From intention to action: The role of presence

Homelessness in Virtual Reality: Experiencing Social Exclusion Improves Attitudes and Behaviors Toward Unhoused People

Virtual reality (VR) interventions are receiving increasing attention from research seeking to promote harmonious intergroup relations. Despite this, the effectiveness of VR methods and the underlying mechanisms for enhancing intergroup relations yield mixed findings. The current research examined if a 360° immersive video where participants embodied an unhoused person could improve attitudes and behavioral intentions toward unhoused people by making participants experience social exclusion and its psychological repercussions. The study (N = 210) adopted a 2 × 2 between-subject design where participants were assigned to embody an unhoused or housed person either watching the video in VR (in 3D using head-mounted devices) or in 2D (on a monitor). The study included a followup after 9 days. Results revealed that embodying the unhoused person (vs. housed control) led to increased experiences of social exclusion, need-threat, and negative emotions. These experiences, in turn, were associated with reduced negative attitudes toward unhoused individuals and heightened intentions to engage in charitable behaviors. Notably, the effects on attitudes and behavioral intentions persisted at the followup, with a stronger impact observed for participants who embodied the unhoused person in 3D compared to 2D. The findings suggest that tailoring VR video interventions to elicit social exclusion by embodying the perspective of marginalized social groups can enhance intergroup attitudes and intentions over time. Overall, this research underscores the prominence of VR-based interventions in improving intergroup harmony compared to less-immersive paradigms.

360° Digital Travel to Improve Emotional State and Well-Being During the COVID-19 Pandemic: The Role of Presence and Sense of Place

The continuation of the COVID-19 pandemic has caused a decline in people's subjective well-being and emotional states. Digital travel based on 360° videos provides an alternate way for people to improve their mental health at home during this specific period. Yet, how to construct effective digital travel content that improves emotions remains an issue. This investigation assessed the impact of people's perceived presence and sense of place (SOP) on emotional improvement during a 360° digital travel experience. A total of 156 undergraduate students volunteered to participate, and anxiety, emotion levels, and life satisfaction were measured before and after the digital travel experience; presence and SOP ratings were also collected after the experience. A Latent Change Score model was then developed, and the results indicated that the greater presence and SOP individuals experienced during their digital travel, the better their digital travel experience and emotional improvement. Furthermore, the current data highlight that SOP has a greater impact on emotional improvement than presence. This result provides a novel understanding that how SOP is generated may be more critical to digital travel than presence. This new understanding should help improve relevant applications in the field of digital travel, such as the possibility of providing meaningful narrative context in a virtual environment to induce SOP more effectively, and improve the digital travel experience. Overall, the findings of this study expand our understanding of the digital travel experience and lay the groundwork for future research on SOP and digital travel.

Designing to Leverage Presence in VR Rhythm Games

Rhythm games are known for their engaging gameplay and have gained renewed popularity with the adoption of virtual reality (VR) technology. While VR rhythm games have achieved commercial success, there is a lack of research on how and why they are engaging, and the connection between that engagement and immersion or presence. This study aims to understand how the design of two popular VR rhythm games, Beat Saber and Ragnarock, leverages presence to immerse players. Through a mixed-methods approach, utilising the Multimodal Presence Scale and a thematic analysis of open-ended questions, we discovered four mentalities which characterise user experiences: action, game, story and musical. We discuss how these mentalities can mediate presence and immersion, suggesting considerations for how designers can leverage this mapping for similar or related games.

Virtual reality and music's impact on psychological well-being

Quality of life is bound to psychological well-being, which in turn is affected by the frequency and magnitude of negative mood states. To regulate mood states, humans often consume media such as music and movies, with varied degrees of effectiveness. The current investigation examined the effectiveness of virtual reality (VR) vs. two-dimensional (2D) online interventions with various stimuli (audiovisual vs. visual only vs. audio only) to assess which interventions were most effective for improved well-being. Additionally, this study examined which groups displayed the highest amount of perceived presence to understand what components are essential when maximizing a person's subjective feeling of being “in” a new place and if this translated toward therapeutic results. Our data suggests that even though VR participants generally experienced more presence and had similar benefits as 2D groups for increasing positive mood, only participants in the 2D groups had a reduction in negative mood overall with 2D audiovisual participants experiencing the best results. These results contradict past studies which indicate that there could be other psychological and theoretical considerations that may play a role in determining what online experiences are more effective than just examining presence and immersive stimuli. Further research and development into using VR as a tool for improved well-being is needed to understand its efficacy in remote and in-person setting.

