Time to Think "Meta": A Critical Viewpoint on the Risks and Benefits of Virtual Worlds for Mental Health

Metaverse for mental health disorders: Opportunities and challenges

Several articles on the mental health impact of the metaverse and the need to balance its potential benefits with the risks of metaverse use has recently published. The metaverse consists of a combination of immersive technologies and artificial intelligence algorithms. The metaverse differs from the preceding digital psychiatric interventions due to its complex structure and interactions between components. The diverse functions of the metaverse ensure that it may have a substantial impact on mental health. However, the evidence for its efficacy in treating mental health disorders is limited to a few trials. The mental health benefits of immersive technologies are well-documented and suggest that metaverse-based psychiatric treatment may be similarly efficacious. The mental health risks of the metaverse are largely unknown, and it is not clear whether they will be greater than other digital psychiatric interventions. Much more research is needed to determine whether metaverse-based psychiatric treatment will meet the standards of appropriate mental healthcare.

Mental health in the virtual world: Are we ready for the metaverse era?

The advent of the metaverse, including virtual reality, augmented reality, and artificial intelligence, is an undeniable issue that health care scientists need to update. It influences all fields of knowledge, interpersonal relationships, and health. Regarding mental health since the post-coronavirus disease 2019 pandemic, it is necessary to consider and understand the potential, possibilities, weaknesses, and consequences arising from and provided by this new scenario. Due to the increasing need for mental health monitoring and care, mental health treatments require in-depth training and preparation to achieve the maximum use of the metaverse advantages and possibilities. Currently, very little is known about the effectiveness of remote mental health treatment, but it is certainly suggested that accessibility and the characteristics associated with the use of metaverse technologies may represent new horizons for accessibility and approach tools, as long as more studies are carried out and more evidence is collected to develop accurate guidelines, safe training, solve ethical concerns, and overcome limitations.

Media Use and Its Associations With Paranoia in Schizophrenia and Bipolar Disorder: Ecological Momentary Assessment

Background

Paranoia is a spectrum of fear-related experiences that spans diagnostic categories and is influenced by social and cognitive factors. The extent to which social media and other types of media use are associated with paranoia remains unclear.

Objective

We aimed to examine associations between media use and paranoia at the within- and between-person levels.

Methods

Participants were 409 individuals diagnosed with schizophrenia spectrum or bipolar disorder. Measures included sociodemographic and clinical characteristics at baseline, followed by ecological momentary assessments (EMAs) collected 3 times daily over 30 days. EMA evaluated paranoia and 5 types of media use: social media, television, music, reading or writing, and other internet or computer use. Generalized linear mixed models were used to examine paranoia as a function of each type of media use and vice versa at the within- and between-person levels.

Results

Of the 409 participants, the following subgroups reported at least 1 instance of media use: 261 (63.8%) for using social media, 385 (94.1%) for watching TV, 292 (71.4%) for listening to music, 191 (46.7%) for reading or writing, and 280 (68.5%) for other internet or computer use. Gender, ethnoracial groups, educational attainment, and diagnosis of schizophrenia versus bipolar disorder were differentially associated with the likelihood of media use. There was a within-person association between social media use and paranoia: using social media was associated with a subsequent decrease of 5.5% (fold-change 0.945, 95% CI 0.904-0.987) in paranoia. The reverse association, from paranoia to subsequent changes in social media use, was not statistically significant. Other types of media use were not significantly associated with paranoia.

Conclusions

This study shows that social media use was associated with a modest decrease in paranoia, perhaps reflecting the clinical benefits of social connection. However, structural disadvantage and individual factors may hamper the accessibility of media activities, and the mental health correlates of media use may further vary as a function of contents and contexts of use.

