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Sagehorn M, Johnsdorf M, Kisker J, Gruber T, Schöne B. Electrophysiological correlates of face and object perception: A comparative analysis of 2D laboratory and virtual reality conditions. Psychophysiology 2024; 61:e14519. [PMID: 38219244 DOI: 10.1111/psyp.14519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/12/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024]
Abstract
Human face perception is a specialized visual process with inherent social significance. The neural mechanisms reflecting this intricate cognitive process have evolved in spatially complex and emotionally rich environments. Previous research using VR to transfer an established face perception paradigm to realistic conditions has shown that the functional properties of face-sensitive neural correlates typically observed in the laboratory are attenuated outside the original modality. The present study builds on these results by comparing the perception of persons and objects under conventional laboratory (PC) and realistic conditions in VR. Adhering to established paradigms, the PC- and VR modalities both featured images of persons and cars alongside standard control images. To investigate the individual stages of realistic face processing, response times, the typical face-sensitive N170 component, and relevant subsequent components (L1, L2; pre-, post-response) were analyzed within and between modalities. The between-modality comparison of response times and component latencies revealed generally faster processing under realistic conditions. However, the obtained N170 latency and amplitude differences showed reduced discriminative capacity under realistic conditions during this early stage. These findings suggest that the effects commonly observed in the lab are specific to monitor-based presentations. Analyses of later and response-locked components showed specific neural mechanisms for identification and evaluation are employed when perceiving the stimuli under realistic conditions, reflected in discernible amplitude differences in response to faces and objects beyond the basic perceptual features. Conversely, the results do not provide evidence for comparable stimulus-specific perceptual processing pathways when viewing pictures of the stimuli under conventional laboratory conditions.
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Affiliation(s)
- Merle Sagehorn
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Marike Johnsdorf
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Joanna Kisker
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Thomas Gruber
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Benjamin Schöne
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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2
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Biedermann SV, Roth L, Biedermann D, Fuss J. Reliability of repeated exposure to the human elevated plus-maze in virtual reality: Behavioral, emotional, and autonomic responses. Behav Res Methods 2024; 56:187-198. [PMID: 36544056 PMCID: PMC10794373 DOI: 10.3758/s13428-022-02046-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
Approach-avoidance conflicts are a hallmark of anxiety-related behaviors. A gold standard for assessing anxiety-related behaviors in rodents is the elevated plus-maze (EPM), which was recently translated to humans using immersive virtual reality. Repeated behavioral testing is particularly interesting for clinical and pharmacological research in humans but could be limited by habituation effects. Here, we tested whether comparable strategies that are used in rodents (different environments and inter-trial interval of 28 days) are sufficient to avoid habituation or sensitization effects on the EPM, making it possible to perform repeated measurement of anxiety-related behavior in humans. Moreover, we developed two novel virtual environments for repeated testing to explore whether a scenario resembling the real world is superior to a video game-like EPM in terms of lifelike physiological, emotional, and behavioral responses. On a behavioral level, no significant differences but a high correlation between first and repeated exposure to the human EPM independent of EPM version were found. On a psychophysiological level, salivary alpha-amylase, skin-conductance, and respiratory frequency increased at first and second exposure independent of EPM version. However, at repeated exposure, skin-conductance and heart rate showed indicators for anticipatory anxiety and a small sensitization effect, while no effect of real-world resemblance on these physiological measures was found. This was also reflected in slightly higher subjective anxiety levels at second exposure, although subjective anxiety still correlated strongly between first and second exposure. In conclusion, the human EPM can be used for longitudinal assessments of human anxiety-related behavior when strategies to avoid habituation and sensitization are considered.
