MAXIMISING THE EFFECTIVENESS AND VIABILITY OF EXPOSURE THERAPY THROUGH PROJECTION-BASED AUGMENTED REALITY FOR THE TREATMENT OF COCKROACH PHOBIA (Q3146035): Difference between revisions
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Revision as of 10:19, 9 October 2021
Project Q3146035 in Spain
| Language | Label | Description | Also known as |
|---|---|---|---|
| English | MAXIMISING THE EFFECTIVENESS AND VIABILITY OF EXPOSURE THERAPY THROUGH PROJECTION-BASED AUGMENTED REALITY FOR THE TREATMENT OF COCKROACH PHOBIA |
Project Q3146035 in Spain |
Statements
28,435.0 Euro
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56,870.0 Euro
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50.0 percent
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1 January 2019
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31 December 2022
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UNIVERSIDAD JAUME I
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39°59'9.71"N, 0°2'15.86"W
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12040
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LA FOBIA ESPECIFICA (FE) ES EL TRASTORNO DE ANSIEDAD MAS PREVALENTE CON UNA ALTA INTERFERENCIA Y COMORBILIDAD. EL MIEDO A LOS ANIMALES ES EL SUBTIPO MAS PREVALENTE DE FE. LA EXPOSICION IN VIVO (EIV) ES EL TRATAMIENTO DE ELECCION PARA LA FE; SIN EMBARGO, EXISTEN UNA SERIE DE LIMITACIONES EN SU IMPLEMENTACION RELACIONADAS CON EL ACCESO Y LA ACEPTACION. SE REQUIEREN NUEVAS ESTRATEGIAS PARA APLICAR LA EXPOSICION CON EL FIN DE MEJORAR SU ADHERENCIA Y ACEPTACION. LA REALIDAD VIRTUAL (RV) Y LA REALIDAD AUMENTADA (RA) PRESENTAN VENTAJAS PARA ADMINISTRAR LA EXPOSICION. LA TERAPIA DE EXPOSICION CON RV (TERV) HA DEMOSTRADO SU EFICACIA FRENTE A EIV PARA LA FOBIA A ARAÑAS. LOS POCOS ESTUDIOS DISPONIBLES UTILIZANDO RA PARA FOBIA A ANIMALES SE HAN CENTRADO EN LA FOBIA A CUCARACHAS Y HAN SIDO REALIZADOS POR NUESTRO GRUPO DE INVESTIGACION. EN EL PRIMER ENSAYO CLINICO ALEATORIZADO, LA EXPOSICION RA DEMOSTRO UNA EFICACIA SIMILAR A EIV. EL SISTEMA RA UTILIZADO MUESTRA IMAGENES DE REALIDAD MIXTA A TRAVES DE UNAS GAFAS 5DT HMD. MAS TARDE, NUESTRO GRUPO DESARROLLO UN SISTEMA DE RA MAS INNOVADOR, TERAPIA DE EXPOSICION MEDIANTE REALIDAD AUMENTADA BASADA EN PROYECCION (P-TERA) QUE, A DIFERENCIA DEL ANTERIOR, PERMITE AL PACIENTE ENFRENTARSE AL ANIMAL DIRECTAMENTE SIN UN DISPOSITIVO INTRUSIVO. LA EFICACIA PRELIMINAR DE P-TERA SE HA MOSTRADO EN UN ESTUDIO DE CASO UNICO. EL OBJETIVO GENERAL DE ESTE PROYECTO ES REALIZAR UN ENSAYO CONTROLADO ALEATORIZADO PARA INVESTIGAR LA EFICACIA Y EFICIENCIA DE P-TERA, COMPARADO CON LA TERAPIA DE EXPOSICION EN VIVO (TEIV) Y UN GRUPO CONTROL DE LISTA DE ESPERA PARA FOBIA A LAS CUCARACHAS. ADEMAS, EN ESTE PROYECTO SE PRETENDE