Virtual Reality Holds Promise for Reducing Phobias in Autism

In a new pilot study, adults with autism showed real-life, functional improvements following a virtual reality (VR) treatment approach in which they were gradually exposed to their fears. The VR treatment was coupled with cognitive behavioral therapy (CBT).

Fears and phobias are common in people with autism spectrum disorder (ASD), and these can have a significant impact on their ability to carry out daily activities.

Graded exposure to anxiety-causing stimuli is a recognized approach for treating fears and phobias in the non-autistic population. But it has been assumed that this method would present special difficulties for people with ASD, as real-life exposure could potentially be too upsetting to allow treatment to take place.

To address this, the research team developed an anxiety-targeting intervention that combined cognitive behavioral therapy with immersive virtual reality exposure. Following successful trials of this intervention with young people on the autism spectrum, the researchers conducted the new pilot study using the same intervention with autistic adults.

For the study, eight ASD adults (aged 18–57 years) received one psychoeducation session and then four 20-minute sessions of graded exposure with a therapist in an immersive VR room. Each participant completed all sessions; this shows that the intervention is both practical and acceptable, say the researchers.

Outcomes were monitored at 6 weeks and 6 months post-intervention. The findings show that 5 of the 8 participants were classified as “intervention responders,” and at 6 months post-intervention, they were experiencing real-life functional improvements.

These preliminary findings, published in the journal Autism in Adulthood, suggest that VR-graded exposure alongside CBT may be an effective treatment for autistic adults with phobias.

“Phobias commonly co-occur with autism and often cause significant distress,” said Christina Nicolaidis, M.D., M.P.H., associate professor of medicine and public health at Portland State University in Oregon and editor-in-chief of Autism in Adulthood.

“While results are very preliminary, it is exciting to see innovative strategies for an issue that has been so hard to treat. Emerging Practices papers, such as this one, look towards the future by highlighting new avenues of research that have potential for improving quality of life for autistic adults.”

Research suggests that approximately half of children with ASD meet criteria for at least one anxiety disorder. Of all types of anxiety disorders, specific phobia is the most common, with prevalence estimates ranging from 31 percent to 64 percent.

Source: Mary Ann Liebert, Inc/ Genetic Engineering News


Treating Phobias With Each Heartbeat

A new U.K. study finds that exposing people with phobias to their specific fear at the exact time their heart beats can lead to a reduction in the phobia’s severity.

“Many of us have phobias of one kind or another — it could be spiders, or clowns or even types of food,” said principle investigator Hugo Critchley, Chair of Psychiatry at Brighton and Sussex Medical School (BSMS) in the U.K.

“Treatment usually involves exposing the person to their fear, but this can take a long time. Our work shows that how we respond to our fears can depend on whether we see them at the time our heart beats, or between heartbeats. You could say we’re within a heartbeat of helping people beat their phobias.”

Individuals with phobias experience a disproportionately intense and disabling anxiety that is induced by specific situations or triggers, such as bridges or crowds.

Phobia therapy is often prolonged and involves a graded exposure to fear-provoking stimuli; however, these types of treatments have made some progress in recent years through the use of computerized therapy. The new study reveals that phobias can be treated more effectively by linking computerized therapy to the patient’s own heart rhythm.

In a previous study, BSMS researchers showed how bodily arousal signals that occur with each individual heartbeat can change the emotional impact of potential threats — for example, when experienced during a heartbeat they can appear greater.

In this proof-of-concept clinical trial, a computerized exposure therapy for spider phobia was combined with online measurements of heartbeats.

For one group of patients, pictures of spiders were presented in-time with heartbeats (during the signaling of cardiac arousal), while for another patient group, pictures of spiders were presented in-between heartbeats. A third control group was shown spiders in a random fashion during therapy sessions.

Although there was some improvement among all patients — as would be expected in exposure therapy — the findings show that participants exposed to spiders in time with their own heartbeats showed a greater reduction in their self-reported fear of spiders, anxiety levels and their physiological responses to spiders.

These improvements were also found to depend on differences in how well an individual patient can accurately feel their own heart beating in their chest, suggesting a further way of tailoring the treatment to benefit each patient.

Source: University of Sussex

Psychedelic Drugs Show Promise for Treating Anxiety, Depression, PTSD

New findings add to the growing body of evidence suggesting that psychedelic drugs may be effective at treating a variety of psychological disorders, including depression, social anxiety and post-traumatic stress disorder (PTSD) and could one day be prescribed to patients.

The research was presented recently at the American Psychological Association’s annual meeting and included studies on the use of LSD, psilocybin (magic mushrooms), MDMA (ecstacy) and ayahuasca (used by indigenous Amazonian people for spiritual ceremonies).

After the discovery of LSD in the 1940s, American researchers began studying hallucinogens for their potential healing benefits, but this research mostly came to a halt after psychedelics were outlawed in the late 1960s.

A shift may be coming soon, however, as MDMA is beginning its third and final phase of clinical trials in an effort to win Food and Drug Administration approval for treatment of post-traumatic stress disorder, said Adam Snider, MA, of Alliant International University Los Angeles, and co-chair of the symposium.

“Combined with psychotherapy, some psychedelic drugs like MDMA, psilocybin and ayahuasca may improve symptoms of anxiety, depression and post-traumatic stress disorder,” said Cristina L. Magalhaes, PhD, of Alliant International University Los Angeles, and co-chair of a symposium on psychedelics and psychotherapy.

