Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
Two Times Pi LLC, Woodland Hills, CA, USA.
Eur J Psychotraumatol. 2024;15(1):2418248. doi: 10.1080/20008066.2024.2418248. Epub 2024 Nov 7.
Fear- and trauma-related conditions, such as post-traumatic stress disorder (PTSD) and social phobia, often manifest as socially avoidant behaviours, which commonly contribute to social and occupational disability transdiagnostically. While gold-standard treatments (i.e. exposure therapy, psychotropic medications) are effective, they are hindered by high dropout rates and limited impact on real-world functioning. Furthermore, most existing interventions only target symptom reduction, with few addressing avoidance-related deficits in social and occupational functioning. This methods paper introduces an innovative augmented reality exposure therapy (ARET) technology designed to address the limitations of traditional interventions for anxiety disorders and PTSD, by directly targeting social and occupational dysfunction through exposure to real-life social contexts. We introduce an ARET system, using artificial intelligence (AI)-driven, augmented reality (AR) technology, that enables exposure to realistic scenarios within the patient's real-world environment, fostering contextual generalization and functional improvement. Featuring holographic three-dimensional humans, precise surface mapping, wireless mobility, and telemedicine capabilities, the software provides customizable exposure scenarios to transform an environment into various spaces (e.g. grocery store, house party) with diverse human characters, as well as flexible AI-driven human interactions tailored to individual needs. We share observations and feedback from the treatment of first responders with PTSD. Patients found the technology easy to use, with immersive realism, active engagement, and strong emotional responses needed for effective exposure therapy. Advances in AI-driven character development and AR hardware accessibility support the wider adoption of ARET by clinicians. By bridging the gap between clinical interventions and real-world functioning, ARET offers a transformative approach to addressing the pervasive impact of psychiatric disorders on social and occupational outcomes.
恐惧和创伤相关的疾病，如创伤后应激障碍（PTSD）和社交恐惧症，通常表现为社交回避行为，这些行为在跨诊断中通常导致社交和职业障碍。虽然黄金标准治疗（即暴露疗法、精神药物治疗）有效，但由于高脱落率和对现实世界功能的影响有限而受到阻碍。此外，大多数现有的干预措施仅针对症状减轻，很少解决社交和职业功能中的回避相关缺陷。本方法论文介绍了一种创新的增强现实暴露疗法（ARET）技术，旨在通过直接针对社交和职业功能障碍进行暴露来解决焦虑障碍和 PTSD 的传统干预措施的局限性，通过暴露于现实生活中的社交环境。我们介绍了一种 ARET 系统，该系统使用人工智能（AI）驱动的增强现实（AR）技术，使患者能够在真实的环境中接受真实场景的暴露，促进情境泛化和功能改善。该软件具有全息三维人类、精确的表面映射、无线移动性和远程医疗功能，提供可定制的暴露场景，可以将环境转换为具有各种人类角色的各种空间（例如杂货店、家庭聚会），还可以根据个人需求灵活调整 AI 驱动的人机交互。我们分享了对 PTSD 急救人员的治疗观察和反馈。患者发现该技术易于使用，具有沉浸式的真实感、积极的参与度和强烈的情感反应，这些都是有效的暴露疗法所必需的。人工智能驱动的角色开发和 AR 硬件可访问性的进步支持 ARET 在临床医生中的更广泛应用。ARET 通过弥合临床干预与现实世界功能之间的差距，为解决精神疾病对社交和职业结果的普遍影响提供了一种变革性的方法。
