The role of immersion and narrative in mediated presence: the virtual hospital experience

Presence and Cybersickness in Virtual Reality Are Negatively Related: A Review

In order to take advantage of the potential offered by the medium of virtual reality (VR), it will be essential to develop an understanding of how to maximize the desirable experience of "presence" in a virtual space ("being there"), and how to minimize the undesirable feeling of "cybersickness" (a constellation of discomfort symptoms experienced in VR). Although there have been frequent reports of a possible link between the observer's sense of presence and the experience of bodily discomfort in VR, the amount of literature that discusses the nature of the relationship is limited. Recent research has underlined the possibility that these variables have shared causes, and that both factors may be manipulated with a single approach. This review paper summarizes the concepts of presence and cybersickness and highlights the strengths and gaps in our understanding about their relationship. We review studies that have measured the association between presence and cybersickness, and conclude that the balance of evidence favors a negative relationship between the two factors which is driven principally by sensory integration processes. We also discuss how system immersiveness might play a role in modulating both presence and cybersickness. However, we identify a serious absence of high-powered studies that aim to reveal the nature of this relationship. Based on this evidence we propose recommendations for future studies investigating presence, cybersickness, and other related factors.

Are You Awed Yet? How Virtual Reality Gives Us Awe and Goose Bumps

“Awe” is a category of emotion within the spectrum of self-transcendent experiences. Awe has wellness benefits, with feelings of social interconnectivity and increased life satisfaction. However, awe experiences remain rare in our everyday lives, and rarer in lab environments. We posit that Virtual Reality (VR) may help to make self-transcendent and potentially transformative experiences of awe more accessible to individuals. Here, we investigated how interactive VR as a positive technology may elicit awe, and how features of aesthetic beauty/scale, familiarity, and personalization (self-selection of travel destinations) may induce awe. In this mixed-methods study, participants used an interactive VR system to explore Earth from ground and orbit. We collected: introspective interviews and self-report questionnaires with participants’ experience of awe; information on personality traits and gender; and we recorded physiological goose bumps on the skin (using an arm-mounted goose bump camera instrument), which is a documented marker of an awe experience. Results showed that on a scale of 0–100 for self-reported awe, four different interactive VR environments yielded an average awe rating of 79.7, indicating that interactive VR can indeed induce awe. 43.8% of participants experienced goose bumps: awe ratings positively correlated with the occurrence of goose bumps with those who experienced goose bumps having showed significantly higher ratings of awe than those who did not. Most (64%) of the goose bumps occurred when participants self-selected their VR environment. Participant statements from the interviews were characteristic of an awe-inspiring experience, revealed themes of social connection, and usability problems with the VR interface. Personality traits yielded no clear correlation to awe ratings, and females appear to experience more goose bumps than males. In summary: (1) Interactive VR can elicit awe, especially within familiar, self-selected environments; (2) Physiological goose bumps can be recorded to provide reliable, non-intrusive indications of awe; (3) Care must be taken to design interaction interfaces that do not impede awe; and (4) While personality traits are not correlated to awe ratings, goose bumps were experienced more frequently among females. We aim to conduct future studies using custom VR environments, interfaces, and additional physiological measures to provide further insight into awe.

Affective computing in virtual reality: emotion recognition from brain and heartbeat dynamics using wearable sensors

Affective Computing has emerged as an important field of study that aims to develop systems that can automatically recognize emotions. Up to the present, elicitation has been carried out with non-immersive stimuli. This study, on the other hand, aims to develop an emotion recognition system for affective states evoked through Immersive Virtual Environments. Four alternative virtual rooms were designed to elicit four possible arousal-valence combinations, as described in each quadrant of the Circumplex Model of Affects. An experiment involving the recording of the electroencephalography (EEG) and electrocardiography (ECG) of sixty participants was carried out. A set of features was extracted from these signals using various state-of-the-art metrics that quantify brain and cardiovascular linear and nonlinear dynamics, which were input into a Support Vector Machine classifier to predict the subject’s arousal and valence perception. The model’s accuracy was 75.00% along the arousal dimension and 71.21% along the valence dimension. Our findings validate the use of Immersive Virtual Environments to elicit and automatically recognize different emotional states from neural and cardiac dynamics; this development could have novel applications in fields as diverse as Architecture, Health, Education and Videogames.

The same video game in 2D, 3D or virtual reality - How does technology impact game evaluation and brand placements?

