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Published Online:https://doi.org/10.1026/1616-3443.35.1.39

Zusammenfassung.Theoretischer Hintergrund und Fragestellung: Eine von Jahr zu Jahr steigende Anzahl von Publikationen signalisiert die Entstehung eines neuen Gebiets der Klinischen Psychologie, das man “Klinische Cyberpsychologie“ nennen könnte. Die vorliegende Arbeit versucht vor allem einen Überblick über die neuesten Ergebnisse der Anwendung “virtueller Realitäten“ (VR) in der psychologischen Diagnostik und Behandlung zu geben. Methode: Es wurden drei Ansätze unterschieden: a) Die E-Therapie, b) die VR-Therapie und c) die VR-Teletherapie. Diese Dreiteilung gilt im Wesentlichen auch für den Bereich der Diagnostik, Beratung und Rehabilitation. Ergebnisse und Schlussfolgerungen: Mit Hilfe computergenerierter virtueller Szenarien kann eine wirklichkeitsnahe Reizmodellierung vorgenommen werden, die nicht nur eine gut kontrollierbare Reizdarbietung ermöglicht, sondern darüber hinaus auch eine interaktive Gestaltung zulässt. Dies gibt Anlass zur Hoffnung, dass durch den gezielten Einsatz virtueller Systeme die psychologische Diagnostik und Behandlung wesentlich verbessert werden kann.


Clinical cyber psychology: The application of virtual realities in psychological diagnosis and treatment

Abstract.Background and objective: A steadily increasing number of publications indicate the emergence of a new field in clinical psychology that may be called “clinical cyber psychology”. An attempt is made to give a survey of recent results of applying “virtual realities” (VR) to psychological assessment and treatment. Method: The present study distinguishes between three approaches: a) E-therapy, b) VR-therapy, and c) VR-teletherapy. By and large, these distinction categories (E, VR, and VR-tele) apply also to psychological assessment, counseling, and rehabilitation. Results and conclusions: Computer-generated 3 D virtual realities provide a high level of control of both stimulus presentation and interaction between patients and the virtual environment. It is hoped that the application of virtual reality technologies may contribute to essential improvements in the field of psychological assessment and treatment.

Literatur

  • Alcaniz, M., Botella, C., Perpiná, C., Banos, R., Lozano, J. A., Montesa, J., Palacios, A., Garcia, A., Villa, H., Alozano, J. (2000). A new realistic 3D body representation in virtual environments for the treatment of disturbed body image in eating disorders. CyberPsychology & Behavior , 3, 433–439. First citation in articleCrossrefGoogle Scholar

  • Alcaniz, M., Botella, C., Banos, R., Perpiná, C., Rey, B., Lozano, J. A., Guillen, V., Barrera, F., Gil, J. A. (2003). Internet-based telehealth system for the treatment of agoraphobia. CyberPsychology & Behavior , 6, 355–358. First citation in articleCrossrefGoogle Scholar

  • Alessi, N. E., Huang, M. P. (2000). Evolution of the virtual human: from term to potential application in psychiatry. CyberPsychology & Behavior , 3, 321–326. First citation in articleCrossrefGoogle Scholar

  • American Psychological Association (1992). Ethical principles of psychologists and code of conduct. American Psychologist , 47, 1597–1611. First citation in articleCrossrefGoogle Scholar

  • American Psychological Association (Ed.) (2000). Psychology and the internet [special issue]. Monitor on Psychology , 31(4),. First citation in articleGoogle Scholar

  • Anderson, P., Jacobs, C., Rothbaum, B. D. (2004). Computer-supported cognitive behavioral treatment of anxiety disorders. Journal of Clinical Psychology , 60, 253–267. First citation in articleCrossrefGoogle Scholar

  • Bandura, A. (1971). Social learning theory. New York: General Learning Press. First citation in articleGoogle Scholar

  • Bandura, A. (1974). Behavior theory and models of man. American Psychologist , 29, 859–869. First citation in articleCrossrefGoogle Scholar

  • Baumann, S., Neff, C., Fetzick, S., Stangl, G., Basler, L., Vereneck, R., Schneider, W. (2003). A virtual reality system für neurobehavioral and functional MRI studies. CyperPsychology & Behavior , 6, 259–266. First citation in articleCrossrefGoogle Scholar

