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Papers by Joe Edwards

In R. L. Kane & T. D. Parsons (Eds.), The role of technology in clinical neuropsychology (pp. 175-235)., Apr 21, 2017

Edwards, J., & Parsons, T. D. (2017). Virtual reality applications for neuropsychological assessm... more Edwards, J., & Parsons, T. D. (2017). Virtual reality applications for neuropsychological assessment in the military: Historical antecedents, current developments, and future directions. In R. L. Kane & T. D. Parsons (Eds.), The role of technology in clinical neuropsychology (pp. 175-235). New York, NY: Oxford University Press.

Abstract: Neuropsychological assessment procedures play a vital role in evaluating the mental health and operational readiness of service members within the United States military. Since the beginning of World War I, various paper-and-pencil based neuropsychological assessment instruments have been devised and refined. While the majority of neuropsychological test instruments used today are still administered via paper-and-pencil, throughout the past several decades, many computer-automated applications have emerged, including several that have been developed specifically for use with military personnel. As technologies have continued to advance, the military has increasingly sought ways of leveraging them as a means of expanding and improving upon assessment practices. Along with computerized cognitive test batteries, interest in the use of virtual reality (VR) based neuropsychological assessment applications continues to build. This chapter will provide an overview of VR-based applications and research within the military, beginning with a brief historical background, followed by discussion of specific individual VR-based assessment platforms, including potential advantages, limitations, and directions for future research.

Applied Neuropsychology: Adult, 21(3), 220-230. doi:10.1080/09084282.2013.796554, 2014

Traumatic brain injury (TBI) is a common event in the current extended conflicts by American serv... more Traumatic brain injury (TBI) is a common event in the current extended conflicts by American service members, with estimates that as many as 300,000 have sustained combat-related concussions during Operation Iraqi Freedom and Operation Enduring Freedom. The limited ecological validity of traditional neuropsychological assessment measures presents a challenge to effective postconcussion evaluation of service members in relation to fitness-for-duty decisions or rehabilitation needs. Virtual reality (VR) technology offers a promising opportunity to advance the field of functional assessment for TBI. This article reviews the current professional literature on VR applications for TBI assessment, with special emphasis on those that are particularly relevant to U.S. service members. VR affords several advantages for clinical use. These include assessment of complex sets of cognitive and behavioral functions rather than the isolated components assessed by traditional measures; more precise control over the standardized presentation of task stimuli and the recording of response data; and enhanced ecological validity that can lead to more useful assessment data in the applied contexts faced by the U.S. military.

Journal of Clinical and Experimental Neuropsychology, 35(2), 113-123. doi:10.1080/13803395.2012.740002, 2013

Virtual environments provide the ability to systematically deliver test stimuli in simulated cont... more Virtual environments provide the ability to systematically deliver test stimuli in simulated contexts relevant to real world behavior. The current study evaluated the validity of the Virtual Reality Stroop Task (VRST), which presents test stimuli during a virtual reality military convoy with simulated combat threats. Active duty Army personnel (N = 49) took the VRST, a customized version of the Automated Neuropsychological Assessment Metrics (ANAM)–Fourth Edition TBI Battery (2007) that included the addition of the ANAM Stroop and Tower tests, and traditional neuropsychological measures, including the Delis-Kaplan Executive Function System version of the Color–Word Interference Test. Preliminary convergent and discriminant validity was established, and performance on the VRST was significantly associated with computerized and traditional tests of attention and executive functioning. Valid virtual reality cognitive assessments open new lines of inquiry into the impact of environmental stimuli on performance and offer promise for the future of neuropsychological assessments used with military personnel.

Studies in Health Technology and Informatics: Vol 173. Medicine Meets Virtual Reality 19 (pp. 331-337). doi:10.3233/978-1-61499-022-2-331, 2012

The assessment and treatment of traumatic brain injury (TBI) has become a difficult challenge for... more The assessment and treatment of traumatic brain injury (TBI) has become a difficult challenge for the DoD medical health system. Clinical neuropsychologists are being asked to make statements regarding a soldier's functional skills, ability to return to active duty, and competence in tasks of community living. Given the increasing prevalence of blast injuries to the head, and the fact that many brain injuries may have no external marker of injury, there is need for researching innovative assessment methods in detecting blast-related brain injury. To address these issues, two virtual reality-based Paced Auditory/Visual Serial Addition Tests (PA/VSAT) were developed that involve the participant being immersed in a Virtual Middle Eastern City as serial addition stimuli are presented. This study is an initial validation of the VRPASAT and VRPVSAT as assessments of neurocognitive functioning. When compared to the paper-and-pencil version of the test, as well as the Automated Neuropsychological Assessment Metrics, the VRPASAT and VRPVSAT appear to have enhanced capacity for providing an indication of a participant's performance while immersed in a military relevant simulation.

