Abordaje terapéutico con realidad virtual en la fobia a volar: un estudio de caso
Resumen
La fobia a volar es un trastorno de ansiedad cuyos principales síntomas son miedos intensos e irracionales, cuya exposición provoca altos niveles de ansiedad y la consiguiente evitación de volar. La realidad virtual (RV) ha demostrado ser eficaz en el tratamiento de fobias específicas, ya que los pacientes pueden enfrentarse a sus miedos de forma controlada y repetitiva en un entorno virtual, lo que les permite aprender estrategias de afrontamiento y reducir el malestar asociado. El objetivo de este estudio es reducir la ansiedad, la preocupación y el miedo asociados a volar mediante el uso de la realidad virtual. A continuación se presenta el caso de una mujer de 23 años con fobia a volar desde la adolescencia. La ansiedad aparece durante el vuelo y raramente en los días previos. Diseño ABA (pre-tratamiento-post-test). Se utilizó una entrevista semiestructurada y los cuestionarios STAI, PSQW, EMV y EPAV para establecer la línea base, con puntuaciones altas en ansiedad rasgo y estado, preocupación y miedo a volar. Se planificó una intervención de 8 sesiones de una hora, con exposición gradual a la realidad virtual antes de la exposición en vivo. La paciente mostró una reducción clínicamente significativa de sus emociones negativas asociadas a volar y pudo hacerlo. La RV puede ser una herramienta eficaz en la práctica clínica para la exposición gradual en el tratamiento del miedo a volar.
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American Psychiatric Association (2014). DSM-V. Diagnostic and Statistical Manual of Mental Disorders. Panamericana.
Baños, R., Botella, C., Guerrero, B., Liaño, V., Alcañiz, M. & Rey, B. (2005). The Third Pole of the Sense of Presence: Comparing Virtual and Imagery Spaces. Psychology Journal, 3(1), 90-100.
Beckham, J.C., Vrana, S.R., May, J.G., Gustafson, D.J. & Smith, G.R. (1990). Emotional processing and fear measurement synchrony as indicators of treatment outcome in fear of flying. Journal of Behavior Therapy and Experimental Psychiatry, 21, 153-162.
Bordnick, P. S., Traylor, A. C., Carter, B. L., and Graap, K. M. (2012). A feasibility study of virtual reality-based coping skills training for nicotine dependence. Research on Social Work Practice, 22, 293–300. https://doi.org/10.1177/1049731511426880
Botella, C., Bretón-López, J., Serrano, B., García-Palacios, A., Quero, S., & Baños, R. (2015). Tratamiento de la fobia a volar usando la exposición de realidad virtual con o sin reestructuración cognitiva: Preferencias de los participantes. Revista de Psicopatología y Psicología Clínica, 19(3), 157–169. https://doi.org/10.5944/rppc.vol.19.num.3.2014.13898
Botella, C., García-Palacios, A., Baños Rivera, R. M.ª & Quero Castellano, S. (2007). Realidad virtual y tratamientos psicológicos. Cuadernos de Medicina Psicosomática y Psiquiatría de Enlace, 82, 17-31
Browning, M.H.E.M., Shin, S., Drong, G., McAnirlin, O., Gagnon, R. J., Ranganathan, S., Sindelar, K., Hoptman, D., Bratman, G. N.Yuan, S. …& Heller, W. (2023). Daily exposure to virtual nature reduces symptoms of anxiety in college students. Scientific Reports, 13, 1239 https://doi.org/10.1038/s41598-023-28070-9
Buela-Casal, G., Guillén-Riquelme, A., & Seisdedos, N. (2011). STAI. Cuestionario de Ansiedad Estado-Rasgo Adaptación del cuestionario de Ansiedad Estado-Rasgo. STAI. TEA ediciones.
