Der Nervenarzt

, Volume 85, Issue 3, pp 298–303 | Cite as

Anwendung virtueller Realitäten in der forensischen Psychiatrie

Ein neues Paradigma?
Leitthema

Zusammenfassung

Hintergrund

Virtuelle Realitäten (VR) werden seit mehr als 20 Jahren erfolgreich in der Diagnostik und Behandlung psychischer Störungen eingesetzt. Die Vorteile von VR liegen dabei in der hohen ökologischen Validität virtueller Umgebungen, in der vollständigen Kontrolle der virtuellen Reize und der Fähigkeit, beim Patienten das Gefühl zu erzeugen, tatsächlich in der virtuellen Realität zu sein. VR erlaubt die Konfrontation mit Reizen und Situationen, die in der Realität nicht zugänglich oder zu gefährlich sind. Trotz dieser Vorteile werden VR-gestützte Verfahren bis jetzt noch nicht in der forensischen Psychiatrie eingesetzt.

Fragestellung, Material und Methoden

Anhand eines Überblickes über den aktuellen Forschungsstand VR-gestützter Anwendungen in der Allgemeinpsychiatrie werden die Vorteile und Möglichkeiten VR-gestützter Verfahren für die forensische Psychiatrie dargestellt.

Ergebnisse und Schlussfolgerungen

Zum gegenwärtigen Zeitpunkt existieren lediglich erste Studien zu VR-gestützter Diagnostik devianter sexueller Interessen. Diese Studien verdeutlichen das hohe Potenzial ökologisch valider virtueller Umgebungen für die Erfassung forensisch-relevanter Symptomgruppen. Einer der größten Vorteile VR-gestützter Verfahren für die forensische Psychiatrie liegt in der erstmaligen Möglichkeit, psychisch kranke Straftäter in deliktrelevanten Risikosituationen ohne Gefährdung Dritter zu beobachten. Dies eröffnet nicht nur aus diagnostischer und prognostischer, sondern auch aus therapeutischer Sicht neue Möglichkeiten. Bevor diese Möglichkeiten im klinischen Alltag ausgeschöpft werden können, ist noch eine umfangreiche Entwicklungs- und Forschungsarbeit notwendig. Angesichts des Potenzials VR-gestützter Verfahren für die forensische Psychiatrie erscheint diese Forschungsarbeit jedoch lohnenswert.

Schlüsselwörter

Virtuelle Realität Forensische Psychiatrie Psychotherapie Diagnostik Prognose 

Use of virtual reality in forensic psychiatry

A new paradigm?

Summary

Background

For more than 20 years virtual realities (VR) have been successfully used in the assessment and treatment of psychiatric disorders. The most important advantages of VR are the high ecological validity of virtual environments, the entire controllability of virtual stimuli in the virtual environment and the capability to induce the sensation of being in the virtual environment instead of the physical environment. VRs provide the opportunity to face the user with stimuli and situations which are not available or too risky in reality. Despite these advantages VR-based applications have not yet been applied in forensic psychiatry.

Objectives and methods

On the basis of an overview of the recent state-of-the-art in VR-based applications in general psychiatry, the article demonstrates the advantages and possibilities of VR-based applications in forensic psychiatry.

Results and conclusions

Up to now only preliminary studies regarding the VR-based assessment of pedophilic interests exist. These studies demonstrate the potential of ecologically valid VR-based applications for the assessment of forensically relevant disorders. One of the most important advantages is the possibility of VR to assess the behavior of forensic inpatients in crime-related situations without endangering others. This provides completely new possibilities not only regarding the assessment but also for the treatment of forensic inpatients. Before utilizing these possibilities in the clinical practice exhaustive research and development will be necessary. Given the high potential of VR-based applications, this effort would be worth it.

