Oswald D. Kothgassner

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• Ap. Prof. Mag. Dr.
• Ap. Professor I Principal Investigator (PI) at Medical University of Vienna

Background and objective Despite evidence supporting the effectiveness of Virtual Reality (VR) for mental disorders, VR adoption in therapy remains low. As VR-technology continues to advance, it is crucial to examine individual and contextual barriers preventing implementation of therapeutic VR. Methods An online survey with closed and open-ended...

Virtual Reality (VR) biofeedback (BF) may be regarded as a viable means to overcoming barriers of traditional 2D-BF. Combining fully immersive VR-BF with gamification promises to particularly benefit children and adolescents. As data on children is scarce, this multicenter RCT set out to evaluate a self-developed VR-BF game in young patients with s...

Long COVID (LC) is a prevalent condition among SARS-CoV-2 infections. Yet, in-depth research on adverse stress responses in LC remains limited. The primary aim of this study was to investigate chronic stress and post-traumatic stress due to the COVID-19 pandemic specifically experienced in LC, as both have been suggested to interplay with the manif...

Background Nonsuicidal self-injury (NSSI) is a prevalent and concerning behavior among adolescents, often triggered by negative interpersonal events. As social media is essential in the daily life of adolescents, gaining a better understanding of the impact of negative online events on NSSI urges and behaviors, distinct from that of real-life event...

Background Non-binary identities are increasingly recognized within the spectrum of gender diversity, yet there is a dearth of research exploring the mental health challenges specific to this population. Therefore, this systematic review and meta-analysis aimed to comprehensively assess the mental health outcomes of non-binary youth in comparison t...

Background: While there are well-established treatments for post-traumatic stress disorder (PTSD), these interventions appear to be less effective for individuals with comorbid borderline personality disorder (BPD) symptoms. Dialectical Behavior Therapy (DBT) for PTSD and DBT Prolonged Exposure (PE) are both effective interventions for treating the...

Background Over the past decades, media use has become a key aspect of young people’s daily lives, significantly shaping their social interactions, learning processes, and recreational pursuits. At the same time, healthcare professionals and researchers are increasingly concerned about the impact of media use on young people’s mental health. This c...

Objectives The COVID-19 pandemic has had unprecedented and deteriorating effects on the mental health of adolescents and young adults. Various studies have described changes regarding substance abuse, but findings are conflicting. Study design We conducted a cross-sectional online survey on nicotine, alcohol, and illicit drug use. Methods From Ma...

Importance Nonsuicidal self-injury (NSSI) is a significant clinical concern among adolescents. Exposure to NSSI-related content on social media platforms has been suspected to potentially act as a trigger for NSSI. Objective To use free-viewing eye-tracking and dot-probe paradigms to examine attentional bias and psychophysiological responses to NS...

Introduction Clinical psychologists in Austria shouldered a large part of the massive increase in demand for mental health services caused by the COVID-19 pandemic. This study aimed to find out how the pandemic affected their work and to gather information on how best to support the profession in the event of a crisis. Methods N = 172 Austrian cli...

Background The COVID-19 pandemic increased the mental health burden in the general population, enhancing the demands placed on mental healthcare professionals. Methods This study aimed to assess the burdens and resources of clinical psychologists that emerged since the beginning of the pandemic. N = 172 Austrian clinical psychologists participated...

Background: Confidentiality is a crucial ethical principle in therapy, particularly for children and adolescents, yet their perception of it remains understudied. We aimed to explore minors’ perspectives and attributions on confidentiality in psychological and medical treatment. Methods: We interviewed 11 pediatric patients aged 7 to 15 and used re...

Introduction Mentalization‐based therapy (MBT) and its adapted version for adolescents (MBT‐A) are repeatedly highlighted as promising treatments for reducing self‐harm, particularly in borderline personality disorder (BPD). Despite the availability of publications providing evidence of their efficacy in reducing self‐harm, recent meta‐analyses hav...

Background The COVID-19 pandemic has impacted many aspects of everyday life, including the (mental) healthcare system. An increase in depression and anxiety symptoms has been reported worldwide, and is particularly pronounced in females and young people. We aimed to evaluate changes in prescription rates for psychopharmacological medication, which...