Cardos, R.A., David, O.A., & David, D.O. (2017). Virtual reality exposure therapy in flight anxiety: A quantitative meta-analysis. Computers in Human Behavior 72, 371-380. https://doi.org/10.1016/j.chb.2017.03.007
Carl, E., Stein, A. T., Levihn-Coon, A., Pogue, J. R., Rothbaum, B., Emmelkamp, P., Asmundson, G. J. G., Carlbring, P. & Powers, M. B. (2019). Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of Anxiety Disorders, 61, 27–36. https://doi.org/10.1016/j.janxdis.2018.08.003
De Luca, R., Leonardi, S., Portaro, S., Le Cause, M., De Domenico, C., Colucci, P. V., Pranio, F., & Calabrò, R. S. (2021). Innovative use of virtual reality in autism spectrum disorder: A case-study. Applied Neuropsychology: Child, 10(1), 90-100. https://doi.org/10.1080/21622965.2019.1610964
Dickinson, P., Gerling, K., Wilson, L., & Parke, A. (2020). Virtual reality as a platform for research in gambling behaviour. Computers in Human Behavior, 107, 106293. https://doi.org/10.1016/j.chb.2020.106293
Difede, J. & Hoffman, H. (2002). Virtual reality exposure therapy for World TradeCenter post-traumatic stress disorder: A case report. Cyberpsychology & Behavior, 5, 529-535.
Dilgul, M., Martinez, J., Laxhman, N., Priebe, S. & Bird, V. (2020). Cognitive behavioural therapy in virtual reality treatments across mental health conditions: a systematic review. Consortium Psychiatricum, 1(1), 30-46. https://doi.org/10.17650/2712-7672-2020-1-1-30-46
Freeman, D., Lambe, S., Kabir, T., Petit, A., Rosebrock, L., Yu, L. M., Dudley, R., Chapman, K., Morrison, A., O’Regan, E. ... & West, J. (2022). Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses. The Lancet Psychiatry, 9(5), 375-388.
Glantz, K., Durlach, N. I., Barnett, R. C., & Aviles, W. A. (1996). Virtual reality (VR) for psychotherapy: From the physical to the social environment. Psychotherapy: Theory, Research, Practice, Training, 33(3), 464-473. https://doi.org/10.1037/0033-3204.33.3.464
Gottlieb, A., Doniger, G. M., Hussein, Y., Noy, S., & Plotnik, M. (2021). The Efficacy of a Virtual Reality Exposure Therapy Treatment for Fear of Flying: A Retrospective Study. Frontiers in Psychology, 12, 641393. https://doi.org/10.3389/fpsyg.2021.641393
Gursky, D.M. y Reiss, S. (1987). Identifying danger and anxiety expectancies as components of common fears. Journal of Behaviour Therapy and Experimental Psychiatry, 18, 317-324.
Hache-Labelle, C., Simard, S., Villeneuve, M., Abdel-Baki, A., Lepage, M., Bravo, M. A., & Lecomte, T. (2023). From home practice to virtual reality: The subjective experience of mindfulness-based therapy of people with concomitant social anxiety and psychotic disorder. Journal of Behavioral and Cognitive Therapy, 33(4), 216-226. https://doi.org/10.1016/j.jbct.2023.10.003
Hakim, A. & Hammad, S. (2022). Use of Virtual Reality in Psychology. In: Biele, C., Kacprzyk, J., Kopeć, W., Owsiński, J.W., Romanowski, A. & Sikorski, M. (eds) Digital Interaction and Machine Intelligence. MIDI 2021. Lecture Notes in Networks and Systems, vol 440. Springer, Cham. https://doi.org/10.1007/978-3-031-11432-8_21
Haug, T., Brenne, L., Johnsen, B.H., Berntzen, D., Götestam, K.G. & Hugdahl, K. (1987). A three systems anlysis o fear of flying: A comparison of a consonant vs. a non-consonant treatment method. Behavior Research and Therapy, 25, 187-194.
Jacobson, N. S. & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.
Jacobson, N. S., Roberts, L. J., Berns, S. B. & McGlinchey, J. B. (1999). Methods for defining and determining the clinical significance of treatment effects: description, application, and alternatives. Journal of Consulting and Clinical Psychology, 67(3), 300-307.
