ARCTT 2006 - The Virtual Reality Medical Center

274 Pages·2009·2.55 MB·English

Annual Review of CyberTherapy and Telemedicine

Virtual Healing: Designing Reality

Editors-in-Chief

Brenda K. Wiederhold, PhD, MBA, BCIA
Interactive Media Institute, San Diego, CA, USA

Stéphane Bouchard, PhD
Université du Québec en Outaouais, Canada

Giuseppe Riva, PhD, MS, MA
Istituto Auxologico Italiano, Verbania, Italy

Volume 4
Interactive Media Institute
Annual Review of CyberTherapy and Telemedicine

Copyright © 2006 Interactive Media Institute
6160 Cornerstone Court East
San Diego, CA 92121

ISBN:
ISSN: 1554-8716

All rights reserved.
Printed in the United States of America

Interactive Media Institute Website: www.interactivemediainstitute.com

LEGAL NOTICE
The publisher is not responsible for the use which might be made of the following information.
Editors-in-Chief
Brenda K. Wiederhold, Ph.D., MBA, BCIA
Interactive Media Institute

Stéphane Bouchard, Ph.D.
Université du Quebéc en Outaouais
Assistant Editors
Albert "Skip" Rizzo, Ph.D.
University of Southern California

Giuseppe Riva, Ph.D., M.S., M.A.
Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano
Editorial Assistant
Ruth Kogen
Interactive Media Institute
Editorial Board
Nathan Appel, Ph.D. Maressa H. Orzack, Ph.D.
National Institute on Drug Abuse (NIH) Computer Addiction Clinic

Maria Teresa Arredondo-Waldmeyer, Ph.D. Patrice Renaud, Ph.D.
Universidad Politecnica de Madrid Universite du Quebec en Outaouais

Cristina Botella, Ph.D. Richard Satava, M.D., FACS
Universitat Jaume I University of Washington

Alex H. Bullinger, M.D., MBA Ben Sawyer
Center of Applied Tech. in Neuroscience Serious Games Initiative

James A. Carter, Ph.D. Susan Schneider, Ph.D., R.N., AOCN
Harvard Medical School Duke University

Joann Difede, Ph.D. Heidi Sveistrup, Ph.D.
Weill Cornell Medical Center University of Ottawa

Walter Greenleaf, Ph.D. Ioannis Tarnanas
Greenleaf Medical Peopleware - Kozani University CATLab

Hunter Hoffman, Ph.D. David Thomas, Ph.D.
University of Washington National Institute on Drug Abuse

Kay Howell Cheryl Trepagnier, Ph.D.
Federation of American Scientists The Catholic University of America

Ashfaq Ishaq, Ph.D., FRSA David Walshe, Ph.D.
International Child Art Foundation University College Cork

Sun I. Kim, Ph.D. Patrice (Tamar) Weiss, Ph.D.
Hanyang University University of Haifa

Harvey Magee Mark D. Wiederhold, M.D., Ph.D., FACP
Telemedicine & Adv Tech Research Center Virtual Reality Medical Center

Fabrizia Mantovani, Ph.D. Christine Youngblut, Ph.D.
Istituto Auxologico Italiano Institute for Defense Analyses

Greg T. Mogel, M.D.
Telemedicine & Adv Tech Research Center West
General Information
Annual Review of CyberTherapy and Telemedicine (ARCTT – ISSN: 1554-8716) is published an-
nually (once per year) by the Interactive Media Institute (IMI), a 501c3 non profit organization, dedi-
cated to incorporating interdisciplinary researchers from around the world to create, test, and develop
clinical protocols for the medical and psychological community. IMI realizes that the mind and body
work in concert to affect quality of life in individuals and works to develop technology that can be ef-
fectively used to improve the standards and reduce the cost of healthcare delivery.

Interactive Media Institute, 6160 Cornerstone Court East, Suite 161, San Diego, CA, USA.

Telephone: [phone], Fax: [phone], E-mail: [email protected]
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Copyright © 2006 by Interactive Media Institute. Printed in the United States of America

About the journal
ARCTT is a peer-reviewed all-purpose journal covering a wide variety of topics of interest to the men-
tal health, neuroscience, and rehabilitation communities. The mission of ARCTT is to provide system-
atic, periodic examinations of scholarly advances in the field of CyberTherapy and Telemedi-
cine through original investigations in the telemedicine and cybertherapy areas, novel experimental
clinical studies, and critical authoritative reviews.

It is directed to healthcare providers and researchers who are interested in the applications of ad-
vanced media for improving the delivery and efficacy of mental healthcare and rehabilitative services.

Manuscript Proposal and Submission
Because Annual Review papers examine either novel therapeutic methods and trials or a specific
clinical application in depth, they are written by experienced researchers upon invitation from our Edi-
torial Board. The editors nevertheless welcome suggestions from our readers. Questions or com-
ments about editorial content or policies should be directed to the editors only.

