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Sep 13, 2007

Virtual reality for the psychophysiological assessment of phobic fear

Virtual reality for the psychophysiological assessment of phobic fear: Responses during virtual tunnel driving.

Psychol Assess. 2007 Sep;19(3):340-6

Authors: Mühlberger A, Bülthoff HH, Wiedemann G, Pauli P

An overall assessment of phobic fear requires not only a verbal self-report of fear but also an assessment of behavioral and physiological responses. Virtual reality can be used to simulate realistic (phobic) situations and therefore should be useful for inducing emotions in a controlled, standardized way. Verbal and physiological fear reactions were examined in 15 highly tunnel-fearful and 15 matched control participants in 3 virtual driving scenarios: an open environment, a partially open tunnel (gallery), and a closed tunnel. Highly tunnel-fearful participants were characterized by elevated fear responses specifically during tunnel drives as reflected in verbal fear ratings, heart rate reactions, and startle responses. Heart rate and fear ratings differentiated highly tunnel-fearful from control participants with an accuracy of 88% and 93%, respectively. Results indicate that virtual environments are valuable tools for the assessment of fear reactions and should be used in future experimental research.

Sep 07, 2007

The scientific research potential of virtual worlds

Science has an interesting article by William Sims Bainbridge on the role that virtual worlds can play in the social sciences

Online virtual worlds, electronic environments where people can work and interact in a somewhat realistic manner, have great potential as sites for research in the social, behavioral, and economic sciences, as well as in human-centered computer science. This article uses Second Life and World of Warcraft as two very different examples of current virtual worlds that foreshadow future developments, introducing a number of research methodologies that scientists are now exploring, including formal experimentation, observational ethnography, and quantitative analysis of economic markets or social networks.


Sep 05, 2007

The treatment of phantom limb pain using immersive virtual reality: Three case studies

The treatment of phantom limb pain using immersive virtual reality: Three case studies.

Disabil Rehabil. 2007 Sep 30;29(18):1465-9

Authors: Murray CD, Pettifer S, Howard T, Patchick EL, Caillette F, Kulkarni J, Bamford C

Purpose. This paper describes the design and implementation of a case study based investigation using immersive virtual reality as a treatment for phantom limb pain. Method. Three participants who experienced phantom limb pain (two with an upper-limb amputation, and one with a lower-limb amputation) took part in between 2 and 5 immersive virtual reality (IVR) sessions over a 3-week period. The movements of participants' anatomical limbs were transposed into the movements of a virtual limb, presented in the phenomenal space of their phantom limb. Results. Preliminary qualitative findings are reported here to assess proof of principle for this IVR equipment. All participants reported the transferal of sensations into the muscles and joints of the phantom limb, and all participants reported a decrease in phantom pain during at least one of the sessions. Conclusion. The authors suggest the need for further research using control trials.

Aug 07, 2007

How good are current HMDs?

Via VRoot 

A head-mounted display (HMD).

Sensics, a company that develops head-mounted displays, (HMD) has conducted a survey amongst academic, commercial, and government users of virtual reality system to understand desired performance characteristics of what was termed a “goodenough” HMD.

Key survey findings include:

  1. Most existing HMDs are not ‘good enough’ according to survey participants. Commonplace horizontal field of view (50 degrees or lower) and commonplace vertical field of view (30 degrees or lower) are considered ‘good enough’ by fewer than 10% of surveyed population.
  2. The lack of ‘good enough’ performance is cited in practically all the cases where buyers with appropriate budgets considered purchasing head-mounted displays yet ultimately did not do so.
  3. Users consider the most important HMD attributes to be: panoramic field of view (over 100 degrees horizontal), large vertical field of view (over 50 degrees), very fast dynamic response (no smear or fade effects), high contrast display, high resolution display and a lightweight design

Read the full survey report  

Aug 02, 2007

Virtual-reality-Assisted treatment of flight phobia

Virtual-reality-Assisted treatment of flight phobia.