  • Bente, G., Krämer, N. C., Petersen, A. (2002). Virtuelle Realität als Gegenstand und Methode in der Psychologie. In G. Bente, N. C. Krämer & A. Petersen (Hrsg.), Virtuelle Realitäten (S. 1-31). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Berufsverband Österreichischer Psychologinnen und Psychologen (Hrsg.) (2003). [Themenheft] Psychologie in Österreich , 23, . First citation in articleGoogle Scholar

  • Biocca, F. (1992). Communication within virtual reality: Creating space for research. Journal of Communication , 42, 5–22. First citation in articleCrossrefGoogle Scholar

  • Biocca, F., Delaney, B. (1995). The vision of virtual reality. In F. Biocca & M. Levy (Eds.), Communicaton in the age of virtual reality (pp. 57-126), Hillsdale, NJ: Erlbaum. First citation in articleGoogle Scholar

  • Birk, L. (1973). Biofeedback - Furor Therapeuticus. In L. Birk (Ed.), Biofeedback: Behavioral Medicine (pp. 1-4). New York: Grune & Stratton. First citation in articleGoogle Scholar

  • Bischof, W., Boulanger, P. (2003). Spatial navigation in virtual reality environments: An EEG analysis. CyberPsychology & Behavior , 6, 487–495. First citation in articleCrossrefGoogle Scholar

  • Brooks, B. M., Rose, F. D., Attree, E. A., Elliott-Square, A. (2002). An evaluation of the efficacy of training people with learning disabilities in virtual environments. Disability and Rehabilitation , 24, 622–626. First citation in articleCrossrefGoogle Scholar

  • Cavanagh, K., Shapiro, D. A. (2004). Computer treatment for common mental health problems. Journal of Clinical Psychology , 60, 239–251. First citation in articleCrossrefGoogle Scholar

  • Castelnuovo, G., Gaggioli, A., Riva, G. (2003). CyberPsychology meets clinical psychology: The emergence of e-therapy in mental health care. In G. Riva & C. Gamimberti (Eds.), Towards Cyberpsychology: Mind, cognition and society in the internet age (pp. 229-252). Amsterdam: IOS Press. First citation in articleGoogle Scholar

  • Clark, L. A., Watson, D. (1999). Temperament: A new paradigm for trait psychology. In L. A. Pervin & O. P. John (Eds.), Handbook of personality: Theory and research (2nd ed., pp. 399-423). New York: Guilford. First citation in articleGoogle Scholar

  • Costa, P. T., McCrae, R. R. (1992). Four ways of five factors are basic. Personality and Individual Differences , 13, 653–665. First citation in articleCrossrefGoogle Scholar

  • Costa, R. M. E. M., De Carvalho, L. A. V., Drummond, R., Wauke, A. P. T., De Sa Guimaraes, M. (2002). The UFRJ-UERJ group: Interdisciplinary virtual reality experiments in neuropsychiatry. CyperPsychology & Behavior , 5, 423–431. First citation in articleCrossrefGoogle Scholar

  • Davidson, J., Smith, M. (2003). Bio-phobias/techno-philias: virtual reality exposure as treatment for phobias of “nature“. Sociology of Health & Illness , 25, 644–661. First citation in articleCrossrefGoogle Scholar

  • De Leo, G., Ponder, M., Molet, T., Fato, M., Thalmann, D., Magnenat-Thalmann, N., Bermano, F., Beltrame, F. (2003). A virtual reality system for the training of volunteers involved in health emergency situations. CyberPsychology & Behavior , 6, 267–274. First citation in articleCrossrefGoogle Scholar

  • Difede, J., Hoffman, H. G. (2002). Virtual reality exposure therapy for the world trade center post-traumatic stress disorder: A case report. CyberPsychology & Behavior , 5, 529–535. First citation in articleCrossrefGoogle Scholar

  • Engel, B. T. (1972). Response specificity. In N. S. Greenfield & R. A. Sternbach (Eds.), Handbook of Psychophysiology (pp. 571-576). New York: Holt, Rinehart and Winston. First citation in articleGoogle Scholar

