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Laura B, Maisto D, Pezzulo G. Modeling and controlling the body in maladaptive ways: an active inference perspective on non-suicidal self-injury behaviors. Neurosci Conscious 2023; 2023:niad025. [PMID: 38028726 PMCID: PMC10681710 DOI: 10.1093/nc/niad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/12/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
A significant number of persons engage in paradoxical behaviors, such as extreme food restriction (up to starvation) and non-suicidal self-injuries, especially during periods of rapid changes, such as adolescence. Here, we contextualize these and related paradoxical behavior within an active inference view of brain functions, which assumes that the brain forms predictive models of bodily variables, emotional experiences, and the embodied self and continuously strives to reduce the uncertainty of such models. We propose that not only in conditions of excessive or prolonged uncertainty, such as in clinical conditions, but also during pivotal periods of developmental transition, paradoxical behaviors might emerge as maladaptive strategies to reduce uncertainty-by "acting on the body"- soliciting salient perceptual and interoceptive sensations, such as pain or excessive levels of hunger. Although such strategies are maladaptive and run against our basic homeostatic imperatives, they might be functional not only to provide some short-term reward (e.g. relief from emotional distress)-as previously proposed-but also to reduce uncertainty and possibly to restore a coherent model of one's bodily experience and the self, affording greater confidence in who we are and what course of actions we should pursue.
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Affiliation(s)
- Barca Laura
- Institute of Cognitive Sciences and Technologies, National Research Council, Via San Martino della Battaglia 44, Rome 00185, Italy
| | - Domenico Maisto
- Institute of Cognitive Sciences and Technologies, National Research Council, Via San Martino della Battaglia 44, Rome 00185, Italy
| | - Giovani Pezzulo
- Institute of Cognitive Sciences and Technologies, National Research Council, Via San Martino della Battaglia 44, Rome 00185, Italy
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2
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Meschberger-Annweiler FA, Ascione M, Porras-Garcia B, Ferrer-Garcia M, Moreno-Sanchez M, Miquel-Nabau H, Serrano-Troncoso E, Carulla-Roig M, Gutiérrez-Maldonado J. An Attentional Bias Modification Task, through Virtual Reality and Eye-Tracking Technologies, to Enhance the Treatment of Anorexia Nervosa. J Clin Med 2023; 12:jcm12062185. [PMID: 36983186 PMCID: PMC10054656 DOI: 10.3390/jcm12062185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Mirror exposure therapies (METs) have been shown to be effective in reducing body image disturbances through the habituation process. Virtual reality (VR) combined with eye-tracking techniques can provide innovative solutions to some of METs’ limitations reported with patients with anorexia nervosa (AN), especially the negative influence of body-related attentional bias (AB). This pilot study aimed to assess the preliminary efficacy of a new VR-based AB modification task (ABMT) among healthy women and the procedure’s user experience. AB levels towards weight- and non-weight-related body parts, using complete fixation time (CFT) and number of fixations (NF), were assessed throughout the ABMT procedure (300 trials). The user experience was evaluated at the end of the procedure. The results showed that VR-based ABMT was effective in reducing AB significantly after 150 trials for both CFT- and NF-based measures, although 225 trials were necessary to get the same result for women with an NF initially more oriented towards weight-related body parts. Overall, the software received a “C-rating” on a scale from “A” (most usable) to “F” (least usable). These results provide evidence of the opportunity to use a VR-based ABMT procedure to reduce AB and improve existing treatments for AN.