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Disclaimer
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opinions of the Journal, its Publisher, and its editorial staff.
Table of Contents
Volume 4
Editorials 9
B. K. Wiederhold, G. Riva, S. Bouchard

CRITICAL REVIEWS

From SIT to PTSD: Developing a Continuum of Care for the Warfighter 13
B. K. Wiederhold, M. D. Wiederhold

Virtual Standardized Patients for Training Health Professionals on Chemical and 19
Biological Agent Exposures
D. L. Sticha, M. J. Roy, D. E. Olsen

Coping with stress using Virtual Reality: a new perspective 25
D. Villani, A. Preziosa, G. Riva

EVALUATION STUDIES

The use of a visible and/or an invisible marker Augmented Reality System for 33
the treatment of phobia to small animals
M. C. Juan, D. Joele, C. Botella, R. Baños, M. Alcañiz, Ch. van der Mast

Randomized Controlled Trial of CBT with Virtual Reality Exposure Therapy 39
for PTSD
M. J. Roy, W. Law, I. Patt, J. Difede, A. Rizzo, Institute K. Graap, B. Rothbaum

Efficacy of Sensory Integration Treatment based on Virtual Reality - Tangible 45
Interaction for Children with Autism
K-E. Jung, H-J. Lee, Y-S. Lee, J-H. Lee

The Usefulness of Virtual Reality Stress Inoculation Training for Military 51
Medical Females: A Pilot Study
M. C. Stetz, R. M. Wildzunas, B. K. Wiederhold, T. A. Stetz, M. P. Hunt

The virtual classroom: An ecological version of the continuous performance 59
test – A pilot study
G. Moreau, M-C. Guay, A. Achim, A. Rizzo, P. Lageix

A study of Active Navigation and Object Recognition in Virtual Environments 67
J. Hahm, K. Lee, S-L. Lim, S-Y. Kim, H-T. Kim, J-H. Lee

ORIGINAL RESEARCH

Optic Flow With a Stereoscopic Display: Sustained Influence on Speed of 73
Locomotion
W. A. Powell, S. Hand, B. Stevens, M. Simmonds
Simulation-based training of communication and emotional competence for the 79
improvement of physician-patient relationship
L. Anolli, A. Vescovo, A. Agliati, F. Mantovani, V. Zurloni

Sexual presence as determined by fractal oculomotor dynamics 87
P. Renaud, S. Chartier, M-P. Bonin, P. de Courville Nico, J. Proulx, J-L. Rouleau,
L-G Cournoyer, P. Fedoroff, J. Bradford, S. Bouchard

Physiological and Momentary Assessment for Identifying Tobacco Use Patterns 95
P. J. Jordan, L. W. Jerome, N. Faraj

Implicit Learning of an Embedded Regularity in Older Adults using a SRT 103
Reaching Task in a Virtual Reality Medium
R. Martini, L. Aquilino, S. Buissé, A. Dumais, V. Pion, E. St. Rose, H. Sveistrup, D. M. Ste-Marie

Presence: Head Mounted Display vs. Translucid Screen 111
P. Gamito, D. Morais, J. Oliveira, L. Gamito, M. Anastácio

Evaluation of Group Performance in a Mediated Environment 117
L. W. Jerome, P. J. Jordan, N. Faraj

Changes in P300 Amplitude in Smokers in Response to Cigarette- 127
Craving Cues
K-W. Jang, J-S. Lee, B-H. Yang, J-H. Lee

Smokers’ attentional bias to smoking-related cues in eye movement 131
S-M. Kwak, D. L. Na, GHo Kim, J-H Lee

Low-Cost Telerehabilitation Using Force Feedback Joysticks 137
H. Sugarman, J. Tiran, A. Weisel-Eichler, E. Dayan

Reaching out to the youth suffering from idiopathic tinnitus via the Internet 145
J. Baribeau

Sexual Preference Classification from Gaze Behavior Data using a Multilayer 153
Perceptron
S. Chartier, P. Renaud, S. Bouchard, J. Proulx, J. L. Rouleau, P. Fedoroff, J. Bradford

Application of Virtual Reality-Cue Exposure Therapy for Reducing Alcohol 161
Craving
H. Kwon, J. Choi, S. Roh, B-H Yang, J-H Lee

CLINICAL OBSERVATIONS

Evaluating the Interaction of Blind Learners with Audio-Based Virtual 167
Environments
J. Sánchez, M. Zúñiga

Generic virtual reality treatment applied to space-related phobias 175
F. Znaidi, I. Viaud-Delmon, R. Jouvent
Virtual Therapy in Patients with Depression. Preliminary Observation 181
V. ChiriŃă, M. Ilinca, R. ChiriŃă, M. Bîşcă, G. Chele

Abstracts from CyberTherapy 2006, June 13-15, 2006, Gatineau, Canada 187
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Editorials
I am honored to welcome you to the fourth volume of Annual Review of CyberTherapy and Telemedi-
cine. This year’s theme, “Virtual Healing: Designing Reality,” acknowledges the importance of two
related types of scientific studies: clinical applications of virtual reality (VR) and other technologies,
and experimental research on why it has such a powerful impact on behavioral healthcare, medicine,
and neuroscience. The theme also highlights changes that have occurred in the past decade; that
which was once in the ream of science-fiction has now increasingly become part of our reality. As
readers, you will therefore have the opportunity to play a role in designing the future. By utilizing
technology for training and therapy, we are able to improve existing protocols, and disseminate care
to a wider segment of the population.