Kahan, M., Tanzer, J., Darvin, D. & Borer, F. (2000). Virtual reality-assisted cognitive-behavioral treatment for fear of flying: acute treatment and follow- up . Cyberpsychology and Behavior, 3, 387 -392 https://doi.org/10.1089/10949310050078832
Kazdin, A. E. (1999). The meanings and measurement of clinical significance. Journal of Consulting and Clinical Psychology, 67(3), 332-339.
Klein, R. A. (1998). Virtual reality exposure therapy (Fear of Flying): From a private practice perspective. Cyberpsychology and Behavior, 1, 311-316. http://doi.org/10.1089/cpb.1998.1.311
Kraemer, H. C., Morgan, G. A., Leech, N. L., Gliner, J. A., Vaske, J. J. & Harmon, R. J. (2003). Measures of Clinical Significance. Journal of the American Academy of Child and Adolescent Psychiatry, 42(12), 1524-1529
Kuntze, M.F., Stoermer, R., Mager, R., Roessler, A., Mueller-Spahn, F. y Bullinger, A.H. (2001) Immersive virtual environments in cues exposure. Cyberpsychology & Behavior, 4, 497-501.
Lee, J.H., Ku, J., Kim, K., Kim, B., Kim, I.Y., Yang, B., 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 and Behavior, 6, 275-280.
Lemmens, J.S., Simon, M. & Sumter, S.R. (2022). Fear and loathing in VR: the emotional and physiological efects of immersive games. Virtual Reality 26, 223–234. https://doi.org/10.1007/s10055-021-00555-w
Maldonado, J. G. (2002). Aplicaciones de la realidad virtual en psicología clínica. Aula Médica Psiquiátrica, 4(2), 92-126.
McLay, R. N., Baird, A., Webb-Murphy, J., Deal, W., Tran, L., Anson, H., Klam, W. & Johnston, S. (2017). A randomized, head-to-head study of virtual reality exposure therapy for posttraumatic stress disorder. Cyberpsychology, Behavior, and Social Networking, 20(4), 218-224.
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487-495 https://doi.org/10.1016/0005- 7967(90)90135-6
Mölbert, S. C., Thaler, A., Mohler, B. J., Streuber, S., Romero, J., Black, M. J., ... & Giel, K. E. (2018). Assessing body image in anorexia nervosa using biometric self-avatars in virtual reality: Attitudinal components rather than visual body size estimation are distorted. Psychological Medicine, 48(4), 642-653. https://doi.org/10.1017/S0033291717002008
Moore, K., Wiederhold, B.K., Wiederhold, M.D. & Riva, G. (2002) Panic and agoraphobia in a virtual world. CyberPsychology & Behavior, 5, 197-202.
Myers T.C., Swan-Kremeier L., Wonderlich S., Lancaster K. & Mitchell J.E. (2004).The use of alternative delivery systems and new technologies in the treatment of patients with eating disorders. International Journal of Eating Disorders, 36, 123-143
North, M. M., North, S. M. & Coble, J. R. (1997). Virtual reality therapy for fear of flying. The American journal of psychiatry, 154(1), 130. https://doi.org/10.1176/ajp.154.1.130b
Oakes, M., & Bor, R. (2010). The psychology of fear of flying (part I): a critical evaluation of current perspectives on the nature, prevalence and etiology of fear of flying. Travel Medicine and Infectious Disease, 8(6), 327–338. https://doi.org/10.1016/j.tmaid.2010.10.001
Psious. (2017). Virtual Reality Therapy. Retrieved April 22, 2017
Renner, V., Witthöft, M., Hardt, J., Conrad, R. & Petrowski, K.. (2024). Potential fearful situations in virtual reality -A pilot study assessing the effects of exposure in virtual reality and in vivo on anxious healthy participants in narrow rooms. Journal of Behavioral and Cognitive Therapy. 34. https://doi.org/10.1016/j.jbct.2024.100500
Ribé-Viñes, J., Gutiérrez-Maldonado, J., Zabolipour, Z., & Ferrer-Garcia, M. (2023). Efficacy of virtual reality-based exposure therapy for the treatment of fear of flying: A systematic review. The Cognitive Behaviour Therapist, 16, E19. https://doi.org/10.1017/S1754470X23000119
Riva, G., Baños, R. M., Botella, C., Mantovani, F. & Gaggioli, A. (2016). Transforming Experience: The Potential of Augmented Reality and Virtual Reality for Enhancing Personal and Clinical Change. Frontiers in Psychiatry, 7. https://doi.org/10.3389/fpsyt.2016.00164
Rothbaum B.O, Hodges L.F, Kooper R, Opdyke D, Williford J.S. & North M. (1995) Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. American Journal of Psychiatry, 152 (4): 626-628
Rothbaum B.O, Hodges L, Ready D, Graap K. &y Alarcon R.D. (2001). Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. Journal of Clinical Psychiatry, 62: 617-622.