“More research and discussion are needed to understand the possible benefits of these drugs, and psychologists can help navigate the clinical, ethical and cultural issues related to their use.”

Findings from another study suggest that symptoms of social anxiety in adults with autism may be treatable with a combination of psychotherapy and MDMA. Twelve autistic adults with moderate to severe social anxiety who were given two treatments of pure MDMA, plus ongoing therapy, showed significant and long-lasting reductions in their symptoms.

“Social anxiety is prevalent in autistic adults and few treatment options have been shown to be effective,” said Alicia Danforth, PhD, of the Los Angeles Biomedical Research Institute at the HarborUCLA Medical Center, who conducted the study. “The positive effects of using MDMA and therapy lasted months, or even years, for most of the research volunteers.”

Other research presented at the meeting shows how LSD, psilocybin and ayahuasca may benefit people with anxiety, depression and eating disorders.

Adele Lafrance, PhD, of Laurentian University, discussed a study of 159 participants who reported on their past use of hallucinogens, level of spirituality and relationship with their emotions. Hallucinogen use was associated with greater levels of spirituality, which led to improved emotional stability and fewer symptoms of anxiety, depression and disordered eating.

“This study reinforces the need for the psychological field to consider a larger role for spirituality in the context of mainstream treatment because spiritual growth and a connection to something greater than the self can be fostered,” said Lafrance.

One study suggests that ayahuasca may help relieve depression and addiction, as well as assist people in coping with trauma. “We found that ayahuasca also fostered an increase in generosity, spiritual connection and altruism,” said Clancy Cavnar, PhD, with Núcleo de Estudos Interdisciplinares sobre Psicoativos.

In addition, for people suffering from life-threatening cancer, psilocybin may offer significant and long-lasting reductions in anxiety and distress.

When combined with psychotherapy, psilocybin helped 13 study participants grapple with loss and existential distress. It also helped the participants reconcile their feelings about death as nearly all participants reported that they developed a new understanding of dying, according to Gabby Agin-Liebes, BA, of Palo Alto University, who conducted the research.

“Participants made spiritual or religious interpretations of their experience and the psilocybin treatment helped facilitate a reconnection to life, greater mindfulness and presence, and gave them more confidence when faced with cancer recurrence,” said Agin-Liebes.

Source: American Psychological Association

Mind-Body Therapies May Reduce Anxiety in Teens

Anxiety affects approximately one in three American teens, with more than eight percent experiencing severe impairment in daily functioning. But according to a new review published in The Nurse Practitioner, mind-body therapies, such as mindfulness, yoga and hypnosis, can play a vital role in reducing the very common problem of adolescent anxiety.

“Mind-body therapies encompass self-regulation and positive thinking…to help promote self-control, physical health, and emotional well-being,” write Bernadette Fulweiler RN, MSN, CPNP-PC, and Rita Marie John DNP, EdD, CPNP-PC, DCC, of Columbia University School of Nursing, New York.

“A growing body of evidence supports the implementation of mind-body therapy as a low-risk and cost-effective strategy in the management of anxious teenagers.”

The researchers also emphasize the role of pediatric nurse practitioners (NPs) in integrating screening and treatment for adolescents with anxiety. NPs can screen young patients for anxiety at every health visit and help create a personalized plan to treat it.

And while NPs are often highly supportive of alternative medicine practices, they need ongoing education regarding the benefits and methods of integrating mind-body medicine into patient care, according to the researchers.

“Whereas anxiety and fear are typical reactions to the academic, social, and developmental challenges common during the adolescent years, clinical or pathological anxiety is excessive, persistent, and disruptive,” according to the authors.

So while anxiety is often situational and temporary, many teens develop chronic anxiety lasting six months or longer.

But the recommended treatments for adolescent anxiety — cognitive behavioral therapy and/or antidepressant medications — have important limitations. They are expensive, often difficult to obtain, and in the case of antidepressants, can have side effects. In fact, research shows that most teens with mental health disorders, especially anxiety, do not receive any form of mental health care.

For the study, the researchers reviewed and analyzed published research on mind-body therapy for anxiety in teens, focusing on four approaches: mindfulness, yoga, hypnosis and biofeedback.

Mindfulness techniques involve aspects of meditation, body scanning, and mindful breathing to help focus attention on the present moment and separate from negative thoughts. Six studies showed positive effects of mindfulness approaches for teens with anxiety, including school-based programs in high-risk populations.

Yoga is one of the most popular mind-body therapies, with positive physical and mental effects including reduced anxiety. The researchers cite five studies, including four randomized trials, reporting positive effects of yoga in school settings.

Hypnosis involves using imagery and relaxation techniques to help control stress responses. The review identified three studies of hypnosis techniques to lower stress in adolescents, including a tele-hypnosis intervention to reduce anxiety-related absences in high school students.

Biofeedback involves becoming mindful of your body’s involuntary reactions (such as the feeling of anxiety arising in the body) through electrodes attached to the skin. Then through the power of your mind, you can gain more control over such reactions. The review identified four studies of biofeedback approaches, showing significant reductions in anxiety and stress in teens receiving heart-rate variability (HRV) monitoring and video game-based biofeedback.

The researchers conclude by saying that mind-body therapies can help to meet the “dire need” for affordable and accessible mental health strategies in pediatric primary care.

Source: Wolters Kluwer Health