Virtual Reality Therapy Could Benefit Victims of Haiti Earthquake

Cyberpsychology is the study of the human mind and behavior in the context of human-technology interaction. Computer-mediated forms of counseling include e-mails or chats online with a therapist; however cyberpsychology is not limited to the use of internet technology as it also includes cyborgs, artificial intelligence, and virtual reality. This type of therapy can be used to treat various types of mental illness including Post Traumatic Stress Disorder.

PTSD is common in soldiers returning from combat duty, victims of sexual or physical assault and survivors of imprisonment or hostage situations. It is also common among individual that have experienced acts of terrorism, accidents or natural disasters and those diagnosed with a life-threatening illness. Conventional approaches to treat PTSD include antidepressant medication and psychotherapy; however recovery rates are far from acceptable.

“Exposure therapy has been recognized as a highly promising method for treating patients with PTSD. Rather than relying on patients' visualization skills to ‘relive’ the traumatic experience, technological strategies such as virtual reality (VR) provide a controlled environment in which patients can experience a situation or scenario while learning to cope with their emotional responses.”

When natural disasters occur relief efforts typically focus on immediate needs, such food, clothing, shelter, first aid, emotional support and family reunification. Treatment of ongoing mental health should play a vital role in the response. The implementation of this type of tool could have major benefits for mass casualty survivors.

In Haiti, for instance, individuals are experiencing major losses that will affect them for years to come. The loss of loved ones, displacement, medical injuries and material loss are all psychologically devastating. In addition, the victims of this tragedy are likely to be disturbed by memories of the trauma and experience flashbacks of mass graves and friends, neighbours and even family members burned or trapped under collapsed buildings. Furthermore, the destroyed buildings and homes, and the absence of family members will continue to serve as traumatic reminders.

“‘Empty situations’ posed by the sense of an absence of personal location, deprives the victim of a safe ‘holding environment’ so necessary for the recovery process. These secondary adversities caused by displacement function as a barrier to the effort required in ‘processing’ the trauma of personal loss.” Rebuilding the lost structure in their lives is necessary for recovery, however efforts cannot end there. Extended treatment is essential to full or near full recovery, therefore, funding should be applied to ongoing mental health treatment. Virtual reality treatment in safe clinical settings could be part of that effort.

Virtual reality treatment is not a quick fix. It consists of many sessions of gradual exposure and it is most often combined with cognitive behavioral therapy and anxiety management in order to cope with the recreation of the traumatic events. It is important to note that the virtual recreation consists only of certain aspects of the event and not the exact recreation of the event itself.

Evidently, time, money and effort of this type of approach far exceeds the efforts of distributing supplies, however success rates are far more important than quick and easy methods. Moreover, this type of therapy should really be considered for relief personnel as their mental health is also at risk from their experiences. Recovering from the effects of a natural disaster is a lengthy process and the treatment for its effects on mental health is an even lengthier one.

Posttraumatic Stress Disorder: Virtual Reality and Other Technologies Offer Hope
Cyberpsychology
The risk of PTSD following the earthquake in Haiti

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Sensitivity to Physical Pain Linked To Social Rejection

Psychologists at UCLA have concluded, in the August 14th online edition of Proceedings of the National Academy of Sciences, that there is a genetic link between sensitivity to physical pain and social rejection. A gene that regulates the mu-opioid receptors in the brain that alleviates physical pain also kills the pain of social rejection.

“Their study indicates that variation in the mu-opioid receptor gene (OPRM1), often associated with physical pain, is related to how much social pain a person feels in response to social rejection. People with a rare form of the gene are more sensitive to rejection and experience more brain evidence of distress in response to rejection than those with the more common form.”

Researchers examined the responses of 122 participants from self-report surveys on sensitivity to social rejection, after having collected and assessed their saliva to determine which OPRM1 gene they possessed. At the same time, 31 of the participants were examined through functional magnetic resonance imaging (fMRI) while playing a virtual game of catch. They were told that they were tossing a ball back and forth with 2 other players who were also hooked up on fMRI machines; however the other players were computer generated. Eventually the computer players stopped tossing the ball to the subject.

"What we found is that individuals with the rare form of the OPRM1 gene, who were shown in previous work to be more sensitive to physical pain, also reported higher levels of rejection sensitivity and showed greater activity in social pain–related regions of the brain — the dorsal anterior cingulate cortex and anterior insula — in response to being excluded," said Naomi Eisenberger, co-author and UCLA assistant professor of psychology and director of UCLA's Social and Affective Neuroscience Laboratory.