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Affiliation(s)
- Franck-Alexandre Meschberger-Annweiler
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Mariarca Ascione
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Bruno Porras-Garcia
- Department of Population Health Science, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84112, USA
| | - Marta Ferrer-Garcia
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Manuel Moreno-Sanchez
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Helena Miquel-Nabau
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Eduardo Serrano-Troncoso
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Marta Carulla-Roig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - José Gutiérrez-Maldonado
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
- Correspondence:
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3
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Experiential AR/VR: a consumer and service framework and research agenda. JOURNAL OF SERVICE MANAGEMENT 2022. [DOI: 10.1108/josm-12-2021-0479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe paper focuses on extended reality technologies and their potential contribution to the improvement of services. First, it identifies extended reality technologies (AR/VR) as the most promising interfaces to enable an experiential consumption of the services. It then summarises their properties and discusses similarities and differences. Last, it maps these technologies onto a consumer psychology framework of experience to derive possible areas of future research.Design/methodology/approachThe authors conduct a literature review and present a conceptual framework of AR/VR contributions on experience.FindingsThe study provides an up-to-date literature review including AR and VR applications for consumer and service experience, as well as recommendations for possible research directions.Originality/valueWhereas previous contributions adopted the same, experiential approach but focused on different technology (e.g. AI) or considered multiple interfaces and their impact on the consumer journey (mostly transactions), this paper aims at digging deeper into AR/VR, while retaining an experiential view on consumption that best serves the contextualisation of AR/VR.
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Vlahovic S, Suznjevic M, Skorin-Kapov L. A survey of challenges and methods for Quality of Experience assessment of interactive VR applications. JOURNAL ON MULTIMODAL USER INTERFACES 2022; 16. [PMCID: PMC9051501 DOI: 10.1007/s12193-022-00388-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
User acceptance of virtual reality (VR) applications is dependent on multiple aspects, such as usability, enjoyment, and cybersickness. To fully realize the disruptive potential of VR technology in light of recent technological advancements (e.g., advanced headsets, immersive graphics), gaining a deeper understanding of underlying factors and dimensions impacting and contributing to the overall end-user experience is of great benefit to hardware manufacturers, software and content developers, and service providers. To provide insight into user behaviour and preferences, researchers conduct user studies exploring the influence of various user-, system-, and context-related factors on the overall Quality of Experience (QoE) and its dimensions. When planning and executing such studies, researchers are faced with numerous methodological challenges related to study design aspects, such as specification of dependant and independent variables, subjective and objective assessment methods, preparation of test materials, test environment, and participant recruitment. Approaching these challenges from a multidisciplinary perspective, this paper reviews different aspects of performing perception-based QoE assessment for interactive VR applications and presents options and recommendations for research methodology design. We provide an overview of different influence factors and dimensions that may affect the overall QoE, with a focus on presence, immersion, and discomfort. Furthermore, we address ethical and practical issues regarding participant choice and test material, present different assessment methods and measures commonly used in VR research, and discuss approaches to choosing study duration and location. Lastly, we provide a concise analysis of key challenges that need to be addressed in future studies centered around VR QoE.
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Affiliation(s)
- Sara Vlahovic
- Faculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, 10000 Zagreb, Croatia
| | - Mirko Suznjevic
- Faculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, 10000 Zagreb, Croatia
| | - Lea Skorin-Kapov
- Faculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, 10000 Zagreb, Croatia
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5
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Burin D, Kawashima R. Repeated Exposure to Illusory Sense of Body Ownership and Agency Over a Moving Virtual Body Improves Executive Functioning and Increases Prefrontal Cortex Activity in the Elderly. Front Hum Neurosci 2021; 15:674326. [PMID: 34135743 PMCID: PMC8200494 DOI: 10.3389/fnhum.2021.674326] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
We previously showed that the illusory sense of ownership and agency over a moving body in immersive virtual reality (displayed in a first-person perspective) can trigger subjective and physiological reactions on the real subject’s body and, therefore, an acute improvement of cognitive functions after a single session of high-intensity intermittent exercise performed exclusively by one’s own virtual body, similar to what happens when we actually do physical activity. As well as confirming previous results, here, we aimed at finding in the elderly an increased improvement after a longer virtual training with similar characteristics. Forty-two healthy older subjects (28 females, average age = 71.71 years) completed a parallel-group randomized controlled trial (RCT; UMIN000039843, umin.ac.jp) including an adapted version of the virtual training previously used: while sitting, participants observed the virtual body in a first-person perspective (1PP) or a third-person perspective (3PP) performing 20 min of virtual high-intensity intermittent exercise (vHIE; the avatar switched between fast and slow walking every 2 min). This was repeated twice a week for 6 weeks. During the vHIE, we measured the heart rate and administered questionnaires to evaluate illusory body ownership and agency. Before the beginning of the intervention, immediately after the first session of vHIE, and at the end of the entire intervention, we evaluated the cognitive performance at the Stroop task with online recording of the hemodynamic activity over the left dorsolateral prefrontal cortex. While we confirm previous results regarding the virtual illusion and its physiological effects, we did not find significant cognitive or neural improvement immediately after the first vHIE session. As a novelty, in the 1PP group only, we detected a significant decrease in the response time of the Stroop task in the post-intervention assessment compared to its baseline; coherently, we found an increased activation on left dorsolateral prefrontal cortex (lDLPFC) after the entire intervention. While the current results strengthen the impact of the virtual full-body illusion and its physiological consequences on the elderly as well, they might have stronger and more established body representations. Perhaps, a longer and increased exposure to those illusions is necessary to initiate the cascade of events that culminates to an improved cognitive performance.