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Affiliation(s)
- Sarah V Biedermann
- Social and Emotional Neuroscience Group, Department of Psychiatry and Psychotherapy, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Lateefah Roth
- Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
- Human Behavior Laboratory, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel Biedermann
- Social and Emotional Neuroscience Group, Department of Psychiatry and Psychotherapy, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- DIPF Leibniz Institute for Research and Information in Education, Frankfurt am Main, Germany
| | - Johannes Fuss
- Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
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Barnett MD, Coldiron AM. Development of the Virtual Kitchen Protocol for Prospective Memory: a virtual reality-based measure of everyday prospective memory abilities. J Clin Exp Neuropsychol 2023; 45:618-635. [PMID: 38063062 DOI: 10.1080/13803395.2023.2287779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 11/19/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION Prospective memory is the ability to remember to accomplish a task at a specified point in the future. While this cognitive ability has a large impact on daily functioning, it is rarely assessed during neuropsychological evaluations. Furthermore, existing clinical prospective memory measures are few in number and have significant limitations, including applicability to everyday functioning and appropriate norming for older adulthood. There are also many gaps in the literature on prospective memory, such as how environmental factors affect performance across the lifespan. METHOD In the current study, we develop and establish a new virtual reality-based measure of prospective memory, the Virtual Kitchen Protocol for Prospective Memory. Young adults (ages 18-29; n = 56), healthy older adults (ages 60-90; n = 94), and clinical older adults (ages 62-90; n = 30) were compared on their performances on both the developed virtual reality prospective memory test and a parallel paper-and-pencil prospective memory test to investigate the impact of test environment across participant group. RESULTS The Virtual Kitchen Protocol for Prospective Memory was found to adequately differentiate between young adult, healthy older adult, and clinical older adult populations - suggesting baseline ability for prospective memory assessment in clinical settings with older adults and potential for future improvement of neuropsychological evaluations. Additionally, the developed virtual prospective memory task appeared to mimic environmental factors in everyday life but did not replicate the benefit previously measured in healthy older adults' prospective memory ability in naturalistic settings. CONCLUSIONS Overall, the current study built upon extant knowledge of prospective memory in both normal and abnormal aging, suggesting future directions in replicating familiar home environments. Findings provided additional evidence toward future validation of virtual reality assessment tools in clinical neuropsychological evaluations of cognitive abilities, such as prospective memory, with both healthy and clinical older adult populations.
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Affiliation(s)
- Michael D Barnett
- Department of Psychology and Counseling, University of Texas at Tyler, Tyler, TX, USA
| | - Allyson M Coldiron
- Department of Psychology and Counseling, University of Texas at Tyler, Tyler, TX, USA
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Bellinger D, Wehrmann K, Rohde A, Schuppert M, Störk S, Flohr-Jost M, Gall D, Pauli P, Deckert J, Herrmann MJ, Erhardt-Lehmann A. The application of virtual reality exposure versus relaxation training in music performance anxiety: a randomized controlled study. BMC Psychiatry 2023; 23:555. [PMID: 37528410 PMCID: PMC10394851 DOI: 10.1186/s12888-023-05040-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/20/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Performance anxiety is the most frequently reported anxiety disorder among professional musicians. Typical symptoms are - on a physical level - the consequences of an increase in sympathetic tone with cardiac stress, such as acceleration of heartbeat, increase in blood pressure, increased respiratory rate and tremor up to nausea or flush reactions. These symptoms can cause emotional distress, a reduced musical and artistical performance up to an impaired functioning. While anxiety disorders are preferably treated using cognitive-behavioral therapy with exposure, this approach is rather difficult for treating music performance anxiety since the presence of a public or professional jury is required and not easily available. The use of virtual reality (VR) could therefore display an alternative. So far, no therapy studies on music performance anxiety applying virtual reality exposure therapy have investigated the therapy outcome including cardiovascular changes as outcome parameters. METHODS This mono-center, prospective, randomized and controlled clinical trial has a pre-post design with a follow-up period of 6 months. 46 professional and semi-professional musicians will be recruited and allocated randomly to an VR exposure group or a control group receiving progressive muscle relaxation training. Both groups will be treated over 4 single sessions. Music performance anxiety will be diagnosed based on a clinical interview using ICD-10 and DSM-5 criteria for specific phobia or social anxiety. A behavioral assessment test is conducted three times (pre, post, follow-up) in VR through an audition in a concert hall. Primary outcomes are the changes in music performance anxiety measured by the German Bühnenangstfragebogen and the cardiovascular reactivity reflected by heart rate variability (HRV). Secondary outcomes are changes in blood pressure, stress parameters such as cortisol in the blood and saliva, neuropeptides, and DNA-methylation. DISCUSSION The trial investigates the effect of VR exposure in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. We expect a reduction of anxiety but also a consecutive improvement of HRV with cardiovascular protective effects. TRIAL REGISTRATION This study was registered on clinicaltrials.gov. (ClinicalTrials.gov Number: NCT05735860).