  • Foa, E. B., Kozak, M. J. (1993). Pathological anxiety: The meaning and the structure of fear. In N. Birbaumer & A. Öhman (Eds.), The structure of emotion. Psychphysiological, cognitive and clinical aspects (pp. 111-121). Seattle: Hogrefe & Huber. First citation in articleGoogle Scholar

  • Fogel, J., Albert, S. M., Schabl, F., Ditkoff, B. A., Neugut, A. I. (2002). Internet use and social support in women with breast cancer. Health Psychology , 21, 398–404. First citation in articleCrossrefGoogle Scholar

  • Frazer, J., Kirkby, K. C., Daniels, B., Gilroy, L., Montgomery, I. M. (2001). Three versus six sessions of computer-aided vicarious exposure treatment for spider phobia. Behaviour Change , 18, 213–224. First citation in articleCrossrefGoogle Scholar

  • Freeman, D., Garety, P. A., Kuipers, E., Fowler, D., Bebbington, P. E. (2002). A cognitive model of persecutery delusions. British Journal of Clinical Psychology , 41, 331–347. First citation in articleCrossrefGoogle Scholar

  • Freeman, D., Slater, M., Bebbington, P. E., Garety, P. A., Kuipers, E., Fowler, D., Met, A., Read, C. M., Jordan, J., Vinayagamoorthy, V. (2003). Can virtual reality be used to investigate persecutory ideation?. Journal of Nervous and Mental Disease , 191, 509–514. First citation in articleCrossrefGoogle Scholar

  • Gaggioli, A., Mantovani, F., Castelnuovo, G., Wiederhold, B., Riva, G. (2003). Avatars in clinical psychology: A framework for the clinical use of virtual humans. CyberPsychology & Behavior , 6, 117–125. First citation in articleCrossrefGoogle Scholar

  • Galimberti, C., Belloni, G. (2003). Three-dimensional virtual environments for cybertherapy: A psychosocial approach to effective usability. CyberPsychology & Behavior , 6, 229–235. First citation in articleCrossrefGoogle Scholar

  • Gamberini, L., Cottone, P., Spagnolli, A., Varotto, D., Mantovani, G. (2003). Responding to a fire emergency in a virtual environment: different patterns of action for different situations. Ergonomics , 46, 842–858. First citation in articleCrossrefGoogle Scholar

  • Garcia-Palacios, A., Hoffman, H., Carlin, A., Furness III, T. A., Botella-Arbona, C. (2002). Virtual reality in the treatment of spider phobia: a controlled study. Behaviour Research and Therapy , 40, 983–993. First citation in articleCrossrefGoogle Scholar

  • Gershon, J., Zimand, E., Lemos, R., Rothbaum, B. O., Hodges, L. (2003). Use of virtual reality as a distractor for painful procedures on a patient with pediatric cancer: A case study. CyberPsychology & Behavior , 6, 657–661. First citation in articleCrossrefGoogle Scholar

  • Gilroy, L. J., Kirkby, K. C., Daniels, B. A., Menzies, R. G., Montgomery, I. M. (2003). Long-term follow-up of computer-aided vicarious exposure versus live graded exposure in the treatment of spider phobia. Behavior Therapy , 34, 65–76. First citation in articleCrossrefGoogle Scholar

  • Gould, M. S., Munfahk, J. L. H., Lubell, K., Kleinman, M., Parker, S. (2002). Journal of the American Acadademy of Child and Adolescence. Psychiatry , 41, 1182–1189. First citation in articleGoogle Scholar

  • Harris, S. R., Kemmerling, R. L., North, M. M. (2002). Brief virtual reality therapy for public speaking anxiety. CyberPsychology & Behavior , 5, 543–550. First citation in articleCrossrefGoogle Scholar

  • Hoffman, H. G., Garcia-Palacios, A., Carlin, A., Furness, T. A. III, Botella-Arbona, C. (2003). Interfaces that heal: Coupling real and virtual objects to cure spider phobia. International Journal of Human-Computer Interaction , 16, 283–300. First citation in articleCrossrefGoogle Scholar

  • Hoffman, H. G., Richards, T., Coda, B., Richards, A., Sharar, S. R. (2003). The illusion of presence in immersive virtual reality during an fMRI brain scan. CyberPsychology & Behavior , 6, 127–131. First citation in articleCrossrefGoogle Scholar