Video game technology is changing from 2D to 3D and virtual reality (VR) graphics. In this research, we analyze how an identical video game that is either played in a 2D, stereoscopic 3D or Head-Mounted-Display (HMD) VR version is experienced by the players, and how brands that are placed in the video game are affected. The game related variables, which are analyzed, are presence, attitude towards the video game and arousal while playing the video game. Brand placement related variables are attitude towards the placed brands and memory (recall and recognition) for the placed brands. 237 players took part in the main study and played a jump'n'run game consisting of three levels. Results indicate that presence was higher in the HMD VR than in the stereoscopic 3D than in the 2D video game, but neither arousal nor attitude towards the video game differed. Memory for the placed brands was lower in the HMD VR than in the stereoscopic 3D than in the 2D video game, whereas attitudes towards the brands were not affected. A post hoc study (n = 53) shows that cognitive load was highest in the VR game, and lowest in the 3D game. Subjects reported higher levels of dizziness and motion-sickness in the VR game than in the 3D and in the 2D game. Limitations are addressed and implications for researchers, marketers and video game developers are outlined.

A Virtual Reality Game to Assess Obsessive-Compulsive Disorder

The retrospective and subjective nature of clinical interviews is an important shortcoming of current psychiatric diagnosis. Consequently, there is a clear need for objective and standardized tools. Virtual reality (VR) can be used to achieve controlled symptom provocation, which allows direct assessment for the clinician. We developed a video VR game to provoke and assess obsessive-compulsive disorder (OCD) symptoms in a standardized and controlled environment. The first objective was to evaluate if the VR game is capable of provoking symptoms in OCD patients as opposed to healthy controls. The second objective was to evaluate the tolerability of the VR game in OCD patients. The VR game was created using a first-person perspective and confronted patients with 15 OCD-specific items, while simultaneously measuring OCD symptoms, including the number of compulsions, anxiety, tension, uncertainty, and urge to control. In this pilot study, eight patients and eight healthy controls performed the VR game. OCD patients performed significantly more compulsions (U = 5, p = 0.003) during the VR game. The anxiety, tension, uncertainty, and urge to control in response to the specific items were also higher for OCD patients, although significance was not yet reached because of the small sample. There were no substantial adverse effects. The results of this pilot study indicate that the VR game is capable of provoking a variety of OCD symptoms in OCD patients, as opposed to healthy controls, and is a potential valuable tool to objectify and standardize an OCD diagnosis.

Does Narrative Feedback Enhance Children's Motor Learning in a Virtual Environment?

Augmented feedback has motivational and informational functions in motor learning, and is a key feature of practice in a virtual environment (VE). This study evaluated the impact of narrative (story-based) feedback as compared to standard feedback during practice of a novel task in a VE on typically developing children's motor learning, motivation and engagement. Thirty-eight children practiced navigating through a virtual path, receiving narrative or non-narrative feedback following each trial. All participants improved their performance on retention but not transfer, with no significant differences between groups. Self-reported engagement was associated with acquisition, retention and transfer for both groups. A narrative approach to feedback delivery did not offer an additive benefit; additional affective advantages of augmented feedback for motor learning in VEs should be explored.

Experiencing EVA Park, a Multi-User Virtual World for People with Aphasia

Virtual worlds are used in wide-ranging ways by many people with long-term health conditions, but their use by people with aphasia (PWA) has been limited. In contrast, this article reports the use of EVA Park, a multi-user virtual world designed for PWA to practice conversations, focusing on people's emotional, social, and conversational experiences. An analysis of observation and interview data collected from 20 people with aphasia who participated in a 5-week therapy intervention revealed key themes related to user experience. The themes offer a rich insight into aspects of the virtual world experience for PWA that go beyond therapeutic outcomes. They are as follows: affect (positive and negative); types of conversation, miscommunication, and misunderstanding; immersion in the virtual world; social presence and initiative and flow. Overall, the study showed that participants experienced positive emotional and social outcomes. We argue that this was achieved as a consequence of EVA Park being not only accessible but also a varied and entertaining environment within which PWA experienced both the realistic and the quirky while engaging with others and having fun.

"Being there" and remembering it: Presence improves memory encoding

Few studies have investigated the link between episodic memory and presence: the feeling of "being there" and reacting to a stimulus as if it were real. We collected data from 244 participants after they had watched the movie Avengers: Age of Ultron. They answered questions about factual (details of the movie) and temporal memory (order of the scenes) about the movie, as well as their emotion experience and their sense of presence during the projection. Both higher emotion experience and sense of presence were related to better factual memory, but not to temporal order memory. Crucially, the link between emotion and factual memory was mediated by the sense of presence. We interpreted the role of presence as an external absorption of the attentional focus toward the stimulus, thus enhancing memory encoding. Our findings could shed light on the cognitive processes underlying memory impairments in psychiatric conditions characterized by an altered sense of reality.