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Affiliation(s)
- Daniel Bellinger
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany.
| | - Kristin Wehrmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Anna Rohde
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
| | | | - Stefan Störk
- Department Clinical Research & Epidemiology, Comprehensive Heart Failure Center Würzburg, University Hospital Würzburg, Würzburg, Germany
| | - Michael Flohr-Jost
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center for Mental Health, University of Würzburg, Würzburg, Germany
| | - Dominik Gall
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center for Mental Health, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center for Mental Health, University of Würzburg, Würzburg, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Angelika Erhardt-Lehmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
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Sagehorn M, Johnsdorf M, Kisker J, Sylvester S, Gruber T, Schöne B. Real-life relevant face perception is not captured by the N170 but reflected in later potentials: A comparison of 2D and virtual reality stimuli. Front Psychol 2023; 14:1050892. [PMID: 37057177 PMCID: PMC10086431 DOI: 10.3389/fpsyg.2023.1050892] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
The perception of faces is one of the most specialized visual processes in the human brain and has been investigated by means of the early event-related potential component N170. However, face perception has mostly been studied in the conventional laboratory, i.e., monitor setups, offering rather distal presentation of faces as planar 2D-images. Increasing spatial proximity through Virtual Reality (VR) allows to present 3D, real-life-sized persons at personal distance to participants, thus creating a feeling of social involvement and adding a self-relevant value to the presented faces. The present study compared the perception of persons under conventional laboratory conditions (PC) with realistic conditions in VR. Paralleling standard designs, pictures of unknown persons and standard control images were presented in a PC- and a VR-modality. To investigate how the mechanisms of face perception differ under realistic conditions from those under conventional laboratory conditions, the typical face-specific N170 and subsequent components were analyzed in both modalities. Consistent with previous laboratory research, the N170 lost discriminatory power when translated to realistic conditions, as it only discriminated faces and controls under laboratory conditions. Most interestingly, analysis of the later component [230–420 ms] revealed more differentiated face-specific processing in VR, as indicated by distinctive, stimulus-specific topographies. Complemented by source analysis, the results on later latencies show that face-specific neural mechanisms are applied only under realistic conditions (A video abstract is available in the Supplementary material and via YouTube: https://youtu.be/TF8wiPUrpSY).
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Affiliation(s)
- Merle Sagehorn
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
- *Correspondence: Merle Sagehorn,
| | - Marike Johnsdorf
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Joanna Kisker
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Sophia Sylvester
- Semantic Information Systems Research Group, Institute of Computer Science, Osnabrück University, Osnabrück, Germany
| | - Thomas Gruber
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Benjamin Schöne
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
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Ritter Y, Bürger D, Pastel S, Sprich M, Lück T, Hacke M, Stucke C, Witte K. Gymnastic skills on a balance beam with simulated height. Hum Mov Sci 2023; 87:103023. [PMID: 36436404 DOI: 10.1016/j.humov.2022.103023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/02/2022] [Accepted: 10/27/2022] [Indexed: 11/26/2022]
Abstract
Virtual reality (VR) is a valuable tool for simulating dangerous situations and training under these conditions with a reduced possibility of injury. This could be beneficial within different sports scenarios. In gymnastics, the height of the balance beam can be dangerous and frightening, especially for beginners. Here, a simulated height can reduce the participant's risk of injury and facilitate entry to balance beam gymnastics. However, the investigation of sports performance in a virtual environment is rare. Therefore, the current study aims to compare beginners' performance in balance beam tasks between the real world (RW) and VR. 34 sports students executed gymnastic balancing forward, backward and the extension of one leg to the front, the side and the back on a regular balance beam in the RW and on a balance beam with simulated height in VR (using a head-mounted display). We analyzed beginners' performance in both conditions (RW and VR) regarding different criteria for each balance beam task. Statistical analyses show significant differences in performance with better results in RW (p < .05). Especially the body tension and the upper body posture were superior in RW. One explanation can be the more difficult regulation of the balance in VR. For the tasks where the motion took part in a fixed position on the beam, the further performance aspects were similar for RW and VR. When the participants moved along the beam, further performance aspects, like the leg extension, were better in RW. In total, the participants executed the VR balance beam tasks with decreased danger of injury due to the simulated height of the balance beam, but their performance was slightly limited. We conclude that for the first contact with the height of a balance beam, VR is a suitable tool to reduce the danger of injury occurring from falling off the beam and facilitate entry to balance beam gymnastics.
