Creating state of the art,next-generation Virtual Reality exposure therapies for anxiety disorders using consumer hardware platforms: design considerations and future directions

Decades of research and more than 20 randomized controlled trials show that Virtual Reality exposure therapy (VRET) is effective in reducing fear and anxiety. Unfortunately, few providers or patients have had access to the costly and technical equipment previously required. Recent technological advances in the form of consumer Virtual Reality (VR) systems (e.g. Oculus Rift and Samsung Gear), however, now make widespread use of VRET in clinical settings and as self-help applications possible. In this literature review, we detail the current state of VR technology and discuss important therapeutic considerations in designing self-help and clinician-led VRETs, such as platform choice, exposure progression design, inhibitory learning strategies, stimuli tailoring, gamification, virtual social learning and more. We illustrate how these therapeutic components can be incorporated and utilized in VRET applications, taking full advantage of the unique capabilities of virtual environments, and showcase some of these features by describing the development of a consumer-ready, gamified self-help VRET application for low-cost commercially available VR hardware. We also raise and discuss challenges in the planning, development, evaluation, and dissemination of VRET applications, including the need for more high-quality research. We conclude by discussing how new technology (e.g. eye-tracking) can be incorporated into future VRETs and how widespread use of VRET self-help applications will enable collection of naturalistic “Big Data” that promises to inform learning theory and behavioral therapy in general.     

Probability,Approximate Truth,and Truthlikeness: More Ways out of the Preface Paradox

The so-called Preface Paradox seems to show that one can rationally believe two logically incompatible propositions. We address this puzzle, relying on the notions of truthlikeness and approximate truth as studied within the post-Popperian research programme on verisimilitude. In particular, we show that adequately combining probability, approximate truth, and truthlikeness leads to an explanation of how rational belief is possible in the face of the Preface Paradox. We argue that our account is superior to other solutions of the paradox, including a recent one advanced by Hannes Leitgeb (Analysis 74.1).     

Answer Sets and Qualitative Decision Making

Logic programs under answer set semantics have become popular as a knowledge representation formalism in Artificial Intelligence. In this paper we investigate the possibility of using answer sets for qualitative decision making. Our approach is based on an extension of the formalism, called logic programs with ordered disjunction (LPODs). These programs contain a new connective called ordered disjunction. The new connective allows us to represent alternative, ranked options for problem solutions in the heads of rules: A × B intuitively means: if possible A, but if A is not possible then at least B. The semantics of logic programs with ordered disjunction is based on a preference relation on answer sets. We show that LPODs can serve as a basis for qualitative decision making.     

Attitudes towards complementary and alternative medicine among medical and psychology students

The use of complementary and alternative medicine (CAM) is increasing in Europe as well as in the USA, but CAM courses are infrequently integrated into medical curricula. In Europe, but also especially in the USA and in Canada, the attitudes of medical students and health science professionals in various disciplines towards CAM have been the subject of investigation. Most studies report positive attitudes. The main aim of this study was to compare the attitudes towards CAM of medical and psychology students in Germany. An additional set of questions concerned how CAM utilisation and emotional and physical condition affect CAM-related attitudes. Two hundred thirty-three medical students and 55 psychology students were questioned concerning their attitudes towards CAM using the Questionnaire on Attitudes Towards Complementary Medical Treatment (QACAM). Both medical students and psychology students were sceptical about the diagnostic and the therapeutic proficiency of doctors and practitioners of CAM. Students' attitudes towards CAM correlated neither with their experiences as CAM patients nor with their emotional and physical condition. It can be assumed that German medical and psychology students will be reluctant to use or recommend CAM in their professional careers. Further studies should examine more closely the correlation between attitudes towards CAM and the students' worldview as well as their existing knowledge of the effectiveness of CAM.     

Acceptance and commitment therapy versus tinnitus retraining therapy in the treatment of tinnitus: a randomised controlled trial

The study compared the effects of Acceptance and Commitment Therapy (ACT) with Tinnitus Retraining Therapy (TRT) on tinnitus impact in a randomised controlled trial. Sixty-four normal hearing subjects with tinnitus were randomised to one of the active treatments or a wait-list control (WLC). The ACT treatment consisted of 10 weekly 60 min sessions. The TRT treatment consisted of one 150 min session, one 30 min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8 h/day for 18 months. Assessments were made at baseline, 10 weeks, 6 months and 18 months. At 10 weeks, results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact (Cohen’s d = 1.04), problems with sleep and anxiety. The results were mediated by tinnitus acceptance. A comparison between the active treatments, including all assessment points, revealed significant differences in favour of ACT regarding tinnitus impact (Cohen’s d = 0.75) and problems with sleep. At 6 months, reliable improvement on the main outcome measure was found for 54.5% in the ACT condition and 20% in the TRT condition. The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients.     

The reproduction of intelligence

Although a negative relationship between fertility and education has been described consistently in most countries of the world, less is known about the relationship between intelligence and reproductive outcomes. Also the paths through which intelligence influences reproductive outcomes are uncertain. The present study uses the NLSY79 to analyze the relationship of intelligence measured in 1980 with the number of children reported in 2004, when the respondents were between 39 and 47 years old. Intelligence is negatively related to the number of children, with partial correlations (age controlled) of ?.156, ?.069, ?.235 and ?.028 for White females, White males, Black females and Black males, respectively. This effect is related mainly to the g-factor. It is mediated in part by education and income, and to a lesser extent by the more “liberal” gender attitudes of more intelligent people. In the absence of migration and with constant environment, genetic selection would reduce the average IQ of the US population by about .8 points per generation.     

Management der Parkinson-Demenz und Demenz mit Lewy-Körperchen

Idiopathisches Parkinson-Syndrom mit Demenz (PDD) und Demenz mit Lewy-K?rperchen (DLB) sind partiell unterschiedliche Manifestationen des Spektrums der Lewy-K?rperchen- und Alzheimer-Erkrankungen. Die Kombination von motorischer Parkinsonsymptomatik mit Demenz, affektiven St?rungen (Depression, Angst), Verhaltensst?rungen (wie REM-Sleep Behaviour Disorder) und psychotischen Episoden (Halluzinationen, Wahn, Delir) neben einer Reihe vegetativer Symptome und zunehmendem Nebenwirkungsrisiko erfordern eine ma?geschneiderte, sorgf?ltige, kombinierte Pharmakotherapie (L-Dopa mit Decarboxylasehemmer, gegebenenfalls Entacapone oder Tolcapone, neuere Antidepressiva wie SSRI, NaSSA, SNRI, Clozapin, Clonazepam, Therapie vegetativer St?rungen) und engmaschige klinische Kontrollen.     

Internet Versus Group Cognitive-Behavioral Treatment of Distress Associated With Tinnitus: A Randomized Controlled Trial

Tinnitus distress can be reduced by means of cognitive-behavior therapy (CBT), and the treatment can be delivered in different ways. The most recent format is Internet-based self-help. The aim of this study was to compare this treatment (n = 26) with standard group-based CBT (n = 25) in a randomized controlled trial. Outcomes on self-report inventories measuring tinnitus distress were evaluated immediately after and 1 year after treatment. Results showed that both groups had improved, and there were few differences between them. The effect size for the Internet treatment was d = 0.73 (95% CI = 0.16–1.30) and for the group treatment was d = 0.64 (95% CI = 0.07–1.21). The Internet treatment consumed less therapist time and was 1.7 times as cost-effective as the group treatment. At pretreatment patients rated the Internet treatment as less credible than the group treatment. In conclusion, Internet treatment for tinnitus distress merits further investigation, as the outcomes achieved are promising.