Журнал высшей нервной деятельности им. И.П. Павлова, 2022, T. 72, № 4, стр. 487-503

Обзор психофизиологических и психотерапевтических исследований стресса с помощью технологий виртуальной реальности

В. В. Косоногов 1*, К. В. Ефимов 1, З. К. Рахманкулова 1, И. А. Зябрева 1

1 Институт Когнитивных Нейронаук, Национальный исследовательский университет “Высшая школа экономики”
Москва, Россия

* E-mail: vkosonogov@hse.ru

Поступила в редакцию 31.10.2021
После доработки 15.12.2021
Принята к публикации 20.12.2021

Аннотация

Данный обзор посвящен применению технологий виртуальной реальности в психофизиологии и психотерапии стресса. Рассмотрены исследования, применяющие виртуальную реальность как для введения испытуемых в состояние стресса, так и для помощи в снижении стрессовых реакций. Описаны методики, разработанные для лечения пациентов, страдающих расстройствами, связанными со стрессом (в частности, ПТСР, фобии). Во многих случаях снижение стрессовых реакций с помощью систем виртуальной реальности достигается не только на уровне самоотчета (переживания), но и на уровне показателей центральной и периферической нервной системы. Это позволяет рассматривать виртуальную реальность как современный, недорогой и эффективный метод, во-первых, для введения испытуемых в состояние стресса в целях проверки определённых психофизиологических гипотез и, во-вторых, для снижения стрессовых реакций.

Ключевые слова: стресс, ПТСР, тревожные расстройства, фобии, виртуальная реальность, ЧСС, КГР, ЭЭГ, психотерапия

Список литературы

  1. Эстербрук С.А., Орлова Е.А., Карпекова Т.А., Гребенников Ю.Л. Когнитивно-бихевиоральная терапия посттравматического стрессового расстройства (по материалам зарубежных исследований). Современная зарубежная психология. 2020. 9: 76–84.

  2. Юдин В.Е. Система комплексного и дифференцированного применения технологий восстановительной медицины в реабилитации специалистов опасных профессий на позднем госпитальном этапе Дисс. д.м.н. 2011. 358 с.

  3. Abu Hasan R., Sulaiman S., Ashykin N.N., Abdullah M.N., Hafeez Y., Ali S. S.A. Workplace Mental State Monitoring during VR-Based Training for Offshore Environment. Sensors. 2021. 21: 4885.

  4. Aminabadi N.A., Erfanparast L., Sohrabi A., Oskouei S.G., Naghili A. The impact of virtual reality distraction on pain and anxiety during dental treatment in 4–6 year-old children: a randomized controlled clinical trial. Journal of Dental Research, Dental Clinics, Dental Prospects. 2012. 6: 117.

  5. Anderson A.P., Mayer M.D., Fellows A.M., Cowan D.R., Hegel M.T., Buckey J.C. Relaxation with immersive natural scenes presented using virtual reality. Aerospace Medicine and Human Performance. 2017. 88: 520–526.

  6. Annerstedt M., Norman J., Boman M., Mattsson L., Grahn P., Währborg P. Finding stress relief in a forest. Ecological Bulletins. 2010. 53: 33–42.

  7. Annerstedt M., Jönsson P., Wallergård M., Johansson G., Karlson B., Grahn P., Hansen Å., Währborg P. Inducing physiological stress recovery with sounds of nature in a virtual reality forest–Results from a pilot study. Physiology & Behavior. 2013. 118: 240–250.

  8. Bălan O., Moise G., Moldoveanu A., Leordeanu M., Moldoveanu F. An investigation of various machine and deep learning techniques applied in automatic fear level detection and acrophobia virtual therapy. Sensors. 2020. 20: 496.

  9. Baños R.M., Guillen V., Quero S., Garcia-Palacios A., Alcaniz M., Botella C.A virtual reality system for the treatment of stress-related disorders: A preliminary analysis of efficacy compared to a standard cognitive behavioral program. International Journal of Human-Computer Studies. 2011. 69: 602–613.

  10. Beidel D.C., Frueh B.C., Neer S.M., Bowers C.A., Trachik B., Uhde T.W., Grubaugh A. Trauma management therapy with virtual-reality augmented exposure therapy for combat-related PTSD: A randomized controlled trial. Journal of Anxiety Disorders. 2019. 61: 64–74.

  11. Bergström I., Kilteni K., Slater M. First-person perspective virtual body posture influences stress: a virtual reality body ownership study PloS One. 2016. 11: e0148060.