Virtual Reality for Research in Social Neuroscience

The emergence of social neuroscience has significantly advanced our understanding of the relationship that exists between social processes and their neurobiological underpinnings. Social neuroscience research often involves the use of simple and static stimuli lacking many of the potentially important aspects of real world activities and social interactions. Whilst this research has merit, there is a growing interest in the presentation of dynamic stimuli in a manner that allows researchers to assess the integrative processes carried out by perceivers over time. Herein, we discuss the potential of virtual reality for enhancing ecological validity while maintaining experimental control in social neuroscience research. Virtual reality is a technology that allows for the creation of fully interactive, three-dimensional computerized models of social situations that can be fully controlled by the experimenter. Furthermore, the introduction of interactive virtual characters—either driven by a human or by a computer—allows the researcher to test, in a systematic and independent manner, the effects of various social cues. We first introduce key technical features and concepts related to virtual reality. Next, we discuss the potential of this technology for enhancing social neuroscience protocols, drawing on illustrative experiments from the literature.

The Potential of Virtual Reality for the Investigation of Awe

The emotion of awe is characterized by the perception of vastness and a need for accommodation, which can include a positive and/or negative valence. While a number of studies have successfully manipulated this emotion, the issue of how to elicit particularly intense awe experiences in laboratory settings remains. We suggest that virtual reality (VR) is a particularly effective mood induction tool for eliciting awe. VR provides three key assets for improving awe. First, VR provides users with immersive and ecological yet controlled environments that can elicit a sense of “presence,” the subjective experience of “being there” in a simulated reality. Further, VR can be used to generate complex, vast stimuli, which can target specific theoretical facets of awe. Finally, VR allows for convenient tracking of participants’ behavior and physiological responses, allowing for more integrated assessment of emotional experience. We discussed the potential and challenges of the proposed approach with an emphasis on VR’s capacity to raise the signal of reactions to emotions such as awe in laboratory settings.

A Study on the Validity of a Computer-Based Game to Assess Cognitive Processes, Reward Mechanisms, and Time Perception in Children Aged 4-8 Years

Background

A computer-based game, named Timo’s Adventure, was developed to assess specific cognitive functions (eg, attention, planning, and working memory), time perception, and reward mechanisms in young school-aged children. The game consists of 6 mini-games embedded in a story line and includes fantasy elements to enhance motivation.

Objective

The aim of this study was to investigate the validity of Timo’s Adventure in normally developing children and in children with attention-deficit/hyperactivity disorder (ADHD).

Methods

A total of 96 normally developing children aged 4-8 years and 40 children with ADHD were assessed using the game. Clinical validity was investigated by examining the effects of age on performances within the normally developing children, as well as performance differences between the healthy controls and the ADHD group.

Results

Our analyses in the normally developing children showed developmental effects; that is, older children made fewer inhibition mistakes (r=−.33, P=.001), had faster (and therefore better) reaction times (r=−.49, P<.001), and were able to produce time intervals more accurately than younger children (ρ=.35, P<.001). Discriminant analysis showed that Timo’s Adventure was accurate in most classifications whether a child belonged to the ADHD group or the normally developing group: 78% (76/97) of the children were correctly classified as having ADHD or as being in the normally developing group. The classification results showed that 72% (41/57) children in the control group were correctly classified, and 88% (35/40) of the children in the ADHD group were correctly classified as having ADHD. Sensitivity (0.89) and specificity (0.69) of Timo’s Adventure were satisfying.

Conclusions

Computer-based games seem to be a valid tool to assess specific strengths and weaknesses in young children with ADHD.

Feasibility of a walking virtual reality system for rehabilitation: objective and subjective parameters

BACKGROUND

Even though virtual reality (VR) is increasingly used in rehabilitation, the implementation of walking navigation in VR still poses a technological challenge for current motion tracking systems. Different metaphors simulate locomotion without involving real gait kinematics, which can affect presence, orientation, spatial memory and cognition, and even performance. All these factors can dissuade their use in rehabilitation. We hypothesize that a marker-based head tracking solution would allow walking in VR with high sense of presence and without causing sickness. The objectives of this study were to determine the accuracy, the jitter, and the lag of the tracking system and its elicited sickness and presence in comparison of a CAVE system.