Virtual reality (VR) is increasingly used in psychotherapy, and the speed of development of therapeutic VR tools is continuously increasing. This narrative review provides an overview of the state of the art regarding VR applications for psychotherapy. The current state of VR therapy research for anxiety disorders and posttraumatic stress disorder...

Social restrictions during the COVID-19 pandemic had a major impact on the mental health of youth. We analyzed a sample of 274 adolescents and young adults that participated in an online survey. We used the Brief Symptom Inventory 18 (BSI 18) and the Perceived Stress Scale to assess mental health status. Furthermore, we assessed the frequency and i...

Gender dysphoric adolescents report a gender identity which is incongruent with their assigned sex at birth, whereby the experienced incongruence is accompanied by clinically relevant distress. The aim of the study was to assess and compare the mental health of transgender youth by assigned sex at birth. A total of n = 49 adolescents (n = 29 assign...

Direct (e.g. being in contact with the virus) and indirect traumatic experiences (e.g. Distressing Social Media Exposure: DSME) of the COVID-19 pandemic led to a variety of psychological and psychosocial consequences. They represent COVID-19-related Posttraumatic Stress Symptoms (PTSS) risk factors, whereby their interactions and their relations to...

Virtual Reality (VR) is a growing field in psychological research and therapy. While there is strong evidence for the efficacy of exposure therapy in VR (VRET) to treat anxiety disorders, new opportunities for using VR to treat mental health disorders are emerging. In this chapter, we first describe the value of VRET for the treatment of several an...

Mental healthcare professionals face diverse challenges during the COVID-19 pandemic, which may augment their risk of experiencing adverse mental health outcomes themselves. We aimed to compare depressive, anxiety, insomnia, and stress symptoms in Austrian clinical psychologists during the COVID-19 pandemic with the Austrian general population. A t...

Background: The CoVid-19 pandemic has impacted many aspects of everyday life, including the (mental) health care system. An increase in depression and anxiety symptoms has been reported worldwide, which is particularly pronounced in females and young people. We aimed at evaluating changes in patient rates of those receiving psychopharmacological me...

(1) Background: Many studies have used a well-known social exclusion task, namely Cyberball, to assess the psychophysiological reactions to ostracism in laboratory settings. However, this task has been recently criticized for its lack of realism. Instant messaging communication platforms are currently central communication channels where adolescent...

In 2019, the global Coronavirus (COVID-19) pandemic and associated prevention measures affected the mental health and psychological well-being of young people with and without a migratory background. The present study aimed to compare the mental health and psychological well-being of migrant and non-migrant young people before and after the COVID-1...

Abstract Background Conspiracy beliefs have become widespread throughout the COVID-19 pandemic. Previous studies have shown that endorsing conspiracy beliefs leads to lower protective guideline adherence (i.e., wearing face masks), posing a threat to public health measures. The current study expands this research across the lifespan, i.e., in a sam...

Durch die fortschreitende Digitalisierung gewinnen virtuelle Entspannungsinterventionen, insbesondere monoskopische 360°Naturaufnahmen, zunehmend an Bedeutung. Während der bisherige Fokus auf der Wirksamkeit monoskopischer 360°Naturaufnahmen lag, haben nur wenige Studien die zugrundeliegenden Wirkfaktoren untersucht. Hierfür untersucht diese Sekun...

Highlights: 1) the "sense of presence" and "immersion" are logically distinct but related concepts which to date have often been confused an used synonymously 2) "immersion" may be conceptualized as an objective property of technology or the extent to which a user feels immersed3) "presence", in turn, is a perceptual illusion in which the user has...

Satisfaction with the detection process of autism and its determinants was investigated using data from the Autism Spectrum Disorder in the European Union (2015–2018) network. A total of 1342 family members, including 1278 parents, completed an online survey collecting information about their experience and satisfaction with the early detection of...

Background In life-threatening emergency events, prompt decision-making and accurate reactions are essential for saving a human's life. Some of these skills can be improved by regular simulation trainings. However, besides these factors, individual characteristics may play a significant role in the patients' outcome after a resuscitation event. Thi...