Keywords

Virtual reality Forensic psychiatry Psychotherapy Diagnostics Prognosis 

Literatur

  1. 1.
    Adams R, Finn P, Moes E et al (2009) Distractibility in Attention/Deficit/Hyperactivity Disorder (ADHD): the virtual reality classroom. Child Neuropsychol 15:120–135PubMedCrossRefGoogle Scholar
  2. 2.
    Armstrong CM, Reger GM, Edwards J et al (2013) Validity of the Virtual Reality Stroop Task (VRST) in active duty military. J Clin Exp Neuropsychol 35:113–123PubMedCrossRefGoogle Scholar
  3. 3.
    Baker EK, Kurtz MM, Astur RS (2006) Virtual reality assessment of medication compliance in patients with schizophrenia. Cyberpsychol Behav 9:224–229PubMedCrossRefGoogle Scholar
  4. 4.
    Bordnick PS, Carter BL, Traylor AC (2011) What virtual reality research in addictions can tell us about the future of obesity assessment and treatment. J Diabetes Sci Technol 5:265–271PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Eichenberg C, Wolters C (2012) Virtual realities in the treatment of mental disorders: a review of the current state of research. In: Eichenberg C (Hrsg) Virtual reality in psychological, medical and pedagogical applications. InTech, Rijeka, CroatiaGoogle Scholar
  6. 6.
    Fengfeng K, Tami I (2013) Virtual-reality-based social interaction training for children with high-functioning autism. J Educ Res 106:441–461CrossRefGoogle Scholar
  7. 7.
    Ferrer-Garcia M, Guiterrez-Maldonado J (2012) The use of virtual reality in the study, assessment, and treatment of body image in eating disorders and nonclinical samples: a review of the literature. Body Image 9:1–11PubMedCrossRefGoogle Scholar
  8. 8.
    Freeman D (2008) Studying and treating schizophrenia using virtual reality (vr): a new paradigm. Schizophr Bull 34:605–610PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Fromberger P, Jordan K, Müller JL (2013) Pedophilia: etiology, diagnostics and therapy. Nervenarzt 84:1123–1135PubMedCrossRefGoogle Scholar
  10. 10.
    Girard B, Turcotte V, Bouchard S et al (2009) Crushing virtual cigarettes reduces tobacco addiction and treatment discontinuation. Cyberpsychol Behav 12:477–483PubMedCrossRefGoogle Scholar
  11. 11.
    Giroux I, Faucher-Gravel A, St-Hilaire A et al (2013) Gambling exposure in virtual reality and modification of urge to gamble. Cyberpsychol Behav Soc Netw 16:224–231PubMedCrossRefGoogle Scholar
  12. 12.
    Keefe FJ, Huling DA, Coggins MJ et al (2012) Virtual reality for persistent pain: a new direction for behavioral pain management. PAIN 153:2163–2166PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Kim J-J, Kim J (2010) Virtual reality-based assessment of social skills and its application to mental illnesses. In: Kim J-J (Hrsg) Virtual Reality. InTech, Rijeka, CroatiaGoogle Scholar
  14. 14.
    Laws DR, Gress CLZ (2004) Seeing things differently: the viewing time alternative to penile plethysmography. Legal and Criminological Psychology 9:183–196CrossRefGoogle Scholar
  15. 15.
    Ma H-I, Hwang W-J, Fang J-J et al (2011) Effects of virtual reality training on functional reaching movements in people with Parkinson’s disease: a randomized controlled pilot trial. Clin Rehabil 25:892–902PubMedCrossRefGoogle Scholar
  16. 16.
    Motraghi TE, Seim RW, Meyer EC et al (2013) Virtual reality exposure therapy for the treatment of posttraumatic stress disorder: a methodological review using CONSORT guidelines. J Clin Psychol. DOI 10.1002/jclp.22051Google Scholar
  17. 17.
    Nedopil N, Müller JL (2012) Forensische Psychiatrie: Klinik, Begutachtung und Behandlung zwischen Psychiatrie und Recht. Thieme, StuttgartGoogle Scholar
  18. 18.
    Opriş D, Pintea S, García-Palacios A et al (2012) Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depress Anxiety 29:85–93PubMedCrossRefGoogle Scholar