Baldwin Way, a UCLA postdoctoral scholar and the lead author, states that the findings of this study suggest that feelings of social rejection may occur in the same neural connections that are alleviated by pain killers such as morphine.

Could such findings help to explain the complexities of addiction and lead to the development of more promising treatment options?

Genetic Link Between Physical Pain And Social Rejection Found

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Fighting Addiction With Prescription Heroin

Former MP John Reynolds believes that Canada should start medicating addicts with prescription heroin; in the same manner it would any other health condition that is controlled with medication. Clearly, convincing Canadians of this presumption will not be an easy feat as addiction is hardly comparable to conditions like high blood pressure or diabetes.

“Mr. Reynolds, a member of the InnerChange Foundation in Vancouver, applauded the research arm of Health Canada for financing the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), which will offer heroin and a legal substitute, Hydromorphone.”

And…“In a secondary phase, some of the 200 addicts who will be recruited to the program will be offered heroin in a pill form - another way of reducing the stigma and health risks associated with injecting drugs.”

"We really hope with SALOME that, if we can show (Hydromorphone) is as effective, there will be so many fewer obstacles to treatment - because it is not called heroin."

Surely society can perceive the benefits for the addict and the community as a whole; however the pill is not the answer. The addict no longer has to commit crimes and suffer various traumas associated with obtaining drugs. The addict can be slowly weaned off drugs in a more controlled manner with the assistance of health professionals in order to ease themselves into proper treatment. The addict would have much needed support during the path to recovery.

No one can deny these benefits; however is the main objective here not to make drug use safer and reduce crime? Many people, including addicts, will view this method as replacing one drug with another, therefore maintaining psychological dependence. In addition, side effects and withdrawal symptoms are not all that unlike those of heroin, morphine or other opiods. Although studies have shown that Hydromorphone can be more successful than methadone, the latter has also not proven to be the much needed solution for many addicts.

I must say that I’m not sold on the idea that addiction is merely a physical condition needing medication, Mr. Reynolds. Recovery requires treatment of both physical and psychological aspects, especially when addiction is so often combined with other mental health conditions.

Prescribe heroin to addicts, former Tory MP says

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A Common Sense Approach to Cocaine Addiction Treatment

“For the first time, researchers from the Institut de physiologie et biologie cellulaire (CNRS/Université de Poitiers) have shown that positive and stimulating environmental conditions make it easier to treat cocaine addiction”.

In particular, Marcello Solinas and Mohamed Jaber exposed cocaine addicted mice to an enriched environment during cocaine withdrawal. The environment consisted of small houses, a running wheel, tunnels and many other stimulating items in a large cage.

The researchers observed three measures of typical addictive behaviour:

1. Behavioural Sensitization: the progressive augmentation of behavioural responses to cocaine that develops during repeated administration.

2. Location Preference: the ability of the context to induce drug-seeking behaviour and strengthen the contextual association with drug use.

3. Probability of Relapse: “cocaine's ability to lead to a relapse after a period of withdrawal.”

Results showed that all three of these typical behaviours disappeared after the mice had endured 30 days of the enriched environment. In the brain, this disappearance was seen by a decrease in activity in the specific areas associated with dopamine transmission and relapse.

Does this seem like news to anyone? Of course rehab won’t work for individuals who are thrust right back into the same environmental circumstances. The rehabilitation process should definitely include changes to living conditions. Availability of cocaine will clearly hinder the probability of relapse. The same basic routine will allow an addict to easily slide back into old habits.

Besides pointing out the obvious, this “new” research does provide a bit of insight. Addiction treatment centres may want to consider adding housing support workers to the therapeutic process. The social, physical and mental stimulation seem to be key factors in maintaining sobriety; therefore it might be beneficial to include exercise regimens and educational programs as well. The ideal solution does not seem to be spending 30 days discussing the reason you became an addict only to settle right back into the same old routine after successful completion of a program. Evidently, the emotional aspect is a necessary step in the process, but if anything, this research proves that there is more to treating cocaine addiction. It’s a complete lifestyle overhaul.