Isr J Psychiatry Relat Sci. 2007;44(1):29-32

Authors: Wallach HS, Bar-Zvi M

BACKGROUND: Flight phobia is a common and debilitating specific phobia. Recently, an effective technology, called Virtual Reality (VR), has been developed for the treatment of various anxiety disorders including flight phobia. METHOD: This article reports the results of a pilot study consisting of four subjects treated for Flight Phobia using Virtual Reality. RESULTS: All four subjects flew post-treatment. They experienced a significant reduction in fear of flying on two measures - anxiety about flying and global rating of fear of flying. Limitations: Due to the small sample size, the lack of a control group, and the lack of objective measures, caution must be exercised in interpreting the results. CONCLUSIONS: The use of Virtual Reality psychotherapy is relatively new worldwide, as well as in Israel. This study suggests the utility of implementing this technology in Israel.

Computer-Generated Virtual Reality to Control Pain and Anxiety

Computer-Generated Virtual Reality to Control Pain and Anxiety in Pediatric and Adult Burn Patients During Wound Dressing Changes.

J Burn Care Res. 2007 Jul 20;Publish Ahead of Print

Authors: van Twillert B, Bremer M, Faber AW

Changing daily wound dressings provokes a substantial amount of pain in patients with severe burn wounds. Pharmacological analgesics alone often are inadequate to solve this problem. This study explored whether immersive virtual reality (VR) can reduce the procedural pain and anxiety during an entire wound care session and compared VR to the effects of standard care and other distraction methods. Nineteen inpatients ages 8 to 65 years (mean, 30 years) with a mean TBSA of 7.1% (range, 0.5-21.5%) were studied using a within-subject design. Within 1 week of admission, standard care (no distraction), VR, or another self-chosen distraction method was administered during the wound dressing change. Each patient received the normal analgesic regimen. Pain was measured with visual analog thermometer scores, and anxiety was measured with the state-version of the Spielberger State Trait Anxiety Inventory. VR distraction and television distraction both significantly reduced pain ratings compared with no distraction. Thirteen of 19 patients reported clinically meaningful (33% or greater) reductions in pain during VR distraction. No side effects were reported. There were no significant reductions in anxiety. No correlations were found between the reduction in pain ratings and patient variables like age, sex, duration of hospital stay, or percentage of (deep) burns. After comparing different distraction methods, only VR and television showed significant pain reductions during wound dressing changes. The effects of VR were superior, but not statistical significant, to that of television. There was no significant reduction of anxiety ratings.

Jul 25, 2007

Research Fellow Post in Eyetracking for Virtual Environments

We are advertising a one or two year post at UCL to work on Eyetracking for Immersive Virtual Environments. We are seeking a post-doctoral Research Fellow to work on eye-tracking within immersive virtual environments. This is a post on the EPSRC-funded Eye Catching project. The project has built a unique tele-collaboration system, where each of three users of different CAVE-like environments can see the eye-motion of the other two users. The applicant will require a PhD in virtual environments, computer graphics, CSCW, eye-tracking or other area related to the topic of the project. They must have experience designing and running user experiments, and be confident writers and presenters. Founded in 1973, the Department of Computer Science has internationally leading groups in Networking, Software Engineering, Bioinformatics, Imaging and Virtual Environments and Computer Graphics. It is an innovative department with 40 faculty members and is located in central London - an ideal environment for young researchers. The post is on the UCL Grade 7 scale, the salary for which ranges from £26,666 to £32,796 (excluding London Allowance of £2,572).  The starting salary for the person appointed will be between £26,666 - £30,913 p.a (excluding London Allowance) and will depend on experience and education. The position is funded for one year from October 2007.
There is the potential of an extension of the post to two years. For further details and information on how to apply, please see our website at http://www.cs.ucl.ac.uk/vacancies
The closing date for applications is Friday August 24th.

Jul 23, 2007

Simulating hemispatial neglect with virtual reality

Simulating hemispatial neglect with virtual reality.

J Neuroengineering Rehabil. 2007 Jul 19;4(1):27

Authors: Baheux K, Yoshizawa M, Yoshida Y

ABSTRACT: BACKGROUND: Hemispatial neglect is a cognitive disorder defined as a lack of attention for stimuli contra-lateral to the brain lesion. The assessment is traditionally done with basic pencil and paper tests and the rehabilitation programs are generally not well adapted. We propose a virtual reality system featuring an eye-tracking device for a better characterization of the neglect that will lead to new rehabilitation techniques. METHODS: This paper presents a comparison of eye-gaze patterns of healthy subjects, patients and healthy simulated patients on a virtual line bisection test. The task was also executed with a reduced visual field condition hoping that fewer stimuli would limit the neglect. RESULTS: We found that patients and healthy simulated patients had similar eye-gaze patterns. However, while the reduced visual field condition had no effect on the healthy simulated patients, it actually had a negative impact on the patients. We discuss the reasons for these differences and how they relate to the limitations of the neglect simulation. CONCLUSIONS: We argue that with some improvements the technique could be used to determine the potential of new rehabilitation techniques and also help the rehabilitation staff or the patient's relatives to better understand the neglect condition.