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Affiliation(s)
- Dalila Burin
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Smart Aging International Research Center, Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- Department of Advanced Brain Science, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Smart Aging International Research Center, Tohoku University, Sendai, Japan
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6
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Manzi F, Sorgente A, Massaro D, Villani D, Di Lernia D, Malighetti C, Gaggioli A, Rossignoli D, Sandini G, Sciutti A, Rea F, Maggioni MA, Marchetti A, Riva G. Emerging Adults' Expectations About the Next Generation of Robots: Exploring Robotic Needs Through a Latent Profile Analysis. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2021; 24:315-323. [DOI: 10.1089/cyber.2020.0161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Federico Manzi
- Department of Psychology, UniToM, Research Unit on Theory of Mind, Università Cattolica del Sacro Cuore, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Angela Sorgente
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Davide Massaro
- Department of Psychology, UniToM, Research Unit on Theory of Mind, Università Cattolica del Sacro Cuore, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniela Villani
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniele Di Lernia
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Clelia Malighetti
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Andrea Gaggioli
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Domenico Rossignoli
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of International Economics, Institutions and Development, DISEIS, Università Cattolica del Sacro Cuore, Milano, Italy
- Cognitive Science and Communication Research Center (CSCC), Università Cattolica del Sacro Cuore, Milano, Italy
| | - Giulio Sandini
- Robotics, Brain and Cognitive Sciences (RBCS) Unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Alessandra Sciutti
- Cognitive Architecture for Collaborative Technologies (CONTACT) Unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Francesco Rea
- Robotics, Brain and Cognitive Sciences (RBCS) Unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Mario A. Maggioni
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of International Economics, Institutions and Development, DISEIS, Università Cattolica del Sacro Cuore, Milano, Italy
- Cognitive Science and Communication Research Center (CSCC), Università Cattolica del Sacro Cuore, Milano, Italy
| | - Antonella Marchetti
- Department of Psychology, UniToM, Research Unit on Theory of Mind, Università Cattolica del Sacro Cuore, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuropsychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
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7
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Brito H, Pham T, Vicente B. Effect of sensorimotor rehabilitation based on an immersive virtual reality model on mental health. Int J Geriatr Psychiatry 2021; 37. [PMID: 33797806 DOI: 10.1002/gps.5541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The aim of this study was to determine the immersive virtual reality-based sensorimotor rehabilitation (IVR-SRB) effect on mental health (global mental health, depression, anxiety and well-being) in older adults. METHODS This study was experimental, with a sample of 111 older adults (control-experimental), considering an application of IVR-SRB in four different virtual settings with exteroceptive synchronization, proprioceptive and vestibular stimuli, for 6 weeks. OUTCOME VARIABLES symptoms associated with depression and anxiety; positive mental health (psychological well-being). A descriptive and inferential approach was used to analyze the data, and the ANCOVA test was used to compare the post-intervention groups, controlled by the baseline; In case of baseline moderation, a linear regression model was applied to identify the level of moderation and a region of significance analysis. RESULTS An IVR-SRB positive net effect was found in the reduction of symptoms of global mental health (p < 0.0001) and depression (p < 0.0001), without baseline moderation. The anxiety scores showed moderation at the beginning (p < 0.0001; b = -0.53), identifying that the greater the presence of anxiety symptoms, the greater the effect of IVR-SRB in reducing these symptoms; its effect is present from scores of 2.9 (Goldberg-12). There were no changes in well-being. CONCLUSION IVR-SRB is recognized as a great intervention tool among elderly population, showing its multidimensional approach capacity, properly responding to the reduction of symptoms associated with mental disorders.
