Cipresso Pietro, Gaggioli Andrea, Serino Silvia, Raspelli Simona, Vigna Cinzia, Pallavicini Federica, Riva Giuseppe
Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.
Stud Health Technol Inform. 2012;181:8-11.
"Psychological stress" occurs when an individual perceives that environmental demands tax or exceed his or her adaptive capacity. According to the Cochrane Database of Systematic Reviews, the best validated approach covering both stress management and stress treatment is the Cognitive Behavioral (CBT) approach. CBT has undergone a very large number of trials in research contexts. However, it has been less efficacious in clinical contexts and it has become obvious that CBT has some failings when applied in general practice. INTERSTRESS is a EU-funded project that aims to design, develop and test an advanced ICT-based solution for the assessment and treatment of psychological stress that is able to address three critical limitations of CBT: a) the therapist is less relevant than the specific protocol used. b) the protocol is not customized to the specific characteristics of the patient; c) the focus of the therapy is more on the top-down model of change (from cognitions to emotions) than on the bottom-up (from emotions to cognitions). To reach this goal the INTERSTRESS project applies an innovative paradigm for e-health - Interreality - that integrates assessment and treatment within a hybrid environment, bridging physical and virtual worlds. On one side, the patient is continuously assessed in the virtual and real worlds by tracking the behavioral and emotional status in the context of challenging tasks (customization of the therapy according to the characteristics of the patient). On the other side, feedback is continuously provided to improve both the appraisal and the coping skills of the patient through a conditioned association between effective performance state and task execution behaviors (improvement of self efficacy). Within this conceptual framework, it is possible to set up and test psychological treatments that could be extended also beyond the traditional research and clinical setting by using more and more emerging mobile technology to deliver real-time interventions during daily activities and ecological contexts.
当个体认为环境要求超出其适应能力时，就会产生“心理压力”。根据考科蓝系统评价数据库，涵盖压力管理和压力治疗的最佳验证方法是认知行为疗法（CBT）。CBT在研究环境中已经进行了大量试验。然而，它在临床环境中的效果较差，并且很明显，CBT在一般实践中应用时存在一些缺陷。INTERSTRESS是一个由欧盟资助的项目，旨在设计、开发和测试一种基于先进信息通信技术的解决方案，用于评估和治疗心理压力，该方案能够解决CBT的三个关键局限性：a）治疗师比所使用的特定方案相关性更低。b）方案未根据患者的具体特征进行定制；c）治疗的重点更多地放在自上而下的改变模式（从认知到情绪）而不是自下而上的模式（从情绪到认知）。为了实现这一目标，INTERSTRESS项目应用了一种创新的电子健康范式——交互现实，它在混合环境中整合了评估和治疗，连接了物理世界和虚拟世界。一方面，通过在具有挑战性的任务背景下跟踪行为和情绪状态，在虚拟和现实世界中持续评估患者（根据患者特征定制治疗）。另一方面，通过有效表现状态与任务执行行为之间的条件关联，持续提供反馈以提高患者的评估和应对技能（提高自我效能）。在这个概念框架内，通过使用越来越多的新兴移动技术在日常活动和生态环境中提供实时干预，可以建立和测试心理治疗方法，这些方法也可以扩展到传统研究和临床环境之外。
