What do virtual reality tools bring to child and adolescent psychiatry?
L'Encéphale. 2018-06-01; 44(3): 280-285
DOI: 10.1016/j.encep.2017.06.005
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1. Encephale. 2018 Jun;44(3):280-285. doi: 10.1016/j.encep.2017.06.005. Epub 2017
Sep 1.
[What do virtual reality tools bring to child and adolescent psychiatry?]
[Article in French]
Bioulac S(1), de Sevin E(2), Sagaspe P(3), Claret A(4), Philip P(3),
Micoulaud-Franchi JA(3), Bouvard MP(5).
Author information:
(1)Pôle universitaire psychiatrie enfants et adolescents, centre hospitalier
Charles-Perrens, 121, rue de la Béchade, 33076 Bordeaux, France; Sommeil,
attention et neuropsychiatrie, USR 3413, université de Bordeaux, CHU Pellegin,
place Amélie-Raba-Léon, 33076 Bordeaux, France; CNRS, SANPSY, USR 3413, CHU
Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France. Electronic address:
.
(2)Sommeil, attention et neuropsychiatrie, USR 3413, université de Bordeaux, CHU
Pellegin, place Amélie-Raba-Léon, 33076 Bordeaux, France; CNRS, SANPSY, USR 3413,
CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
(3)Sommeil, attention et neuropsychiatrie, USR 3413, université de Bordeaux, CHU
Pellegin, place Amélie-Raba-Léon, 33076 Bordeaux, France; CNRS, SANPSY, USR 3413,
CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France; Clinique du
sommeil, CHU Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
(4)Centre Jean-Abadie, CHU, 89, rue des Sablières, 33077 Bordeaux, France.
(5)Pôle universitaire psychiatrie enfants et adolescents, centre hospitalier
Charles-Perrens, 121, rue de la Béchade, 33076 Bordeaux, France.
Virtual reality is a relatively new technology that enables individuals to
immerse themselves in a virtual world. It offers several advantages including a
more realistic, lifelike environment that may allow subjects to « forget » they are
being assessed, allow a better participation and an increased generalization of
learning. Moreover, the virtual reality system can provide multimodal stimuli,
such as visual and auditory stimuli, and can also be used to evaluate the
patient’s multimodal integration and to aid rehabilitation of cognitive
abilities. The use of virtual reality to treat various psychiatric disorders in
adults (phobic anxiety disorders, post-traumatic stress disorder, eating
disorders, addictions…) and its efficacy is supported by numerous studies.
Similar research for children and adolescents is lagging behind. This may be
particularly beneficial to children who often show great interest and
considerable success on computer, console or videogame tasks. This article will
expose the main studies that have used virtual reality with children and
adolescents suffering from psychiatric disorders. The use of virtual reality to
treat anxiety disorders in adults is gaining popularity and its efficacy is
supported by various studies. Most of the studies attest to the significant
efficacy of the virtual reality exposure therapy (or in virtuo exposure). In
children, studies have covered arachnophobia social anxiety and school refusal
phobia. Despite the limited number of studies, results are very encouraging for
treatment in anxiety disorders. Several studies have reported the clinical use of
virtual reality technology for children and adolescents with autistic spectrum
disorders (ASD). Extensive research has proven the efficiency of technologies as
support tools for therapy. Researches are found to be focused on communication
and on learning and social imitation skills. Virtual reality is also well
accepted by subjects with ASD. The virtual environment offers the opportunity to
administer controlled tasks such as the typical neuropsychological tools, but in
an environment much more like a standard classroom. The virtual reality classroom
offers several advantages compared to classical tools such as more realistic and
lifelike environment but also records various measures in standardized
conditions. Most of the studies using a virtual classroom have found that
children with Attention Deficit/Hyperactivity Disorder make significantly fewer
correct hits and more commission errors compared with controls. The virtual
classroom has proven to be a good clinical tool for evaluation of attention in
ADHD. For eating disorders, cognitive behavioural therapy (CBT) program enhanced
by a body image specific component using virtual reality techniques was shown to
be more efficient than cognitive behavioural therapy alone. The body
image-specific component using virtual reality techniques boots efficiency and
accelerates the CBT change process for eating disorders. Virtual reality is a
relatively new technology and its application in child and adolescent psychiatry
is recent. However, this technique is still in its infancy and much work is
needed including controlled trials before it can be introduced in routine
clinical use. Virtual reality interventions should also investigate how newly
acquired skills are transferred to the real world. At present virtual reality can
be considered a useful tool in evaluation and treatment for child and adolescent
disorders.
Copyright © 2017 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights
reserved.
DOI: 10.1016/j.encep.2017.06.005
PMID: 28870688