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Affiliation(s)
- Héctor Brito
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Concepción, Concepcion, Chile
- Physiotherapy Department, Faculty of Health Sciences, Health Rehabilitation Sciences Research Unit (I-CIRESA), Universidad Autónoma de Chile, Chile
| | - Trung Pham
- Department of Computer Sciences & Cyberworx, US Air Force Academy, Colorado, USA
| | - Benjamín Vicente
- Department of Psychiatry and Mental Health, Faculty of Medicine, Universidad de Concepción, Concepcion, Chile
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8
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AN-VR-BE. A Randomized Controlled Trial for Reducing Fear of Gaining Weight and Other Eating Disorder Symptoms in Anorexia Nervosa through Virtual Reality-Based Body Exposure. J Clin Med 2021; 10:jcm10040682. [PMID: 33578767 PMCID: PMC7916489 DOI: 10.3390/jcm10040682] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 12/18/2022] Open
Abstract
In vivo body exposure therapy is considered an effective and suitable intervention to help patients with anorexia nervosa (AN) reduce their body image disturbances (BIDs). However, these interventions have notable limitations and cannot effectively reproduce certain fears usually found in AN, such as the fear of gaining weight (FGW). The latest developments in virtual reality (VR) technology and embodiment-based procedures could overcome these limitations and allow AN patients to confront their FGW and BIDs. This study aimed to provide further evidence of the efficacy of an enhanced (by means of embodiment) VR-based body exposure therapy for the treatment of AN. Thirty-five AN patients (16 in the experimental group, 19 in the control group) participated in the study. FGW, BIDs, and other body-related and ED measures were assessed before and after the intervention and three months later. The experimental group received treatment as usual (TAU) and five additional sessions of VR-based body exposure therapy, while the control group received only TAU. After the intervention, ED symptoms were clearly reduced in both groups, with most of the changes being more noticeable in the experimental group. Specifically, after the intervention and at follow-up, significant group differences were found in the FGW and BIDs, with the experimental group showing significantly lower values than the control group. The current study provides new insights and encouraging findings in the field of exposure-based therapies in AN. VR technology might improve research and clinical practice in AN by providing new tools to help patients confront their core fears (i.e., food- or weight-related cues) and improve their emotional, cognitive, and behavioral responses to their body image.