Hintergrund: Virtual Reality (VR) wird zunehmend als Hilfsmittel für psychologische Interventionen eingesetzt. Auch für sozial-emotionale Fähigkeiten kann VR realitätsnahe Übungsszenarien kreieren. Fragestellung: Dieses systematische Review gibt einen Überblick über den aktuellen Forschungsstand zu VR-Trainings sozial-emotionaler Fähigkeiten. Metho...

As a global health crisis, COVID-19 has led to a rise in overall stress levels. Concurrently, conspiracy beliefs regarding the origin and spread of the disease have become widespread. Engaging in such beliefs can be explained as a form of coping in order to deal with elevated levels of stress. The present study investigated the indirect effects of...

Background: Given the prevalence of post-traumatic stress disorder (PTSD), particularly among military personnel, new treatment approaches are needed. One may be virtual relaxation interventions, especially 360-degree nature videos, since studies have demonstrated their relaxation effects for healthy participants. If these relaxation effects can be...

Hintergrund: Virtual Reality (VR) wird zunehmend als Hilfsmittel für psychologische Interventionen eingesetzt. Auch für sozial-emotionale Fähigkeiten kann VR realitätsnahe Übungsszenarien kreieren. Fragestellung: Dieses systematische Review gibt einen Überblick über den aktuellen Forschungsstand zu VR-Trainings sozial-emotionaler Fähigkeiten. Metho...

Introduction Emotion dysregulation is a common challenge pertaining to numerous psychiatric disorders in adolescence and is associated with increased morbidity and mortality. Dialectical Behavior Therapy for Adolescents (DBT®-A) has been shown to be an effective treatment, especially in the reduction of self-harm and suicidality. Measures in relati...

This systematic review and meta-analysis aimed to investigate the association of neonatal exposure to pain, stress, opiate administration alone, as well as opiate administration prior to a painful procedure on neuronal cell death, motor, and behavioral outcomes in rodents. In total, 36 studies investigating the effect of pain (n=18), stress (n=15),...

The question of what contributes to users’ identification with media characters remains an open issue in research. Apart from media interactivity, user characteristics like gender, age, immersive tendencies, and factual transportation into the narrative are promising factors. Yet, research is still in its infancy, and the usage of different media l...

Background: Virtual reality (VR)-based biofeedback is a relatively new intervention and is increasingly being used for the treatment of anxiety disorders. This is the first research synthesis regarding effects and efficacy of this novel mode of treatment. Method: We conducted a systematic review and meta-analysis of the VR biofeedback literature...

The COVID-19 pandemic has been shown to have impaired the mental health and well-being of young people. This study, for the first time, explores these aspects in young people with and without a migratory background during the extended course of the pandemic and restrictive measures, comparing two countries with a high COVID-19 prevalence: Austria a...

Humans are biologically endowed with the faculty of language. However, the way neonates can crack this complex communicative code is yet not totally understood. While phonetic discrimination has been widely investigated in neonates, less is known about the role of supra-segments patterns in the recognition of native language. Therefore, the aim of...

It is generally accepted that natural environments reduce stress and improve mood. Since access to natural environments is sometimes limited, virtual natural environments, especially monoscopic 360°nature videos, offer a viable alternative. However, it remains unclear whether presenting monoscopic 360°nature videos via a head-mounted display (HMD)...

Background Although the Trier Social Stress Test (TSST) constitutes a valid paradigm for social stress induction, less is known about the effects of a virtual reality (VR) TSST on short- and long-term hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adreno-medullar (SAM) axis responses. Hence, this study set out to evaluate reactivity and...

Background The COVID‐19 pandemic results in disproportional consequences for psychiatric patients. Due to restraints in physical contacts, providers switched from face‐to‐face contacts to teletherapy, but prior experiences were mostly limited. The study aimed at assessing symptom dynamics, potentially increased adversities and factors influencing a...

Background Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical. Methods We conducted a systematic review and me...

Background The relevance of medical cannabis (MC) increases; and, educating those who are at the forefront of patient care is imperative. Yet, research on medical students’ expertise and opinions is still scarce. Objective This study set out to evaluate Austrian medical students’ knowledge about and attitudes towards MC and compare them with other...