Exposure to Green, Blue and Historic Environments and Mental Well-Being: A Comparison between Virtual Reality Head-Mounted Display and Flat Screen Exposure

Improving the mental health of urban residents is a global public health priority. This study builds on existing work that demonstrates the ability of virtual exposure to restorative environments to improve population mental health. It compares the restorative effects of green, blue and historic environments delivered by both flat screen and immersive virtual reality technology, and triangulates data from psychological, physiological and qualitative sources. Results from the subjective measure analyses showed that exposures to all the experimental videos were associated with self-reported reduced anxiety and improved mood, although the historic environment was associated with a smaller reduction of anxiety (p < 0.01). These results were supported by the qualitative accounts. For two of the electroencephalography (EEG) frequency bands, higher levels of activity were observed for historic environments. In relation to the mode of delivery, the subjective measures did not suggest any effect, while for the EEG analyses there was evidence of a significant effect of technology across three out of four frequency bands. In conclusion, this study adds to the evidence that the benefits of restorative environments can be delivered through virtual exposure and suggests that virtual reality may provide greater levels of immersion than flat screen viewing.

Defining Transformative Experiences: A Conceptual Analysis

The concept of transformative experience (TE) has been widely explored by several disciplines from philosophy to neurobiology, and in different domains, from the spiritual to the educational one. This attitude has engendered heterogeneous models to explain this phenomenon. However, a consistent and clear understanding of this construct remains elusive. The aim of this work is to provide an initial comprehensive interdisciplinary, cross-domain, up-to-date, and integrated overview on the concept of TEs. Firstly, all the models and theories on TEs were reviewed to extract and analyze TEs’ main components emerging from different disciplines. Then, this preliminary analysis was integrated with an in-depth examination of redundancies and particularities across domains and disciplines, to provide an integrated theoretical framework of TEs and a preliminary interdisciplinary operational definition of TEs. This examination, in turn, can help organize current research and theories, thus providing suggestions for operationalizing TEs as well as encouraging new interdisciplinary research endeavors.

Scientific Landscape of Embodied Experience in the Virtual Environment: A Bibliometric Analysis

The realm of architecture has been influenced by the expansion in virtual environments (VEs), along with Industry 4.0 technologies transforming human–VE interactions. Despite increasing scholarly interest in embodied experience-integrated VE, there have been few comprehensive literature reviews undertaken on VEs from a holistic experience perspective. Therefore, this article reviews the literature on the embodied experiential dimension of VEs that has become necessary to adapt theories and methodologies in a way that enhances the user experience in a VE. This study employs a bibliometric analysis to review research performance and undertake a science mapping of the literature. The 969 pieces of data retrieved from Web of Science were subjected to a performance analysis, and VOSviewer was used to visualize the intellectual structure and research themes. The results of this study emphasize the strength and growing interest in VEs from the embodied experience perspective. Another significant finding is that VE experience studies are mostly based on embodied technologies. In this paper, the results of analyses are discussed in terms of productivity, collaboration, and research themes for future. This study contributes to the literature by providing a significant theoretical reference for the potential of the embodied experience in VE research, which will mostly attract the interest of architectural design researchers.

Immersive Virtual Reality-Based Cognitive Intervention for the Improvement of Cognitive Function, Depression, and Perceived Stress in Older Adults With Mild Cognitive Impairment and Mild Dementia: Pilot Pre-Post Study

Background

The incidence of dementia is increasing annually, resulting in varying degrees of adverse effects for individuals, families, and society. With the continuous development of computer information technology, cognitive interventions are constantly evolving. The use of immersive virtual reality (IVR) as a cognitive intervention for older adults with mild cognitive impairment (MCI) and mild dementia (MD) is promising, although only few studies have focused on its use.

Objective

The Chinese virtual supermarket (CVSM) IVR system was developed to provide a comprehensive and individual cognitive intervention program for older patients with MCI and MD. The aim of this study was to explore the feasibility and clinical effectiveness of this 5-week IVR-based cognitive intervention.