Jul 13, 2007

A VR extended neuropsychological assessment for topographical disorientation

A virtual reality extended neuropsychological assessment for topographical disorientation: a feasibility study.

J Neuroengineering Rehabil. 2007 Jul 11;4(1):26

Authors: Morganti F, Gaggioli A, Strambi L, Rusconi ML, Riva G

ABSTRACT: BACKGROUND: Topographical disorientation represents one of the main consequences of brain injury. Up to now several methodological approaches have been used in the assessment of the brain injured patient's navigational abilities showing a moderate correlation with the impairments observed in everyday contexts. METHODS: We propose a combination of standardized neuropsychological tests and a more situated virtual reality-based assessment for the evaluation of spatial orientation in brain injured patients. RESULTS: When tested with this virtual reality integrated procedure patients showed performance and execution times congruent with their neuropsychological evaluation. When compared to a control group, patients revealed significantly slower times and greater errors in solving virtual reality based spatial tasks. CONCLUSIONS: The use of virtual reality, when combined with classical neuropsychological tests, can provide an effective tool for the study of topographical disorientation.

Jul 11, 2007

Randomized controlled trial of virtual reality simulator training: transfer to live patients

Randomized controlled trial of virtual reality simulator training: transfer to live patients.

Am J Surg. 2007 Aug;194(2):205-11

Authors: Park J, MacRae H, Musselman LJ, Rossos P, Hamstra SJ, Wolman S, Reznick RK

BACKGROUND: New Residency Review Committee requirements in general surgery require 50 colonoscopies. Simulators have been widely suggested to help prepare residents for live clinical experience. We assessed a computer-based colonoscopy simulator for effective transfer of skills to live patients. METHODS: A randomized controlled trial included general surgery and internal medicine residents with limited endoscopic experience. Following a pretest, the treatment group (n = 12) practiced on the simulator, while controls (n = 12) received no additional training. Both groups then performed a colonoscopy on a live patient. Technical ability was evaluated by expert endoscopists using previously validated assessment instruments. RESULTS: In the live patient setting, the treatment group scored significantly higher global ratings than controls (t(22) = 1.84, P = .04). Only 2 of the 8 computer-based performance metrics correlated significantly with previously validated global ratings of performance. CONCLUSIONS: Residents trained on a colonoscopy simulator prior to their first patient-based colonoscopy performed significantly better in the clinical setting than controls, demonstrating skill transfer to live patients. The simulator's performance metrics showed limited concurrent validity, suggesting the need for further refinement.

Jul 07, 2007

Training cognitive skills in virtual reality: measuring performance

Training cognitive skills in virtual reality: measuring performance.

Cyberpsychol Behav. 2007 Apr;10(2):286-9

Authors: Tichon J

Across a variety of operational environments, virtual reality (VR) is being increasingly used as a means of simulating hazardous work conditions in order to allow trainees to practice advanced cognitive skills such as problem-solving and decision-making. Replicating dangerous conditions particularly involving heavy machinery in the real world can be dangerous and costly. The use of VR is therefore appealing across many industries such as aviation, mining, and rail. However, while the number of training prototypes increase less focus is being given to appropriate evaluation of the training provided via this technology. Increasing skills acquisition and performance does not depend solely on the appropriate design of simulation training. Of equal importance are strong performance measures which can ultimately feedback on the success or otherwise of training and highlight any deficits to guide ongoing improvements. To ensure cognitive skills acquired in a virtual training environment (VTE) are transferable to the real world, training objectives need to be tied directly to realistic scenario events which in turn are directly linked to measures of specific required behaviors.

Jun 19, 2007

NeuroVR presented to the US congress

a little self-promotion... ;-)

last week we presented NeuroVR, an open-source virtual reality software platform for clinical and neuroscience applications, to the Congressional Modeling & Simulation Caucus , during the CyberTherapy Reception.