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Affiliation(s)
- Yvonne Ritter
- Department of Sport Engineering and Movement Science, Otto-von-Guericke-University Magdeburg, Institute III: Sport Science, Magdeburg, Germany
| | - Dan Bürger
- Department of Sport Engineering and Movement Science, Otto-von-Guericke-University Magdeburg, Institute III: Sport Science, Magdeburg, Germany.
| | - Stefan Pastel
- Department of Sport Engineering and Movement Science, Otto-von-Guericke-University Magdeburg, Institute III: Sport Science, Magdeburg, Germany
| | - Maria Sprich
- Department of Sport Engineering and Movement Science, Otto-von-Guericke-University Magdeburg, Institute III: Sport Science, Magdeburg, Germany
| | - Tammy Lück
- Department of Sport Engineering and Movement Science, Otto-von-Guericke-University Magdeburg, Institute III: Sport Science, Magdeburg, Germany
| | - Marvin Hacke
- Department of Sport Engineering and Movement Science, Otto-von-Guericke-University Magdeburg, Institute III: Sport Science, Magdeburg, Germany
| | - Christine Stucke
- Department of Sport Engineering and Movement Science, Otto-von-Guericke-University Magdeburg, Institute III: Sport Science, Magdeburg, Germany
| | - Kerstin Witte
- Department of Sport Engineering and Movement Science, Otto-von-Guericke-University Magdeburg, Institute III: Sport Science, Magdeburg, Germany
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Andreatta M, Winkler MH, Collins P, Gromer D, Gall D, Pauli P, Gamer M. VR for Studying the Neuroscience of Emotional Responses. Curr Top Behav Neurosci 2023; 65:161-187. [PMID: 36592276 DOI: 10.1007/7854_2022_405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Emotions are frequently considered as the driving force of behavior, and psychopathology is often characterized by aberrant emotional responding. Emotional states are reflected on a cognitive-verbal, physiological-humoral, and motor-behavioral level but to date, human research lacks an experimental protocol for a comprehensive and ecologically valid characterization of such emotional states. Virtual reality (VR) might help to overcome this situation by allowing researchers to study mental processes and behavior in highly controlled but reality-like laboratory settings. In this chapter, we first elucidate the role of presence and immersion as requirements for eliciting emotional states in a virtual environment and discuss different VR methods for emotion induction. We then consider the organization of emotional states on a valence continuum (i.e., from negative to positive) and on this basis discuss the use of VR to study threat processing and avoidance as well as reward processing and approach behavior. Although the potential of VR has not been fully realized in laboratory and clinical settings yet, this technological tool can open up new avenues to better understand the neurobiological mechanisms of emotional responding in healthy and pathological conditions.
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Affiliation(s)
- Marta Andreatta
- Department of Psychology, Educational Sciences, and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Markus H Winkler
- Department of Psychology, University of Wuerzburg, Wuerzburg, Germany
| | - Peter Collins
- Department of Psychology, University of Wuerzburg, Wuerzburg, Germany
| | - Daniel Gromer
- Department of Psychology, University of Wuerzburg, Wuerzburg, Germany
| | - Dominik Gall
- Department of Psychology, University of Wuerzburg, Wuerzburg, Germany
| | - Paul Pauli
- Department of Psychology, University of Wuerzburg, Wuerzburg, Germany
| | - Matthias Gamer
- Department of Psychology, University of Wuerzburg, Wuerzburg, Germany.