METHODS

The accuracy and the jitter around the working area at three different heights and the lag of the head tracking system were analyzed. In addition, 47 healthy subjects completed a search task that involved navigation in the walking VR system and in the CAVE system. Navigation was enabled by natural locomotion in the walking VR system and through a specific device in the CAVE system. An HMD was used as display in the walking VR system. After interacting with each system, subjects rated their sickness in a seven-point scale and their presence in the Slater-Usoh-Steed Questionnaire and a modified version of the Presence Questionnaire.

RESULTS

Better performance was registered at higher heights, where accuracy was less than 0.6 cm and the jitter was about 6 mm. The lag of the system was 120 ms. Participants reported that both systems caused similar low levels of sickness (about 2.4 over 7). However, ratings showed that the walking VR system elicited higher sense of presence than the CAVE system in both the Slater-Usoh-Steed Questionnaire (17.6 ± 0.3 vs 14.6 ± 0.6 over 21, respectively) and the modified Presence Questionnaire (107.4 ± 2.0 vs 93.5 ± 3.2 over 147, respectively).

CONCLUSIONS

The marker-based solution provided accurate, robust, and fast head tracking to allow navigation in the VR system by walking without causing relevant sickness and promoting higher sense of presence than CAVE systems, thus enabling natural walking in full-scale environments, which can enhance the ecological validity of VR-based rehabilitation applications.

Psychometric assessment and behavioral experiments using a free virtual reality platform and computational science

Background

Virtual Reality has been extensively used in a wide range of psychological experiments. In this study, we aimed to introduce NeuroVirtual 3D, a platform that clinicians could use free of charge.

Implementation

The platform we developed relies on NeuroVR software, but we extended it to apply to experiments. The software is available free of charge to researchers and clinical practitioners who can also use a large number of virtual environments and objects already developed.

Results

The platform has been developed to connect to virtually every device ever produced by the means of Virtual-Reality Peripheral Network (VRPN) protocols; however, a number of these have already been included and tested in the platform. Among the available devices, the Microsoft Kinect low-cost sensor has already been configured for navigation through the virtual environments and to trigger specific action (sounds, videos, images, and the like) when a specific gesture is recognized, e.g., a step forward or an arm up. A task for neglect and a task for spatial abilities assessment were already implemented within the platform. Moreover, NeuroVirtual 3D integrated a TCP-IP-based module (bridge) to collect the data from virtually any existent biosensor (Thought-Technology, Zephyr and StarStim devices have already been included in the platform). It is able to record any psychophysiological signal during any experiment using also the computed indices in real time.

Conclusions

NeuroVirtual 3D is able to record external and internal (e.g., coordinates, keys-press, timestamp) data with a millisecond precision, representing de facto the most advanced technology for experimental psychology using virtual environments available without the needs to program code.

Effects of personal relevance and simulated darkness on the affective appraisal of a virtual environment

This study investigated whether personal relevance influences the affective appraisal of a desktop virtual environment (VE) in simulated darkness. In the real world, darkness often evokes thoughts of vulnerability, threat, and danger, and may automatically precipitate emotional responses consonant with those thoughts (fear of darkness). This influences the affective appraisal of a given environment after dark and the way humans behave in that environment in conditions of low lighting. Desktop VEs are increasingly deployed to study the effects of environmental qualities and (architectural or lighting) interventions on human behaviour and feelings of safety. Their (ecological) validity for these purposes depends critically on their ability to correctly address the user’s cognitive and affective experience. Previous studies with desktop (i.e., non-immersive) VEs found that simulated darkness only slightly affects the user’s behavioral and emotional responses to the represented environment, in contrast to the responses observed for immersive VEs. We hypothesize that the desktop VE scenarios used in previous studies less effectively induced emotional and behavioral responses because they lacked personal relevance. In addition, factors like signs of social presence and relatively high levels of ambient lighting may also have limited these responses. In this study, young female volunteers explored either a daytime or a night-time (low ambient light level) version of a desktop VE representing a deserted (no social presence) prototypical Dutch polder landscape. To enhance the personal relevance of the simulation, a fraction of the participants were led to believe that the virtual exploration tour would prepare them for a follow-up tour through the real world counterpart of the VE. The affective appraisal of the VE and the emotional response of the participants were measured through self-report. The results show that the VE was appraised as slightly less pleasant and more arousing in simulated darkness (compared to a daylight) condition, as expected. However, the fictitious follow-up assignment had no emotional effects and did not influence the affective appraisal of the VE. Further research is required to establish the qualities that may enhance the validity of desktop VEs for both etiological (e.g., the effects of signs of darkness on navigation behaviour and fear of crime) and intervention (e.g., effects of street lighting on feelings of safety) research.