Background Post-traumatic stress disorder (PTSD) is a debilitating disorder that is often accompanied by alterations in the hypothalamic-pituitary (HPA) axis. While there is abundant evidence for the efficacy of psychological therapies in reducing post-traumatic stress symptoms, barely anything is known about pharmacological interventions. Given th...

While ostracism constitutes a social stressor with negative effects on physical and mental health, social inclusion seems to increase resilience. This may be true not only for face-to-face settings, but also for computer-mediated interactions. Hence, this study examined the differences between ostracism and social inclusion in real-life or Virtual...

Aim To provide a systematic review on studies examining problematic smartphone (PSU) use in children and adolescents, and its impact on quality of life, life satisfaction, and well‐being. Methods An extensive literature search was conducted in Google Scholar, Scopus and Pubmed. Results The search yielded k = 9 articles for which inclusion criteri...

Little is known about the impact of the COVID-19 pandemic on the mental health and psychological well-being of young people. The aim of this study is to investigate the psychological well-being and changes in the mental-health state of young people living in Austria and Turkey. By using an anonymous online survey, we recruited 1240 people aged 15–2...

Some post-traumatic stress disorder (PTSD) patients do not benefit from imaginal exposure therapy. One possible approach to reach such patients are virtual trauma interventions. Herein, a qualitative scoping review was conducted. Different types of virtual trauma exposure interventions were identified. For each type of virtual trauma exposure inter...

Highlights Conspiracy beliefs are spread via social media platforms and may have a negative impact on preventive health measures. Preventive measures against fear and misinformation need to consider the differential effects of different forms of conspiracy theories on behavior. Fostering awareness in society about COVID-19 misinformation in social...

Owed to the COVID-19 pandemic, teletherapeutic offers skyrocketed, in the need of the moment seemingly faster that the background technology and training could be provided. This spotlight communication gives an overview of results and ideas on teletherapeutic offers for adolescent psychiatric outpatients and impulses for further investigations. We...

In medicine or industry, the analysis of high-dimensional data sets is increasingly required. However, available technical solutions are often complex to use. Therefore, new approaches like immersive analytics are welcome. Immersive analytics promise to experience high-dimensional data sets in a convenient manner for various user groups and data se...

Digitale Medien bilden einen integralen Bestandteil der heutigen Lebenswelt von Kindern und Jugendlichen. Einerseits bieten sie, wenn sie verantwortungsbewusst genutzt werden, eine Möglichkeit zur Teilhabe an der Gesellschaft, andererseits stellen sie mitunter hohe Anforderungen an die Medienkompetenzen derjenigen, die sie nutzen. In der Psychother...

Introduction: Psychotic-like experiences (PLE) are usually a transitory state, and most individuals will not transition to psychosis. However, individuals with PLE may experience symptoms such as social anxiety, which may lead to choosing the Internet as a preferred means of social interaction. Objectives: To examine the relation between PLE and pr...

Minors with and without migration background can have different risk factors and triggering reasons for self-harming and suicidal behaviour. We retrospectively analysed the data of 192 children and adolescents to investigate the transcultural differences in self-harming, as well as suicidal behaviour in Austrian, Turkish, and Bosnian/Croatian/Serbi...

Early services for ASD need to canvas the opinions of both parents and professionals. These opinions are seldom compared in the same research study. This study aims to ascertain the views of families and professionals on early detection, diagnosis and intervention services for young children with ASD. An online survey compiled and analysed data fro...

The original version of this article unfortunately contained a mistake in one of the co-author’s family name. The correct name should be María Victoria Martín-Cilleros instead of María Victoria Cilleros-Martín.

Background: Parental beliefs about the cause of their child's illness are thought to affect parents' help-seeking behaviors, treatment decisions, and the child's health outcomes. Yet, research on parental beliefs about disease causation is still scarce. While a small number of studies assesses parental cause attributions for singular disorders (e....

The proliferation of Virtual Reality (VR) over the past decades has introduced a tool to research that holds the promise of providing a means to overcoming drawbacks of traditional experimental and assessment methods in social sciences. By stimulating multiple sensory channels and displaying dynamic contexts, it fosters responses comparable to real...

Background Adolescents suffering from psychiatric disorders are at risk of disproportionally suffering from the current COVID-19-pandemic. We aimed to assess their specific needs and to evaluate factors influencing a successful transition into teletherapy. Methods Thirty adolescent psychiatric outpatients participated in a series of interviews. The...

