CyberEurope. Seventh Framework Programme (FP7): health.
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Aged↗
Biomedical subjects
Giuseppe Riva
Publications and source records attributed to Giuseppe Riva.
Is severe obesity a form of addiction? Rationale, clinical approach, and controlled clinical trial.
For many, obesity is just a problem of energy input and expenditure: more energy input than expenditure. However, the clinical practice and epidemiological data clearly show that weight control is more complex than expected by this simple equation. This is particularly true in morbid obesity, a form of severe obesity in which a person's Body Mass Index (BMI, kg/m(2)) is over 40. If we compare the definitions and diagnostic criteria for "dependence" and "addiction" with the situation of many severe obese subjects, it is apparent that they match very well. Further, different neurological studies confirm this similarity: both addiction and obesity patients have a deficiency of dopamine receptors. Nevertheless, when we compare many of the actual obesity treatments with the ones used in the area of addictions it is possible to find relevant differences: obesity treatments neither consider different levels of type and intensity of care, nor a multidimensional approach. To overcome these limitations, in this paper we propose a bio-psychosocial approach in which the genetic influence (lack of dopamine receptors) is matched by psychosocial issues (pressure for thinness and diet as main body image dissatisfaction treatment). Further, the paper outlines how this approach may influence the treatment options, by focusing both on the lessons coming from actual addiction treatment and the opportunities offered by virtual reality. Finally, the paper presents and discusses the outcome of a controlled trial, based on the proposed approach, including a 6-month follow-up (211 morbid obese females with a BMI of >40 and a documented history of failures.
Adaptation, Psychological↗
A strategy for computer-assisted mental practice in stroke rehabilitation.
OBJECTIVE: To investigate the technical and clinical viability of using computer-facilitated mental practice in the rehabilitation of upper-limb hemiparesis following stroke. DESIGN: A single-case study. SETTING: Academic-affiliated rehabilitation center. PARTICIPANT: A 46-year-old man with stable motor deficit of the upper right limb following subcortical ischemic stroke. INTERVENTION: Three computer-enhanced mental practice sessions per week at the rehabilitation center, in addition to usual physical therapy. A custom-made virtual reality system equipped with arm-tracking sensors was used to guide mental practice. The system was designed to superimpose over the (unseen) paretic arm a virtual reconstruction of the movement registered from the nonparetic arm. The laboratory intervention was followed by a 1-month home-rehabilitation program, making use of a portable display device. MAIN OUTCOME MEASURES: Pretreatment and posttreatment clinical assessment measures were the upper-extremity scale of the Fugl-Meyer Assessment of Sensorimotor Impairment and the Action Research Arm Test. Performance of the affected arm was evaluated using the healthy arm as the control condition. RESULTS: The patient's paretic limb improved after the first phase of intervention, with modest increases after home rehabilitation, as indicated by functional assessment scores and sensors data. CONCLUSION: Results suggest that technology-supported mental training is a feasible and potentially effective approach for improving motor skills after stroke.
Arm↗
Linguistic intergroup bias in political communication.
The Linguistic Intergroup Bias (LIB) illustrates the disposition to communicate positive in-group and negative out-group behaviors more abstractly than negative in-group and positive out-group behaviors. The present research examined the function of language in reinforcing this bias in political communication. To illustrate the LIB, the Linguistic Category Model (LCM) was used, including a nouns category. Because social stereotypes are usually conveyed by nominal terms, the aim was to observe the relationship between stereotypes and language in political communication. Moreover, we were interested in analyzing the psychological processes that drive the LIB. Therefore, we verified whether the LIB is more related to language abstractness than to agent-patient causality. Several political debates and interviews, which took place before the latest Italian provincial elections, were analyzed. Results suggested that the language politicians use in communicating about political groups are conceptualized as stereotypes rather than as trait-based categories. Moreover, it seems that the LIB could not be explained only at a lexical level. Social implications of the present findings in interpersonal relations and causal attribution were discussed.