  19. 19.
    Optale G, Marin S, Pastore M et al (2003) Male sexual dysfunctions and multimedia immersion therapy (follow-up). Cyberpsychol Behav 6:289–294PubMedCrossRefGoogle Scholar
  20. 20.
    Park K-M, Ku J, Choi S-H et al (2011) A virtual reality application in role-plays of social skills training for schizophrenia: a randomized, controlled trial. Psychiatry Res 189:166–172PubMedCrossRefGoogle Scholar
  21. 21.
    Parsons TD (2011) Neuropsychological assessment using virtual environments: enhanced assessment technology for improved ecological validity. In: Brahnam S (Hrsg) Advanced computational intelligence paradigms in healthcare: virtual reality in psychotherapy, rehabilitation, and assessment. Springer-Verlag, Berlin, S 271–289Google Scholar
  22. 22.
    Peikert M (2013) Evaluation von Stimulisets zur Messung des sexuellen Interesses in der forensisch-sexualwissenschaftlichen Forschung. Bachelorarbeit, Georg-Elias-Müller Institut für Psychologie, Universtät Göttingen, GöttingenGoogle Scholar
  23. 23.
    Poeschl S, Doering N (2013) The German VR Simulation Realism Scale – psychometric construction for virtual reality applications with virtual humans. Stud Health Technol Inform 191:33–37PubMedGoogle Scholar
  24. 24.
    Renaud P, Chartier S, Rouleau J-L et al (2013) Using immersive virtual reality and ecological psychology to probe into child molesters‘ phenomenology. J Sex Aggress 19:102–120CrossRefGoogle Scholar
  25. 25.
    Renaud P, Chartier S, Rouleau JL et al (2009) Gaze behavior nonlinear dynamics assessed in virtual immersion as a diagnostic index of sexual deviancy: preliminary results. J Virt Real Broadcast 3Google Scholar
  26. 26.
    Renaud P, Joyal C, Stoleru S et al (2011) Real-time functional magnetic imaging-brain-computer interface and virtual reality promising tools for the treatment of pedophilia. Prog Brain Res 192:263–272PubMedCrossRefGoogle Scholar
  27. 27.
    Renaud P, Rouleau JL, Proulx J et al (2010) Virtual characters designed for forensic assessment and rehabilitation of sex offenders: standardized and made-to-measure. J Virt Real Broadcast 7Google Scholar
  28. 28.
    Riener R, Harders M (2012) Virtual reality in medicine. Springer, LondonGoogle Scholar
  29. 29.
    Rizzo AA, Buckwalter JG, Bowerly T et al (2000) The virtual classroom: a virtual reality environment for the assessment and rehabilitation of attention deficits. Cyberpsychol Behav 3:483–499CrossRefGoogle Scholar
  30. 30.
    Schultheis MT, Rizzo AA (2001) The application of virtual reality technology in rehabilitation. Rehabil Psychol 46:296–311CrossRefGoogle Scholar
  31. 31.
    Stolpman G (2001) Psychiatrische Maßregelbehandlung. Hogrefe, GöttingenGoogle Scholar
  32. 32.
    Sutherland I (1965) The ultimate display. Proceedings of IFIP Congress, S 506–508Google Scholar
  33. 33.
    Ticknor B, Tillinghast S (2011) Virtual reality and the criminal justice system: new possibilities for research, training and rehabilitation. J Virt Worlds Res 4Google Scholar
  34. 34.
    Trottier D, Renaud P, Goyette M et al (2013) Assessing sexual interests with computer-generated stimuli in virtual reality: an improvement from audio scenarios. Arch Sex Behav (submitted)Google Scholar
  35. 35.
    Trottier D, Rouleau, JL, Renaud P et al (2013). Using eye tracking to identify faking attemps during penile plethysmography assessment. J Sex Res. DOI 10.1080/00224499.2013.832133Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Ludwig-Meyer-Institut für Forensische Psychiatrie und Psychotherapie, Georg-August-Universität Göttingen, Universitätsmedizin GöttingenGöttingenDeutschland
  2. 2.Asklepios Fachklinikum Göttingen, Forensische PsychiatrieGöttingenDeutschland

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