Much has changed over the past eleven years since the inception of the CyberTherapy Conference.
We have now tapped further into the potential of VR than many of us could have ever imagined. An
exciting body of research regarding the utilization of advanced technologies in behavioral healthcare
has emerged over the past decade, revealing the continuous advances and discoveries made by
over 450 investigators to help patients with both mental and physical disorders. I am proud to report
that as VR’s use in behavioral healthcare has grown, so have submissions to the Annual Review of
CyberTherapy and Telemedicine. For the first seven years, CyberTherapy was represented by a spe-
cialized symposium at the Medicine Meets Virtual Reality (MMVR) Conference featuring presenta-
tions that dealt primarily with conceptual matters and future possibilities. Over the years, the sympo-
sium continued to grow in both size and scientific evidence. In 2003, the symposium spun off into a
separate three-day conference. The 10th Annual CyberTherapy Conference, held in June 2005,
highlighted the largest program ever presented on controlled clinical trials of VR and other cutting-
edge technologies in the areas of mental health, rehabilitation, disabilities, training, and education. It
involved representatives from 21 countries, reflecting its truly international character.

I sincerely hope that you will find this year’s volume to be an interesting and intellectually stimulating
read. I continue to believe that together we can change the future of healthcare.

Sincerely,

Brenda K. Wiederhold, Ph.D., MBA, BCIA
Co-Editor-in-Chief
9
Editorials
According to recent reports presented by IST Advisory Group (ISTAG) - the Unit within the European
Union providing independent advice concerning the strategy, content, and direction of research work
to be carried out in Information and Communication Technologies (ICT) (http://cordis.europa.eu/ist/
istag-reports.htm) - the evolution of technology in support of the Knowledge Society of the 2010s will
be rooted within three dominant trends:

− Pervasive diffusion of intelligence in the space around us, through the development of net-
work technologies and intelligent sensors toward so-called “Ambient Intelligence” (AmI);
− The increasingly relevant role of mobility through the development of mobile communica-
tions, moving from the Universal Mobile Telecommunications System (UMTS) to "Beyond
3rd Generation" (B3G);
− Increase of the range, accessibility, and comprehensiveness of communications, through
the development of multi-channel multimedia technologies.

The convergence of AmI, B3G, and multi channel multimedia technologies manifests itself as the
next frontier of ICT. This convergence stimulates a change in the way health care is carried out,
making it a globally distributed process in which communication and collaboration between geo-
graphically dispersed users plays a key role.

In reaching this goal, "Immersive Virtual Telepresence" (IVT) will be essential. In IVT tools, distrib-
uted virtual reality (VR) systems are combined with wireless multimedia facilities (real-time video)
and innovative input devices (tracking sensors, biosensors, brain-computer interfaces).

In general, the IVT perspective is reached through:

− Widening of the input channel through the use of biosensors (brain-computer interface, psy-
cho-physiological measurements, etc.) and advanced tracking systems (wide body tracking,
gaze analysis, etc.).
− Induction of a sense of “presence” or “telepresence” through multimodal human/machine
communication in the dimensions of sound, vision, and touch-and-feel (haptics). Typically, a
sense of presence is achieved through multisensorial stimula, such that actual reality is ei-
ther hidden or substituted via a synthetic scenario, (i.e. made virtual through audio and 3-D
video analysis, and modelling procedures). In high-end IVT systems, multimedia data-
streams, such as live stereo-video and audio, are transmitted and integrated into the virtual
space of another participant remotely, allowing geographically separated groups to meet in a
common virtual space while maintaining eye-contact, gaze awareness and body language.
A sense of presence with other people who may be at distant sites is achieved through ava-
tar representations using data about body movement streamed over a high-speed network.

Since distance learning and e-health are principally involved with handling and transmission of medi-
cal information, IVT has the potential to enhance their user experience through the expansion of hu-
man input and output channels. The two principle ways in which IVT can be applied are:
− as an interface, which enables a more intuitive manner of interacting with information, and
− as an extended communicative environment that enhances the feeling of presence during
the interaction.

These approaches will be strengthened by the development of 3rd generation IVT systems including
biosensors, mobile communication, and mixed reality. Introducing IVT in cybertherapy will provide
significant advantages:

− IVT-based treatment differs from traditional therapy in that computer graphics and various
display and input/output technologies are integrated to provide the patient with a sense of
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