Virtual Reality: entering a world of escapism or growing our therapeutic toolbox?
Let’s play a word association game. What is the first thing that comes to mind when you hear the term “virtual-reality?” What about the terms “gaming,” “Oculus Rift,” “Alzheimer’s,” and “exposure therapy?” If your mind jumped to the former two terms, then you are in for a surprise.
The use of virtual reality (VR) is gaining momentum, with technology companies claiming that VR in the coming decades will become a normal part of our daily lives. Vast improvements in graphics and technology have set the stage for immersive psychological and perceptual adventures. This is all very exciting; I mean, who would not want the chance to finally get their letter to Hogwarts or enter the realm of Westeros?
Although gaming is the most talked about application of virtual reality, for me the widespread appeal of VR comes from its use in clinical psychology and medicine. More specifically, in its ability to assess and treat psychiatric disorders. There are clear benefits to using VR: the ability of the researcher to maintain full controllability of the stimuli and environment, the high ecological validity, and the opportunity to place the participant in scenarios that are not available or pose too much risk in reality. VR has already proved to be effective in helping to treat PTSD and phobias through exposure therapy, as well as in surgical training and musculoskeletal recovery!
Now let’s focus on one particular application. Imagine heavy smoke seeping through the cracks of your office door. The fire alarm sounds, vibrating in your ears. How would you leave the building? How would your grandma with dementia navigate out of the building?
A growing concern for our aging population is the prevalence of degenerative diseases. I stumbled upon one study that focuses on dementia, a complex disorder that impairs cognitive functions not limited to navigational ability, memory, executive functioning, and language. The goal was to construct a screening tool for early dementia using VR and this study used a fire evacuation Virtual Reality Day-Out Task (VR-DOT) environment to assess performance profiles (the setup is depicted in the diagram to the left). Wouldn’t you agree that this is a safer, ecologically valid alternative? Better still, it is relevant for the elderly population with dementia, as they often have difficulties interacting with their physical and social environment.
The VR-DOT is a multifaceted task breakdown, which incudes a baseline psychomotor and neuropsychological evaluation, and a naturalistic fire evacuation drill, as shown in the picture above, (6 different conditions with increasing difficulty) requiring prospective memory, reasoning, and spatial navigation — all sensitive to cognitive impairment (Tarnanas 2013).
While surveying associations among the performances of three groups of participants (mild Alzheimer’s-type dementia, amnestic single-domain mild cognitive impairment, healthy controls), the “novel VR-DOT functional index correlated strongly with standard cognitive and functional measurements, such as mini-mental state examination and Bristol Activities of Daily Living (ADL) scale scores” (Tarnanas 2013). The new VR measures of functional ability appear more sensitive to impairment than traditional qualitative measures of pre-dementia, and therefore, it is able to accurately discriminate pre-dementia and mild AD from healthy controls. With these positive results, I’ll be waiting for VR instruments to be used more frequently!
The breadth of psychological testing and applications of VR are endless. I believe VR shows great promise as a new class of therapeutic tools for diagnostic assessment and cognitive rehabilitation. We must maintain that psychological testing and measurement remains a flexible field, constantly adapting to the new technological advances and unexpected demands.
I highly recommend reading the original papers listed below!
Srivastava, Kalpana, R. C. Das, and S. Chaudhury. “Virtual Reality Applications in Mental Health: Challenges and Perspectives.” Industrial Psychiatry Journal. Medknow Publications & Media Pvt Ltd, n.d. Web. 27 Jan. 2016. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4361984/>.
Tarnanas, Ioannis, Winfried Schlee, Magda Tsolaki, René Müri, Urs Mosimann, and Tobias Nef. “Ecological Validity of Virtual Reality Daily Living Activities Screening for Early Dementia: Longitudinal Study.” JMIR Serious Games 1.1 (2013): n. pag. Web. <http://games.jmir.org/2013/1/e1/>