Representation of Patients' Hand Modulates Fear Reactions of Patients with Spider Phobia in Virtual Reality

Embodiment (i.e., the involvement of a bodily representation) is thought to be relevant in emotional experiences. Virtual reality (VR) is a capable means of activating phobic fear in patients. The representation of the patient's body (e.g., the right hand) in VR enhances immersion and increases presence, but its effect on phobic fear is still unknown. We analyzed the influence of the presentation of the participant's hand in VR on presence and fear responses in 32 women with spider phobia and 32 matched controls. Participants sat in front of a table with an acrylic glass container within reaching distance. During the experiment this setup was concealed by a head-mounted display (HMD). The VR scenario presented via HMD showed the same setup, i.e., a table with an acrylic glass container. Participants were randomly assigned to one of two experimental groups. In one group, fear responses were triggered by fear-relevant visual input in VR (virtual spider in the virtual acrylic glass container), while information about a real but unseen neutral control animal (living snake in the acrylic glass container) was given. The second group received fear-relevant information of the real but unseen situation (living spider in the acrylic glass container), but visual input was kept neutral VR (virtual snake in the virtual acrylic glass container). Participants were instructed to touch the acrylic glass container with their right hand in 20 consecutive trials. Visibility of the hand was varied randomly in a within-subjects design. We found for all participants that visibility of the participant's hand increased presence independently of the fear trigger. However, in patients, the influence of the virtual hand on fear depended on the fear trigger. When fear was triggered perceptually, i.e., by a virtual spider, the virtual hand increased fear. When fear was triggered by information about a real spider, the virtual hand had no effect on fear. Our results shed light on the significance of different fear triggers (visual, conceptual) in interaction with body representations.

Being Present in Action: A Theoretical Model About the "Interlocking" Between Intentions and Environmental Affordances

Recent neuropsychological evidence suggest that a key role in linking perceptions and intentions is played by sense of presence. Despite this phenomenon having been studied primarily in the field of virtual reality (conceived as the illusion of being in the virtual space), recent research highlighted that it is a fundamental feature of everyday experience. Specifically, the function of presence as a cognitive process is to locate the Self in a physical space or situation, based on the perceived possibility to act in it; so, the variations in sense of presence allow one to continuously adapt his own action to the external environment. Indeed intentions, as the cognitive antecedents of action, are not static representations of the desired outcomes, but dynamic processes able to adjust their own representational content according to the opportunities/restrictions emerging in the environment. Focusing on the peculiar context of action mediated by interactive technologies, we here propose a theoretical model showing how each level of an intentional hierarchy (future-directed; present directed; and motor intentions) can “interlock” with environmental affordances in order to promote a continuous stream of action and activity.

Effect of virtual reality exposure therapy on social participation in people with a psychotic disorder (VRETp): study protocol for a randomized controlled trial

BACKGROUND

Many patients with a psychotic disorder participate poorly in society. When psychotic disorders are in partial remission, feelings of paranoia, delusions of reference, social anxiety and self-stigmatization often remain at diminished severity and may lead to avoidance of places and people. Virtual reality exposure therapy (VRET) is an evidence-based treatment for several anxiety disorders. For patients with a psychotic disorder, the VRETp was developed to help them experience exposure to feared social situations. The present study aims to investigate the effects of VRETp on social participation in real life among patients with a psychotic disorder.

METHODS/DESIGN

The study is a single-blind randomized controlled trial with two conditions: the active condition, in which participants receive the virtual reality treatment together with treatment as usual (TAU), and the waiting list condition, in which participants receive TAU only. The two groups are compared at baseline, at 3 months posttreatment and at 6 months follow-up. All participants on the waiting list are also offered the virtual reality treatment after the follow-up measurements are completed. The primary outcome is social participation. Secondary outcomes are quality of life, interaction anxiety, depression and social functioning in general. Moderator and mediator analyses are conducted with stigma, cognitive schemata, cognitive biases, medication adherence, simulator sickness and presence in virtual reality. If effective, a cost-effectiveness analysis will be conducted.

DISCUSSION

Results from the posttreatment measurement can be considered strong empirical indicators of the effectiveness of VRETp. The 6-month follow-up data may provide reliable documentation of the long-term effects of the treatment on the outcome variables. Data from pre-treatment and mid-treatment can be used to reveal possible pathways of change.

TRIAL REGISTRATION

Current Controlled Trials: ISRCTN12929657 . Date of registration: 8 September 2015.