The Reception was held on Wednesday, June 13 from 5-7 pm in the foyer of the Rayburn House Office Building, Washington, DC, USA.

read the full news release



Jun 14, 2007

2006 International Workshop on Virtual Reality in Rehabilitation

Introduction to the special issue from the proceedings of the 2006 International Workshop on Virtual Reality in Rehabilitation.

J Neuroengineering Rehabil. 2007 Jun 6;4(1):18

Authors: Keshner EA, Weiss PT

ABSTRACT: New technologies are rapidly having a great impact on the development of novel rehabilitation interventions. One of the more popular of these technological advances is virtual reality. The wide range of applications of this technology, from immersive environments to tele-rehabilitation equipment and care, lends versatility to its use as a rehabilitation intervention. But increasing access to this technology requires that we further our understanding about its impact on a performer. The International Workshop on Virtual Reality in Rehabilitation (IWVR), now known as Virtual Rehabilitation 2007, is a conference that emerged from the need to discover how virtual reality could be applied to rehabilitation practice. Individuals from multiple disciplines concerned with the development, transmission, and evaluation of virtual reality as a technology applied to rehabilitation attend this meeting to share their work. In this special issue of the Journal of NeuroEngineering and Rehabilitation we are sharing some of the papers presented at the 2006 meeting of IWVR with the objective of offering a description of the state of the art in this research field. A perusal of these papers will provide a good cross-section of the emerging work in this area as well as inform the reader about new findings relevant to research and practice in rehabilitation.






15:57 Posted in Cybertherapy | Permalink | Comments (0) | Tags: virtual reality

Jun 07, 2007

Virtual reality exposure therapy for anxiety disorders: A meta-analysis.

Virtual reality exposure therapy for anxiety disorders: A meta-analysis.

J Anxiety Disord. 2007 Apr 27;

Authors: Powers MB, Emmelkamp PM

There is now a substantial literature investigating virtual reality exposure therapy (VRET) as a viable treatment option for anxiety disorders. In this meta-analysis we provide effect size estimates for virtual reality treatment in comparison to in vivo exposure and control conditions (waitlist, attention control, etc.). A comprehensive search of the literature identified 13 studies (n=397) that were included in the final analyses. Consistent with prediction the primary random effects analysis showed a large mean effect size for VRET compared to control conditions, Cohen's d=1.11 (S.E.=0.15, 95% CI: 0.82-1.39). This finding was consistent across secondary outcome categories as well (domain-specific, general subjective distress, cognition, behavior, and psychophysiology). Also as expected in vivo treatment was not significantly more effective than VRET. In fact, there was a small effect size favoring VRET over in vivo conditions, Cohen's d=0.35 (S.E.=0.15, 95% CI: 0.05-0.65). There was a trend for a dose-response relationship with more VRET sessions showing larger effects (p=0.06). Outcome was not related to publication year or sample size. Implications are discussed.

Virtual Systems and Multimedia 2007: Call for Participation

Via Networked Performance


The 13th International Conference Virtual Systems and Multimedia 2007 :: September 23 - 26, 2007 in Brisbane, Queensland, Australia :: Theme: Exchange and Experience in Space and Place :: Papers - Long and Short Papers: June 17, 2007 :: Notification July 15 - Camera-ready August 10 :: Posters due July 15, 2007 :: Notification August 10 - Camera-ready due September 15 :: Long Papers will be published by Springer in their LCNS. Others will be published locally.

Keynotes currently include: Dr Mark Billinghurst, Director, Human Interface Technology Laboratory New Zealand, based at Canterbury University; Professor Mark Burry, Professor of Innovation (Spatial Information Architecture), at RMIT University; Dr Jonathan Fulcher, Head of Native Title Practice, Minter Ellison; Aden Ridgeway, Executive Chairman, Indigenous Tourism Australia (ITA); Ms Minja Yang, Director and UNESCO Representative to Bhutan, India, Maldives and Sri Lanka. The conference is endorsed by the Australian National Commission for UNESCO.

Bursaries for postgraduate students

Five student bursaries of USD$250 each will be offered. To be considered you must be a full-time postgraduate student and have a letter endorsing your full-time enrolment status from your supervisor and which also states that you do not hold an academic staff position. Full details are shown on the web site.

Brisbane information

Brisbane is an alive and bustling city of 1.6million people with all the requisite offerings of the nation's fastest growing capital and remarkable recreational experiences. Go to http://www.brisbanemarketing.com.au/aboutbrisbane/.