  12. Botella C., Baños R.M., Perpiñá C., Villa H., Alcañiz M., Rey A. Virtual reality treatment of claustrophobia: a case report. Behaviour Research and Therapy. 1998. 36: 239–246.

  13. Botella C., García-Palacios A., Villa H., Baños R.M., Quero S., Alcañiz M., Riva G. Virtual reality exposure in the treatment of panic disorder and agoraphobia: A controlled study. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice. 2007. 14: 164–175.

  14. Bouchard S., Dumoulin S., Robillard G., Guitard T., Klinger E., Forget H., Loranger C., Roucaut F.X. Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: a three-arm randomised controlled trial. The British Journal of Psychiatry. 2017. 210: 276–283.

  15. Brouwer A.M., Neerincx M.A., Kallen V., van der Leer L., ten Brinke M. EEG alpha asymmetry, heart rate variability and cortisol in response to virtual reality induced stress. Journal of CyberTherapy & Rehabilitation. 2011. 4: 21–34.

  16. Carl E., Stein A.T., Levihn-Coon A., Pogue J.R., Rothbaum B., Emmelkamp P., Asmundson G.J.D., Carlbring P., Powers M.B. Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. Journal of Anxiety Disorders. 2019. 61: 27–36.

  17. Chicchi Giglioli I.A., Pravettoni G., Sutil Martín D.L., Parra E., Raya M.A. A novel integrating virtual reality approach for the assessment of the attachment behavioral system. Frontiers in Psychology. 2017. 8: 959.

  18. Cho D., Ham J., Oh J., Park J., Kim S., Lee N.K., Lee B. Detection of stress levels from biosignals measured in virtual reality environments using a kernel-based extreme learning machine. Sensors. 2017. 17: 2435.

  19. Clifford R.M., Jung S., Hoermann S., Billinghurst M., Lindeman R.W. Creating a stressful decision making environment for aerial firefighter training in virtual reality. IEEE Conference on Virtual Reality and 3D User Interfaces (VR). 2019. 181–189.

  20. Crescentini C., Capurso V., Furlan S., Fabbro F. Mindfulness-oriented meditation for primary school children: Effects on attention and psychological well-being. Frontiers in Psychology. 2016. 7: 805.

  21. Deng W., Hu D., Xu S., Liu X., Zhao J., Chen Q., Liu J., Zhang Z., Jiang W., Ma L., Hong X., Cheng, S., Liu B., Li, X. The efficacy of virtual reality exposure therapy for PTSD symptoms: A systematic review and meta-analysis. Journal of Affective Disorders. 2019. 257: 698–709.

  22. Dibbets P. A novel virtual reality paradigm: Predictors for stress-related intrusions and avoidance behavior. Journal of Behavior Therapy and Experimental Psychiatry. 2020. 67: 101449.

  23. Diemer J., Alpers G.W., Peperkorn H.M., Shiban Y., Mühlberger A. The impact of perception and presence on emotional reactions: a review of research in virtual reality. Frontiers in Psychology. 2015. 6: 26.

  24. Difede J., Cukor J., Jayasinghe N., Patt I., Jedel S., Spielman L., Giosan C., Hoffman H. G. Virtual reality exposure therapy for the treatment of posttraumatic stress disorder following September 11, 2001. Journal of Clinical Psychiatry. 2007. 68: 1639.

  25. Difede J., Hoffman H.G. Virtual reality exposure therapy for World Trade Center post-traumatic stress disorder: A case report. Cyberpsychology & Behavior. 2002. 5: 529–535.

  26. Ekeberg Ø., Kjeldsen S. E. Greenwood D. T., Enger E. Correlations between psychological and physiological responses to acute flight phobia stress, Scandinavian Journal of Clinical and Laboratory Investigation. 1990. 50: 671–677

  27. Fadeev K.A., Smirnov A.S., Zhigalova O.P., Bazhina P.S., Tumialis A.V., Golokhvast K.S. Too real to be virtual: Autonomic and EEG responses to extreme stress scenarios in virtual reality. Behavioural Neurology. 2020. 5758038.

  28. Felnhofer A., Kothgassner O.D., Schmidt M., Heinzle A.K., Beutl L., Hlavacs H., Kryspin-Exner I. Is virtual reality emotionally arousing? Investigating five emotion inducing virtual park scenarios. International Journal of Human-Computer Studies. 2015. 82: 48–56.

