Albert S. Carlin

Virtual reality in the treatment of spider phobia: a controlled study

This study explored whether virtual reality (VR) exposure therapy was effective in the treatment of spider phobia. We compared a treatment condition vs. a waiting list condition in a between group design with 23 participants. Participants in the VR treatment group received an average of four one-hour exposure therapy sessions. VR exposure was effective in treating spider phobia compared to a control condition as measured with a Fear of Spiders questionnaire, a Behavioural Avoidance Test (BAT), and severity ratings made by the clinician and an independent assessor. Eighty-three percent of patients in the VR treatment group showed clinically significant improvement compared with 0% in the waiting list group, and no patients dropped out. This study shows that VR exposure can be effective in the treatment of phobias.

Virtual reality and tactile augmentation in the treatment of spider phobia: a case report.

This is the first case report to demonstrate the efficacy of immersive computer-generated virtual reality (VR) and mixed reality (touching real objects which patients also saw in VR) for the treatment of spider phobia. The subject was a 37-yr-old female with severe and incapacitating fear of spiders. Twelve weekly 1-hr sessions were conducted over a 3-month period. Outcome was assessed on measures of anxiety, avoidance, and changes in behavior toward real spiders. VR graded exposure therapy was successful for reducing fear of spiders providing converging evidence for a growing literature showing the effectiveness of VR as a new medium for exposure therapy.

The Effect of Differences in Objective and Subjective Definitions of Childhood Physical Abuse on Estimates of Its Incidence and Relationship to Psychopathology.

The relationship between objective and subjective definitions of physical abuse and the lifetime prevalence of depression was examined in 280 women attending a family medicine clinic at a large medical center. Based on their responses to a detailed questionnaire regarding discipline and abuse in childhood, 28.2% of these women were objectively defined as abused. Only 11.4% subjectively defined themselves as abused. The proportion of women who experienced depression during their lifetime was highest among those who defined themselves as abused (83%), intermediate among those who met objective criteria for having been physically abused, but did not define themselves as such (56%), and lowest among those who did not meet objective criteria for a history of physical abuse (35%). Similar relationships were found for history of psychotherapy, receipt of psychoactive medication, history of hospitalization for depression, suicide attempts and self-injury.

Subtypes of psychiatric inpatient women who have been sexually abused

The sexual abuse histories of 171 women admitted to a psychiatric inpatient service revealed that 40.3% had a positive history of sexual abuse. The DSM-III diagnoses made on discharge were not related to presence of abuse, age of abuse onset, duration and frequency of abuse, or relationship of the victim to the perpetrator. However, the diagnosis of personality disorder was associated with greater invasiveness of sexual abuse. Cluster analysis of the MMPIs provided by these women revealed four clusters. Membership in the more disturbed cluster was associated with a history of sexual abuse, but not with invasiveness, age of onset, relationship to the perpetrator, or duration and frequency of abuse. The implications of these findings for the role of mitigating factors, such as coping style and adaptation to stress, are discussed.

The Effect of Long-Term Chronic Marijuana Use on Neuropsychological Functioning

Ten normal subjects who smoked marijuana daily for an average of 5 years and who denied other drug use were examined on a neuropsychological test battery. When compared with normal nonsmoking Ss, minimal differences were observed. It was concluded that long-term cannabis use does not cause a generalized decrement in adaptive abilities which might be related to cerebral impairments.

Neuropsychological deficit in polydrug users ☆: A preliminary report of the findings of the Collaborative Neuropsychological Study of Polydrug Users

The Collaborative Neuropsychological Study of Polydrug Users performed extensive neuropsychological assessments on 15 polydrug users 3 weeks after their enrollment in each of eight polydrug demonstration programs. Fifty-six (37%) of these subjects exhibited neuropsychological deficit. This deficit was partially related to increasing age, poor education and premorbid medical risk factors. The deficit was also associated with extensive and intensive use of two classes of drugs: sedatives (sleeping pills and minor tranquilizers) and opiates (heroin and other narcotic drugs). Seventeen (26%) of a comparison group of 66 psychiatric in-patients and day patients also demonstrated age- and education-correlated neuropsychological deficit. For these patients impairment was also related to lifetime experience with antipsychotic drugs and (perhaps) with clinical diagnosis of schizophrenia. Although both polydrug users and psychiatric patients revealed serious psychopathology as measured by the MMPI, the pattern of the neuropsychological test findings suggested that psychopathology alone did not account for impairment. The 3 month follow-up which is in progress should delineate further the time course and enduring features of neuropsychological deficit among polydrug users, and may establish more clearly the relationship of sedative and opiate use to such impairment. Changes in psychopathological status of both polydrug users and psychiatric patients should also help to clarify the influence of this variable on neuropsychological findings.

Neuropsychological function in young alcoholics and polydrug abusers

Abstract The neuropsychological abilities of younger (mean age, 30) alcoholics and polydrug abusers were compared. On the basis of a clinicians rating of Halstead-Reitan results, 10 of 20 polydrug users (50%) and 4 of 20 alcoholics (20%) were found to show impairment. The polydrug users also scored significantly worse on Halsteads Impairment Index, Category Test, and Trail-Making Test, part B. Because the two groups were closely matched in age, education, Verbal IQ, and the medical history, the possibility is raised that, whereas 10 years of heavy drinking is not sufficient to yield neuropsychological impairment in younger persons, heavy multiple drug abuse might have more serious implications for cerebral functioning.

Drug abuse style, drug use type, and neuropsychological deficit in polydrug users

Abstract Seventy-nine polydrug users were classified into one of two behavioral categories (“streetwise” vs. “straight”) and into two motivational groupings (“recreational use” vs. “self-medicating”). Detailed medical and drug use histories were obtained, and all subjects received neuropsychological examination with the Halstead-Reitan Battery 3 weeks after entry into treatment. Neuropsychological impairment was related to different variables in the two groupings. “Streetwise” users who were impaired reported very heavy alcohol and opiate consumption. “Straight” users who were impaired used fewer drugs of all kinds except depressants, but had frequent positive medical histories.

Psychopathology and drug abuse: An MMPI comparison of polydrug abuse patients with psychiatric inpatients and outpatients

Abstract Clinical evidence suggest that individuals who misuse a variety of non-opiate drugs (polydrugs) are experiencing psychological disturbance rather than manifesting sociopathy. This investigation compared MMPI profiles of polydrug abuse patients with three groups of traditional psychiatric patients who varied in psychopathology (inpatient psychiatric patients, traditional outpatients and patients attending a behavioral/educational oriented program). Findings suggest that the polydrug abusing patients are most similar to impatients and support the hypothesis that they are a severely disturbed population. The degree of psychopathology among the polydrug patients raises questions regarding the efficacy of treatment which primarily focuses on the drug use and suggests the need to consider more broadly based treatment approaches.

Drug use and achievement

The relationship between lowered achievement and nonmedical use of drugs has become a concern as drug use increases. Two hundred sixty-six young males, some of whom were marihuana smokers, and some of whom used other drugs also, were interviewed about their levels of achievement and drug use. It was found that lowered levels of achievement were associated with higher rates of drug experience for both marihuana and other psychedelic drugs. Goal setting varied as a function of the decision to use drugs or not, rather than amount of drugs used. These two findings, taken together, suggest that observed lowered achievement is not the result primarily of a change in values, but of perhaps several factors which are discussed.