Methods

A pretest-posttest study design was conducted with 31 older adults with MCI and MD from August 2020 to January 2021. All participants participated in a 5-week immersive virtual cognitive training program using the CVSM system. Feasibility was assessed as the incidence and severity of cybersickness symptoms and participant satisfaction based on questionnaires conducted after the intervention. Clinical effectiveness was evaluated using neuropsychological assessments, including several commonly used measures of cognitive function, depression, perceived stress, and activities of daily living. Measurements were obtained at baseline and after the intervention period.

Results

A total of 18 patients with MCI (mean age 82.94 [SD 5.44] years; 12 females) and 13 patients with MD (mean age 85.7 [SD 4.67] years, 10 females) participated in this pilot study. Both groups showed significant improvements in all cognitive function measurements (P<.001). The MD group had a significantly greater improvement in general cognitive function compared to the MCI group in Montreal Cognitive Assessment Scale, Symbol Digit Modalities Test, Shape Trail Test, and Auditory Verbal Learning Test. Furthermore, an intervention effect was observed in the improvement of perceived stress (P=.048 for MD group, P=.03 for MCI group ).

Conclusions

The use of the CVSM system may be effective in enhancing the cognitive function of patients with MCI and MD, including general cognitive function, memory, executive function, and attention. IVR technology enriches cognitive intervention approaches and provides acceptable, professional, personalized, and interesting cognitive training for older adults with cognitive impairment.

Trial Registration

ClinicalTrials ChiCTR2100043753; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2100043753

Presence, flow, and narrative absorption: an interdisciplinary theoretical exploration with a new spatiotemporal integrated model based on predictive processing

Presence, flow, narrative absorption, immersion, transportation, and similar subjective phenomena are studied in many different disciplines, mostly in relation to mediated experiences (books, film, VR, games). Moreover, since real, virtual, or fictional agents are often involved, concepts like identification and state empathy are often linked to engaging media use. Based on a scoping review that identified similarities in the wording of various questionnaire items conceived to measure different phenomena, we categorize items into the most relevant psychological aspects and use this categorization to propose an interdisciplinary systematization. Then, based on a framework of embodied predictive processing, we present a new cognitive model of presence-related phenomena for mediated and non-mediated experiences, integrating spatial and temporal aspects and also considering the role of fiction and media design. Key processes described within the model are: selective attention, enactment of intentions, and interoception. We claim that presence is the state of perceived successful agency of an embodied mind able to correctly enact its predictions. The difference between real-life and simulated experiences ("book problem," "paradox of fiction") lays in the different precision weighting of exteroceptive and interoceptive signals.

Effect of Cognitive Training in Fully Immersive Virtual Reality on Visuospatial Function and Frontal-Occipital Functional Connectivity in Predementia: Randomized Controlled Trial

Background

Cognitive training can potentially prevent cognitive decline. However, the results of recent studies using semi-immersive virtual reality (VR)-assisted cognitive training are inconsistent.

Objective

We aimed to examine the hypothesis that cognitive training using fully immersive VR, which may facilitate visuospatial processes, could improve visuospatial functioning, comprehensive neuropsychological functioning, psychiatric symptoms, and functional connectivity in the visual brain network in predementia.

Methods

Participants over 60 years old with subjective cognitive decline or mild cognitive impairment from a memory clinic were randomly allocated to the VR (n=23) or the control (n=18) group. The VR group participants received multidomain and neuropsychologist-assisted cognitive training in a fully immersive VR environment twice a week for 1 month. The control group participants did not undergo any additional intervention except for their usual therapy such as pharmacotherapy. Participants of both groups were evaluated for cognitive function using face-to-face comprehensive neuropsychological tests, including the Rey-Osterrieth Complex Figure Test (RCFT) copy task; for psychiatric symptoms such as depression, apathy, affect, and quality of life; as well as resting-state functional magnetic resonance imaging (rsfMRI) at baseline and after training. Repeated-measures analysis of variance was used to compare the effect of cognitive training between groups. Seed-to-voxel–based analyses were used to identify the cognitive improvement–related functional connectivity in the visual network of the brain.

