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Ad De Jongh - One of the best experts on this subject based on the ideXlab platform.
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efficacy of virtual reality exposure therapy for the treatment of Dental Phobia in adults a randomized controlled trial
Journal of Anxiety Disorders, 2019Co-Authors: Kumar Raghav Gujjar, Arjen J Van Wijk, Ratika Kumar, Ad De JonghAbstract:Background: Although Virtual Reality Exposure Therapy (VRET) has proven to be effective in the treatment of various subtypes of specific Phobia, there is limited evidence of its role in the treatment of Dental Phobia. Method: A single-blind RCT was conducted among 30 randomized patients with Dental Phobia to either VRET or informational pamphlet (IP) condition. Primary outcome anxiety measures (VAS-A, MDAS and DFS) were evaluated at baseline, pre- and post-intervention, 1-week, 3-months and 6-months follow-up. Secondary outcome measures assessed were pre-post behavioral avoidance, temporal variations of heart rate and VR-experience during and post-VRET, and Dental treatment acceptance in both conditions at 6-month follow-up. Results: Intention to treat analysis, using a repeated measures MANOVA, revealed a multivariate interaction effect between time and condition (p = 0.015) for all primary outcome measures (all ps < 0.001). Only patients of the VRET condition showed a significant reduction in anxiety scores (mean reduction s.d.: VAS-A 44.4 36.1; MDAS 7.1 5.4; DFS 21.2 13.1) whereas the patients in the IP group did not (mean reduction s.d.: VAS-A −0.33 7.7; MDAS −0.33 1.3; DFS −1.9 3.8), F (15, 14) = 3.3, p = 0.015. Conclusions: VRET was found to be efficacious in the treatment of Dental Phobia. © 2018 Elsevier Ltd
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virtual reality exposure therapy for the treatment of Dental Phobia a controlled feasibility study
Behavioural and Cognitive Psychotherapy, 2017Co-Authors: Kumar Raghav Gujjar, Ratika Sharma, Arjen J Van Wijk, Ad De JonghAbstract:Background: Virtual reality exposure therapy (VRET) has been used to treat a variety of fears and Phobias. Aim: To determine the feasibility (i.e. safety and efficacy) of using VRET to treat Dental Phobia. Method: Safety was evaluated by determining any adverse events or symptom exacerbation. Efficacy of VRET was evaluated by comparing the reduction in Dental anxiety scores (measured 16 times within a 14-week study period, and at 6-month follow-up), and its behavioural effects with that of an informational pamphlet (IP) on ten randomized patients with Dental Phobia using a controlled multiple baseline design. Participants’ heart rate response during VRET, and their experience post-VRET, were indexed. Results: No personal adverse events or symptom exacerbation occurred. Visual analysis and post-hoc intention-to-treat analysis showed a significantly greater decrease in Dental anxiety scores [higher PND (percentage of non-overlap data) scores of 100% and lower POD (percentage of overlap data) of 0%, Modified Dental Anxiety Scale, F (1,8) = 8.61, p = 0.019, and Dental Fear Scale, F (1,8) = 10.53, p = 0.012], and behavioural avoidance in the VRET compared with the IP group [d = 4.2 and –1.4, respectively). There was no increase in average heart rate during VRET. Of the nine treatment completers, six (four from the VRET group and two from the IP group) no longer had Dental Phobia at 6-month follow-up. Four of the five VRET participants, but none of the IP participants, scheduled a Dental treatment appointment following the intervention. Conclusion: VRET is a feasible alternative for patients with Dental Phobia.
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Virtual Reality Exposure Therapy for Treatment of Dental Phobia.