  29. Foa E.B., McLean C.P., Brown L.A., Zang Y., Rosenfield D., Zandberg L.J., Ealey W., Hanson B., Hunter L., Lillard I., Patterson T., Rosado J., Scott V., Weber C., Wise J., Zamora C., Mintz J., Young-McCaughan S., Peterson A.L. The effects of a prolonged exposure workshop with and without consultation on provider and patient outcomes: a randomized implementation trial. Implementation Science. 2020. 15: 1–14.

  30. Folkman S. (ed.). The Oxford handbook of stress, health, and coping. – Oxford University Press. 2011. 3: 12–15.

  31. Gaggioli A., Pallavicini F., Morganti L., Serino S., Scaratti C., Briguglio M., Crifaci G., Vetrano N., Giulintano A., Bernava G., Tartarisco G., Pioggia G., Raspelli S., Cipresso P., Vigna C., Grassi A., Baruffi M., Wiederhold B., Riva G. Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: a block randomized controlled trial. Journal of Medical Internet Research. 2014. 16: e3235.

  32. Ganry L., Hersant B., Sidahmed-Mezi M., Dhonneur G., Meningaud J. P. Using virtual reality to control preoperative anxiety in ambulatory surgery patients: A pilot study in maxillofacial and plastic surgery. Journal of Stomatology, Oral and Maxillofacial Surgery. 2018. 119: 257–261.

  33. Ham J., Cho D., Oh J., Lee B. Discrimination of multiple stress levels in virtual reality environments using heart rate variability. 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). 2017: 3989–3992.

  34. Hartanto D., Kampmann I. L., Morina N., Emmelkamp P.G., Neerincx M.A., Brinkman W.P. Controlling social stress in virtual reality environments. PloS One. 2014. 9: e92804.

  35. Hesse K., Schroeder P.A., Scheeff J., Klingberg S., Plewnia C. Experimental variation of social stress in virtual reality–feasibility and first results in patients with psychotic disorders. Journal of Behavior Therapy and Experimental Psychiatry. 2017. 56: 129–136.

  36. Jönsson P., Wallergård M., Österberg K., Hansen Å.M., Johansson G., Karlson B. Cardiovascular and cortisol reactivity and habituation to a virtual reality version of the Trier Social Stress Test: a pilot study. Psychoneuroendocrinology. 2010. 35: 1397–1403.

  37. Kamkuimo Kengne S.A., Fossaert M., Girard B., Menelas B. Action-centered exposure therapy (ACET): a new approach to the use of virtual reality to the care of people with post-traumatic stress disorder. Behavioral Sciences. 2018. 8: 76.

  38. Kim H., Kim D.J., Kim S., Chung W.H., Park K.A., Kim J.D., Kim D., Kim M., Kim K., Jeon H.J. Effect of Virtual Reality on Stress Reduction and Change of Physiological Parameters Including Heart Rate Variability in People With High Stress: An Open Randomized Crossover Trial. Frontiers in Psychiatry. 2021. 12: 614539.

  39. Kotlyar M., Donahue C., Thuras P., Kushner M.G., O’Gorman N., Smith E.A., Adson D.E. Physiological response to a speech stressor presented in a virtual reality environment. Psychophysiology. 2008. 45: 1034–1037.

  40. Lee J., Park B.J., Tsunetsugu Y., Kagawa T., Miyazaki Y. Restorative effects of viewing real forest landscapes, based on a comparison with urban landscapes. Scandinavian Journal of Forest Research. 2009. 24: 227–234.

  41. Levy C.E., Miller D.M., Akande C.A., Lok B., Marsiske M., Halan S. V-Mart, a virtual reality grocery store: A focus group study of a promising intervention for mild traumatic brain injury and posttraumatic stress disorder. American Journal of Physical Medicine & Rehabilitation. 2019. 98: 191–198.

  42. Li C., Sun C., Sun M., Yuan Y., Li P. Effects of brightness levels on stress recovery when viewing a virtual reality forest with simulated natural light. Urban Forestry & Urban Greening. 2020. 56: 126865.

  43. Lin J., Cao L., Li N. Assessing the influence of repeated exposures and mental stress on human wayfinding performance in indoor environments using virtual reality technology. Advanced Engineering Informatics. 2019. 39: 53–61.

  44. Martens M.A., Antley A., Freeman D., Slater M., Harrison P.J., Tunbridge E.M. It feels real: physiological responses to a stressful virtual reality environment and its impact on working memory. Journal of Psychopharmacology. 2019. 33: 1264–1273.