Rus-Calafell, M., Gutiérrez-Maldonado, J., Botella, C., & Baños, R. M. (2013). Virtual reality exposure and imaginal exposure in the treatment of fear of flying: a pilot study. Behavior Modification, 37(4), 568-590. https://doi.org/10.1177/01454455134829
Sandín, B., Chorot, P., Valiente, R. M. & Lostao, L. (2009). Validación española del cuestionario de preocupación PSWQ : estructura factorial y propiedades psicométricas. Revista De Psicopatología Y Psicología Clínica, 14(2), 107–122. https://doi.org/10.5944/rppc.vol.14.num.2.2009.4070
Slater M, Pertaud D.P. & Steed A. (1999): Public speaking in virtual reality: Facing an audience of avatars. IEEE Computer Graphics and Applications, 19, 6-9.
Smith, V., Warty, R. R., Sursas, J. A., Payne, O., Nair, A., Krishnan, S., da Silva Costa, F., Wallace, E. M. & Vollenhoven, B. (2020). The Effectiveness of Virtual Reality in Managing Acute Pain and Anxiety for Medical Inpatients: Systematic Review. Journal of Medical Internet research, 22(11), e17980. https://doi.org/10.2196/17980
Sosa, C. D., Capafóns, J. I. & Viña, C. M. (1995). La evaluación del miedo a viajar en avión: estudio psicométrico de dos instrumentos de tipo autoinforme [Assessing the fear of flying: Psychometric analysis of two self-report instruments]. Psicología Conductual: Revista Internacional de Psicología Clínica de la Salud, 3(2), 133–158.
Spielberger, C.D., Gorsuch, R.L., Lushene, R.E., Vagg, P.R. & Jacobs, G.A. (1983). Manual for the State-Trait Anxiety Inventory (STAI). Consulting Psychologist Press
Takac, M., Collett, J., Blom, K. J., Conduit, R., Rehm, I., & De Foe, A. (2019). Public speaking anxiety decreases within repeated virtual reality training sessions. PloS one, 14(5), e0216288. https://doi.org/10.1371/journal.pone.0216288
Tortella-Feliu, M. Fullana, M.A. & Bornas, X. (2000) Miedo a volar: Características clínicas de la fobia y estrategias de intervención. Medicina Aeroespacial y Ambiental Vol. III (1). 26-36
Van, L. G., & Diekstra, R. (2000). Fear of flying treatment programs for passengers: an international review. Aviation, Space, and Environmental Medicine, 71, 430–437.
Wiederhold, B. K., Gevirtz, R. & Wiederhold, M. D. (1998). Fear of flying: A case report using virtual reality therapy with physiological monitoring. CyberPsychology y Behavior, 1(2), 97–103. https://doi.org/10.1089/cpb.1998.1.97
Wilson, C. J., & Soranzo, A. (2015). The use of virtual reality in psychology: A case study in visual perception. Computational and Mathematical Methods in Medicine, 2015(1), 151702
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