Dental update, 2017Co-Authors: Kumar Raghav Gujjar, Ratika Sharma, Ad De JonghAbstract:Virtual Reality Exposure Therapy (VRET) has gained in popularity as an effective treatment for anxiety disorders. The purpose of this article is to determine the applicability of VRET in the treatment of Dental Phobia of two patients. Two case examples of female Dental patients, aged 56 and 24 years, who met the criteria for Dental Phobia according to the Phobia Checklist, illustrate the use of VRET in the Dental setting. VRET that is used as a psychological treatment for Dental fear and Dental Phobia can potentially be given by a non-specialist (for example Dental assistant), thereby making it a cost-effective therapy for the treatment of Dental Phobia. CPD/Clinical Relevance: This article is the first of its kind to demonstrate Virtual Reality Exposure Therapy (VRET) in the treatment of Dental anxiety.
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efficacy of virtual reality exposure therapy for treatment of Dental Phobia a randomized control trial
BMC Oral Health, 2016Co-Authors: Ad De Jongh, Arjen J Van Wijk, Kumar Raghav, Fawzia Abdullah, Md Nurul Islam, Marc BernatchezAbstract:Virtual Reality Exposure Therapy (VRET) is found to be a promising and a viable alternative for in vivo exposure in the treatment of specific Phobias. However, its usefulness for treating Dental Phobia is unexplored. The aims of the present study are to determine: (a) the efficacy of VRET versus informational pamphlet (IP) control group in terms of Dental trait and state anxiety reductions at 1 week, 3 months and 6 months follow-up (b) the real-time physiological arousal [heart rate (HR)] of VRET group participants during and following therapy (c) the relation between subjective (presence) and objective (HR) measures during VRET. This study is a single blind, randomized controlled trial with two parallel arms in which participants will be allocated to VRET or IP with a ratio of 1:1. Thirty participants (18-50 years) meeting the Phobia Checklist criteria of Dental Phobia will undergo block randomization with allocation concealment. The primary outcome measures include participants’ Dental trait anxiety (Modified Dental Anxiety Scale and Dental Fear Survey) and state anxiety (Visual Analogue Scale) measured at baseline (T0), at intervention (T1), 1-week (T2), 3 months (T3) and 6 months (T4) follow-up. A behavior test will be conducted before and after the intervention. The secondary outcome measures are real-time evaluation of HR and VR (Virtual Reality) experience (presence, realism, nausea) during and following the VRET intervention respectively. The data will be analyzed using intention-to-treat and per-protocol analysis. This study uses novel non-invasive VRET, which may provide a possible alternative treatment for Dental anxiety and Phobia. ISRCTN25824611 , Date of registration: 26 October 2015.
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efficacy of a trauma focused treatment approach for Dental Phobia a randomized clinical trial
European Journal of Oral Sciences, 2013Co-Authors: Stephan Doering, Ad De Jongh, Mariechristin Ohlmeier, Arne Hofmann, Vanessa BispingAbstract:It has been hypothesized that treatment specifically focused on resolving memories of negative Dental events might be efficacious for the alleviation of anxiety in patients with Dental Phobia. Thirty-one medication-free patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria of Dental Phobia were randomly assigned to either Eye Movement Desensitization and Reprocessing (EMDR) or a waitlist control condition. Dental anxiety was assessed using the Dental Anxiety Questionnaire (DAS), the Dental Fear Survey (DFS), a behavior test, and Dental attendance at 1-yr of follow up. Eye Movement Desensitization and Reprocessing was associated with significant reductions of Dental anxiety and avoidance behavior as well as in symptoms of post-traumatic stress disorder (PTSD). The effect sizes for the primary outcome measures were d = 2.52 (DAS) and d = 1.87 (DFS). These effects were still significant 3 months (d = 3.28 and d = 2.28, respectively) and 12 months (d = 3.75 and d = 1.79, respectively) after treatment. After 1 yr, 83.3% of the patients were in regular Dental treatment (d = 3.20). The findings suggest that therapy aimed at processing memories of past Dental events can be helpful for patients with Dental Phobia.
Anne Schienle - One of the best experts on this subject based on the ideXlab platform.