You will be just a short plane trip from Sydney with its stunning Harbour and world-famous Opera House, or you can visit the World Heritage-listed Kakadu National Park and Uluru in the Northern Territory. Attending VSMM 2007 and also visiting some of Australia's truly great places is highly recommended!

Theme - Exchange And Experience In Space And Place including:

- Virtual Heritage and Virtual Cultures for details see http://australia.vsmm.org/cfp-theme1.htm
- Virtual Environments and Virtual Experiences for details see http://australia.vsmm.org/cfp-theme2.htm
- Applied technologies and systems for details see http://australia.vsmm.org/cfp-theme3.htm

In addition to traditional conference paper and workshop proposals, VSMM07 encourages innovative submissions including movies, interactive or immersive designs and simulations, theatre, and installations. Non-academic submissions are very welcome.

Multimedia and Virtual Environment technologies are increasingly appearing in an array of applications that foster deeper understandings of the environments around us. In the spirit of international exchange, cooperation and development, the focus of VSMM in 2007 will be on the application of these technologies in `Bridging Space and Place through digital exchange and experience'.

Detailed conference themes include, but are not restricted to:

Virtual Heritage and Virtual Cultures:

Addressing the Digital Divide
Applied Cultural Theory
Applied Virtual Heritage
Cultural heritage legislation in a digital domain
Cultural Heritage Management
Cyber anthropology
Ethics of the design and use of VR
Experience Design
Finance and Legal
Funding for cultural heritage projects
Guidelines and International Charters
Heritage legislation, IP and digital rights management
Historical perspectives
Indigenous Knowledge & Knowledge Systems
Indigenous Knowledge and Virtual Environments
Legal issues, challenges and solutions
Narratives and Knowledge
Policy development and the role of technology
Professional Guidelines and Ethics
Social dimensions of Virtual Heritage
Space and place
Theoretical Virtual Heritage
Virtual Heritage and Museum Environments
Virtual property
Virtual Reality in Archaeology and Historical Research

Virtual Environments and Virtual Experiences:

Application of Serious Gaming technologies
Artificial life and dynamic worlds
Digital Arts and Politics
Digital performance
Digital storytelling
Engagement research
Generative VR
Human-Centred design issues
Immersion and emotion
Immersion research
Immersive Audio for presence and immersion
Media Arts & Creative Expression
Mobile Futures and devices and their application
Playfulness and experience design
Presence Research
Simulation and engagement
Spatial narratives
Virtual systems and real worlds
Visualisation and perception

Applied technologies and systems:

3D GIS: modelling and interpretation
3D scanner and remote sensing devices and their application
Augmented VR
Capture Technologies and Delivery Platforms
Convergent devices
Delivery and Distribution
Immersive Systems
Mobile Devices and their application
Modelling and rendering
On-site Delivery
Participatory 3D GIS
Projection Spaces
Standards and metadata
Stereoscopy and Panoramas

Important Dates:

Long and Short Papers: June 17, 2007
Notification: July 15, 2007
Camera-ready: August 10, 2007

Posters due - July 15, 2007
Notification - August 10, 2007
Camera-ready due - September 15, 2007

Long papers: 12 pages (approx 3000-4000 words)
Short papers: 5 pages (approx 1200-1800 words)
Posters: single A2 (or other format by negotiation)

Earlybird Registration: August 10, 2007

Five student bursaries of USD$250 each will be offered (see official website for details).

Contact us: Any queries, email aus_reviewers[at]vsmm.org or phone +61 7 3337 7821.

Note: VSMM07 SYDNEY WORKSHOP 21ST SEPTEMBER 2007 - In addition to the conference, VSMM invites all participants to attend a one day seminar on the 21st September 2007 in Sydney that focuses attention on new virtual heritage and electronic art research applied to the Advanced Visualisation Interactive Environment (AVIE), at the iCinema Centre for Interactive Cinema Research, University of New South Wales http://australia.vsmm.org/sydworkshop/seminar.pdf.

May 25, 2007

Haptic Telexistence

From Networked Performance



Haptic Telexistence (SIGGRAPH 2007)provides highly realistic haptic interaction among humans and objects located in remote places. Human interaction will be dramatically improved by this concept, which perceives us as the properties of an object.

Enhanced Life: With conventional systems, we can only perceive the stiffness of an object. But with Haptic Telexistence, we can also perceive the exact shape of an object, and more natural and dexterous object manipulations become possible. This simplifies complex tasks such as telesurgery and 3D modeling.