Mental health in the virtual world: Challenges and opportunities in the metaverse era

Current rates of mental illness are worrisome. Mental illness mainly affects females and younger age groups. The use of the internet to deliver mental health care has been growing since 2020 and includes the implementation of novel mental health treatments using virtual reality, augmented reality, and artificial intelligence. A new three dimensional digital environment, known as the metaverse, has emerged as the next version of the Internet. Artificial intelligence, augmented reality, and virtual reality will create fully immersive, experiential, and interactive online environments in the metaverse. People will use a unique avatar to do anything they do in their "real" lives, including seeking and receiving mental health care. In this opinion review, we reflect on how the metaverse could reshape how we deliver mental health treatment, its opportunities, and its challenges.

Being in Virtual Reality and Its Influence on Brain Health-An Overview of Benefits, Limitations and Prospects

BACKGROUND

Dynamic technological development and its enormous impact on modern societies are posing new challenges for 21st-century neuroscience. A special place is occupied by technologies based on virtual reality (VR). VR tools have already played a significant role in both basic and clinical neuroscience due to their high accuracy, sensitivity and specificity and, above all, high ecological value.

OBJECTIVE

Being in a digital world affects the functioning of the body as a whole and its individual systems. The data obtained so far, both from experimental and modeling studies, as well as (clinical) observations, indicate their great and promising potential, but apart from the benefits, there are also losses and negative consequences for users.

METHODS

This review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework across electronic databases (such as Web of Science Core Collection; PubMed; and Scopus, Taylor & Francis Online and Wiley Online Library) to identify beneficial effects and applications, as well as adverse impacts, especially on brain health in human neuroscience.

RESULTS

More than half of these articles were published within the last five years and represent state-of-the-art approaches and results (e.g., 54.7% in Web of Sciences and 63.4% in PubMed), with review papers accounting for approximately 16%. The results show that in addition to proposed novel devices and systems, various methods or procedures for testing, validation and standardization are presented (about 1% of articles). Also included are virtual developers and experts, (bio)(neuro)informatics specialists, neuroscientists and medical professionals.

CONCLUSIONS

VR environments allow for expanding the field of research on perception and cognitive and motor imagery, both in healthy and patient populations. In this context, research on neuroplasticity phenomena, including mirror neuron networks and the effects of applied virtual (mirror) tasks and training, is of interest in virtual prevention and neurogeriatrics, especially in neurotherapy and neurorehabilitation in basic/clinical and digital neuroscience.

Associations between digital media use and psychotic experiences in young adults of Quebec, Canada: a longitudinal study

PURPOSE

Digital media use has been associated with psychotic experiences in youth from the community, but the direction of association remains unclear. We aimed to examine between- and within-person associations of digital media use and psychotic experiences in youth.

METHODS

The sample included 425 participants aged 18-25 years (82.5% female) from the community, followed between May 2021 and January 2022 over 3 time points-of which 263 participants (61.9%) completed at least 2. Digital media use was self-reported as time spent daily on TV and streaming platforms, social media, and video games over the past 3 months. Psychotic experiences in the past 3 months were measured with the 15-item Community Assessment of Psychic Experiences. Associations between digital media use and psychotic experiences were estimated using a random-intercept cross-lagged panel model.

RESULTS

On average, individuals who reported greater digital media use also reported higher levels of psychotic experiences (r = 0.34, 95% CI 0.15, 0.53). However, a person's variation in digital media use, relative to their personal average, was not significantly associated with subsequent variations in their levels of psychotic experiences, or vice-versa. Results were similar across TV/streaming, social media and video game use, and after adjusting for age, sex, education, sleep, physical activity, and cannabis use.

CONCLUSION

Individuals with a tendency for higher levels of digital media use also had a tendency for higher levels of psychotic experiences. Understanding this association may help personalize mental health interventions for people with psychotic experiences, which may be offered digitally to promote their accessibility.