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altered functional connectivity of basal ganglia circuitry in Dental Phobia
Social Cognitive and Affective Neuroscience, 2014Co-Authors: Wilfried Scharmüller, Verena Leutgeb, Rudolf Stark, Florian Schongasner, Andrea Hermann, Anne SchienleAbstract:Recent symptom provocation studies that compared patients suffering from Dental Phobia with healthy controls identified hyperactivation of basal ganglia structures, but none have assessed striatal functional connectivity. We reanalyzed data from a previous functional magnetic resonance imaging study on Dental Phobia. Patients (20 men, 25 women) and healthy controls (18 men, 23 women) had been exposed to pictures showing Dental treatment, and neutral contents. We conducted connectivity analyses via psychophysiological interactions (PPIs). Relative to non-phobic controls, the patients showed decreased connectivity between prefrontal and basal ganglia regions. Moreover, the clinical group was characterized by increased internal basal ganglia connectivity, which was more pronounced in female compared with male patients. This study provides first evidence for an altered information flow within a fronto-striatal network in dentophobic individuals during visual symptom provocation, which can be considered a neuromarker of this disorder.
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sex specific associations between grey matter volume and phobic symptoms in Dental Phobia
Neuroscience Letters, 2014Co-Authors: Albert Wabnegger, Wilfried Scharmüller, Anne SchienleAbstract:The knowledge about brain structure and function in men and women suffering from Dental Phobia is still limited. We compared grey matter volume (GMV) data from 36 patients suffering from Dental Phobia and 36 non-phobic controls via voxel-based morphometry. Half of the subjects were male, the other half female. Scores on different Dental anxiety and pain questionnaires were correlated with GMV. Relative to controls, the patients had a smaller volume of the dorsomedial and dorsolateral prefrontal cortex (DMPFC/DLPFC). Within the phobic group, personal pain experience during Dental treatment was negatively correlated with DLPFC volume. Sex-specific correlations were found for the amygdala and the hippocampus. Whereas in female patients GMV of both structures was positively correlated with self-reported Dental anxiety, for male patients experienced Dental pain was negatively associated with hippocampus volume. Our findings show that memory as well as anticipation of Dental pain is associated with amygdala-hippocampal structure in men and women afflicted by Dental Phobia.
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do not think about pain neural correlates of attention guiding during visual symptom provocation in Dental Phobia an fmri study
Brain Research, 2014Co-Authors: Wilfried Scharmüller, Verena Leutgeb, Albert Wabnegger, Sonja Ubel, Florian Schoengassner, Anne SchienleAbstract:Patients undergoing Dental treatment employ different attentional strategies. In order to investigate associated neuronal correlates, we exposed 20 women suffering from Dental Phobia and 20 non-anxious women to disorder-related and unrelated pictures. They were asked to either direct their attention to a foreground stimulus in the image (distraction), to classify the content, or to judge whether the picture elicited fear of pain. The patients rated the majority of Dental pictures as pain-relevant (84%) in contrast to the control group (12%). Observed group differences were restricted to the pain condition with enhanced orbitofrontal cortex (OFC) activation displayed by the patients. For the controls, OFC and amygdala activity were positively correlated with self-reported Dental anxiety during attention to pain. Across both groups, pain focusing provoked increased amygdala recruitment. As the OFC and amygdala are central for the evaluation of threat signals, the mere thinking about the possible pain relevance of stimuli seems to be dysfunctional.