Because this system can present properties such as texture and temperature, it will support dramatic improvements in human life. For example, not only will we be able to shake hands with people at remote locations but we will also be able to feel the warmth of their hands. While shopping on the web, we will be able to check the texture of an article before purchase.

Goals: Our ultimate goal is to present all the haptic sensations through a master-slave system. Using current telepresence systems, we can interact with humans or objects even if they are located in remote places or in virtual environments. We can watch, listen, touch, and move objects. However, the properties of an object are not present in these systems, and that reduces realism and interactivity. Haptic Telexistence aims to provide highly realistic haptic interaction among human and objects in remote places.

Innovations: The system consists of four innovative devices: a dexterous slave hand, q finger-shaped haptic sensor for the slave hand, an encounter-type master hand, and an electro-tactile display. Each of these devices has more advantages than the corresponding conventional ones. In addition, integrating them to realize Haptic Telexistence is also a technical innovation.

Vision: Because haptic and robotic technologies continue to improve rapidly, we believe that this technology will be fully realized with 10 years.

Katsunari Sato
The University of Tokyo
Katsunari_Sato (at) ipc.i.u-tokyo.ac.jp

May 02, 2007

Virtual reality device helps multiple sclerosis patients walk

Via Medgadget 


Via Medgadget

audio visual walker.JPG

Researchers at Technion Institute of Technology in Israel have developed a wearable virtual reality that  device to provide patients suffering from balance disorders with supplemental auditory and visual information to restore normal gait. 

From the press release 

The visual component presents users with a virtual, tiled-floor image displayed on one eye via a tiny piece that clips onto glasses worn by the user. This allows the user to distinguish between the virtual floor and real obstacles, making it possible to navigate even rough terrain or stairs.

The researchers found that auditory feedback significantly improved the gait of both MS and Parkinson's patients (though the improvement was less pronounced in Parkinson's patients). With regard to walking speed, patients showed an average improvement of 12.84% while wearing the device. There were also positive residual short-term therapeutic effects (18.75% improvement) after use. Average improvement in stride was 8.30% while wearing the device and 9.93% residually.

"Healthy people have other tools, such as sensory feedback from muscles nerves, which report on muscle control, telling them whether or not they are using their muscles correctly," says Baram. "This feedback is damaged in Parkinson and MS patients and the elderly, but auditory feedback can be used to help them walk at a fixed pace."

Results from a small study (14 randomly selected patients with gait disturbances predominantly due to MS) on the device are published in the February 2007 issue of the Journal of the Neurological Sciences .

The integrated device - the first to respond to the patient's motions rather than just providing fixed visual or auditory cues - is already in use at a number of medical centers in Israel and the United States, including the University of Cincinnati and the State University of New York.

Apr 30, 2007

Benefits of virtual world learning

Apr 27, 2007

New IBM Mainframe Platform For Virtual Worlds

Re-blogged from 3dPoint

The International Herald Tribune breaks the news that IBM is launching a new mainframe platform specifically designed for next-generation virtual worlds and 3D virtual environments. In concert with Brazilian game developer Hoplon, IBM will use the PlayStation3’s ultra-high-powered Cell processor to create a mainframe architecture that will provide the security, scalability and speed that are currently lacking in 3D environments — a lack that is one of the factors keeping them from becoming widely adopted. If it works, it sounds like worldmakers working on IBM’s platform should be able to support concurrencies far above todays’ capabilities, and implement commerce systems far more secure than is currently possible.

Are complex psychotherapies more effective than biofeedback, progressive muscle relaxation, or both

Are complex psychotherapies more effective than biofeedback, progressive muscle relaxation, or both? A meta-analysis.

Psychol Rep. 2007 Feb;100(1):303-24

Authors: Stevens SE, Hynan MT, Allen M, Braun MM, McCart MR

A meta-analysis of 26 studies was conducted to assess whether more complex forms of psychotherapy would be superior to control treatments of either biofeedback, progressive muscle relaxation, or both. Consistent with hypotheses, more complex treatments provided a small, significant improvement over biofeedback and progressive muscle relaxation (r = .09). A subset of the more complex behavioral treatments accounted for most of this small incremental effectiveness of more complex treatments (r = .15). Possible sources of this incremental effectiveness are discussed.