  45. McLay R., Ram V., Murphy J., Spira J., Wood D.P., Wiederhold M.D., Wiederhold B., Johnston S., Reeves D. Effect of virtual reality PTSD treatment on mood and neurocognitive outcomes. Cyberpsychology, Behavior, and Social Networking. 2014. 17: 439–446.

  46. McLay R.N., Wood D.P., Webb-Murphy J.A., Spira J.L., Wiederhold M.D., Pyne J.M., Wiederhold B.K. A randomized, controlled trial of virtual reality-graded exposure therapy for post-traumatic stress disorder in active duty service members with combat-related post-traumatic stress disorder. Cyberpsychology, Behavior, and Social Networking. 2011. 14: 223–229.

  47. Mistry D., Zhu J., Tremblay P., Wekerle C., Lanius R., Jetly R., Frewen P. Meditating in virtual reality: Proof-of-concept intervention for posttraumatic stress. Psychological Trauma: Theory, Research, Practice, and Policy. 2020. 12: 847–858.

  48. Mühlberger A., Herrmann M.J., Wiedemann G., Ellgring H., Pauli P. Repeated exposure of flight phobics to flights in virtual reality. Behaviour Research and Therapy. 2001. 39: 1033–1050.

  49. Pallavicini F., Orena E., di Santo S., Greci L., Caragnano C., Ranieri P., Vuolato C., Pepe A., Veronese G., Dakanalis A., Rossini A., Caltagirone C., Clerici M., Mantovani F. MIND-VR: Design and Evaluation Protocol of a Virtual Reality Psychoeducational Experience on Stress and Anxiety for the Psychological Support of Healthcare Workers Involved in the COVID-19 Pandemic. Front in Virtual Reality. 2021. 2: 620225.

  50. Pallavicini F., Argenton L., Toniazzi N., Aceti L., Mantovani, F. Virtual reality applications for stress management training in the military. Aerospace Medicine and Human Performance. 2016. 87: 1021–1030.

  51. Park B.J., Tsunetsugu Y., Kasetani T., Hirano H., Kagawa T., Sato M., Miyazaki Y. Physiological effects of shinrin-yoku (taking in the atmosphere of the forest) using salivary cortisol and cerebral activity as indicators. Journal of physiological anthropology. 2007. 26: 123–128.

  52. Peperkorn H.M., Diemer J., Mühlberger A. Temporal dynamics in the relation between presence and fear in virtual reality. Computers in Human Behavior. 2015. 48: 542–547.

  53. Pertaub D.P., Slater M., Barker C. An experiment on public speaking anxiety in response to three different types of virtual audience. Presence. 2002. 11: 68–78.

  54. Peterson S.M., Furuichi E., Ferris D.P. Effects of virtual reality high heights exposure during beam-walking on physiological stress and cognitive loading. PloS One. 2018. 13: e0200306.

  55. Piskorz J., Czub M. Effectiveness of a virtual reality intervention to minimize pediatric stress and pain intensity during venipuncture. Journal for Specialists in Pediatric Nursing. 2018. 23: e12201.

  56. Powers M.B., Emmelkamp P.M. Virtual reality exposure therapy for anxiety disorders: A meta-analysis. Journal of Anxiety Disorders. 2008. 22: 561–569.

  57. Ready D.J., Pollack S., Rothbaum B.O., Alarcon R.D. Virtual reality exposure for veterans with posttraumatic stress disorder. Journal of Aggression, Maltreatment & Trauma. 2006. 12: 199–220.

  58. Reger G.M., Koenen-Woods P., Zetocha K., Smolenski D.J., Holloway K.M., Rothbaum B.O., Difede J., Rizzo A., Edwards-Stewart A., Skopp N., Mishkind M., Gahm G.A. Randomized controlled trial of prolonged exposure using imaginal exposure vs. virtual reality exposure in active duty soldiers with deployment-related posttraumatic stress disorder (PTSD). Journal of Consulting and Clinical Psychology. 2016. 84: 946.

  59. Ríos A., Pelechano N. Follower behavior under stress in immersive VR. Virtual Reality. 2020. 24: 683–694.

  60. Riva G., Mantovani F., Capideville C. S., Preziosa A., Morganti F., Villani D., Gaggioli A., Botella C., Alcañiz M. Affective interactions using virtual reality: the link between presence and emotions. Cyberpsychology & Behavior. 2007. 10: 45–56.

  61. Rizzo A., John B., Newman B., Williams J., Hartholt A., Lethin C., Buckwalter J.G. Virtual reality as a tool for delivering PTSD exposure therapy and stress resilience training. Military Behavioral Health. 2013. 1: 52–58.