Games for Health Journal, 1(4), 312-318. doi:10.1089/g4h.2012.0014, 2012

"Objective: Exercise is an effective intervention for depressed individuals, but adherence is oft... more "Objective: Exercise is an effective intervention for depressed individuals, but adherence is often poor. Exergaming may be useful for stimulating motivation and adherence with physical activity. This study piloted the use of the Nintendo® “Wii™ Fit” (Nintendo of America, Inc., Redwood City, CA) as part of cognitive behavioral treatment (CBT) for soldiers.

Subjects and Methods: Male soldiers with depression (N=3) were treated in a military treatment facility using a case-controlled research design. Patients were loaned a “Wii Fit” during five of 10 CBT treatment sessions and asked to exercise at least 20 minutes/day.

Results: Rates of compliance and minutes of exercise were no different during the periods with and without the “Wii Fit.” All three patients reported a reduction in depression severity following treatment.

Conclusions: This study provides important lessons learned for future studies of exergaming for patients with depression. Exergaming software is typically not designed for clinical populations, and certain characteristics of the game may decrease the likelihood of use. Researchers should consider the characteristics of various available exergaming platforms and select one that represents a clinical and cultural fit for their patient population.
"

Conference Presentations by Joe Edwards

In M. K. Alvord (Chair), Apps, telehealth, virtual reality: Addressing mental health needs of service women and men and veterans. Videotaped presentation presented at the 121st Annual Convention of the American Psychological Association (APA), Honolulu, HI.

See attached for related info: APA Division 46 sessions from the 2013 annual convention from the ... more See attached for related info: APA Division 46 sessions from the 2013 annual convention from the Spring/Summer 2013 edition of The Amplifier Magazine of the Society for Media Psychology and Technology, Division 46 of the American Psychological Association.

In R. L. Kane & T. D. Parsons (Eds.), The role of technology in clinical neuropsychology (pp. 175-235)., Apr 21, 2017

Edwards, J., & Parsons, T. D. (2017). Virtual reality applications for neuropsychological assessm... more Edwards, J., & Parsons, T. D. (2017). Virtual reality applications for neuropsychological assessment in the military: Historical antecedents, current developments, and future directions. In R. L. Kane & T. D. Parsons (Eds.), The role of technology in clinical neuropsychology (pp. 175-235). New York, NY: Oxford University Press.

Abstract: Neuropsychological assessment procedures play a vital role in evaluating the mental health and operational readiness of service members within the United States military. Since the beginning of World War I, various paper-and-pencil based neuropsychological assessment instruments have been devised and refined. While the majority of neuropsychological test instruments used today are still administered via paper-and-pencil, throughout the past several decades, many computer-automated applications have emerged, including several that have been developed specifically for use with military personnel. As technologies have continued to advance, the military has increasingly sought ways of leveraging them as a means of expanding and improving upon assessment practices. Along with computerized cognitive test batteries, interest in the use of virtual reality (VR) based neuropsychological assessment applications continues to build. This chapter will provide an overview of VR-based applications and research within the military, beginning with a brief historical background, followed by discussion of specific individual VR-based assessment platforms, including potential advantages, limitations, and directions for future research.

Applied Neuropsychology: Adult, 21(3), 220-230. doi:10.1080/09084282.2013.796554, 2014

Traumatic brain injury (TBI) is a common event in the current extended conflicts by American serv... more Traumatic brain injury (TBI) is a common event in the current extended conflicts by American service members, with estimates that as many as 300,000 have sustained combat-related concussions during Operation Iraqi Freedom and Operation Enduring Freedom. The limited ecological validity of traditional neuropsychological assessment measures presents a challenge to effective postconcussion evaluation of service members in relation to fitness-for-duty decisions or rehabilitation needs. Virtual reality (VR) technology offers a promising opportunity to advance the field of functional assessment for TBI. This article reviews the current professional literature on VR applications for TBI assessment, with special emphasis on those that are particularly relevant to U.S. service members. VR affords several advantages for clinical use. These include assessment of complex sets of cognitive and behavioral functions rather than the isolated components assessed by traditional measures; more precise control over the standardized presentation of task stimuli and the recording of response data; and enhanced ecological validity that can lead to more useful assessment data in the applied contexts faced by the U.S. military.