  • Holden, G., Bearison, D. J., Rode, D. C., Rosenberg, G., Fishman, M. (1999). Evaluating the effects of a virtual environment (STARBRIGHT World) with hospitalized children. Research on Social Work Practice , 9, 365–382. First citation in articleCrossrefGoogle Scholar

  • Holden, G., Bearison, D. J., Rode, D. C., Fishman-Kapiloff, M., Rosenberg, G. (2000). The effects of a computer network on pediatric pain and axiety. Journal of Technology in Human Services , 17, 27–47. First citation in articleCrossrefGoogle Scholar

  • Holden, G., Bearison, D. J., Rode, D. C., Fishman-Kapiloff, M., Rosenberg, G., Rosenzweig, J. (2002). The impact of a computer network on pediatric pain and anxiety: A randomized controlled clinical trial. Social Work in Health Care , 36, 21–33. First citation in articleCrossrefGoogle Scholar

  • Holden, G., Bearison, D. J., Rode, D. C., Fishman-Kapiloff, M., Rosenberg, G., Onghena, P. (2003). Pediatric pain and Anxiety: A meta-analysis of outcomes for a behavioral telehealth intervention. Research on Social Work Practice , 13, 693–704. First citation in articleCrossrefGoogle Scholar

  • Jordan, P. W. (1998). An introduction to usability. New York: Taylor and Francis. First citation in articleGoogle Scholar

  • Kahana, M. J., Sekuler, R., Caplan, J. B., Kirschen, M., Madsen, J. R. (1999). Human theta oscillation exhibit task dependence during virtual maze navigation. Nature , 399, 781–784. First citation in articleCrossrefGoogle Scholar

  • Krämer, N. C., Bente, G. (2002). Virtuelle Helfer: Embodied Conversational Agents in der Mensch-Computer-Interaktion. In G. Bente, N. C. Krämer & A. Petersen (Hrsg.), Virtuelle Realitäten (S. 202-225). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Krijn, M., Emmelkamp, P. M. G., Biemond, R., de Wilde de Ligny, C., Schuemie, M. J., van der Mast, C. A. P. G. (2004). Treatment of acrophobia in virtual reality: The role of immersion and presence. Behaviour Research and Therapy , 42, 229–239. First citation in articleCrossrefGoogle Scholar

  • Lang, P. J. (1979). A bio-informational theory of emotional imagery. Psychophysiology , 16, 495–512. First citation in articleCrossrefGoogle Scholar

  • Larkin, M. (2000). Online support groups gaining credibility. Lancet , 355, 1834–. First citation in articleCrossrefGoogle Scholar

  • Larnier, J., Biocca, F. (1992). An inside view of the future of virtual reality. Journal of Communication , 42, 150–172. First citation in articleCrossrefGoogle Scholar

  • Lee, J. H., Ku, J., Kim, K., Kim, B., Kim, I. Y., Yang, B.-H., Kim, S. H., Wiederhold, B. K., Wiederhold, M. D., Park, D.-W., Lim, Y., Kim, S. I. (2003). Experimental application of virtual reality for nicotine craving through cue exposure. CyberPsychology & Behavior , 6, 275–280. First citation in articleCrossrefGoogle Scholar

  • Maltby, N., Kirsch, I., Mayers, M., Allen, G. J. (2002). Virtual reality exposure therapy for the treatment of fear of flying: A controlled investigation. Journal of Consulting and Clinical Psychology , 70, 1112–1118. First citation in articleCrossrefGoogle Scholar

  • Marwitz, M., Stemmler, G. (1998). On the status of individual response specificity. Psychophysiology , 35, 1–15. First citation in articleCrossrefGoogle Scholar

  • McComas, J., MacKay, M., Pivik, J. (2002). Effectiveness of virtual reality for teaching pedestrian safety. CyberPsychology & Behavior , 5, 185–190. First citation in articleCrossrefGoogle Scholar

  • Moore, K., Wiederhold, B., Wiederhold, M., Riva, G. (2002). Panic and agoraphobia in a virtual world. CyberPsychology & Behavior , 5, 197–202. First citation in articleCrossrefGoogle Scholar