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Schöne B, Kisker J, Lange L, Gruber T, Sylvester S, Osinsky R. The reality of virtual reality. Front Psychol 2023; 14:1093014. [PMID: 36874824 PMCID: PMC9975753 DOI: 10.3389/fpsyg.2023.1093014] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/06/2023] [Indexed: 02/17/2023] Open
Abstract
Virtual reality (VR) has become a popular tool for investigating human behavior and brain functions. Nevertheless, it is unclear whether VR constitutes an actual form of reality or is more like an advanced simulation. Determining the nature of VR has been mostly achieved by self-reported presence measurements, defined as the feeling of being submerged in the experience. However, subjective measurements might be prone to bias and, most importantly, do not allow for a comparison with real-life experiences. Here, we show that real-life and VR height exposures using 3D-360° videos are mostly indistinguishable on a psychophysiological level (EEG and HRV), while both differ from a conventional 2D laboratory setting. Using a fire truck, three groups of participants experienced a real-life (N = 25), a virtual (N = 24), or a 2D laboratory (N = 25) height exposure. Behavioral and psychophysiological results suggest that identical exogenous and endogenous cognitive as well as emotional mechanisms are deployed to process the real-life and virtual experience. Specifically, alpha- and theta-band oscillations in line with heart rate variability, indexing vigilance, and anxiety were barely indistinguishable between those two conditions, while they differed significantly from the laboratory setup. Sensory processing, as reflected by beta-band oscillations, exhibits a different pattern for all conditions, indicating further room for improving VR on a haptic level. In conclusion, the study shows that contemporary photorealistic VR setups are technologically capable of mimicking reality, thus paving the way for the investigation of real-world cognitive and emotional processes under controlled laboratory conditions. For a video summary, see https://youtu.be/fPIrIajpfiA.
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Affiliation(s)
- Benjamin Schöne
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Joanna Kisker
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Leon Lange
- Differential Psychology and Personality Research, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Thomas Gruber
- Experimental Psychology I, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Sophia Sylvester
- Semantic Information Systems Research Group, Institute of Computer Science, Osnabrück University, Osnabrück, Germany
| | - Roman Osinsky
- Differential Psychology and Personality Research, Institute of Psychology, Osnabrück University, Osnabrück, Germany
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Šlosar L, Voelcker-Rehage C, Paravlić AH, Abazovic E, de Bruin ED, Marusic U. Combining physical and virtual worlds for motor-cognitive training interventions: Position paper with guidelines on technology classification in movement-related research. Front Psychol 2022; 13:1009052. [PMID: 36591050 PMCID: PMC9797127 DOI: 10.3389/fpsyg.2022.1009052] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
Efficient movements require intact motor and cognitive function. There is a growing literature on motor-cognitive interventions to improve the overall quality of life of healthy or diseased older people. For such interventions, novel technological advances are crucial not only in terms of motivation but also to improve the user experience in a multi-stimuli world, usually offered as a mixture of real and virtual environments. This article provides a classification system for movement-related research dealing with motor-cognitive interventions performed in different extents of a virtual environment. The classification is divided into three categories: (a) type of digital device with the associated degree of immersiveness provided; (b) presence or absence of a human-computer interaction; and (c) activity engagement during training, defined by activity >1.5 Metabolic Equivalent of task. Since virtual reality (VR) often categorizes different technologies under the same term, we propose a taxonomy of digital devices ranging from computer monitors and projectors to head-mounted VR technology. All immersive technologies that have developed rapidly in recent years are grouped under the umbrella term Extended Reality (XR). These include augmented reality (AR), mixed reality (MR), and VR, as well as all technologies that have yet to be developed. This technology has potential not only for gaming and entertainment, but also for research, motor-cognitive training programs, rehabilitation, telemedicine, etc. This position paper provides definitions, recommendations, and guidelines for future movement-related interventions based on digital devices, human-computer interactions, and physical engagement to use terms more consistently and contribute to a clearer understanding of their implications.