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Tuena C, Mancuso V, Stramba-Badiale C, Pedroli E, Stramba-Badiale M, Riva G, Repetto C. Egocentric and Allocentric Spatial Memory in Mild Cognitive Impairment with Real-World and Virtual Navigation Tasks: A Systematic Review. J Alzheimers Dis 2021; 79:95-116. [PMID: 33216034 PMCID: PMC7902987 DOI: 10.3233/jad-201017] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Spatial navigation is the ability to estimate one's position on the basis of environmental and self-motion cues. Spatial memory is the cognitive substrate underlying navigation and relies on two different reference frames: egocentric and allocentric. These spatial frames are prone to decline with aging and impairment is even more pronounced in Alzheimer's disease (AD) or in mild cognitive impairment (MCI). OBJECTIVE To conduct a systematic review of experimental studies investigating which MCI population and tasks are used to evaluate spatial memory and how allocentric and egocentric deficits are impaired in MCI after navigation. METHODS PRISMA and PICO guidelines were applied to carry out the systematic search. Down and Black checklist was used to assess methodological quality. RESULTS Our results showed that amnestic MCI and AD pathology are the most investigated typologies; both egocentric and allocentric memory are impaired in MCI individuals, and MCI due to AD biomarkers has specific encoding and retrieval impairments; secondly, spatial navigation is principally investigated with the hidden goal task (virtual and real-world version), and among studies involving virtual reality, the privileged setting consists of non-immersive technology; thirdly, despite subtle differences, real-world and virtual versions showed good overlap for the assessment of MCI spatial memory. CONCLUSION Considering that MCI is a subclinical entity with potential risk for conversion to dementia, investigating spatial memory deficits with navigation tasks might be crucial to make accurate diagnosis and rehabilitation.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Valentina Mancuso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Faculty of Psychology, Universitá eCampus, Novedrate, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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10
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Virtual Body Ownership Illusions for Mental Health: A Narrative Review. J Clin Med 2021; 10:jcm10010139. [PMID: 33401596 PMCID: PMC7796179 DOI: 10.3390/jcm10010139] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
Over the last 20 years, virtual reality (VR) has been widely used to promote mental health in populations presenting different clinical conditions. Mental health does not refer only to the absence of psychiatric disorders but to the absence of a wide range of clinical conditions that influence people’s general and social well-being such as chronic pain, neurological disorders that lead to motor o perceptual impairments, psychological disorders that alter behaviour and social cognition, or physical conditions like eating disorders or present in amputees. It is known that an accurate perception of oneself and of the surrounding environment are both key elements to enjoy mental health and well-being, and that both can be distorted in patients suffering from the clinical conditions mentioned above. In the past few years, multiple studies have shown the effectiveness of VR to modulate such perceptual distortions of oneself and of the surrounding environment through virtual body ownership illusions. This narrative review aims to review clinical studies that have explored the manipulation of embodied virtual bodies in VR for improving mental health, and to discuss the current state of the art and the challenges for future research in the context of clinical care.
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11
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The Effect of a Virtual-Reality Full-Body Illusion on Body Representation in Obesity. J Clin Med 2019; 8:jcm8091330. [PMID: 31466376 PMCID: PMC6780081 DOI: 10.3390/jcm8091330] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 11/26/2022] Open
Abstract
Background. The effective illusory ownership over an artificial body in modulating body representations in healthy and eating disorders population has been repeatedly reported in recent literature. In this study, we extended this research in the field of obesity: specifically, we investigated whether ownership over a virtual body with a skinny abdomen might be successfully experienced by participants affected by obesity. Methods. Fifteen participants with obesity and fifteen healthy-weight participants took part at this study in which the VR-Full-Body Illusion was adopted. The strength of illusion was investigated through the traditional Embodiment Questionnaire, while changes in bodily experience were measured through a body size estimation task. Results. Participants with obesity as well as healthy-weight participants reported to experience the illusion. About the body size estimation task, both groups reported changes only in the estimation of the abdomen’s circumference after the experimental condition, in absence of any another difference. Discussion. Participants with obesity reported to experience the illusion over a skinny avatar, but the modulation of the bodily experience seems controversial. Future lines of research exploiting this technique for modulating body representations in obesity, specifically in terms of potential therapeutic use, were discussed.