Results

After VR cognitive training, significant improvement was found in the total score (F_1,39=14.69, P=.001) and basic components score of the RCFT copy task (F_1,39=9.27, P=.005) compared with those of the control group. The VR group also showed improvements, albeit not significant, in naming ability (F_1,39=3.55, P=.07), verbal memory delayed recall (F_1,39=3.03, P=.09), and phonemic fluency (F_1,39=3.08, P=.09). Improvements in psychiatric symptoms such as apathy (F_1,39=7.02, P=.01), affect (F_1,39=14.40, P=.001 for positive affect; F_1,39=4.23, P=.047 for negative affect), and quality of life (F_1,39=4.49, P=.04) were found in the VR group compared to the control group. Improvement in the RCFT copy task was associated with a frontal-occipital functional connectivity increase revealed by rsfMRI in the VR group compared to the control group.

Conclusions

Fully immersive VR cognitive training had positive effects on the visuospatial function, apathy, affect, quality of life, and increased frontal-occipital functional connectivity in older people in a predementia state. Future trials using VR cognitive training with larger sample sizes and more sophisticated designs over a longer duration may reveal greater improvements in cognition, psychiatric symptoms, and brain functional connectivity.

Trial Registration

Clinical Research Information Service KCT0005243; https://tinyurl.com/2a4kfasa

Spatial Presence, Performance, and Behavior between Real, Remote, and Virtual Immersive Environments

Spatial presence encompasses the user's ability to experience a sense of "being there". While particular attention was given to assess spatial presence in real and virtual environments, few have been interested in measuring it in telepresence situations. To bridge this gap, the present work introduces a study that compares the execution of a task in three conditions: a real physical environment, a remote environment via a telepresence system, and a virtual simulation of the real environment. Following a within-subject design, 27 participants performed a navigation task consisting in following a route while avoiding obstacles. Spatial presence and five related factors (affordance, enjoyment, attention allocation, reality, and cybersickness) were evaluated using a presence questionnaire. In addition, performance measures were gathered regarding environment recollection and task execution. The evaluation also included a behavioral metric measured by obstacle avoidance distance extracted from participants' trajectories. Results indicated a higher presence in the real environment, along with the best performance measures. No difference was found in spatial presence between the remote and the virtual conditions, although a higher degree of affordance and enjoyment was attributed to the virtual environment, and a higher degree of reality was attributed to the remote environment. The number of collisions was found to be lower in the remote condition compared to the virtual condition. Similarly, the avoidance distance was also bigger (and almost similar) in the real and the remote environments compared to the virtual environment indicating a greater caution of participants. These cues highlight that the behavior of participants in the remote condition was closer to their behavior in the real situation than it was in the virtual condition. Furthermore, positive correlations were found between the reality factor and two of the three performance measures, as well as with the behavioral metric. This suggests that the degree of physical existence of the space in which participants operate can influence their performance and behavior.

Extended Reality for the Clinical, Affective, and Social Neurosciences

Brain science research often involves the use of low-dimensional tools and stimuli that lack several of the potentially valuable features of everyday activities and interactions. Although this research has provided important information about cognitive, affective, and social processes for both clinical and nonclinical populations, there is growing interest in high-dimensional simulations that extend reality. These high-dimensional simulations involve dynamic stimuli presented serially or concurrently to permit the assessment and training of perceivers' integrative processes over time. Moreover, high-dimensional simulation platforms can contextually restrain interpretations of cues about a target's internal states. Extended reality environments extend assessment and training platforms that balance experimental control with emotionally engaging background narratives aimed at extending the affective experience and social interactions. Herein, we highlight the promise of extended reality platforms for greater ecological validity in the clinical, affective, and social neurosciences.