Background Psychotic-like experiences (PLE) are reported in the general population, characterizing a non-clinical psychosis phenotype. Although those who report PLE have a higher probability of transitioning to psychosis, PLE are usually a transitory state, and most individuals will not transition to psychosis. However, PLE samples may experience s...

Background: Psychotic-like experiences (PLE) are reported in the general population, characterizing a non-clinical psychosis phenotype. Although those who report PLE have a higher probability of transitioning to psychosis, PLE are usually a transitory state, and most individuals will not transition to psychosis. However, PLE samples may experience...

Background Self-harm is a clinically relevant and prevalent behaviour which peaks in adolescence. Given the high prevalence of self-harm, the high levels of psychiatric comorbidity, and its role as a risk factor for suicide, delivering evidence-based care is critical. Methods We conducted a systematic review and meta-analysis of the literature on...

Anxiety disorders are one of the most prevalent mental disorders in children and adolescents which may effectively be treated by several forms of exposure therapy. An emerging approach to exposure is virtual reality exposure therapy (VRET), but a literature search synthesis focusing specifically on the use of VRET in children and adolescents is sti...

In this report, we present a case of a 16,9-year-old patient with multiple substance use disorder (cannabis, MDMA, cocaine, ecstacy), severe depression, social phobia and narcissistic personality disorder. We administered Cannabidiol (CBD) capsules in different dosages (starting dosage 100 mg up to 600 mg over 8 weeks) after unsuccessful treatment...

Post-traumatic stress disorder (PTSD) symptoms are prevalent in both civilian and military service members. As the number of smartphone-based applications (apps) grows rapidly in health care, apps are also increasingly used to help individuals with subthreshold PTSD or full PTSD. Yet, if the apps are self-managed, the feasibility and efficacy of su...

Abstract. This study investigates the relationship between adverse childhood experiences (ACEs), age, and sex with respect to their avatar preference in online games. The analyses comprise a subsample of n = 1817 adolescents and adults from 14 to 60 years within a representative German population-based study. Results indicate that 14 % of this samp...

In this paper we present a novel VR-based tool for the treatment of anxiety disorders for children and adolescents. The tool consists of a photo-realistic VR game, together with a biofeedback device, and a second screen for enabling interventions for the practitioner. We describe the tool, how we measure and use biofeedback, and evaluate the sense...

Numerous studies have demonstrated that acute psychological stress, induced by the Trier Social Stress Test (TSST) paradigm, affects salivary cortisol secretion and self-reported stress measures including anxiety. Allergy has been related to altered cortisol responsiveness and increased stress vulnerability. Here, we investigated acute stress respo...

Objectives Research on participatory medical decision making in children is still scarce. At the same time, there is broad consensus that involving young patients in decision making processes increases their adherence to medical procedures and reduces anxiety. Thus, this cross-sectional study’s objective was to assess mothers’, fathers’, and childr...

Background: Psychological sequels to criminal violence can be long lasting and severe. They are in many countries not sufficiently considered in court cases as an important circumstance that could be used to assess the severity of the crime, also guiding redress, compensation, and rehabilitation of the victim, and—in children—child custody consider...

Background The percentage of smartphone users—especially among minors—is growing, and so is the body of literature hinting at increasing rates of problematic smartphone use in children and adolescents. However, comprehensive reviews regarding this issue are still scarce. Objective The main aim of this review was to provide an overview of studies f...

Rund 70 % der Kinder mit Autismus-Spektrum-Störung (ASS) sind auch von einer Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) betroffen. Umgekehrt wird bei rund 13 % der Kinder mit ADHS auch ASS diagnostiziert. Die phänomenologischen Gemeinsamkeiten und Unterschiede sowie Behandlungsoptionen für Kinder und Jugendliche mit einer Doppeldiagnose...

Contrary to specific phobias, for which Virtual Reality Exposure Therapy (VRET) constitutes an effective treatment, uncertainty still exists regarding the usefulness of VRET for posttraumatic stress disorder (PTSD). Therefore, this meta-analysis investigated the efficacy of VRET for PTSD as compared to waitlist and active comparators. A literature...