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Sex differences in the functional and structural neuroanatomy of Dental Phobia
Brain Structure and Function, 2013Co-Authors: Anne Schienle, Verena Leutgeb, Wilfried Scharmüller, Axel Schäfer, Rudolf StarkAbstract:Although Dental Phobia is a common mental disorder, which afflicts both men and women, little is known about sex differences at the neural level. Patients suffering from Dental Phobia (20 men, 25 women) and healthy controls (18 men, 23 women) participated in a functional magnetic resonance imaging (fMRI) experiment. They were shown pictures depicting Dental treatment, generally fear-eliciting, disgust-eliciting and neutral contents. After the fMRI experiment, the participants rated the affective value of the pictures. Additionally, grey matter volume (GMV) was compared between patients and controls, as well as between the sexes. Male and female patients responded differently to the phobogenic pictures. Women showed greater activation of the caudate nucleus, whereas men exhibited enhanced dorsolateral prefrontal cortex (DLPFC) involvement. Their DLPFC activation was negatively correlated with experienced arousal. Dentophobic females were characterized by a greater caudate volume relative to phobic males. The GMV of this structure was positively correlated with experienced arousal during exposure and symptom severity, only in female patients. This study provides first evidence of sex-specific brain activation and structure in patients suffering from Dental Phobia. The neural pattern during symptom provocation as well as the brain structural specificity might mirror different attention and self-control strategies of both sexes. The consideration of such differences could contribute to greater effectiveness in treating Dental Phobia.
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frontal late positivity in Dental Phobia a study on gender differences
Biological Psychology, 2011Co-Authors: Anne Schienle, Angelika Kochel, Verena LeutgebAbstract:Abstract Although Dental Phobia afflicts men and women, gender differences in neural correlates of this disorder have not been investigated thus far. We recorded event-related potential (ERPs) in 30 individuals with Dental Phobia (15 women, 15 men with comparable disorder severity) and 30 nonphobic controls (15 women, 15 men) while they passively viewed pictures depicting Dental treatment, generally fear-eliciting, disgust-eliciting and neutral contents. Male and female individuals with Dental Phobia as compared with controls displayed an enlarged centro-parietal late positivity (300–1500 ms). Gender difference concerned prefrontal ERPs. Only men with dentoPhobia showed an enhanced positivity towards the phobic relative to the neutral pictures in the time window between 300 and 1500 ms. Such a differentiation was absent in the other groups (male controls, female phobics, female controls). This finding indicates a gender-dependent recruitment of frontal attention networks in Dental Phobia and might reflect that male and female sufferers of dentoPhobia differ with regard to controlled attention focusing and cognitive avoidance during exposure.
Ulrike Lueken - One of the best experts on this subject based on the ideXlab platform.
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neurostructural correlates of two subtypes of specific Phobia a voxel based morphometry study
Psychiatry Research-neuroimaging, 2015Co-Authors: Kevin Hilbert, Hans-ulrich Wittchen, Ricarda Evens, Nina Isabel Maslowski, Ulrike LuekenAbstract:The animal and blood-injection-injury (BII) subtypes of specific Phobia are both characterized by subjective fear but distinct autonomic reactions to threat. Previous functional neuroimaging studies have related these characteristic responses to shared and non-shared neural underpinnings. However, no comparative structural data are available. This study aims to fill this gap by comparing the two subtypes and also comparing them with a non-phobic control group. Gray and white matter data of 33 snake Phobia subjects (SP), 26 Dental Phobia subjects (DP), and 37 healthy control (HC) subjects were analyzed with voxel-based morphometry. Especially DP differed from HC and SP by showing significantly increased grey matter volumes in widespread areas including the right subgenual anterior cingulate gyrus, left insula, left orbitofrontal and left prefrontal (PFC) cortices. In addition, white matter volume was significantly increased in the left PFC in DP compared with SP. These results are in line with functional changes observed in Dental Phobia and point toward those brain circuits associated with emotional processing and regulation. Future studies should aim to further delineate functional and structural connectivity alterations in specific Phobia.
