Jorge Osma

Virtual reality treatment of flying phobia

Flying phobia (FP) might become a very incapacitating and disturbing problem in a persons social, working, and private areas. Psychological interventions based on exposure therapy have proved to be effective, but given the particular nature of this disorder they bear important limitations. Exposure therapy for FP might be excessively costly in terms of time, money, and efforts. Virtual reality (VR) overcomes these difficulties as different significant environments might be created, where the patient can interact with what he or she fears while in a totally safe and protected environment, the therapists consulting room. This paper intends, on one hand, to show the different scenarios designed by our team for the VR treatment of FP, and on the other, to present the first results supporting the effectiveness of this new tool for the treatment of FP in a multiple baseline study.

Treatment of Complicated Grief Using Virtual Reality: A Case Report

This is the first work exploring the application of new technologies, concretely virtual reality, to facilitate emotional processing in the treatment of Complicated Grief. Our research team has designed a virtual reality environment (EMMAs World) to foster the expression and processing of emotions. In this study the authors present a description of EMMAs World, the clinical protocol, and a case report. The treatment program was applied in eight sessions. We present a brief description of the session agendas including the techniques used. We offer short-term (from pre-test to post-test) and long-term (2-, 6- and 12-month follow-ups) efficacy data. Our results offer preliminary support of the use of EMMAs World for the treatment of Complicated Grief.

Bifactor analysis and construct validity of the HADS: a cross-sectional and longitudinal study in fibromyalgia patients.

The dimensionality of the Hospital Anxiety and Depression Scale (HADS) is a current source of controversy among experts. The present study integrates a solid theoretical framework (Clark & Watsons, 1991, tripartite theory) and a fine-grained methodological approach (structural equation modeling; SEM) to examine the dimensionality and construct validity of the HADS in fibromyalgia (FM) patients. Using the HADS data of 269 Spanish patients with FM, we estimated the cross-sectional and, for the first time, longitudinal fit (autoregressive model) of 2 competing models (oblique 2-factor vs. bifactor) via confirmatory factor analysis. The pattern of relationships between the HADS latent dimensions and positive and negative affect (PA and NA) was analyzed using SEM. HADS reliability was assessed by computing the omega and omega hierarchical coefficients. The bifactor model, which accounted for the covariance among HADS items with regard to 1 general factor (psychological distress) and 2 specific factors (depression and anxiety), described the HADS structure better than the original oblique 2-factor model during both study periods. All latent dimensions of the bifactor model were temporally stable. The SEM analysis revealed a significant link between psychological distress and NA as well as between depression and low PA. Only the general factor of psychological distress showed adequate reliability. In conclusion, the HADS shows a clear bifactor structure among FM patients. Our results indicate that it is not recommendable to compute anxiety and depression scores separately because anxiety variance is tapped primarily by the broader construct of psychological distress, and both specific dimensions show low reliability.

Personality disorders among patients with panic disorder and individuals with high anxiety sensitivity

BACKGROUND No studies have been found that compared the psychopathology features, including personality disorders, of Panic Disorder (PD) and Panic Disorder with Agoraphobia (PDA), and a nonclinical sample with anxiety vulnerability. METHOD The total sample included 152 participants, 52 in the PD/PDA, 45 in the high anxiety sensitivity (AS) sample, and 55 in the nonclinical sample. The participants in PD/PDA sample were evaluated with the structured interview ADIS-IV. The Brief Symptom Inventory and the MCMI-III were used in all three samples. RESULTS Statistically significant differences were found between the PD/PDA and the nonclinical sample in all MCMI-III scales except for antisocial and compulsive. No significant differences were found between PD/PDA and the sample with high scores in AS. Phobic Anxiety and Paranoid Ideation were the only scales where there were significant differences between the PD/PDA sample and the high AS sample. CONCLUSIONS Our findings showed that people who scored high on AS, despite not having a diagnosis of PD/PDA, were similar in regard to psychopathology features and personality to individuals with PD/PDA.