Adult↗
Transformation of flow in rehabilitation: the role of advanced communication technologies.
Authentic rehabilitation requires the active participation of patients and their involvement with opportunities for action and development. Within this framework, in this article we outline the possibility of using two emerging computing and communication technologies-ambient intelligence (AmI) and virtual reality (VR)--for a new breed of rehabilitative and clinical applications based on a strategy defined as transformation of flow. Transformation of flow is a person's ability to exploit an optimal (flow) experience to identify and use new and unexpected psychological resources as sources of involvement. We identify the feeling of presence--the feeling of being in a world that exists outside oneself--as the theoretical link between the technology and rehabilitation. AmI and VR are used to trigger broad empowerment processes induced by a strong sense of presence, leading to greater agency and control over one's actions and environment.
Aged↗
Stress management using UMTS cellular phones: a controlled trial.
One of the best strategies for dealing with stress is learning how to relax. However, relaxing is difficult to achieve in typical real world situations. For this study, we developed a specific protocol based on mobile narratives - multimedia narratives experienced on UMTS/3G phones - to help workers in reducing commuting stress. In a controlled trial 33 commuters were randomly divided between three conditions: Mobile narratives (MN); New age music and videos (NA); no treatment (CT). In two consecutive days the MN and NA samples experienced during their commute trip 2 x 2 6-minute multimedia experiences on a Motorola A925 3G phone provided by the "TRE" Italian UMTS carrier: the MN sample experienced a mobile narrative based on the exploration of a desert beach; the NA sample experienced a commercial new age video with similar visual contents. The trials showed the efficacy of mobile narratives in reducing the level of stress experienced during a commute trip. No effects were found in the other groups. These results suggest that 3G mobile handsets may be used as relaxation tool if backed by a specific therapeutic protocol and meaningful narratives.
Adult↗
Virtual reality in psychotherapy: review.
Virtual reality (VR) has recently emerged as a potentially effective way to provide general and specialty health care services, and appears poised to enter mainstream psychotherapy delivery. Because VR could be part of the future of clinical psychology, it is critical to all psychotherapists that it be defined broadly. To ensure appropriate development of VR applications, clinicians must have a clear understanding of the opportunities and challenges it will provide in professional practice. This review outlines the current state of clinical research relevant to the development of virtual environments for use in psychotherapy. In particular, the paper focuses its analysis on both actual applications of VR in clinical psychology and how different clinical perspectives can use this approach to improve the process of therapeutic change.
Humans↗
Effects of group experiential cognitive therapy for the treatment of panic disorder with agoraphobia.
A treatment protocol, called experiential cognitive therapy (ExCT), was developed. It integrated traditional cognitive behavior therapy (CBT) with virtual reality exposure for the treatment of panic disorder with agoraphobia (PDA). The objective of this study was to test the efficacy of short-term (four sessions) ExCT compared with a traditional 12-session panic control program (PCP) for the treatment of PDA. Forty patients diagnosed as having PDA by the diagnostic criteria of DSM-IV were randomly assigned to ExCT and PCP groups of 20 patients each. The treatment effects were measured with self-report questionnaires, including the BDI, STAI, ASI, PBQ, ACQ, and BSQ. The authors also assessed high end-state functioning (HES), including the success rate of stopping or reducing medication at post-treatment and 6-month follow-up. In all ratings, both ExCT and PCP groups showed significant improvement post-treatment compared with pre-treatment scores. There were no significant differences between the two treatment groups in HES and medication discontinuation at post-treatment, but there was a significant difference in medication discontinuation at 6-month follow-up. These results suggested that although short-term effectiveness of ExCT might be comparable to the effectiveness of PCP, long-term effectiveness of ExCT might be relatively inferior to the effectiveness of PCP.
Adult↗
Personality of people using chat: an on-line research.