Transforming Experience: The Potential of Augmented Reality and Virtual Reality for Enhancing Personal and Clinical Change

During life, many personal changes occur. These include changing house, school, work, and even friends and partners. However, the daily experience shows clearly that, in some situations, subjects are unable to change even if they want to. The recent advances in psychology and neuroscience are now providing a better view of personal change, the change affecting our assumptive world: (a) the focus of personal change is reducing the distance between self and reality (conflict); (b) this reduction is achieved through (1) an intense focus on the particular experience creating the conflict or (2) an internal or external reorganization of this experience; (c) personal change requires a progression through a series of different stages that however happen in discontinuous and non-linear ways; and (d) clinical psychology is often used to facilitate personal change when subjects are unable to move forward. Starting from these premises, the aim of this paper is to review the potential of virtuality for enhancing the processes of personal and clinical change. First, the paper focuses on the two leading virtual technologies - augmented reality (AR) and virtual reality (VR) - exploring their current uses in behavioral health and the outcomes of the 28 available systematic reviews and meta-analyses. Then the paper discusses the added value provided by VR and AR in transforming our external experience by focusing on the high level of personal efficacy and self-reflectiveness generated by their sense of presence and emotional engagement. Finally, it outlines the potential future use of virtuality for transforming our inner experience by structuring, altering, and/or replacing our bodily self-consciousness. The final outcome may be a new generation of transformative experiences that provide knowledge that is epistemically inaccessible to the individual until he or she has that experience, while at the same time transforming the individual's worldview.

This Drives Me Nuts!

Video games are an interesting example of technologies/media able to generate complex emotions. Indeed, part of the emotions commonly arising in the experience of video gamers are quite negative. On the one hand, video gamers may feel frustration and anger due to the difficulty of the gameplay. On the other hand, they may experience sadness, anxiety and fear due to the immersion into emotionally rich narratives. Yet, video gamers seem to appreciate gaming technologies generating negative emotions, and the research on media frequently highlights a counterintuitive positive relation between negative affect and enjoinment/well-being outcomes. Starting from these premises, the present chapter is aimed to review the negative emotions typical of video games, in order to understand in what ways they can concur in generating an overall positive experience. Then, the chapter discusses implications for research on video games as positive technologies, namely technologies able to promote well-being in their users.

Virtual Reality for Enhanced Ecological Validity and Experimental Control in the Clinical, Affective and Social Neurosciences

An essential tension can be found between researchers interested in ecological validity and those concerned with maintaining experimental control. Research in the human neurosciences often involves the use of simple and static stimuli lacking many of the potentially important aspects of real world activities and interactions. While this research is valuable, there is a growing interest in the human neurosciences to use cues about target states in the real world via multimodal scenarios that involve visual, semantic, and prosodic information. These scenarios should include dynamic stimuli presented concurrently or serially in a manner that allows researchers to assess the integrative processes carried out by perceivers over time. Furthermore, there is growing interest in contextually embedded stimuli that can constrain participant interpretations of cues about a target’s internal states. Virtual reality environments proffer assessment paradigms that combine the experimental control of laboratory measures with emotionally engaging background narratives to enhance affective experience and social interactions. The present review highlights the potential of virtual reality environments for enhanced ecological validity in the clinical, affective, and social neurosciences.

Actors and avatars: why learners prefer digital agents

Purpose

– The purpose of this study is to compare learner experiences of recorded instructional videos (DVDs) with Machinima.

Design/methodology/approach

– In this exploratory study, sets of learning sequences in management skills training were delivered to 32 learners using both methods, and learner reactions were gathered using post-event interviews.

Findings

– Analysis of learner responses showed that participants prefer Machinima as a learning delivery mechanism. Participants also reported being better able to concentrate on the message of the Machinima learning sequences.

Research limitations/implications

– The sample was not representative, being a convenience sample derived by open invitation from cohorts of two master’s degree programmes conducted at the School of Business, Maynooth University, Maynooth, Co. Kildare. The age range of the participants was significantly skewed toward a younger age grouping. No learning test was given to assess the teaching efficacy of the methods. Implications for practice include using Machinima to model desirable behaviours to trainees. Future research should extend the research to other settings.

Practical implications

– Research should be considered into the potential for Machinima to be considered as a replacement for DVD in management training. Sufficient encouragement arises from this study to suggest that Machinima contains none of the distractions of DVD that are recorded in this study. In addition, many organisations seek to utilise training materials with diverse audiences.

Originality/value

– Originality of the study stems from the potential replacement of DVD with Machinima in learning.