"Science Manipulates the Things and Lives in Them": Reconsidering Approach-Avoidance Operationalization Through a Grounded Cognition Perspective

Approach and avoidance orientations are key elements of adaptive regulation at the evaluation-behavior interface. On the one hand, continuous evaluations of the world fuel approach-avoidance reactions as a function of the individual's immediate environment. On the other hand, in turn these individual-environment adjustments influence evaluations. A grounded perspective of social cognition, placing the sensorimotor aspects of individual-environment interactions at the core of cognition, has much to offer for the understanding of evaluative processes. Despite the growing enthusiasm for a grounded view of cognition and action in the approach-avoidance literature, its core principles are seldom reflected at the operationalization level. In this paper, we relied on the insights of a grounded perspective to propose more encompassing operationalizations of approach-avoidance orientations and investigate their influence on evaluations. Across six studies, we varied the approach-avoidance operationalizations (upper-body incline, upper-body posture and walking steps) and incrementally considered the grounded assumptions. We failed to obtain the theorized positive effect of approach (as compared to avoidance) on evaluations. Interestingly, further exploratory analyses on two studies conducted in Virtual Reality suggested that the more participants felt being present in the situation, the more the approach-avoidance ecological actions activated the corresponding neuropsychological systems. We discuss these emergent findings in light of grounded cognition and the notion of feeling of presence.

Enacting Space in Virtual Reality: A Comparison Between Money's Road Map Test and Its Virtual Version

In the field of spatial cognition research the mutual relationship between perception and action that brings out spatial orientation was lately investigated. Besides, the sameness between creating a cognitive map from the exploration of a not simulated environment, from the use of an allocentric (survey-like) sketched map, and from the interaction with egocentric (route-like) 3D virtual environments, is generally contrived. To understand if different embodied affordances could provide different knowledge organization during wayfinding through the use of distinct spatial simulations, the same group of 61 healthy subjects experienced both the classical version of the Money's Road Map test (M-RMT) and a virtual reality version of the Road Map test (VR-RMT). The M-RMT requires a allocentric to egocentric right/left reasoning to explore a stylized city provided in a survey perspective. The VR-RMT is a 3D version of the same environment through which participants can actively navigate by choosing egocentric-based right/left directions in a route perspective. The results showed that the different embodiments afforded by the two environments and the increasing complexity in turn types provides different spatial outcomes. Results were discussed according to the sensorimotor coupling theory provided from the enactive cognition approach and significances for spatial cognition research were provided.

New Trends in Episodic Memory Assessment: Immersive 360° Ecological Videos

How best to measure memory in a reliable and valid way has been intensely debated in neuropsychological literature. Specifically, classical neuropsychological tests often fail to predict real-life performance or capture the multifaceted nature of memory function. To solve these issues, there has been a growing emphasis on the use of more ecological memory assessment. In this scenario, several virtual reality based tools have been developed to evaluate memory function. The aim of the current perspective is to discuss critically the possibilities offered for episodic memory assessment by one of the most innovative trends in the technology field, i.e., 360° videos. Immersivity, egocentric view and realism appear to be crucial features of 360° videos enabling them to enhance the ecological validity of classical assessment tools of memory abilities.

Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine

Is virtual reality (VR) already a reality in behavioral health? To answer this question, a meta-review was conducted to assess the meta-analyses and systematic and narrative reviews published in this field in the last twenty-two months. Twenty-five different articles demonstrated the clinical potential of this technology in both the diagnosis and the treatment of mental health disorders: VR compares favorably to existing treatments in anxiety disorders, eating and weight disorders, and pain management, with long-term effects that generalize to the real world. But why is VR so effective? Here, the following answer is suggested: VR shares with the brain the same basic mechanism: embodied simulations. According to neuroscience, to regulate and control the body in the world effectively, the brain creates an embodied simulation of the body in the world used to represent and predict actions, concepts, and emotions. VR works in a similar way: the VR experience tries to predict the sensory consequences of an individual's movements, providing to him/her the same scene he/she will see in the real world. To achieve this, the VR system, like the brain, maintains a model (simulation) of the body and the space around it. If the presence in the body is the outcome of different embodied simulations, concepts are embodied simulations, and VR is an embodied technology, this suggests a new clinical approach discussed in this article: the possibility of altering the experience of the body and facilitating cognitive modeling/change by designing targeted virtual environments able to simulate both the external and the internal world/body.