  62. Rothbaum B.O. Virtual reality exposure therapy in the treatment of fear of flying: A case report. Behaviour Research and Therapy. 1996. 34: 477–481.

  63. Rothbaum B.O. Virtual reality graded exposure in the treatment of acrophobia: A case report. Behavior Therapy. 1995. 26: 547–554.

  64. Scates D., Dickinson J.I., Sullivan K., Cline H., Balaraman R. Using nature-inspired virtual reality as a distraction to reduce stress and pain among cancer patients. Environment and Behavior. 2020. 52: 895–918.

  65. Selye H. The stress of life. New York McGraw-Hill. 1956.

  66. Shah L.B.I., Torres S., Kannusamy P., Chng C.M.L., He H.G., Klainin-Yobas P. Efficacy of the virtual reality-based stress management program on stress-related variables in people with mood disorders: the feasibility study. Archives of Psychiatric Nursing. 2015. 29: 6–13.

  67. Shiban Y., Diemer J., Müller J., Brütting-Schick J., Pauli P., Mühlberger A. Diaphragmatic breathing during virtual reality exposure therapy for aviophobia: functional coping strategy or avoidance behavior? A pilot study. BMC Psychiatry. 2017. 17: 1–10.

  68. Slater M., Pertaub D.P., Barker C., Clark D.M. An experimental study on fear of public speaking using a virtual environment. CyberPsychology & Behavior. 2006. 5: 627–633.

  69. Slobounov S.M., Ray W., Johnson B., Slobounov E., Newell K.M. Modulation of cortical activity in 2D versus 3D virtual reality environments: an EEG study. International Journal of Psychophysiology. 2015. 95: 254–260.

  70. Soyka F., Leyrer M., Smallwood J., Ferguson C., Riecke B.E., Mohler B.J. Enhancing stress management techniques using virtual reality. Proceedings of the ACM Symposium on Applied Perception. 2016: 85–88.

  71. Tartarisco G., Carbonaro N., Tonacci A., Bernava G.M., Arnao A., Crifaci G., Cipresso P., Riva G., Gaggioli D., de Rossi D., Tognetti A., Pioggia G. Neuro-fuzzy physiological computing to assess stress levels in virtual reality therapy. Interacting with Computers. 2015. 27: 521–533.

  72. van’t Wout-Frank M., Shea M.T., Larson V.C., Greenberg B.D., Philip N.S. Combined transcranial direct current stimulation with virtual reality exposure for posttraumatic stress disorder: feasibility and pilot results. Brain Stimulation. 2019. 12: 41–43.

  73. Veling W., Pot-Kolder R., Counotte J., van Os J., van der Gaag M. Environmental social stress, paranoia and psychosis liability: a virtual reality study. Schizophrenia Bulletin. 2016. 42: 1363–1371.

  74. Vieira Á., Melo C., Machado J., Gabriel J. Virtual reality exercise on a home-based phase III cardiac rehabilitation program, effect on executive function, quality of life and depression, anxiety and stress: a randomized controlled trial. Disability and Rehabilitation: Assistive Technology. 2018. 13: 112–123.

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

  76. Wang X., Shi Y., Zhang B., Chiang Y. The influence of forest resting environments on stress using virtual reality. International Journal of Environmental Research and Public Health. 2019. 16: 3263.

  77. Wiederhold B.K., Jang D.P., Gevirtz R.G., Kim S.I., Kim I.Y., Wiederhold M.D. The treatment of fear of flying: a controlled study of imaginal and virtual reality graded exposure therapy. IEEE Transactions on Information Technology in Biomedicine. 2002. 6: 218–223.

  78. Wolitzky K., Fivush R., Zimand E., Hodges L., Rothbaum B.O. Effectiveness of virtual reality distraction during a painful medical procedure in pediatric oncology patients. Psychology and Health. 2005. 20: 817–824.

  79. Yin J., Yuan J., Arfaei N., Catalano P.J., Allen J.G., Spengler J.D. Effects of biophilic indoor environment on stress and anxiety recovery: A between-subjects experiment in virtual reality. Environment International. 2020. 136: 105427.

  80. Zimmer P., Buttlar B., Halbeisen G., Walther E., Domes, G. Virtually stressed? A refined virtual reality adaptation of the Trier Social Stress Test (TSST) induces robust endocrine responses. Psychoneuroendocrinology. 2019. 101: 186–192.

Дополнительные материалы отсутствуют.