Virtual emotions and Criminal Law

This article examines the role that Criminal Law should play in regulating the non-therapeutic use of immersive Virtual Reality (VR), specifically its massive use by consumers. The starting point has been to consider VR as an intermediate risk scenario, for the purposes of Criminal Law, between the criminality entirely generated in the physical world and that developed in the 2D digital environments [cybercrimes and criminality linked to social networks and persuasive Artificial Intelligence (AI)]. Firstly, specialize literature has been analyzed to establish the nature of virtual reality. From a technical standpoint, virtual reality is a neurotechnology infused with high-risk artificial intelligence; an inseparable synthesis of non-invasive neurotechnology and a set of AI systems, considered high-risk for the fundamental rights of citizens. From the perspective of its functioning, VR is a "transformative" neurotechnology capable of altering what people perceive as reality. This is possible, because its realism lies in the emotional immersion of the user in the virtual experience, similarly to how our brain functions. Therefore, the key idea in the immersive functioning of virtual reality is its capacity to evoke and modify human emotions, which results its greater harmful potential compared to the 2D environment. From there, three central and specific areas of (legally unaddressed) risk arise: (1) the special comprehensive nature of the data collected and stored during its use; (2) its ability to mentally reproduce the "physical" experience of the avatar in the user; and (3) its significant capacity to manipulate individuals. Secondly, the paper examines both the reported cases and the foreseeable criminality in virtual worlds or "proto-metaverse," focusing on the three risk areas, and exemplifying them with attacks on mental privacy, sexual freedom, and consumer manipulation. Finally, it is proposed that Criminal Law should also intervene (as soon as possible) to define the "red lines" of massive virtual reality use by citizens. With a democratic and human-centered approach, a basic legal framework is outlined for the criminalization of specific harms and risks associated with virtual reality, adapting the existing legal framework as necessary.

The intersection of technology and mental health: enhancing access and care

In recent times, technology has increasingly become a central force in shaping the landscape of mental health care. The integration of various technological advancements, such as teletherapy, virtual care platforms, mental health apps, and wearable devices, holds great promise in improving access to mental health services and enhancing overall care. Technology's impact on mental health care is multi-faceted. Teletherapy and virtual care have brought about a revolution in service delivery, eliminating geographical barriers and offering individuals convenient and flexible access to therapy. Mobile mental health apps empower users to monitor their emotional well-being, practice mindfulness, and access self-help resources on the move. Furthermore, wearable devices equipped with biometric data can provide valuable insights into stress levels and sleep patterns, potentially serving as valuable indicators of mental health status. However, integrating technology into mental health care comes with several challenges and ethical considerations. Bridging the digital divide is a concern, as not everyone has equal access to technology or the necessary digital literacy. Ensuring privacy and data security is crucial to safeguard sensitive client information. The rapid proliferation of mental health apps calls for careful assessment and regulation to promote evidence-based practices and ensure the delivery of quality interventions. Looking ahead, it is vital to consider future implications and adopt relevant recommendations to fully harness technology's potential in mental health care. Continuous research is essential to evaluate the efficacy and safety of digital interventions, fostering collaboration between researchers, mental health professionals, and technology developers. Proper training on ethical technology utilization is necessary for mental health practitioners to maintain therapeutic boundaries while leveraging technological advancements responsibly.

Counseling Psychological Understanding and Considerations of the Metaverse: A Theoretical Review

The COVID-19 pandemic has triggered the interest in and demand for online platforms that can replace traditional face-to-face activities. Accordingly, metaverses have been increasingly used across society, especially in the Mental health field. This broad use of metaverses is now recognized as a major trend that will drive various industries across healthcare and society. In response to this societal change, this study provides a theoretical framework for understanding and applying metaverses as therapeutic spaces in mental health fields through a conceptualization and characterization of metaverses for a range of technologies and services. The value of metaverses as a human-centered "field of experience" was identified and proposed based on the essential aspect of the user, the human being, rather than from the technology used. According to existing psychotherapeutic theories, four therapeutic concepts for the metaverse were proposed: metaverse as an "average expectable environment" in the developmental and therapeutic categories of the self, a transitional stage for adaptation to reality, a creative space for memory and communication for the self, and an expanded or "surplus" reality. This work is expected to be a useful basis for expanding new psychotherapeutic strategies and methods as therapeutic spaces for maintaining mental health through the metaverse.