Conflicting claims have been presented in the literature about on-line management of personal relationships. The current research, carried out in a substantially descriptive design, aimed to consider psychological and social features of a particular electronic environment, the Chat room. One hundred fifty-eight participants filled out an on-line questionnaire set, designed to investigate the personality traits and the prevailing interpersonal values of those participants who set up interpersonal relationships on-line. The Web research showed that, if sampling control and validity assessment were provided, it could be a valid alternative to a more traditional paper-based procedure. The results highlighted that Chat users were not an homogenous group, but were composed of different personality types. Basically, however, this specific virtual environment proved to be crowded with rather close individuals, who were looking for independence but who needed also to be supported and encouraged. They created deep on-line relationships, but these remained limited to the virtual world.
Adolescent↗
A telemedicine survey among Milan doctors.
We surveyed physicians' attitudes to the use of telemedicine. A questionnaire was sent to 2987 Italian physicians and 361 responded (12%). The topics covered by the survey were: current telemedicine technology knowledge/usage level; general attitude towards telemedicine applications; perceived efficacy of telemedicine in enhancing quality of care; and intention to use telemedicine. In all, 83% of respondents had heard about telemedicine. Some doctors considered telemedicine to be of limited interest and many physicians were not convinced that it could improve clinical practice. These beliefs were more common among doctors of higher seniority, probably because they are more reluctant to accept change. To reduce such negative evaluations, better dissemination of information about the state of the art of research and development in telemedicine is needed. A logistic regression model was used to determine which factors influenced the intention to use telemedicine. The final model predicted 80% of the responses correctly.
Adult↗
Presence and rehabilitation: toward second-generation virtual reality applications in neuropsychology.
Virtual Reality (VR) offers a blend of attractive attributes for rehabilitation. The most exploited is its ability to create a 3D simulation of reality that can be explored by patients under the supervision of a therapist. In fact, VR can be defined as an advanced communication interface based on interactive 3D visualization, able to collect and integrate different inputs and data sets in a single real-like experience.However, "treatment is not just fixing what is broken; it is nurturing what is best" (Seligman & Csikszentmihalyi). For rehabilitators, this statement supports the growing interest in the influence of positive psychological state on objective health care outcomes.This paper introduces a bio-cultural theory of presence linking the state of optimal experience defined as "flow" to a virtual reality experience. This suggests the possibility of using VR for a new breed of rehabilitative applications focused on a strategy defined as transformation of flow. In this view, VR can be used to trigger a broad empowerment process within the flow experience induced by a high sense of presence.The link between its experiential and simulative capabilities may transform VR into the ultimate rehabilitative device. Nevertheless, further research is required to explore more in depth the link between cognitive processes, motor activities, presence and flow.
Journal Article↗
The layers of presence: a bio-cultural approach to understanding presence in natural and mediated environments.
This paper proposes a bio-cultural theory of presence based on four different positions related to the role and structure of presence, as follows. First, presence is a defining feature of self and it is related to the evolution of a key feature of any central nervous system: the embedding of sensory-referred properties into an internal functional space. Without the emergence of the sense of presence it is impossible for the nervous system to experience distal attribution: the referencing of our perception to an external space beyond the limits of the sensory organs themselves. Second, even if the experience of the sense of presence is a unitary feeling, conceptually it can be divided in three different layers, phylogenetically different and strictly related to the three levels of self identified by Damasio. In particular we can make conceptual distinctions between proto presence (self vs. non self), core presence (self vs. present external world), and extended presence (self relative to present external world). Third, given that each layer of presence solves a particular facet of the internal/external world separation, it is characterized by specific properties. Finally, in humans the sense of presence is a direct function of these three layers: the more they are integrated, the more we are present. In the experience of optimal presence, biologically and culturally determined cognitive processes are working in harmony--to focus all levels of the self on a significant situation in the external world, whether this is real or virtual.
Animals↗
Cybertherapy in practice: the VEPSY updated project.