Virtual Reality for Anxiety Reduction Demonstrated by Quantitative EEG: A Pilot Study

While previous research has established that virtual reality (VR) can be successfully used in the treatment of anxiety disorders, including phobias and PTSD, no research has examined changes in brain patterns associated with the use of VR for generalized anxiety management. In the current study, we compared a brief nature-based mindfulness VR experience to a resting control condition on anxious participants. Self-reported anxiety symptoms and resting-state EEG were recorded across intervals containing quiet rest or the VR intervention. EEG activity was analyzed as a function of global power shifts in Alpha and Beta activity, and with sLORETA current source density estimates of cingulate cortex regions of interest. Results demonstrated that both a quiet rest control condition and the VR meditation significantly reduced subjective reports of anxiety and increased Alpha power. However, the VR intervention uniquely resulted in shifting proportional power from higher Beta frequencies into lower Beta frequencies, and significantly reduced broadband Beta activity in the anterior cingulate cortex. These effects are consistent with a physiological reduction of anxiety. This pilot study provides preliminary evidence supporting the therapeutic potential of VR for anxiety management and stress reduction programs.

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.

Designing Awe in Virtual Reality: An Experimental Study

Awe is a little-studied emotion with a great transformative potential. Therefore, the interest toward the study of awe's underlying mechanisms has been increased. Specifically, researchers have been interested in how to reproduce intense feelings of awe within laboratory conditions. It has been proposed that the use of virtual reality (VR) could be an effective way to induce awe in controlled experimental settings, thanks to its ability of providing participants with a sense of "presence," that is, the subjective feeling of being displaced in another physical or imaginary place. However, the potential of VR as awe-inducing medium has not been fully tested yet. In the present study, we provided an evidence-based design and a validation of four immersive virtual environments (VEs) involving 36 participants in a within-subject design. Of these, three VEs were designed to induce awe, whereas the fourth VE was targeted as an emotionally neutral stimulus. Participants self-reported the extent to which they felt awe, general affect and sense of presence related to each environment. As expected, results showed that awe-VEs could induce significantly higher levels of awe and presence as compared to the neutral VE. Furthermore, these VEs induced significantly more positive than negative affect. These findings supported the potential of immersive VR for inducing awe and provide useful indications for the design of awe-inspiring virtual environments.

The neuroscience of body memory: From the self through the space to the others

Our experience of the body is not direct; rather, it is mediated by perceptual information, influenced by internal information, and recalibrated through stored implicit and explicit body representation (body memory). This paper presents an overview of the current investigations related to body memory by bringing together recent studies from neuropsychology, neuroscience, and evolutionary and cognitive psychology. To do so, in the paper, I explore the origin of representations of human body to elucidate their developmental process and, in particular, their relationship with more explicit concepts of self. First, it is suggested that our bodily experience is constructed from early development through the continuous integration of sensory and cultural data from six different representations of the body, i.e., the Sentient Body (Minimal Selfhood), the Spatial Body (Self Location), the Active Body (Agency), the Personal Body (Whole Body Ownership - Me); the Objectified Body (Objectified Self - Mine), and the Social Body (Body Satisfaction - Ideal Me). Then, it is suggested that these six representations can be combined in a coherent supramodal representation, i.e. the "body matrix", through a predictive, multisensory processing activated by central, top-down, attentional processes. From an evolutionary perspective, the main goal of the body matrix is to allow the self to protect and extend its boundaries at both the homeostatic and psychological levels. From one perspective, the self extends its boundaries (peripersonal space) through the enactment and recognition of motor schemas. From another perspective, the body matrix, by defining the boundaries of the body, also defines where the self is present, i.e., in the body that is processed by the body matrix as the most likely to be its one, and in the space surrounding it. In the paper I also introduce and discuss the concept of "embodied medicine": the use of advanced technology for altering the body matrix with the goal of improving our health and well-being.

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.

How Ego Depletion Affects Sexual Self-Regulation: Is It More Than Resource Depletion?

Rational thinking and decision making are impacted when in a state of sexual arousal. The inability to self-regulate arousal can be linked to numerous problems, like sexual risk taking, infidelity, and sexual coercion. Studies have shown that most men are able to exert voluntary control over their sexual excitation with various levels of success. Both situational and dispositional factors can influence self-regulation achievement. The goal of this research was to investigate how ego depletion, a state of low self-control capacity, interacts with personality traits-propensities for sexual excitation and inhibition-and cognitive absorption, to cause sexual self-regulation failure. The sexual responses of 36 heterosexual males were assessed using penile plethysmography. They were asked to control their sexual arousal in two conditions, with and without ego depletion. Results suggest that ego depletion has opposite effects based on the trait sexual inhibition, as individuals moderately inhibited showed an increase in performance while highly inhibited ones showed a decrease. These results challenge the limited resource model of self-regulation and point to the importance of considering how people adapt to acute and high challenging conditions.