Journal of Clinical and Experimental Neuropsychology, 35(2), 113-123. doi:10.1080/13803395.2012.740002, 2013

Virtual environments provide the ability to systematically deliver test stimuli in simulated cont... more Virtual environments provide the ability to systematically deliver test stimuli in simulated contexts relevant to real world behavior. The current study evaluated the validity of the Virtual Reality Stroop Task (VRST), which presents test stimuli during a virtual reality military convoy with simulated combat threats. Active duty Army personnel (N = 49) took the VRST, a customized version of the Automated Neuropsychological Assessment Metrics (ANAM)–Fourth Edition TBI Battery (2007) that included the addition of the ANAM Stroop and Tower tests, and traditional neuropsychological measures, including the Delis-Kaplan Executive Function System version of the Color–Word Interference Test. Preliminary convergent and discriminant validity was established, and performance on the VRST was significantly associated with computerized and traditional tests of attention and executive functioning. Valid virtual reality cognitive assessments open new lines of inquiry into the impact of environmental stimuli on performance and offer promise for the future of neuropsychological assessments used with military personnel.

Studies in Health Technology and Informatics: Vol 173. Medicine Meets Virtual Reality 19 (pp. 331-337). doi:10.3233/978-1-61499-022-2-331, 2012

The assessment and treatment of traumatic brain injury (TBI) has become a difficult challenge for... more The assessment and treatment of traumatic brain injury (TBI) has become a difficult challenge for the DoD medical health system. Clinical neuropsychologists are being asked to make statements regarding a soldier's functional skills, ability to return to active duty, and competence in tasks of community living. Given the increasing prevalence of blast injuries to the head, and the fact that many brain injuries may have no external marker of injury, there is need for researching innovative assessment methods in detecting blast-related brain injury. To address these issues, two virtual reality-based Paced Auditory/Visual Serial Addition Tests (PA/VSAT) were developed that involve the participant being immersed in a Virtual Middle Eastern City as serial addition stimuli are presented. This study is an initial validation of the VRPASAT and VRPVSAT as assessments of neurocognitive functioning. When compared to the paper-and-pencil version of the test, as well as the Automated Neuropsychological Assessment Metrics, the VRPASAT and VRPVSAT appear to have enhanced capacity for providing an indication of a participant's performance while immersed in a military relevant simulation.

Games for Health Journal, 1(4), 312-318. doi:10.1089/g4h.2012.0014, 2012

"Objective: Exercise is an effective intervention for depressed individuals, but adherence is oft... more "Objective: Exercise is an effective intervention for depressed individuals, but adherence is often poor. Exergaming may be useful for stimulating motivation and adherence with physical activity. This study piloted the use of the Nintendo® “Wii™ Fit” (Nintendo of America, Inc., Redwood City, CA) as part of cognitive behavioral treatment (CBT) for soldiers.

Subjects and Methods: Male soldiers with depression (N=3) were treated in a military treatment facility using a case-controlled research design. Patients were loaned a “Wii Fit” during five of 10 CBT treatment sessions and asked to exercise at least 20 minutes/day.

Results: Rates of compliance and minutes of exercise were no different during the periods with and without the “Wii Fit.” All three patients reported a reduction in depression severity following treatment.

Conclusions: This study provides important lessons learned for future studies of exergaming for patients with depression. Exergaming software is typically not designed for clinical populations, and certain characteristics of the game may decrease the likelihood of use. Researchers should consider the characteristics of various available exergaming platforms and select one that represents a clinical and cultural fit for their patient population.
"

In M. K. Alvord (Chair), Apps, telehealth, virtual reality: Addressing mental health needs of service women and men and veterans. Videotaped presentation presented at the 121st Annual Convention of the American Psychological Association (APA), Honolulu, HI.

See attached for related info: APA Division 46 sessions from the 2013 annual convention from the ... more See attached for related info: APA Division 46 sessions from the 2013 annual convention from the Spring/Summer 2013 edition of The Amplifier Magazine of the Society for Media Psychology and Technology, Division 46 of the American Psychological Association.