  • Mraz, R., Hong, J., Quintin, G., Staines, W. R., McIlroy, W. E., Zakzanis, K. K., Graham, S. J. (2003). A Platform for combining virtual reality experiments with functional magnetic resonance imaging. CyberPsychology & Behavior , 6, 359–368. First citation in articleCrossrefGoogle Scholar

  • Mühlberger, A., Herrmann, M. J., Wiedemann, G., Ellgring, H., Pauli, P. (2001). Repeated exposure of flight phobics to flights in virtual reality. Behaviour Research and Therapy , 39, 1033–1050. First citation in articleCrossrefGoogle Scholar

  • Mühlberger, A., Wiedemann, G., Pauli, P. (2003). Efficacy of a one-session virtual reality exposure treatment for fear of flying. Psychotherapy Research , 13, 323–336. First citation in articleCrossrefGoogle Scholar

  • Onghena, P., Edgington, E. S. (1994). Randomization tests for restricted alternating treatment designs. Behavior Research and Therapy , 32, 783–786. First citation in articleCrossrefGoogle Scholar

  • Paechter, M., Schweizer, K., Weidenmann, B. (2000). Parasoziale Beziehungen zu einer Dozentin im Netz. Medienpsychologie , 12, 242–259. First citation in articleGoogle Scholar

  • Page, S. (2003). “Virtual“ health care organizations and the challenges of improving quality. Health Care Management Review , 28, 79–92. First citation in articleCrossrefGoogle Scholar

  • Pepina, C., Botella, C., Banos, R. M. (2003). Virtual reality in eating disorders. European Eating Disorders Review , 11, 261–278. First citation in articleCrossrefGoogle Scholar

  • Petersen, A., Bente, G., Krämer, N. C. (2002). Virtuelle Stellvertreter: Analyse avatar-vermittelter Kommunikationsprozesse. In G. Bente, N. C. Krämer & A. Petersen (Hrsg.), Virtuelle Realitäten (S. 228-253). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Plante, T. G., Aldridge, A., Bogden, R., Hanelin, C. (2003). Might virtual reality promote the mood benefits of exercise?. Computers in Human Behavior , 19, 495–509. First citation in articleCrossrefGoogle Scholar

  • Rabasca, L. (2000). Self-help sites: a blessing or bane?. Monitor on Psychology , 31, 28–30. First citation in articleGoogle Scholar

  • Read, S. J., Miller, L. C. (2002). Virtual personalities: A neural network model of personality. Personality and Social Psychology Review , 6, 357–369. First citation in articleCrossrefGoogle Scholar

  • Reid, D. (2002). Virtual reality and the person-environment experience. CyberPsychology & Behavior , 5, 559–564. First citation in articleCrossrefGoogle Scholar

  • Repperger, D. W., Gilkey, R. H., Green, R., LaFleur, T., Haas, M. W. (2003). Effects of haptic feedback and turblence on landing performence using immersive cave automatic virtual environment (CAVE). Perceptual and Motor Skills , 97, 820–832. First citation in articleCrossrefGoogle Scholar

  • Riva, G. (2002). Virtual reality for health care: The Status of research. CyberPsychology , 5, 219–225. First citation in articleCrossrefGoogle Scholar

  • Riva, G. (1997). Virtual reality as assessment tool in psychology. Studies in Health Technology and Informatics , 44, 77–79. First citation in articleGoogle Scholar

  • Riva, G., Melis, L. (1997). Virtual reality for the treatment of body image disturbances. In G. Riva (Ed.), Virtual reality in neuro-psycho-physiology: Cognitive, clinical and methodological issues in assessment and rehabilitation (pp. 95-111). Amsterdam: IOS Press. First citation in articleGoogle Scholar

  • Rizzo, A. A., Bowerly, T., Buckwalter, J. G., Schultheis, M., Matheis, R., Shahabi, C., Neumann, U., Kim, L., Sharifzadeh, M. (2002). Virtual environments for the assessment of attention and memory processes: The virtual classroom and office. Proceeedings of the International Conference on Disability, Virtual Reality and Associated Technology (ICDVRAT 2002). Veszprem, Hungary. First citation in articleGoogle Scholar

  • Rizzo, A. A., Strickland, D., Bouchard, S. (in press)The challenge of using virtual reality in telerehabilitation. Telemedicine Journal and E-Health , . First citation in articleGoogle Scholar

