 frequent gamblers and 36 infrequent gamblers); (b) the usefulness of a treatment protocol with only two CBT sessions using VR (N = 34 pathological gamblers); and (c) the safety of a four-session treatment program of CBT in VR (N = 25 pathological gamblers). Study 1 reveals that immersions in VR can elicit desire and a positive anticipation to gamble in frequent gamblers that are (a) significantly stronger than for infrequent gamblers and for playing a control game of skill and (b) as strong as for gambling on a real video lottery terminal. Study 2 documents the feasibility of integrating VR in CBT, its usefulness in identifying more high-risk situations and dysfunctional thoughts, how inducing cravings during relapse prevention exercises significantly relates to treatment outcome, and the safety of the procedure in terms of cybersickness. Results from Study 3 confirm that, compared to inducing urges to gamble in imagination, using VR does not lead to urges that are stronger, last longer, or feel more out of control. Outcome data and effect sizes are reported for both randomized control pilot trials conducted in inpatient settings. Suggestions for future research are provided, including on increasing the number of VR sessions in the treatment program. © 2017 Bouchard, Robillard, Giroux, Jacques, Loranger, St-Pierre, Chrétien and Goulet.
7.
Laforest, M.; Bouchard, S.; Bossé, J.; Mesly, O.
In: Frontiers in Psychiatry, vol. 7, no. JUN, 2016, ISSN: 16640640 (ISSN), (Publisher: Frontiers Research Foundation).
Abstract | Links | BibTeX | Tags: adult, aged, article, CBT, clinical effectiveness, cognitive behavioral therapy, disease severity, exposure, female, generalized anxiety disorder, human, hypnosis, male, obsessive compulsive disorder, Obsessive-Compulsive Disorder, pilot study, psychologic assessment, Response prevention, self report, treatment duration, treatment outcome, treatment response, virtual reality, Yale Brown Obsessive Compulsive Scale
@article{laforest_effectiveness_2016,
title = {Effectiveness of in virtuo exposure and response prevention treatment using cognitive-behavioral therapy for obsessive-compulsive disorder: A study based on a single-case study protocol},
author = {M. Laforest and S. Bouchard and J. Bossé and O. Mesly},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84977551825&doi=10.3389%2ffpsyt.2016.00099&partnerID=40&md5=8aaf926230112d06a0c1e629e49b51c6},
doi = {10.3389/fpsyt.2016.00099},
issn = {16640640 (ISSN)},
year = {2016},
date = {2016-01-01},
journal = {Frontiers in Psychiatry},
volume = {7},
number = {JUN},
abstract = {Obsessive-compulsive disorder (OCD) is characterized by the presence of distressing, recurrent and intrusive thoughts, impulses, or doubts as well as behavioral or mental rituals. OCD has various subtypes, including the fear of contamination in which individuals fear bacteria, germs, disease, or bodily secretions, and engage in clinically significant cleaning and avoidance rituals. Cognitive-behavioral therapy (CBT) is an effective treatment for OCD and involves, among other therapeutic strategies, exposing patients to feared stimuli while preventing them to engage in compulsive behaviors. In recent years, virtual reality (VR) has shown the potential of in virtuo exposure with people suffering from anxiety disorders and OCD. The objective of this pilotstudy is to examine the effectiveness of a CBT program where exposure in conducted in virtuo. Three adults suffering from OCD with a dominant subtype of contamination were enrolled in a single-case design with multiple baselines across participants. The presence and intensity of obsessions and compulsions were assessed daily during baselines of 3-, 4-, or 5-week, and a 12-session treatment. Follow-up information was gathered after 4 and 8 months. Treatment outcome is assessed with visual inspection of the graphs and ARMA time-series analyses. Clinical information, self-reports, and details of the treatment are provided for each patient. Statistical analyses for the time-series data revealed a statistically significant improvement in all three participants, but global improvement is considered positive for only two. This study innovates in proving preliminary support for the usefulness of VR in the CBT of OCD with contamination features. © 2016 Laforest, Bouchard, Bossé and Mesly.},
note = {Publisher: Frontiers Research Foundation},
keywords = {adult, aged, article, CBT, clinical effectiveness, cognitive behavioral therapy, disease severity, exposure, female, generalized anxiety disorder, human, hypnosis, male, obsessive compulsive disorder, Obsessive-Compulsive Disorder, pilot study, psychologic assessment, Response prevention, self report, treatment duration, treatment outcome, treatment response, virtual reality, Yale Brown Obsessive Compulsive Scale},