Testing Augmented Reality for Cue Exposure in Obese Patients: An Exploratory Study

Binge eating is one of the key behaviors in relation to the etiology and severity of obesity. Cue exposure with response prevention consists of exposing patients to binge foods while actual eating is not allowed. Augmented reality (AR) has the potential to change the way cue exposure is administered, but very few prior studies have been conducted so far. Starting from these premises, this study was aimed to (a) investigate whether AR foods elicit emotional responses comparable to those produced by the real stimuli, (b) study differences between obese and control participants in terms of emotional responses to food, and (c) compare emotional responses to different categories of foods. To reach these goals, we assess in 15 obese (age, 44.6 ± 13 years; body mass index [BMI], 44.2 ± 8.1) and 15 control participants (age, 43.7 ± 12.8 years; BMI, 21.2 ± 1.4) the emotional responses to high-calorie (savory and sweet) and low-calorie food stimuli, presented through different exposure conditions (real, photographic, and AR). The State-Trait Anxiety Inventory was used for the assessment of state anxiety, and it was administered at the beginning and after the exposure to foods, along with the Visual Analog Scale (VAS) for Hunger and Happiness. To assess the perceived pleasantness, the VAS for Palatability was administered after the exposure to food stimuli. Heart rate, skin conductance response, and facial corrugator supercilii muscle activation were recorded. Although preliminary, the results showed that (a) AR food stimuli were perceived to be as palatable as real stimuli, and they also triggered a similar arousal response; (b) obese individuals showed lower happiness after the exposure to food compared to control participants, with regard to both psychological and physiological responses; and (c) high-calorie savory (vs. low-calorie) food stimuli were perceived by all the participants to be more palatable, and they triggered a greater arousal response.

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.

Evaluating the Authenticity of Virtual Environments: Comparison of Three Devices

Immersive virtual environments (VEs) have the potential to provide novel cost effective ways for evaluating not only new environments and usability scenarios, but also potential user experiences. To achieve this, VEs must be adequately realistic. The level of perceived authenticity can be ascertained by measuring the levels of immersion people experience in their VE interactions. In this paper the degree of authenticity is measured via anauthenticity indexin relation to three different immersive virtual environment devices. These devices include (1) a headband, (2) 3D glasses, and (3) a head-mounted display (HMD). A quick scale for measuring immersion, feeling of control, and simulator sickness was developed and tested. The HMD proved to be the most immersive device, although the headband was demonstrated as being a more stable environment causing the least simulator sickness. The results have design implication as they provide insight into specific factors which make experience in a VE seem more authentic to users. The paper emphasizes that, in addition to the quality of the VE, focus needs to be placed on ergonomic factors such as the weight of the devices, as these may compromise the quality of results obtained when examining studying human-technology interaction in a VE.

Behavioral Bias for Food Reflected in Hand Movements: A Preliminary Study with Healthy Subjects

Palatable food induces general approach tendencies when compared to nonfood stimuli. For eating disorders, the modification of an attention bias toward food was proposed as a treatment option. Similar approaches have been efficient for other psychiatric conditions and, recently, successfully incorporated approach motivation. The direct impact of attentional biases on spontaneous natural behavior has hardly been investigated so far, although actions may serve as an intervention target, especially seeing the recent advances in the field of embodied cognition. In this study, we addressed the interplay of motor action execution and cognition when interacting with food objects. In a Virtual Reality (VR) setting, healthy participants repeatedly grasped or warded high-calorie food or hand-affordant ball objects using their own dominant hand. This novel experimental paradigm revealed an attention-like bias in hand-based actions: 3D objects of food were collected faster than ball objects, and this difference correlated positively with both individual body mass index and diet-related attitudes. The behavioral bias for food in hand movements complements several recent experimental and neurophysiological findings. Implications for the use of VR in the treatment of eating-related health problems are discussed.