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fear processing in Dental Phobia during crossmodal symptom provocation an fmri study
BioMed Research International, 2014Co-Authors: Kevin Hilbert, Hans-ulrich Wittchen, Ricarda Evens, Nina Isabel Maslowski, Ulrike LuekenAbstract:While previous studies successfully identified the core neural substrates of the animal subtype of specific Phobia, only few and inconsistent research is available for Dental Phobia. These findings might partly relate to the fact that, typically, visual stimuli were employed. The current study aimed to investigate the influence of stimulus modality on neural fear processing in Dental Phobia. Thirteen Dental phobics (DP) and thirteen healthy controls (HC) attended a block-design functional magnetic resonance imaging (fMRI) symptom provocation paradigm encompassing both visual and auditory stimuli. Drill sounds and matched neutral sinus tones served as auditory stimuli and dentist scenes and matched neutral videos as visual stimuli. Group comparisons showed increased activation in the insula, anterior cingulate cortex, orbitofrontal cortex, and thalamus in DP compared to HC during auditory but not visual stimulation. On the contrary, no differential autonomic reactions were observed in DP. Present results are largely comparable to brain areas identified in animal Phobia, but also point towards a potential downregulation of autonomic outflow by neural fear circuits in this disorder. Findings enlarge our knowledge about neural correlates of Dental Phobia and may help to understand the neural underpinnings of the clinical and physiological characteristics of the disorder.
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how specific is specific Phobia different neural response patterns in two subtypes of specific Phobia
NeuroImage, 2011Co-Authors: Ulrike Lueken, Johann Daniel Kruschwitz, Markus Muehlhan, Jens Siegert, Jürgen Hoyer, Hans-ulrich WittchenAbstract:Specific Phobia of the animal subtype has been employed as a model disorder exploring the neurocircuitry of anxiety disorders, but evidence is lacking whether the detected neural response pattern accounts for all animal subtypes, nor across other Phobia subtypes. The present study aimed at directly comparing two subtypes of specific Phobia: snake Phobia (SP) representing the animal, and Dental Phobia (DP) representing the blood-injection-injury subtype. Using functional magnetic resonance imaging (fMRI), brain activation and skin conductance was measured during phobogenic video stimulation in 12 DP, 12 SP, and 17 healthy controls. For SP, the previously described activation of fear circuitry structures encompassing the insula, anterior cingulate cortex and thalamus could be replicated and was furthermore associated with autonomic arousal. In contrast, DP showed circumscribed activation of the prefrontal and orbitofrontal cortex (PFC/OFC) when directly compared to SP, being dissociated from autonomic arousal. Results provide preliminary evidence for the idea that snake and Dental Phobia are characterized by distinct underlying neural systems during sustained emotional processing with evaluation processes in DP being controlled by orbitofrontal areas, whereas phobogenic reactions in SP are primarily guided by limbic and paralimbic structures. Findings support the current diagnostic classification conventions, separating distinct subtypes in DSM-IV-TR. They highlight that caution might be warranted though for generalizing findings derived from animal Phobia to other phobic and anxiety disorders. If replicated, results could contribute to a better understanding of underlying neurobiological mechanisms of specific Phobia and their respective classification.
Hans-ulrich Wittchen - One of the best experts on this subject based on the ideXlab platform.
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neurostructural correlates of two subtypes of specific Phobia a voxel based morphometry study
Psychiatry Research-neuroimaging, 2015Co-Authors: Kevin Hilbert, Hans-ulrich Wittchen, Ricarda Evens, Nina Isabel Maslowski, Ulrike LuekenAbstract:The animal and blood-injection-injury (BII) subtypes of specific Phobia are both characterized by subjective fear but distinct autonomic reactions to threat. Previous functional neuroimaging studies have related these characteristic responses to shared and non-shared neural underpinnings. However, no comparative structural data are available. This study aims to fill this gap by comparing the two subtypes and also comparing them with a non-phobic control group. Gray and white matter data of 33 snake Phobia subjects (SP), 26 Dental Phobia subjects (DP), and 37 healthy control (HC) subjects were analyzed with voxel-based morphometry. Especially DP differed from HC and SP by showing significantly increased grey matter volumes in widespread areas including the right subgenual anterior cingulate gyrus, left insula, left orbitofrontal and left prefrontal (PFC) cortices. In addition, white matter volume was significantly increased in the left PFC in DP compared with SP. These results are in line with functional changes observed in Dental Phobia and point toward those brain circuits associated with emotional processing and regulation. Future studies should aim to further delineate functional and structural connectivity alterations in specific Phobia.