pubstate = {published},
tppubtype = {article}
}
Obsessive-compulsive disorder (OCD) is characterized by the presence of distressing, recurrent and intrusive thoughts, impulses, or doubts as well as behavioral or mental rituals. OCD has various subtypes, including the fear of contamination in which individuals fear bacteria, germs, disease, or bodily secretions, and engage in clinically significant cleaning and avoidance rituals. Cognitive-behavioral therapy (CBT) is an effective treatment for OCD and involves, among other therapeutic strategies, exposing patients to feared stimuli while preventing them to engage in compulsive behaviors. In recent years, virtual reality (VR) has shown the potential of in virtuo exposure with people suffering from anxiety disorders and OCD. The objective of this pilotstudy is to examine the effectiveness of a CBT program where exposure in conducted in virtuo. Three adults suffering from OCD with a dominant subtype of contamination were enrolled in a single-case design with multiple baselines across participants. The presence and intensity of obsessions and compulsions were assessed daily during baselines of 3-, 4-, or 5-week, and a 12-session treatment. Follow-up information was gathered after 4 and 8 months. Treatment outcome is assessed with visual inspection of the graphs and ARMA time-series analyses. Clinical information, self-reports, and details of the treatment are provided for each patient. Statistical analyses for the time-series data revealed a statistically significant improvement in all three participants, but global improvement is considered positive for only two. This study innovates in proving preliminary support for the usefulness of VR in the CBT of OCD with contamination features. © 2016 Laforest, Bouchard, Bossé and Mesly.
8.
Grenier, S.; Forget, H.; Bouchard, S.; Isere, S.; Belleville, S.; Potvin, O.; Rioux, M. -È.; Talbot, M.; Pachana, N. A.; Voshaar, R. C. Oude
In: International Psychogeriatrics, vol. 27, no. 7, pp. 1217–1225, 2015, ISSN: 10416102, (Publisher: Cambridge University Press).
Abstract | Links | BibTeX | Tags: adult, aged, aging, Anxiety, Anxiety disorder, Anxiety Disorders, clinical effectiveness, cognition, cognitive defect, cognitive therapy, Depression, disease association, exposure, Fear, generalized anxiety disorder, gerontopsychiatry, human, Humans, late life anxiety disorder, panic, patient counseling, posttraumatic stress disorder, procedures, psychology, randomized controlled trial (topic), relaxation training, Research, review, Social Support, treatment outcome, trends, virtual reality, virtual reality exposure therapy
@article{grenier_using_2015,
title = {Using virtual reality to improve the efficacy of cognitive-behavioral therapy (CBT) in the treatment of late-life anxiety: Preliminary recommendations for future research},
author = {S. Grenier and H. Forget and S. Bouchard and S. Isere and S. Belleville and O. Potvin and M. -È. Rioux and M. Talbot and N. A. Pachana and R. C. Oude Voshaar},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84931830085&doi=10.1017%2fS1041610214002300&partnerID=40&md5=6a937a7a7f13fca31c84fc7859b365d0},
doi = {10.1017/S1041610214002300},
issn = {10416102},
year = {2015},
date = {2015-01-01},
journal = {International Psychogeriatrics},
volume = {27},
number = {7},
pages = {1217–1225},
abstract = {Cognitive-behavioral therapy (CBT) using traditional exposure techniques (i.e. imaginal and in vivo) seems less effective to treat anxiety in older adults than in younger ones. This is particularly true when imaginal exposure is used to confront the older patient to inaccessible (e.g. fear of flying) or less tangible/controllable anxiety triggers (e.g. fear of illness). Indeed, imaginal exposure may become less effective as the person gets older since normal aging is characterized by the decline in cognitive functions involved in the creation of vivid/detailed mental images. One way to circumvent this difficulty is to expose the older patient to a virtual environment that does not require the ability to imagine the frightening situation. In virtuo exposure has proven to be efficient to treat anxiety in working-age people. In virtuo exposure could be employed to improve the efficacy of CBT with exposure sessions in the treatment of late-life anxiety? The current paper explores this question and suggests new research avenues. Copyright © International Psychogeriatric Association 2014.},
note = {Publisher: Cambridge University Press},
