Background: First responders are a prime example of professionals that are at a high risk of being exposed to traumatic experiences. Reappraisal as a coping strategy might help first responders to better cope with their emotional responses to traumatic events. Objective: This study investigated the effects of repeated sessions of a digital reappraisal training among seven firefighters. The training consisted of four sessions supported by a virtual agent, conducted at home or at work, over a two-week period in a single case series. Method: Sixteen data points were collected from each participant in the eight days pre- and post-training. Results: Significantly more themes were used at post-training than at pre-training, implying more flexibility and confirming the main hypothesis of the study. Negative side effects were not reported during or in the week after the training. Conclusions: More controlled studies into the short- and long-term effects of a training of this nature are needed. Furthermore, it provides a reference for developers in this field.@en

Post-traumatic stress affects millions of people worldwide. Appraisal training is an intervention that has been used to decrease the negative effects of a traumatic event. In two studies, the acceptance and effects of technology in supporting appraisal was studied. Study 1, a descriptive study, examined the response to and acceptance of a workshop on perspective broadening with technological support among soldiers and firefighters. Results revealed that both groups evaluated the training as useful and feasible, and both favoured the full version of the tool. Study 2 investigated the effect of the support tool among a student sample in comparison to the paper-based training. Participants followed the training individually. Comparisons between the two groups revealed no significant differences on multiple outcome measures. Behaviour observed during the training suggests that shorter sessions might prove more effective. The findings indicate acceptance of the technology supported training but gives no indication that the effects of the training are improved by technological support.@en

Although well-established therapies exist for post-traumatic stress disorder (PTSD), barriers to seek mental health care are high. Technology-based interventions may play a role in improving the reach of efforts to treat, especially when therapist availability is low. The goal of the current randomized controlled trial was to pilot the efficacy of a computer-based trauma intervention with elements of virtual reality (VR; 3MR system) and limited therapist involvement for the treatment of PTSD in a childhood sexual abuse (CSA) and war veteran sample and to compare this to “treatment as usual” (TAU). TAU consisted of evidence-based approaches such as imaginal exposure, EMDR, or narrative exposure therapy. A total of 44 patients with PTSD were included and randomly assigned to 12 sessions of 3MR intervention or TAU (completer n 3MR = 12, TAU = 18). Several measures (PCL-5, BDI-II, OQ-45-2, and the M.I.N.I. 5.0.0.) were administered to measure symptoms of PTSD and depression and scores of overall well-being at pre, post, and a three-month follow-up measurement. Analyses suggest that symptoms of PTSD and depression in the 3MR condition decreased, and overall well-being increased between pre and post measurements. Results did not indicate any clear differences between the treatment conditions over time which suggests that treatment gains of the 3MR intervention seem no less than those of TAU. Finally, both treatment conditions produced similar remission rates of PTSD and depression. Therefore, the 3MR intervention could possibly constitute an appropriate treatment alternative. The small sample size as well as evident drop-out rates in the 3MR condition (45%) do warrant further research. The procedures of this study were approved by the Medical Ethical Research Committee (MERC) of the Erasmus Medical Center in Rotterdam (MEC-NL46279.078.13) and pre-registered via ClinicalTrials.gov (Protocol Record CI1-12-S028-1).@en

Effective psychological interventions for anxiety disorders often include exposure to fearful situations. However, individuals with low self-efficacy may find such exposure too overwhelming. We created a vicarious experience in virtual reality, which enables observation of one’s experience from a first person perspective without actual performance and which might increase self-efficacy. With similarities to both traditional vicarious experiences and direct experiences, the level of self-identification with the experience was hypothesized to affect self-efficacy and its relationship with direct experiences. To test this, vicarious experiences with two distinct levels of self-identification were compared in a between-subjects experiment ((Formula presented.)). After being exposed to a vicarious experience of giving lectures on elementary arithmetic in front of a virtual audience with either a high or low level of self-identification with the public speaker, participants from both conditions actively gave another lecture. The results revealed that self-identification affected people’s self-efficacy after vicarious experience. They further revealed that self-identification is a moderator of (1) the correlation between perceived performance and self-efficacy, (2) the correlation between self-efficacy measured after the vicarious and the follow-up direct experience; and (3) the correlation between the sense of presence reported in the vicarious and in the follow-up direct experience. We anticipate that the first-person-perspective experiences with high-level of self-identification have the potential to be beneficial for training where changing people’s self-efficacy is desirable.@en