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fear processing in Dental Phobia during crossmodal symptom provocation an fmri study
BioMed Research International, 2014Co-Authors: Kevin Hilbert, Hans-ulrich Wittchen, Ricarda Evens, Nina Isabel Maslowski, Ulrike LuekenAbstract:While previous studies successfully identified the core neural substrates of the animal subtype of specific Phobia, only few and inconsistent research is available for Dental Phobia. These findings might partly relate to the fact that, typically, visual stimuli were employed. The current study aimed to investigate the influence of stimulus modality on neural fear processing in Dental Phobia. Thirteen Dental phobics (DP) and thirteen healthy controls (HC) attended a block-design functional magnetic resonance imaging (fMRI) symptom provocation paradigm encompassing both visual and auditory stimuli. Drill sounds and matched neutral sinus tones served as auditory stimuli and dentist scenes and matched neutral videos as visual stimuli. Group comparisons showed increased activation in the insula, anterior cingulate cortex, orbitofrontal cortex, and thalamus in DP compared to HC during auditory but not visual stimulation. On the contrary, no differential autonomic reactions were observed in DP. Present results are largely comparable to brain areas identified in animal Phobia, but also point towards a potential downregulation of autonomic outflow by neural fear circuits in this disorder. Findings enlarge our knowledge about neural correlates of Dental Phobia and may help to understand the neural underpinnings of the clinical and physiological characteristics of the disorder.
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how specific is specific Phobia different neural response patterns in two subtypes of specific Phobia
NeuroImage, 2011Co-Authors: Ulrike Lueken, Johann Daniel Kruschwitz, Markus Muehlhan, Jens Siegert, Jürgen Hoyer, Hans-ulrich WittchenAbstract:Specific Phobia of the animal subtype has been employed as a model disorder exploring the neurocircuitry of anxiety disorders, but evidence is lacking whether the detected neural response pattern accounts for all animal subtypes, nor across other Phobia subtypes. The present study aimed at directly comparing two subtypes of specific Phobia: snake Phobia (SP) representing the animal, and Dental Phobia (DP) representing the blood-injection-injury subtype. Using functional magnetic resonance imaging (fMRI), brain activation and skin conductance was measured during phobogenic video stimulation in 12 DP, 12 SP, and 17 healthy controls. For SP, the previously described activation of fear circuitry structures encompassing the insula, anterior cingulate cortex and thalamus could be replicated and was furthermore associated with autonomic arousal. In contrast, DP showed circumscribed activation of the prefrontal and orbitofrontal cortex (PFC/OFC) when directly compared to SP, being dissociated from autonomic arousal. Results provide preliminary evidence for the idea that snake and Dental Phobia are characterized by distinct underlying neural systems during sustained emotional processing with evaluation processes in DP being controlled by orbitofrontal areas, whereas phobogenic reactions in SP are primarily guided by limbic and paralimbic structures. Findings support the current diagnostic classification conventions, separating distinct subtypes in DSM-IV-TR. They highlight that caution might be warranted though for generalizing findings derived from animal Phobia to other phobic and anxiety disorders. If replicated, results could contribute to a better understanding of underlying neurobiological mechanisms of specific Phobia and their respective classification.
Kumar Raghav Gujjar - One of the best experts on this subject based on the ideXlab platform.