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12
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Ferracci S, Brancucci A. The influence of age on the rubber hand illusion. Conscious Cogn 2019; 73:102756. [DOI: 10.1016/j.concog.2019.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/12/2019] [Accepted: 05/13/2019] [Indexed: 12/21/2022]
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13
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Gadsby S. Manipulating body representations with virtual reality: Clinical implications for anorexia nervosa. PHILOSOPHICAL PSYCHOLOGY 2019. [DOI: 10.1080/09515089.2019.1632425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Stephen Gadsby
- Cognition and Philosophy Lab, School of Philosophical, Historical, and International Studies, Monash University, Melbourne, Australia
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14
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Karnath HO, Mölbert SC, Klaner AK, Tesch J, Giel KE, Wong HY, Mohler BJ. Visual perception of one's own body under vestibular stimulation using biometric self-avatars in virtual reality. PLoS One 2019; 14:e0213944. [PMID: 30883577 PMCID: PMC6422330 DOI: 10.1371/journal.pone.0213944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/04/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND PURPOSE Vestibular input is projected to "multisensory (vestibular) cortex" where it converges with input from other sensory modalities. It has been assumed that this multisensory integration enables a continuous perception of state and presence of one's own body. The present study thus asked whether or not vestibular stimulation may impact this perception. METHODS We used an immersive virtual reality setup to realistically manipulate the length of extremities of first person biometric avatars. Twenty-two healthy participants had to adjust arms and legs to their correct length from various start lengths before, during, and after vestibular stimulation. RESULTS Neither unilateral caloric nor galvanic vestibular stimulation had a modulating effect on the perceived size of own extremities. CONCLUSION Our results suggest that vestibular stimulation does not directly influence the explicit somatosensory representation of our body. It is possible that in non-brain-damaged, healthy subjects, changes in whole body size perception are principally not mediated by vestibular information. Alternatively, visual feedback and/or memory may dominate multisensory integration and thereby override possibly existing modulations of body perception by vestibular stimulation. The present observations suggest that multisensory integration and not the processing of a single sensory input is the crucial mechanism in generating our body representation in relation to the external world.
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Affiliation(s)
- Hans-Otto Karnath
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, SC, United States of America
| | - Simone Claire Mölbert
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Medical University Hospital Tübingen, Dept. of Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Anna Katharina Klaner
- Centre of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Joachim Tesch
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Medical University Hospital Tübingen, Dept. of Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Hong Yu Wong
- Institute of Philosophy, University of Tübingen, Tübingen, Germany
| | - Betty J. Mohler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Technical University Darmstadt, Institute of Sports Science, Darmstadt, Germany
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15
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Riva G, Wiederhold BK, Mantovani F. Neuroscience of Virtual Reality: From Virtual Exposure to Embodied Medicine. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2018; 22:82-96. [PMID: 30183347 PMCID: PMC6354552 DOI: 10.1089/cyber.2017.29099.gri] [Citation(s) in RCA: 160] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Giuseppe Riva
- 1 Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.,2 Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Brenda K Wiederhold
- 3 Virtual Reality Medical Center, La Jolla, California.,4 Virtual Reality Medical Institute, Brussels, Belgium
| | - Fabrizia Mantovani
- 5 Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milan, Italy
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16
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Di Lernia D, Cipresso P, Pedroli E, Riva G. Toward an Embodied Medicine: A Portable Device with Programmable Interoceptive Stimulation for Heart Rate Variability Enhancement. SENSORS 2018; 18:s18082469. [PMID: 30061531 PMCID: PMC6111417 DOI: 10.3390/s18082469] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/22/2018] [Accepted: 07/25/2018] [Indexed: 12/21/2022]
Abstract
In this paper, we describe and test a new portable device that is able to deliver tactile interoceptive stimulation. The device works by delivering precise interoceptive parasympathetic stimuli to C-tactile afferents connected to the lamina I spinothalamocortical system. In humans, interoceptive stimulation can be used to enhance heart rate variability (HRV). To test the effectiveness of the device in enhancing HRV, 13 subjects were randomly assigned in a single-blind between-subjects design either to the experimental condition or to the control condition. In the experimental condition, subjects received stimulation with the developed device; in the control condition subjects received stimulation with static non-interoceptive pressure. Subjects’ electrocardiograms (ECG) were recorded, with sampling at 1000 Hz for 5 min as a baseline, and then during the stimulations (11 min). Time domain analyses were performed to estimate the short-term vagally mediated component (rMSSD) of HRV. Results indicated that the experimental group showed enhanced rMSSD, compared to the control group. Moreover, frequency domain analyses indicated that high frequency band power, which reflects parasympathetic activity in humans, also appeared to be enhanced in the experimental group compared to control subjects. Conclusions and future challenges for an embodied perspective of rehabilitative medicine are discussed.
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Affiliation(s)
- Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy.
| | - Pietro Cipresso
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy.
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco, 2, 20149 Milan, Italy.
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco, 2, 20149 Milan, Italy.
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy.
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco, 2, 20149 Milan, Italy.
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