IR UN PASO MAS ALLA Y EXPLORAR FORMAS DE OPTIMIZAR LA TERAPIA DE EXPOSICION BASADAS EN EL ENFOQUE DE APRENDIZAJE INHIBITORIO. LA RV O LA RA PUEDEN MAXIMIZAR ALGUNAS ESTRATEGIAS AL PERMITIR UN MAYOR CONTROL AL TERAPEUTA O LA ¿EXPOSICION A MULTIPLES CONTEXTOS¿. EN RELACION A ESTA ULTIMA ESTRATEGIA, ALGUNOS ESTUDIOS HAN ENCONTRADO QUE LA TERV A MULTIPLES CONTEXTOS PRODUCE UN EFECTO POSITIVO EN TERMINOS DE RENOVACION DEL MIEDO Y GENERALIZACION DE LOS RESULTADOS EN FOBIA A LAS ARAÑAS. EN UN ESTUDIO POSTERIOR SE OBSERVO QUE LOS CAMBIOS DE CONTEXTO DURANTE LA TERV REDUCIA EL RETORNO DEL MIEDO POST-TRATAMIENTO, PERO NO EN EL SEGUIMIENTO, MIENTRAS QUE VARIAR EL TIPO DE ESTIMULO (DIFERENTES TIPOS DE ARAÑAS) DURANTE LA EXPOSICION PARECIA BENEFICIAR LA EFICACIA DEL TRATAMIENTO A CORTO Y LARGO PLAZO. NO SE EVIDENCIO SUPERIORIDAD AL COMBINAR LAS CONDICIONES DE ESTIMULOS MULTIPLES Y CONTEXTOS. ESTOS HALLAZGOS SON PRELIMINARES Y SE REQUIERE MAS INVESTIGACION SOBRE ESTE FENOMENO. EL SEGUNDO OBJETIVO DEL PROYECTO ES REALIZAR UN ENSAYO CLINICO ALEATORIZADO PARA INVESTIGAR LA EFICACIA Y EFICIENCIA DE VARIAR LOS ESTIMULOS FOBICOS DURANTE LA P-TERA: UTILIZANDO MULTIPLES ESTIMULOS (P-TERA ME) COMPARADO CON ESTIMULO UNICO (P-TERA EU) EN FOBIA A CUCARACHAS. EN AMBOS ESTUDIOS EL PROTOCOLO DE EVALUACION SEGUIRA RDOC CUBRIENDO EL TRIPLE SISTEMA DE RESPUESTA QUE CARACTERIZA LOS TRASTORNOS DE ANSIEDAD (MEDIDAS CONDUCTUALES, COGNITIVAS Y FISIOLOGICAS), APLICANDOSE EL TRATAMIENTO DE ¿UNA SESION INTENSIVA¿ (OST, 1989). CON ESTE PROYECTO ESPERAMOS, POR UNA PARTE, MEJORAR LA EFICIENCIA DE LA TERAPIA DE EXPOSICION, AL SUPERAR LA PRINCIPAL LIMITACION DE LA EEV, QUE ES, LA BAJA ACEPTACION DE PACIENTES Y TERAPEUTAS. Y, POR OTRA PARTE, OPTIMIZAR LA TERAPIA DE EXPOSICION AL UTILIZAR LA VARIABILIDAD DE ESTIMULOS DISPONIBLES EN EL SISTEMA DE RA. (Spanish)
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SPECIFIC PHOBIA (SP) IS THE MOST PREVALENT ANXIETY DISORDER WITH SUBSTANTIAL IMPAIRMENT AND COMORBIDITY. ANIMAL FEAR IS ONE OF THE MOST PREVALENT SUBTYPES OF SP. IN VIVO EXPOSURE (IVE) IS THE TREATMENT OF CHOICE FOR SP; HOWEVER, IT IS ASSOCIATED TO A NUMBER OF LIMITATIONS IN ITS IMPLEMENTATION RELATED TO THE ACCESS AND ACCEPTABILITY. NEW STRATEGIES TO APPLY EXPOSURE WITH THE AIM TO IMPROVE TREATMENT ADHERENCE AND ACCEPTANCE ARE NEEDED. VIRTUAL REALITY (VR) AND AUGMENTED REALITY (AR) HAVE SOME ADVANTAGES IN DELIVERING THE EXPOSURE TECHNIQUE. VR EXPOSURE THERAPY (VRET) HAS SHOWED COMPARABLE EFFICACY TO IVE IN THE TREATMENT OF SPIDER PHOBIA. THE FEW STUDIES AVAILABLE THAT USE AR FOR ANIMAL PHOBIA HAVE FOCUSED ON THE TREATMENT OF COCKROACH PHOBIA AND HAVE BEEN CONDUCTED BY OUR RESEARCH GROUP. IN THE FIRST RANDOMIZED CLINICAL TRIAL AR EXPOSURE SHOWED COMPARABLE EFFICACY