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efficacy of virtual reality exposure therapy for the treatment of Dental Phobia in adults a randomized controlled trial
Journal of Anxiety Disorders, 2019Co-Authors: Kumar Raghav Gujjar, Arjen J Van Wijk, Ratika Kumar, Ad De JonghAbstract:Background: Although Virtual Reality Exposure Therapy (VRET) has proven to be effective in the treatment of various subtypes of specific Phobia, there is limited evidence of its role in the treatment of Dental Phobia. Method: A single-blind RCT was conducted among 30 randomized patients with Dental Phobia to either VRET or informational pamphlet (IP) condition. Primary outcome anxiety measures (VAS-A, MDAS and DFS) were evaluated at baseline, pre- and post-intervention, 1-week, 3-months and 6-months follow-up. Secondary outcome measures assessed were pre-post behavioral avoidance, temporal variations of heart rate and VR-experience during and post-VRET, and Dental treatment acceptance in both conditions at 6-month follow-up. Results: Intention to treat analysis, using a repeated measures MANOVA, revealed a multivariate interaction effect between time and condition (p = 0.015) for all primary outcome measures (all ps < 0.001). Only patients of the VRET condition showed a significant reduction in anxiety scores (mean reduction s.d.: VAS-A 44.4 36.1; MDAS 7.1 5.4; DFS 21.2 13.1) whereas the patients in the IP group did not (mean reduction s.d.: VAS-A −0.33 7.7; MDAS −0.33 1.3; DFS −1.9 3.8), F (15, 14) = 3.3, p = 0.015. Conclusions: VRET was found to be efficacious in the treatment of Dental Phobia. © 2018 Elsevier Ltd
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virtual reality exposure therapy for the treatment of Dental Phobia a controlled feasibility study
Behavioural and Cognitive Psychotherapy, 2017Co-Authors: Kumar Raghav Gujjar, Ratika Sharma, Arjen J Van Wijk, Ad De JonghAbstract:Background: Virtual reality exposure therapy (VRET) has been used to treat a variety of fears and Phobias. Aim: To determine the feasibility (i.e. safety and efficacy) of using VRET to treat Dental Phobia. Method: Safety was evaluated by determining any adverse events or symptom exacerbation. Efficacy of VRET was evaluated by comparing the reduction in Dental anxiety scores (measured 16 times within a 14-week study period, and at 6-month follow-up), and its behavioural effects with that of an informational pamphlet (IP) on ten randomized patients with Dental Phobia using a controlled multiple baseline design. Participants’ heart rate response during VRET, and their experience post-VRET, were indexed. Results: No personal adverse events or symptom exacerbation occurred. Visual analysis and post-hoc intention-to-treat analysis showed a significantly greater decrease in Dental anxiety scores [higher PND (percentage of non-overlap data) scores of 100% and lower POD (percentage of overlap data) of 0%, Modified Dental Anxiety Scale, F (1,8) = 8.61, p = 0.019, and Dental Fear Scale, F (1,8) = 10.53, p = 0.012], and behavioural avoidance in the VRET compared with the IP group [d = 4.2 and –1.4, respectively). There was no increase in average heart rate during VRET. Of the nine treatment completers, six (four from the VRET group and two from the IP group) no longer had Dental Phobia at 6-month follow-up. Four of the five VRET participants, but none of the IP participants, scheduled a Dental treatment appointment following the intervention. Conclusion: VRET is a feasible alternative for patients with Dental Phobia.
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Virtual Reality Exposure Therapy for Treatment of Dental Phobia.
Dental update, 2017Co-Authors: Kumar Raghav Gujjar, Ratika Sharma, Ad De JonghAbstract:Virtual Reality Exposure Therapy (VRET) has gained in popularity as an effective treatment for anxiety disorders. The purpose of this article is to determine the applicability of VRET in the treatment of Dental Phobia of two patients. Two case examples of female Dental patients, aged 56 and 24 years, who met the criteria for Dental Phobia according to the Phobia Checklist, illustrate the use of VRET in the Dental setting. VRET that is used as a psychological treatment for Dental fear and Dental Phobia can potentially be given by a non-specialist (for example Dental assistant), thereby making it a cost-effective therapy for the treatment of Dental Phobia. CPD/Clinical Relevance: This article is the first of its kind to demonstrate Virtual Reality Exposure Therapy (VRET) in the treatment of Dental anxiety.