A training platform for many-dimensional prosthetic devices using a virtual reality environment

Brain machine interfaces (BMIs) have the potential to assist in the rehabilitation of millions of patients worldwide. Despite recent advancements in BMI technology for the restoration of lost motor function, a training environment to restore full control of the anatomical segments of an upper limb extremity has not yet been presented. Here, we develop a virtual upper limb prosthesis with 27 independent dimensions, the anatomical dimensions of the human arm and hand, and deploy the virtual prosthesis as an avatar in a virtual reality environment (VRE) that can be controlled in real-time. The prosthesis avatar accepts kinematic control inputs that can be captured from movements of the arm and hand as well as neural control inputs derived from processed neural signals. We characterize the system performance under kinematic control using a commercially available motion capture system. We also present the performance under kinematic control achieved by two non-human primates (Macaca Mulatta) trained to use the prosthetic avatar to perform reaching and grasping tasks. This is the first virtual prosthetic device that is capable of emulating all the anatomical movements of a healthy upper limb in real-time. Since the system accepts both neural and kinematic inputs for a variety of many-dimensional skeletons, we propose it provides a customizable training platform for the acquisition of many-dimensional neural prosthetic control.

Outcomes associated with virtual reality in psychological interventions: where are we now?

The impending commercial release of affordable VR systems is likely to accelerate both the opportunity and demand for VR applications that specifically target psychological conditions. The aim of this study was to conduct a meta-analysis of outcomes associated with VR psychological interventions and to examine the methodological rigour used in these interventions. Literature search was conducted via Ovid, ProQuest Psychology Journals and ScienceDirect (Psychology) databases. Interventions were required to: be published between 1980 to 2014; use a randomised controlled trial design; be published in a scholarly journal; focused primarily on psychological/behavioural intervention; include validated measures; include reported means and standard deviations of outcome measures; and include one group with clinical/subclinical disorders, syndromes or distressing behaviours. Thirty eligible studies were identified. Random effects meta-analysis found an overall moderate effect size for VR interventions. Individual meta-analyses found an overall large effect size against non-intervention wait-lists and an overall moderate effect size against active interventions. No correlation was found between treatment outcomes and methodological rigour. Limitations may include limited study numbers, the use of a single coder, a need for more in-depth analyses of variation in form VR intervention, and omission of presence as a moderating factor. The current review supports VR interventions as efficacious, promising forms of psychological treatment. Use of reporting guidelines such as the CONSORT and CONSORT-EHEALTH statements should promote greater emphasis on methodological rigour, providing a firm foundation for the further development of clinical VR applications.

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.

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.

Substitutional reality system: a novel experimental platform for experiencing alternative reality

We have developed a novel experimental platform, referred to as a substitutional reality (SR) system, for studying the conviction of the perception of live reality and related metacognitive functions. The SR system was designed to manipulate people's reality by allowing them to experience live scenes (in which they were physically present) and recorded scenes (which were recorded and edited in advance) in an alternating manner without noticing a reality gap. All of the naïve participants (n = 21) successfully believed that they had experienced live scenes when recorded scenes had been presented. Additional psychophysical experiments suggest the depth of visual objects does not affect the perceptual discriminability between scenes, and the scene switch during head movement enhance substitutional performance. The SR system, with its reality manipulation, is a novel and affordable method for studying metacognitive functions and psychiatric disorders.

The potential of virtual reality technologies to improve adherence to weight loss behaviors

A significant proportion of the global population is obese, foreshadowing an epidemic of chronic disease. Self-monitoring (of diet, exercise, and body weight), decreasing energy intake, and increasing energy expenditure are robust predictors of successful weight loss. However, few individuals consistently practice these behaviors, making long-term weight loss and maintenance unlikely. Technologies afford unique opportunities to overcome barriers and increase the reach of traditional obesity interventions. In this article, we introduce ENGAGED, a technology-enhanced modification of the Diabetes Prevention Program designed to improve adherence to weight loss behaviors. Using a treatment implementation framework, we suggest how virtual reality technologies might further improve the delivery, receipt, and enactment of ENGAGED to maximize patient impact.