The impact of perception and presence on emotional reactions: a review of research in virtual reality

Virtual reality (VR) has made its way into mainstream psychological research in the last two decades. This technology, with its unique ability to simulate complex, real situations and contexts, offers researchers unprecedented opportunities to investigate human behavior in well controlled designs in the laboratory. One important application of VR is the investigation of pathological processes in mental disorders, especially anxiety disorders. Research on the processes underlying threat perception, fear, and exposure therapy has shed light on more general aspects of the relation between perception and emotion. Being by its nature virtual, i.e., simulation of reality, VR strongly relies on the adequate selection of specific perceptual cues to activate emotions. Emotional experiences in turn are related to presence, another important concept in VR, which describes the user’s sense of being in a VR environment. This paper summarizes current research into perception of fear cues, emotion, and presence, aiming at the identification of the most relevant aspects of emotional experience in VR and their mutual relations. A special focus lies on a series of recent experiments designed to test the relative contribution of perception and conceptual information on fear in VR. This strand of research capitalizes on the dissociation between perception (bottom–up input) and conceptual information (top-down input) that is possible in VR. Further, we review the factors that have so far been recognized to influence presence, with emotions (e.g., fear) being the most relevant in the context of clinical psychology. Recent research has highlighted the mutual influence of presence and fear in VR, but has also traced the limits of our current understanding of this relationship. In this paper, the crucial role of perception on eliciting emotional reactions is highlighted, and the role of arousal as a basic dimension of emotional experience is discussed. An interoceptive attribution model of presence is suggested as a first step toward an integrative framework for emotion research in VR. Gaps in the current literature and future directions are outlined.

Psychological factors influencing the effectiveness of virtual reality-based analgesia: a systematic review

The experience of pain is affected by remarkable psychological factors. The concept of neuromatrix suggests that pain is an amalgam of affect, cognition, and sensation mediated through diverse brain regions. Moreover, the experience of pain appears to be reduced by environmental stimuli that drive attention away from the noxious events. Accordingly, immersion in a computer-generated, three-dimensional virtual environment has been used as an efficient distraction tool in a number of studies on pain management. However, no systematic approaches have explored the psychological factors that influence the effectiveness of virtual reality (VR) as a distraction technology. This review aims to outline the fundamental psychological factors involved in the use of VR to provide pain management. An analysis of the literature revealed some important elements associated with the patients' subjective experience. Eleven studies met the inclusion criteria and were included in the review. The results suggest the importance of different psychological factors in the effectiveness of the analgesic distraction. While sense of presence influence the effectiveness of VR as a distraction tool, anxiety as well as positive emotions directly affect the experience of pain. Future challenges for pain management via VR include adopting properly validated measures to assess psychological factors and using different experimental conditions to better understand their complex effects.

Afraid to be there? Evaluating the relation between presence, self-reported anxiety, and heart rate in a virtual public speaking task

The link between anxiety and presence in a virtual environment (VE) is still a subject of an unresolved debate, with little empirical research to support theoretical claims. Thus, the current study analyzed presence, self-reported anxiety, and a physiological parameter (heart rate [HR]) in a sample of 30 high anxious and 35 low anxious participants. Both groups delivered a 5 minute speech in a virtual lecture hall. Results indicate no mediating influences of presence on group differences in self-reported state anxiety during the speech, but point toward negative correlations between state anxiety and the iGroup Presence Questionnaire (IPQ) scales "sense of being there" and "realism." Furthermore, HR was found to be unrelated to self-reported presence. Only the IPQ scale "spatial presence" showed a marginally significant influence on group differences in state anxiety. The present results support the assumption that presence and anxiety are logically distinct, meaning that presence does not directly influence the intensity of an emotion felt in a VE. Rather, it constitutes a precondition for an emotion to be at all elicited by a VE. Also, HR has proven to be no adequate substitute measure for presence, since it only assesses anxiety not presence. It may, however, mediate the interplay between trait anxiety and state anxiety. Possible implications of the current findings are discussed alongside the problem of using presence questionnaires that seem to be prone to subjective bias (i.e., participants confusing presence and emotion).

Is virtual reality always an effective stressors for exposure treatments? Some insights from a controlled trial

BACKGROUND

Several research studies investigating the effectiveness of the different treatments have demonstrated that exposure-based therapies are more suitable and effective than others for the treatment of anxiety disorders. Traditionally, exposure may be achieved in two manners: in vivo, with direct contact to the stimulus, or by imagery, in the person's imagination. However, despite its effectiveness, both types of exposure present some limitations that supported the use of Virtual Reality (VR). But is VR always an effective stressor? Are the technological breakdowns that may appear during such an experience a possible risk for its effectiveness?