Rapid and far-reaching technological advances are changing the ways in which people relate, communicate, and live. Technologies that were hardly used ten years ago, such as the Internet, e-mail, and video teleconferencing are becoming familiar methods for diagnosis, therapy, education and training. This is producing an emerging field (cybertherapy) whose focus is the use of communication and information technologies to improve the health care processes. To exploit and understand this potential was the aim of the Telemedicine and Portable Virtual Environment in Clinical Psychology, VEPSY UPDATED, an European Community funded research project (IST-2000-25323, http://www.cybertherapy.info). The chapter describes the clinical and technical rationale behind the cybertherapy applications developed by the project. Further, the actual role of virtual reality in the cybertherapy field is discussed, focusing on the advantages provided by its three different faces: technological, experiential and communicative.
Italy↗
New tools in cybertherapy: the VEPSY web site.
In the last years the rapid development of the Internet and new communication technologies has had a great impact on psychology and psychotherapy. Psychotherapists seem to rely with more and more interest on the new technological tools such as videophone, audio and video chat, e-mail, SMS and the new Instant Messaging Tools (IMs). All these technologies outline a stimulating as well as complex scenario: in order to effectively exploit their potential, it is important to study which is the possible role played by the Internet-based tools inside a psychotherapeutic iter. Could the technology substitute the health care practitioners or are these tools only a resource in addition to the traditional ones in the therapist's hand? The major aim of this chapter is to provide a framework for the integration of old and new tools in mental health care. Different theoretical positions about the possible role played by e-therapy are reported showing the possible changes that psychotherapy will necessarily face in a cyber setting. The VEPSY website, an integration of different Internet-based tools developed within the VEPSY UPDATED Project, is described as an example of clinical application matching between old (and functional) practices with new (and promising) media for the treatment of different mental disorders. A rationale about the possible scenarios for the use of the VEPSY website in the clinical process is provided.
Humans↗
Virtual reality and psychotherapy.
Virtual Reality (VR) is a new technology consisting on a graphic environment in which the user, not only has the feeling of being physically present in a virtual world, but he/she can interact with it. The first VR workstations were designed for big companies in order to create environments that simulate certain situations to train professionals. However, at this moment a great expansion of this technology is taking place in several fields, including the area of health. Especially interesting for us is the use of VR as a therapeutic tool in the treatment of psychological disorders. Compared to the traditional treatments, VR has many advantages (e.g., it is a protected environment for the patient, he/she can re-experience many times the feared situation, etc.). There are already data on the effectiveness of this technology in the treatment of different psychological disorders; here anxiety disorders, eating disorders and sexual disorders are reviewed. Finally, this chapter ends with some words about the limitations of VR and future perspectives.
Humans↗
The use of VR in the treatment of eating disorders.
In the treatment of eating disorders, the cognitive behavioral therapy (CBT) is still considered the best approach but could present different limitations related to costs of behavioural procedures (such as exposure and desensitization) or difficulty of cognitive techniques (such as imagination of daily scenarios). The major aim of this contribution is the description of a new Virtual Reality-enhanced treatment named Experiential Cognitive Therapy (ECT). Rationale and protocols about this new approach are explained. Moreover data about clinical trials, carried on with the VEPSY Project, are shown comparing different groups: experimental group (ECT), cognitive-behavioural therapy group (CBT), nutritional group and control group.
Cognitive Behavioral Therapy↗
Immersive Virtual Telepresence: virtual reality meets eHealth.
Immersive Virtual Telepresence (IVT) tools are virtual reality environments combined with wireless multimedia facilities--real-time video and audio--and advanced input devices--tracking sensors, biosensors, brain-computer interfaces. For its features IVT can be considered an innovative communication interface based on interactive 3D visualization, able to collect and integrate different inputs and data sets in a single real-like experience. In this paper we try to outline the current state of research and technology that is relevant to the development of IVT in medicine. Moreover, we discuss the clinical principles and possible advantages associated with the use of IVT in this field.
Biosensing Techniques↗