Drug Addiction: Environmental Conditions Play Major Role In Effective Treatment And Preventing Relapses, Animal Study Shows

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Assessment of Trichotillomania

The following is a snippet of a recent paper that I have written regarding a disorder that seriously lacks attention:

“Late at night, I sit at the end of the sofa, pull the shade off the lamp and allow the bright light to expose hundreds of beautiful hairs. My focus is intense and with great concentration, I locate very fine hairs and pluck them. This gives me great pleasure and the sharp pain relaxes me. The concentration takes me away. I love releasing the once buried little hairs and pulling them. With great luck, I find the thick hairs, some with their black sac still attached. I save those hairs like trophies carefully laying them along the arm of the sofa, black against white. […] now I go to bed exhausted but satisfied.” (Penzel, 2003, p. 10)

This scenario depicts the experience of some sufferers of trichotillomania. The term can be traced back to 1889 when it was first defined by French physician Halipeau (Long, Miltenberger & Rapp, 2006, p. 133). The term itself is Greek in origin; trich refers to hair, tillo refers to pull, and mania refers to madness (Penzel, 2003, p. 2). There is a tendency for this disorder to be more common among females and to develop in childhood or early adolescence (Long et al., 2006, p. 137). Trichotillomania is also commonly associated with other disorders such as mood or anxiety (Long et al., 2006, p. 138). Common areas of pulling are the scalp, eyebrows, eyelashes, face, limbs, and pubic area (Penzel, 2003, p. 8). The physical and emotional costs of this disorder can be debilitating. A number of physical consequences may include calluses on finger tips, strain injuries such as in the neck and back, infections such as on the eyelids and pubic area, and the development of gastrointestinal problems from the swallowing of hair or what is called trichophagy (Penzel, 2003, p. 4). Subsequently, “feelings of shame, helplessness, isolation, and frustration can take a tremendous toll on sufferers” (Penzel, 2003, p. 5). Although, it is estimated to affect roughly 2.5 million people in the United States, the actual rate of occurrence is often inaccurate due to misdiagnoses and extraordinary attempts at disguising or concealing the disorder (Kelly, McCormick & White Kress, 2004, p. 2). The fourth edition of The Diagnostic and Statistical Manual of Mental Disorders currently groups trichotillomania with other Axis I impulse control disorders such as pyromania and kleptomania and is defined by the following criterion:

A. Recurrent pulling out of one’s hair resulting in noticeable hair loss.
B. Feeling of tension immediately before pulling hair out or when attempting to pull hair out.
C. Sense of pleasure, gratification, or relief when pulling out hair.
D. Hair pulling is not better explained by the presence of some other disorder.
E. Hair pulling causes significant distress and an impairment of the ability to function in an important area of one’s life. (Penzel, 2003, p. 2)

The assessment of trichotillomania is conducted through several non-standard and standard measures. The initial interview establishes the baseline and allows the clinician to gather a complete picture of the presenting behaviour and its effect on the individual’s life. Standardized tests help to assess the severity of the disorder; however there is an obvious deficiency in strong assessment measures and Breckenridge et al. (1999) suggest that this is in part due to the scales’ context (p. 168). Results from various studies suggest that a multi-method approach is most effective when assessing trichotillomania. “An ideal TM measure would include homogeneous subscales that measure situational variables, affective states, and sensory stimuli associated with hair pulling behaviour in addition to frequency, duration, and interference of symptoms” (Breckenridge et al., 1999, p. 168). To date, trichotillomania lacks answers to such questions as whether the disorder is conceptually related to OCD or more similar to other disorders such as skin picking (Penzel, 2000, p. 1). The controversy with respect to etiology has an extensive impact on assessment methods and tools. Inevitably, assessment influences treatment and treatment affects outcome, so this begs the question: are trichotillomaniacs obtaining appropriate benefits from current methods?

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FeelingBetterNow.com

This website diagnoses and recommends a specified treatment of nine major mental disorders, from depression to post-traumatic stress disorder. It was designed by Dr. Sam Ozersky and other leading mental health experts that form Mensante Corp. This website that has been around since January 2006 diagnoses, treats, and follows up when a risk of mental illness is detected from answers to an online survey. It seems to be designed for the workforce. The site is actually endorsed by the Canadian College of Family Physicians.

This seems like yet another desperate attempt at making psychology the science that it will never be. Although the idea is similar to the administration of psychological inventories it lacks a very important element, namely professional interpretation and explanation. Besides the fact that this puts many well-educated professionals out of work, the job would be placed in the hands of those seriously lacking in experience. Also, what about computer error? After putting so much effort into studies and work in the field, I could never support or put any faith in such an invention unless it is used with extreme caution. I suppose it could prove to be valuable for some when used as a "guide", but it will hardly replace any existing practices. The fact that it might provide comprehensive information in one place may be it's best feature.

Of course, the greatest benefits are most likely to be seen in the money saved due to increased productivity and decreased payouts in disability claims because in the end that is the real aim of this approach is it not?

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