METHODS

To answer these questions we compared changes following the exposure to an academic examination, one of the most universal examples of real-life stressors, in a sample of 39 undergraduate students. The same experience was offered using text (TX), audio (AU), video (VD), and VR. However, in the virtual environment we manipulated the experience introducing technological breakdowns. The Post Media Questionnaire (PMQ) and the Slater-Usoh-Steed Presence Questionnaire (SUS) were administered to each participant in order to evaluated self-report measures of anxiety and relaxation and the level of presence experience during media exposure. Electrocardiogram (ECG), Thoracic Respiration Signal (RSP) and Facial corrugator supercilii muscle Electromyography (EMG) were recorded in order to obtain objective measures of subjects' emotional state.

RESULTS

Analyses conducted on PMQ showed a significant increase in anxiety scores and a mirror decrease in relax scores after all our emotional procedures, showing that all the condition were effective in inducing a negative emotional response. Psychometric scores and psychophysiological indexes showed that VR was less effective than other procedures in eliciting stress responses. Moreover, we did not observe significative difference in SUS scores: VR induced a sense of presence similar to that experienced during the exposition to other media.

CONCLUSIONS

Technological breakdowns significantly reduce the possibility of VR eliciting emotions related to complex real-life stressors. Without a high sense of presence, the significant advantages offered by VR disappear and its emotional induction abilities are even lower than the ones provided by much cheaper media.

TRIAL REGISTRATION

TRIAL REGISTRATION NUMBER

NCT01683617.

Using virtual reality to assess user experience

OBJECTIVE

The aim of this article is to discuss how user experience (UX) evaluation can benefit from the use of virtual reality (VR).

BACKGROUND

UX is usually evaluated in laboratory settings. However, considering that UX occurs as a consequence of the interaction between the product, the user, and the context of use, the assessment of UX can benefit from a more ecological test setting. VR provides the means to develop realistic-looking virtual environments with the advantage of allowing greater control of the experimental conditions while granting good ecological validity.

METHOD

The methods used to evaluate UX, as well as their main limitations, are identified.The currentVR equipment and its potential applications (as well as its limitations and drawbacks) to overcome some of the limitations in the assessment of UX are highlighted.

RESULTS

The relevance of VR for UX studies is discussed, and a VR-based framework for evaluating UX is presented.

CONCLUSION

UX research may benefit from a VR-based methodology in the scopes of user research (e.g., assessment of users' expectations derived from their lifestyles) and human-product interaction (e.g., assessment of users' emotions since the first moment of contact with the product and then during the interaction).

APPLICATION

This article provides knowledge to researchers and professionals engaged in the design of technological interfaces about the usefulness of VR in the evaluation of UX.

Use of Virtual World for Soft/Communication Skills Training

The current state of the economy has created an increased pressure on companies to establish more efficient training programs, resulting in an upswing in e-learning and distance learning programs. With this increased demand for e-learning/distance learning training, the need for more interactive training that goes beyond the traditional webinar and video conference has also been identified. The literature regarding virtual learning platforms suggests that the use of simulations, both asynchronous and synchronous, holds great potential for enhancing the knowledge and skills of learning in a myriad of fields. Although these platforms are proving to have great benefits, they also are showing some challenges and barriers to overcome. After a review of current research, Cicatelli Associates, Inc. (CAI), conducted an internal feasibility study to determine the feasibility of the use of virtual worlds in training healthcare and health care service provision staff in general counseling skills and communications skills. After examining, both the strengths and the challenges of utilizing this method for training it was determined that several barriers exist that currently prohibit the organization from using this method. These barriers include access to appropriate computer systems, as well as the lack of fine or micro non-verbal gestures in virtual worlds.

The key to unlocking the virtual body: virtual reality in the treatment of obesity and eating disorders

Obesity and eating disorders are usually considered unrelated problems with different causes. However, various studies identify unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse), induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. But how might negative body image--common to most adolescents, not only to medical patients--be behind the development of obesity and eating disorders? In this paper, I review the "allocentric lock theory" of negative body image as the possible antecedent of both obesity and eating disorders. Evidence from psychology and neuroscience indicates that our bodily experience involves the integration of different sensory inputs within two different reference frames: egocentric (first-person experience) and allocentric (third-person experience). Even though functional relations between these two frames are usually limited, they influence each other during the interaction between long- and short-term memory processes in spatial cognition. If this process is impaired either through exogenous (e.g., stress) or endogenous causes, the egocentric sensory inputs are unable to update the contents of the stored allocentric representation of the body. In other words, these patients are locked in an allocentric (observer view) negative image of their body, which their sensory inputs are no longer able to update even after a demanding diet and a significant weight loss. This article discusses the possible role of virtual reality in addressing this problem within an integrated treatment approach based on the allocentric lock theory.