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Étude de faisabilité d’une exposition thérapeutique en réalité virtuelle pour joueurs pathologiques - 30/01/20

Feasibility study of therapeutic exposure in virtual reality for pathological gamblers

Doi : 10.1016/j.encep.2019.09.002 
J.-J. Rémond a, , M. Hernández-Mora c, C. Marseille c, G. Mesure c, L. Romo a, b
a CLIPSYD 4430 EA 4430, université Paris Nanterre, 92, 92000 Nanterre, France 
b Inserm U494 centre hospitalier Sainte-Anne (CMME), 75014 Paris, France 
c CSAPA Imagine, hospitalier Eaubonne-Montmorency, Ermont, 95, 14, rue de Saint-Prix, 95600 Eaubonne, France 

Auteur correspondant. Laboratoire CliPsyD, EA 4430, UFR SPSE 200, université Paris Nanterre, avenue de la République, 92001 Nanterre cedex, FranceLaboratoire CliPsyD, EA 4430, UFR SPSE 200, université Paris Nanterreavenue de la RépubliqueNanterre cedex92001France

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Résumé

L’exposition par immersion en réalité virtuelle (RV) pour les joueurs pathologiques est bénéfique dans le contexte des interventions cognitives et comportementales.

Objectif

L’objectif de l’étude était d’investiguer les possibilités mises en œuvre par la réalité virtuelle dans le cas d’une exposition pour les joueurs pathologiques pour susciter un désir de jouer et travailler avec le patient dans un milieu identique à celui écologique.

Méthode

Des patients (n=10) en soins courants pour le traitement du jeu pathologique ont obtenu quatre séances d’exposition en réalité virtuelle intégrées à une prise en charge traditionnelle. Une batterie de questionnaires a été proposée pour évaluer les comportements liés au jeu (ICJP, GRCS, UPPS), analyser l’intérêt de l’exposition en réalité virtuelle (SIS, CGI, TEI, EVA) et entrevoir les capacités d’immersion (QEP et QPI).

Résultats

Les résultats de cette étude ont démontré la viabilité que l’exposition en réalité virtuelle peut participer à la diminution des symptômes de jeu pathologique et à la sévérité perçue par les thérapeutes (ICJP : t=1,6 ; p=0,001 ; CGI : t=4,87 ; p=0,001) entre le début de la prise en charge et la fin de la prise en charge et à J+1. Nous avons également pu observer des résultats significatifs (p<0,05) concernant une diminution des distorsions cognitives (GRCS).

Conclusion

Cette étude exploratoire démontre l’utilité de la réalité virtuelle pour accroître l’efficacité de la restructuration cognitive et la compréhension de l’envie de jouer liée à des stimuli au sein de l’environnement de jeu.

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Abstract

The experiment presented is the result of a partnership between the Paris-Nanterre University (CLIPSYD laboratory, EA 4430) and the CSAPA Imagine (Simone Veil Hospital, GH Eaubonne-Montmorency). Virtual reality immersion exposure for pathological gamblers is beneficial in the context of cognitive and behavioral interventions. It can be used to evoke the desire to play and to have access to automatic thoughts and mistaken beliefs of the players when they find themselves in a gambling context. Exposure is used until the urge to play diminishes and disappears which is the process of desensitization or extinction.

Objective

The objective of the study was to investigate the possibilities implemented by virtual reality in the case of an exhibition for pathological gamers to create a desire to play and work with the patient in an environment identical to the ecological one. Two hypotheses were proposed. On the one hand, the virtual reality exhibition will help to change the desire to play in relation to the game. On the other hand, virtual exhibition sessions associated with cognitive restructuring will have a greater impact on the perception of reality.

Method

After a diagnosis was made, participation in the study was offered to patients (n=10) in routine care and able to participate (exclusion criteria). It consisted of four virtual reality exposure sessions integrated with traditional care. Exposure did not exceed 20minutes. To carry out this study we used the virtual reality headset “Oculus Rift CV1” and the headphones measuring EEG waves, “Emotiv Epoc”. A battery of questionnaires were proposed to evaluate gambling-related behaviors (ICJP, GRCS, UPPS), to analyze the interest of the virtual reality exhibition (SIS, CGI, TEI, EVA), and to glimpse the immersion abilities (QEP and QPI).

Results

Ten participants aged 25 to 60 agreed to participate in the study. The results of this study demonstrated the viability of RV gamers’ exposure as a tool that can help reduce pathological gambling symptoms and the severity perceived by therapists (CPI: t=1.6, P=0.001; CGI: t=4.87, P=0.001) between the beginning of the care and the end of the care and at D+1. We were also able to observe significant results (P<0.05) concerning a decrease in cognitive distortions (GRCS tot, Illusion of control, Power of prediction, Favorable interpretation).

Conclusion

The feasibility study shows that the desire to play is very present during the virtual reality exhibition in accordance with literature studies. The results also demonstrate the utility of virtual reality to allow the patient to elaborate on the cognitive distortions associated with the practice of pathological gambling. From a therapeutic point of view, the results suggest that virtual reality can increase the effectiveness of cognitive restructuring and increase understanding of the urge to play related to stimuli in the environment of play.

Il testo completo di questo articolo è disponibile in PDF.

Mots clés : Jeux pathologiques, Exposition en réalité virtuelle, Restructuration cognitive, Distorsions cognitives, Immersion

Keywords : Gambling disorder, Virtual reality exposure, Cognitive restructuring, Cognitive distortion, Immersion


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