keywords = {adult, aged, aging, Anxiety, Anxiety disorder, Anxiety Disorders, clinical effectiveness, cognition, cognitive defect, cognitive therapy, Depression, disease association, exposure, Fear, generalized anxiety disorder, gerontopsychiatry, human, Humans, late life anxiety disorder, panic, patient counseling, posttraumatic stress disorder, procedures, psychology, randomized controlled trial (topic), relaxation training, Research, review, Social Support, treatment outcome, trends, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Cognitive-behavioral therapy (CBT) using traditional exposure techniques (i.e. imaginal and in vivo) seems less effective to treat anxiety in older adults than in younger ones. This is particularly true when imaginal exposure is used to confront the older patient to inaccessible (e.g. fear of flying) or less tangible/controllable anxiety triggers (e.g. fear of illness). Indeed, imaginal exposure may become less effective as the person gets older since normal aging is characterized by the decline in cognitive functions involved in the creation of vivid/detailed mental images. One way to circumvent this difficulty is to expose the older patient to a virtual environment that does not require the ability to imagine the frightening situation. In virtuo exposure has proven to be efficient to treat anxiety in working-age people. In virtuo exposure could be employed to improve the efficacy of CBT with exposure sessions in the treatment of late-life anxiety? The current paper explores this question and suggests new research avenues. Copyright © International Psychogeriatric Association 2014.
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.
Robillard, G.; Bouchard, S.; Dumoulin, S.; Guitard, T.
The development of the SWEAT questionnaire: A scale measuring costs and efforts inherent to conducting exposure sessions Journal Article
In: Annual Review of CyberTherapy and Telemedicine, vol. 9, no. 1, pp. 85–89, 2011, ISSN: 15548716.
Abstract | Links | BibTeX | Tags: article, clinical effectiveness, controlled study, cost benefit analysis, exposure, human, in vivo study, psychologist, questionnaire, reliability, specific work for exposure applied in therapy questionnaire, virtual reality
@article{robillard_development_2011-1,
title = {The development of the SWEAT questionnaire: A scale measuring costs and efforts inherent to conducting exposure sessions},
author = {G. Robillard and S. Bouchard and S. Dumoulin and T. Guitard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-83455179431&partnerID=40&md5=c2fde1fc8ce186d921450fe0909cee56},
issn = {15548716},
year = {2011},
date = {2011-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {9},
number = {1},
pages = {85–89},
abstract = {For decades, empirical studies have shown the effectiveness of exposure techniques when used in cognitivebehavioral therapy (CBT) treatment for anxiety disorders. A few studies are now suggesting that using Virtual Reality (VR) may be an effective way to conduct exposure and overcome some of the limitations of in vivo exposure. The aim of this study is to validate the Specific Work for Exposure Applied in Therapy (SWEAT) questionnaire that measures costs and efforts required to conduct in vivo and in virtuo exposure. A total of 265 exposure sessions (in vivo = 140; in virtuo = 125) were rated by experienced psychologists. Reliability analysis revealed three main factors in the construct of the SWEAT questionnaire. Results also showed that conducting exposure in VR is less of a burden and more readily adapted to the patients' needs than in vivo.},
keywords = {article, clinical effectiveness, controlled study, cost benefit analysis, exposure, human, in vivo study, psychologist, questionnaire, reliability, specific work for exposure applied in therapy questionnaire, virtual reality},
pubstate = {published},
tppubtype = {article}
}
For decades, empirical studies have shown the effectiveness of exposure techniques when used in cognitivebehavioral therapy (CBT) treatment for anxiety disorders. A few studies are now suggesting that using Virtual Reality (VR) may be an effective way to conduct exposure and overcome some of the limitations of in vivo exposure. The aim of this study is to validate the Specific Work for Exposure Applied in Therapy (SWEAT) questionnaire that measures costs and efforts required to conduct in vivo and in virtuo exposure. A total of 265 exposure sessions (in vivo = 140; in virtuo = 125) were rated by experienced psychologists. Reliability analysis revealed three main factors in the construct of the SWEAT questionnaire. Results also showed that conducting exposure in VR is less of a burden and more readily adapted to the patients' needs than in vivo.