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Chapter 2. State of the Art Various methods have also been developed for the treatment of social phobia. For example, some researchers have proposed the use of Internet to expose patients to videos [Botella et al., 2000, 2004a]. Others have proposed to use a combination of virtual environments with live video [Lee et al., 2002b]. Similar to many of the existing applications for the treatment of social phobia, we propose an architecture which allows the use of various environments such as a bar, a cafeteria or an auditorium. Our architecture equally allows the definition the number of characters to be present in each scene. In addition, we use recorded background sounds in order for our environments to be more immersive as well as pre-recorded sentences to allow our characters to talk. Our application can be used on a simple computer screen, can be projected on a large back-projection screen or even in an HMD. This latter is used in combination with a head tracker in order for the images to change with respect to the user’s head movements. 2.1.2 VRET For Agoraphobia The term “agoraphobia” is now taken to include fears not only of open spaces but also of related aspects such as the presence of crowds and the difficulty of immediate easy escape to a safe place (usually home). The lack of an immediately available exit is one of the key features of many of these agoraphobic situations [WHO, 1993]. North et al. proposed a series of scenarios to be used in VRET treatment of agoraphobia [North et al., 1996]. These scenarios, however, did not consider crowds but only open spaces. To create the scenarios, they used the same software setup as in their application for social phobia [North et al., 1998]. These depicted a balcony, an empty room, a dark barn with or without a black cat, a covered bridge, a lift, a canyon and hot air balloons. They tested their scenarios from least to most anxiety provoking on a population of 30 individuals. They then compared their results with those of a control group of 30 people. These showed significant improvement in the patients having followed the VRET. The anxiety towards the feared situations decreased in the case of the patients having been through VRET whereas it stayed the same for the control group subjects. Moore et al. proposed a series of environments to be used by people suffering from panic attacks and agoraphobia [Moore et al., 2002]. These environments were developed by Giuseppe Riva’s team and represented a lift, a supermarket, a town square with and without people, and a beach. The characters were represented as billboards on which were applied real human textures. The exploration of the environments was done through HMD and navigation was obtained by using a joystick. They tested those environments on 9 healthy people by recording their physiological responses during exposure. They measured the skin conductance and temperature, heart rate and breathing rate. Their results showed that there was a physiological arousal during exposure. The aim of the authors with this study was to propose a baseline in studying physiological measures on agoraphobic patients. Vincelli et al. proposed a set of 4 environments to be used with agoraphobic patients [Vincelli et al., 2003]. These environments were also developed by Giuseppe Riva. They represented a lift, a supermarket, a metro car, and a large square. The software actually consisted in one application, the Virtual Environments for Panic Disorders (VEPD), depicting a fourzone environment developed with the Superscape VRT 5.6 toolkit [superscape, 2009]. The 22
2.1. Virtual Reality Exposure Therapy Figure 2.5: Left: Virtual supermarket for the treatment of panic attacks and agoraphobia [Villa Martin et al., 2007]. Right: Metro station for the exposure to panic attacks and agoraphobia [Botella et al., 2004c]. application allowed the definition of the zone to be explored, the length of exposure and the number of characters to be present in the scene (from none to a crowd). The authors then tested these environments on 12 agoraphobic patients randomly divided into three groups. The first group followed VRET with an HMD as part of the therapy during 8 sessions, the second followed traditional CBT during 12 sessions and the third was on a waiting list. Their results showed that both VRET and CBT could significantly reduce the number of panic attacks. Moreover, this was the case for fewer sessions in VRET than in traditional CBT. The authors therefore suggest that VRET could actually be more efficient. Botella et al. proposed a set of 5 different environments to be used in VRET of agoraphobia [Botella et al., 2004c]. These depicted a room, a bus, a tunnel, a supermarket, and a metro station. The supermarket and metro station are depicted in Figure 2.5. The environments were developed within the VEPSY Updated project [vepsy, 2009] using Virtools Dev 2.0 [Dassault Systèmes, 2009]. They also simulated various sensations such as increased heart beat, being out of breath, and blurry vision by modifying images and sound. Their effect was to bring the patients back to the symptoms they may feel during a panic attack. They also allowed their situations to be modulated for gradual exposure. For example, they could vary the number of characters, the trip length or the type of conversation to be held. The authors then tested this setup on 37 patients [Botella et al., 2007] divided into three groups, those following VRET, those following in-vivo exposure and those on a waiting list. Their results supported the efficacy of VRET in the treatment of panic attacks and agoraphobia. The same team further tested their environments in the treatment of a 26-year old woman suffering from panic attacks and agoraphobia [Villa Martin et al., 2007]. Her results showed a decrease in anxiety following the VRET sessions which was maintained 12 months after. Finally, Peñate et al. proposed a set of 7 virtual environments depicting a square and street, an airport building and an airplane, a bank office, a lift and an underground car park, a beach, a highway, and a cableway [Peñate et al., 2007]. These were developed using OpenGL and were based on a Torque engine from Garage Games [GarageGames, 2009]. Two projectors were used in order to send two different images on screen and allow for the environments to be visualized in stereo using polarized glasses. Finally, the environments were projected on a 2.5 x 2.5 meters screen allowing increased immersion as compared to a normal computer screen. The authors tested their application on 28 patients suffering 23
Page 1: Simulating Interactions with Virtua
Page 4 and 5: 3.2.4 Scripts . . . . . . . . . . .
Page 6 and 7: 7.3 Experimental Protocol . . . . .
Page 8 and 9: Résumé La Réalité Virtuelle (RV
Page 11 and 12: CHAPTER 1 Introduction 1.1 Context
Page 13 and 14: 1.3. Contributions in areas of dail
Page 15 and 16: 1.5. Organization of this Document
Page 17 and 18: CHAPTER 2 State of the Art 2.1 Virt
Page 19 and 20: 2.1. Virtual Reality Exposure Thera
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CHAPTER 6 Experimental Validations
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6.2. Clinical Study on VRET for Soc
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6.4. Eye-tracking for Interaction t
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CHAPTER 7 Experimental Validation -
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7.3. Experimental Protocol Figure 7
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7.4. Results User-centered Interest
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7.4. Results 10 9 8 7 6 5 4 3 2 1 0
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7.4. Results 10 9 8 7 6 5 4 3 2 1 0
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7.4. Results 1-2 1-3 1-4 2-3 2-4 3-
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7.6. Conclusion percentage of the v
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CHAPTER 8 Conclusion In the past de
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8.2. Perspectives and Future Work 8
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APPENDIX A Ethics Commission Reques
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- Cette condition persiste pendant
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laires sur un groupe de personnes s
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Richard G Heimberg, Social Phobia -
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APPENDIX B Fearful Situation Docume
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APPENDIX C List of Abbreviations AS
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APPENDIX D Glossary Acrophobia: acr
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List of Figures LIST OF FIGURES 2.1
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List of Figures 6.3 Results to the
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Bibliography BIBLIOGRAPHY American
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Bibliography Dassault Systèmes. ht
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Bibliography Iscan. http://www.isca
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Bibliography A. Mühlberger, M.J. W
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Bibliography B.O. Rothbaum, L.F. Ho
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WHO. The ICD-10 Classification Of M
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