  • Robillard, G., Bouchard, S., Fournier, T., Renaud, P. (2003). Anxiety and presence during VR immersion: A comparative study of the reactions of phobic a nd non-phobic participants in therapeutic virtual environments derived from computer games. CyberPsychology & Behavior , 6, 467–476. First citation in articleCrossrefGoogle Scholar

  • Rose, F. D., Attree, E. A., Brooks, B. M., Andrews, D. K. (2001). Learning and memory in virtual environments - a role in neurorehabilitation? Questions (and occasional answers) from UEL. Presence-Teleoperators and Virtual Environment , 10, 345–358. First citation in articleCrossrefGoogle Scholar

  • Rothbaum, B. O., Hodges, L., Smith, S., Lee, J. H., Price, L. (2000). A controlled study of virtual reality exposure therapy for fear of flying. Journal of Consulting and Clinical Psychology , 68, 1020–1026. First citation in articleCrossrefGoogle Scholar

  • Vincelli, F., Riva, G. (2002). Virtual reality: a new tool for panic disorder therapy. Expert Rev. Neurotherapeutics , 2, 89–95. First citation in articleCrossrefGoogle Scholar

  • Schneider, S. M., Ellis, M., Coombs, W. T., Shonkwiler, R. N., Folsom, L. C. (2003). Virtual reality intervention for older women with breast cancer. CyberPsychology & Behavior , 6, 301–307. First citation in articleCrossrefGoogle Scholar

  • Simpson, G., Johnston, L., Richardson, M. (2003). An investigation of road crossing in a virtual environment. Accident Analysis & Prevention , 35, 787–796. First citation in articleCrossrefGoogle Scholar

  • Slater, M., Usoh, M. (1993). Representation systems, percerptual position, and presence in immersive virtual environments. Presence , 2, 221–233. First citation in articleCrossrefGoogle Scholar

  • Steuer, J. (1992). Defining virtual reality: Dimensions determing telepresence. Journal of Communication , 42, 73–93. First citation in articleCrossrefGoogle Scholar

  • Taylor, H., Leitman, R. (2001). EHealth traffic critically dependent onsearch engines and portals. Health Care News , 1(13),1–3. First citation in articleGoogle Scholar

  • Tate, D. F., Zabinski, M. F. (2004). Computer and internet applications for psychological treatment: Update for clinicians. Journal of Clinical Psychology , 60, 209–220. First citation in articleCrossrefGoogle Scholar

  • Wald, J., Taylor, S. (2003). Preliminary research on the efficacy of virtual reality exposure therapy to treat driving phobia. CyberPsychology & Behavior , 6, 459–467. First citation in articleCrossrefGoogle Scholar

  • Walshe, D. G., Lewis, E. J., Kim, S. I., O’Sullivan, K., Wiederhold, B. K. (2003). Exploring the use of computer games and virtual reality in exposure therapy for fear of driving following a motor vehicle accident. CyberPsychology & Behavior , 6, 329–334. First citation in articleCrossrefGoogle Scholar

  • Weiss, P. L., Bialik, P., Kizony, R. (2003). Virtual realitiy provides leisure time opportunities for young adults with physical and intellectual disabilities. CyberPsychology & Behavior , 6, 335–342. First citation in articleCrossrefGoogle Scholar

  • Wiederhold, B. K., Wiederhold, M. D. (2003). Three-year follow-up for virtual reality exposure for fear of flying. CyberPsychology & Behavior , 6, 441–445. First citation in articleCrossrefGoogle Scholar

  • Wiggins, J. S., Trapnell, P. D. (1996). A dyadic-interactional perspective on the five-factor model. In J. S. Wiggins (Ed.), The five-factor model of personality: Theoretical perspectives (pp. 88-162). New York: Guilford. First citation in articleGoogle Scholar

  • Winzelberg, A. J., Eppstein, D., Eldredge, K. L., Wilfley, D., Dasmahapatra, R., Dev, P., Taylor, C. B. (2000). Effectiveness of an internet-based program for reducing risk factors for eating disorders. Journal of Consulting and Clinical Psychology , 68, 346–350. First citation in articleCrossrefGoogle Scholar