TO IVE. THE AR SYSTEM USED DISPLAYED THE MIXED REALITY IMAGES WITH A 5DT HMD (HEAD-MOUNTED DISPLAY). LATER OUR GROUP DEVELOPED A MORE INNOVATIVE AR SYSTEM, THE PROJECTION-BASED AUGMENTED REALITY EXPOSURE (P-ARE) SYSTEM THAT, UNLIKE THE PREVIOUS SYSTEM, ALLOWS THE PATIENT TO CONFRONT THE ANIMAL DIRECTLY WITHOUT INTRUSIVE HARDWARE. PRELIMINARY EFFICACY OF THE P-ARET HAS BEEN FOUND IN A SINGLE CASE STUDY. A GENERAL OBJECTIVE OF THE PRESENT PROJECT IS TO CONDUCT A RANDOMIZED CONTROLLED TRIAL TO TEST THE EFFICACY AND EFFICIENCY OF THE P-ARET, COMPARED TO IN VIVO EXPOSURE THERAPY (IVET) AND A WAITING LIST CONTROL GROUP FOR THE TREATMENT OF COCKROACH PHOBIA. FURTHERMORE, IN THIS PROJECT WE PRETEND TO GO A STEP BEYOND AND EXPLORE WAYS OF OPTIMIZING EXPOSURE THERAPY BASED ON THE INHIBITORY LEARNING APPROACH. INDEED VR OR AR CAN MAXIMIZE SOME STRATEGIES REPORTED BY CRASKE ET AL. (2014) BY ALLOWING GREATER CONTROL BY THE THERAPISTS OR ¿EXPOSURE TO MULTIPLE CONTEXTS¿. REGARDING THIS LAST STRATEGY, SOME STUDIES HAVE FOUND THAT VRET TO MULTIPLE CONTEXTS PRODUCED A POSITIVE EFFECT IN TERMS OF FEAR RENEWAL AND GENERALIZATION OF THE RESULTS IN SPIDER PHOBICS. ALSO FINDINGS FROM A LATER TREATMENT ANALOGUE STUDY SHOWED THAT CHANGES OF CONTEXTS DURING VR EXPOSURE REDUCED RETURN OF FEAR AT POST-TREATMENT, BUT NOT AT FOLLOW-UP, WHILE VARYING THE STIMULI (DIFFERENT TYPES OF SPIDERS) DURING EXPOSURE SEEMED TO HAVE BENEFICIAL EFFECTS ON TREATMENT EFFICACY AT SHORT AND LONG-TERM. NO EVIDENCE FOR SUPERIORITY WAS OBSERVED FOR THE COMBINATION OF MULTIPLE STIMULI AND CONTEXTS CONDITION. THESE ENCOURAGING FINDINGS ARE PRELIMINARY AND FURTHER INVESTIGATION OF THIS PHENOMENON IS NEEDED. A SECOND GENERAL AIM OF THIS PROJECT IS TO CARRY OUT A RANDOMIZED CLINICAL TRIAL TO TEST THE EFFICACY AND EFFICIENCY OF VARYING THE PHOBIC STIMULI DURING THE ARET: USING MULTIPLE STIMULI (MS) (P-ARET MS) VERSUS SINGLE STIMULUS (SS) (P-ARET SS) IN PARTICIPANTS WITH COCKROACH PHOBIA. IN BOTH STUDIES THE ASSESSMENT PROTOCOL WILL FOLLOW RDOC COVERING THE TRIPLE RESPONSE SYSTEM THAT CHARACTERIZES ANXIETY DISORDERS (BEHAVIORAL, COGNITIVE, AND PHYSIOLOGICAL MEASURES) AND THE INTENSIVE ¿ONE-SESSION TREATMENT¿ (OST, 1989) WILL BE APPLIED. WITH THIS PROJECT WE EXPECT, ON ONE HAND, TO IMPROVE THE EFFICIENCY OF EXPOSURE THERAPY, BY OVERCOMING THE MAIN LIMITATION OF IVE, THAT IS, THE LOW ACCEPTABILITY BY PATIENTS AND THERAPISTS. AND, ON THE OTHER, TO OPTIMIZE EXPOSURE THERAPY BY MAKING USE OF THE STIMULI VARIABILITY AVAILABLE IN THE AR SYSTEM. (English)
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Castellón de la Plana/Castelló de la Plana
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Identifiers
RTI2018-100993-B-I00
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