Speaker at Games for Health Europe Conference 2014

1. FEAR FIGHTERS
Brenda K. Wiederhold, Ph.D., MBA, BCB, BCN
Virtual Reality Medical Institute

2. VRMC Corporate Overview
Incorporated in 2001 (S Corp) Professional Medical Corp
Headquarters located in San Diego, CA
Additional office located in Los Angeles
Affiliated non-profit: Interactive Media Institute (IMI) (2001)
Affiliated international non-profit (2006)
Affiliated Belgian SME, VRMI—BVBA legal structure (2006)
Affiliated company China: Cybercare(2011) San DiegoLos AngelesBrusselsQingdao

3. History of Development
1996—Began International Conference
1997—1stAnxiety/VR controlled trial completed (flying)
1998—Began International Journal
2001—U.S. Non-profit and For Profit companies, clinics
mid-2000s—VR products disseminated, publications for general public/scientific community
2006—International Association formed in Belgium, Magazine Publication, 2ndScientific Journal
2006—European SME incorporated in Belgium
2007—Ported VR to Mobile Platforms, Specialty Workshops, and Continuing Education classes
2009—1stPTSD controlled trial completed (OIF/OEF)
2010—1stEuropean Union grant began (INTERSTRESS)
2011—Opened company in Qingdao, China
2014—Opened clinic as part of VRMI in Brussels

4. Experience
Virtual Technologies and Environments
Performance Metrics for Evaluating Training Transfer Effectiveness in a Virtual Environment Simulation
Human Behavior and Performance Analysis
Medical & Trauma Care Training
Tactical Language & Culture Training
Augmented Cognition
Situational Awareness
Shipboard Remediation and Training
Advanced Distance and Distributed Learning
Distributed Instruction Utilizing COTS
Cognitive Task Analysis for Instructional Systems
Scenario-based Instruction
The VRMC team has experience in the following areas:

5. Qualifications
Delivery of turnkey PTSD systems and APA-approved therapist training programs to over 20 locations in U.S./Europe
Sole source contract for VISN 23 VA Hospitals
ISO 9001:2000 and ISO 13485:2003 medical device level certified manufacturing and testing facilities
Listed in the Central Contractor Registry (CCR)
Current DCAA approved accounting system
Successfully bid and won over 50 competitive government contracts
Certified by the Department of the Navy Human Research Protection Protocol approved by the Navy Surgeon General
Certified Veteran’s Administration Hospital vendor
NATO approved contract vendor

6. Clinical Training & Education
VRMC’s 501c3 non-profit affiliate, the Interactive Media Institute (IMI), is certified by the American Psychological Association (APA) to provide Continuing Education (CE) credits for VR therapy
Workshops and training courses for the past 19 years
Training programs for interns, fellows, post docs, medical students, master’s students in psychology, and students of biofeedback and physiological regulation
NATO-sponsored 10-day training program for VR and biofeedback to treat and prevent PTSD
NATO-sponsored symposium series on Invisible Wounds of War:
Suicide
PTSD
TBI
Pain
Additional funding from Austrian & Croatian MOD and US Army MRMC
19 nations in attendance

7.  Human Identification at
a Distance
 Cultural Influences on
Virtual Reality
Environment Response
Behavior
 Student State
 VR for Pain Distraction
during Dental Procedures
 VR for Burn Pain Distraction
 VR for Chronic Pain
 VR and physiological
Monitoring for pain
 Cyber Therapy Conference
 ARO Adaptive Displays
Conference at AMC
SIGGRAPH 2004
 Combat Medic
 Injury Creation Science
 SIT for AeroMeds
 PTSD in Iraq
 PTSD Coalition Forces
 Mobile Medical Monitor
 CAP Program  CDC VR Driving Simulator
for Training and Evaluating
Driver Behavior
 SIT
 PTSD
 Rehabilitation
 BioWatch
 TBI Cognitive
Rehabilitation
 ICS Severe Trauma
Training
 Mixed Reality
 Science for Peace and Security Rehabilitation System
 North Atlantic Treaty Organization
Partners and Programs

8. Virtual Reality Medical Institute
VRMI integrates medical science with cutting edge simulation and training technologies to develop new products and training protocols for the treatment of medical, traumatic, and other stress- related injuries and disorders.

10. Common Childhood Phobias
Strangers
Separation anxiety
Monsters/ghosts
Natural disasters
Thunder/lightning
Animals (ex. Dogs)
Loud noises
Darkness
School
Injury
Needles
Death

11. Anxiety Disorder Prevalence
Prevalence between 9% and 32% during childhood and adolescence
Implications:
Depression
Behavioral disorders
Suicidal thoughts
Negative impact on education
Stress in family life
CreswellC, et al. ArchDis Child 2014;99:674–678. doi:10.1136/archdischild-2013-303768

12. Anxiety
Associated with:
Fear
Nervousness
Apprehension
Panic
Can involve:
Cardiovascular system
Respiratory system
Gastrointestinal system
Nervous system
Martin P., Dialogues ClinNeursoci. 2003 Sep;5(30):281-98.

13. DSM-5 Classifications
Specific phobia
Generalized anxiety disorder
Social anxiety disorder
Formally social phobia
Panic disorder
Agoraphobia
CreswellC, et al. ArchDis Child 2014;99:674– 678. doi:10.1136/archdischild-2013-303768

14. Age of Onset
Anxiety disorders (phobias and separation anxiety disorder) have median age of onset of 7-14 years old
Inter-quartile range of 4-20 years old
Kessler et al. CurrOpin Psychiatry. 2007 July; 20(4): 359–364

15. Specific Phobias
Subtypes (according to DSM-IV)
Animal
Natural environment
Blood-injection-injury
Situational
Frequently co-occur
Lifetime prevalence of 12.5%
About twice as common for women than men
Most specific phobias begin in childhood
Fond G, Franc N. Encephale. 2013 Apr;39(2):109-14.

16. Childhood Anxiety
Increases risk of:
Depression
Anxiety later in life
Suicide attempts
Psychiatric hospitalization
Fond G, Franc N. Encephale. 2013 Apr;39(2):109-14.

17. Treating Childhood Anxiety
Counter-conditioning
Extinction
Habituation
Change in catastrophic cognitions
Development of coping skills
Increased self-efficacy
Emotional processing
Changes in expectancies
Changes in perceptions of dangerousness
Fond G, Franc N. Encephale. 2013 Apr;39(2):109-14.
Processes that can treat childhood anxiety:

18. FEAR FIGHTERS APP

19. Fear Fighters App
Downloadable app for iPhone and Android
Suggested price: $2.99
Additional modules: $.99 per scenario
Available on iTunes Store and Google Play

20. Fear Fighters App
Small screen virtual environments can be just as immersive as large screen virtual environments

21. Story Board
Lily
Mateo

24. Research has found no difference between using first-person or third-person avatars to feel present in virtual-reality environments

32. Merchandise

33. Points of Contact
Europe
Professor Dr. Brenda K. Wiederhold, Ph.D., MBA, BCB, BCN
Virtual Reality Medical Institute
30 Clos Chapelleaux Champs, 6thFloor
1200 Brussels, Belgium
+32 2 880 6226
b@vrphobia.eu
USA and China
Professor Dr. Mark D. Wiederhold, M.D., Ph.D., FACP
Virtual Reality Medical Center
9565 WaplesStreet, Suite 200
San Diego, CA 92121
+1 858 642 0267
mwiederhold@vrphobia.com