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Affiliation(s)
- Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia,Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
| | - Claudia Voelcker-Rehage
- Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | - Armin H. Paravlić
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia,Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia,Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Ensar Abazovic
- Faculty of Sport and Physical Education, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Eling D. de Bruin
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden,Department of Health, OST – Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland,Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia,Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia,*Correspondence: Uros Marusic,
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Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, Blumenthal N, Li M, Asché L, Jonas S, Bey K, Schulze M, Steffens M, Pensel MC, Guth M, Rohlfsen F, Ekhlas M, Lügering H, Fileccia H, Pakos J, Lux S, Philipsen A, Braun N. Virtual reality in the diagnostic and therapy for mental disorders: A systematic review. Clin Psychol Rev 2022; 98:102213. [PMID: 36356351 DOI: 10.1016/j.cpr.2022.102213] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 08/21/2022] [Accepted: 10/11/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Virtual reality (VR) technologies are playing an increasingly important role in the diagnostics and treatment of mental disorders. OBJECTIVE To systematically review the current evidence regarding the use of VR in the diagnostics and treatment of mental disorders. DATA SOURCE Systematic literature searches via PubMed (last literature update: 9th of May 2022) were conducted for the following areas of psychopathology: Specific phobias, panic disorder and agoraphobia, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder, eating disorders, dementia disorders, attention-deficit/hyperactivity disorder, depression, autism spectrum disorder, schizophrenia spectrum disorders, and addiction disorders. ELIGIBILITY CRITERIA To be eligible, studies had to be published in English, to be peer-reviewed, to report original research data, to be VR-related, and to deal with one of the above-mentioned areas of psychopathology. STUDY EVALUATION For each study included, various study characteristics (including interventions and conditions, comparators, major outcomes and study designs) were retrieved and a risk of bias score was calculated based on predefined study quality criteria. RESULTS Across all areas of psychopathology, k = 9315 studies were inspected, of which k = 721 studies met the eligibility criteria. From these studies, 43.97% were considered assessment-related, 55.48% therapy-related, and 0.55% were mixed. The highest research activity was found for VR exposure therapy in anxiety disorders, PTSD and addiction disorders, where the most convincing evidence was found, as well as for cognitive trainings in dementia and social skill trainings in autism spectrum disorder. CONCLUSION While VR exposure therapy will likely find its way successively into regular patient care, there are also many other promising approaches, but most are not yet mature enough for clinical application. REVIEW REGISTRATION PROSPERO register CRD42020188436. FUNDING The review was funded by budgets from the University of Bonn. No third party funding was involved.
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Affiliation(s)
- Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Benjamin Selaskowski
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ann-Kathrin Thöne
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lisa Pramme
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Nike Blumenthal
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mengtong Li
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Asché
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Stephan Jonas
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Marcel Schulze
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Maria Steffens
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Max Christian Pensel
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Matthias Guth
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Felicia Rohlfsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Mogda Ekhlas
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Lügering
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Helena Fileccia
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Julian Pakos
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
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11
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Rodríguez MF, Ramirez Butavand D, Cifuentes MV, Bekinschtein P, Ballarini F, García Bauza C. A virtual reality platform for memory evaluation: Assessing effects of spatial strategies. Behav Res Methods 2022; 54:2707-2719. [PMID: 34918216 DOI: 10.3758/s13428-021-01758-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 01/01/2023]
Abstract
Human spatial memories are usually evaluated using computer screens instead of real arenas or landscapes where subjects could move voluntarily and use allocentric cues to guide their behavior. A possible approach to fill this gap is the adoption of virtual reality, which provides the opportunity to create spatial memory tasks closer to real-life experience. Here we present and evaluate a new software to create experiments using this technology. Specifically, we have developed a spatial memory task that is carried out in a computer-assisted virtual environment where participants walk around a virtual arena using a joystick. This spatial memory task provides an immersive environment where the spatial component is constantly present without the use of virtual reality goggles. The design is similar to that of tasks used for animal studies, allowing a direct comparison across species. We found that only participants who reported using spatial cues to guide their behavior showed significant learning and performed significantly better during a memory test. This tool allows evaluation of human spatial memory in an ecological environment and will be useful to develop a wide range of other tasks to assess spatial cognition.
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Affiliation(s)
- María Florencia Rodríguez
- CONICET, PLADEMA, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.
| | - Daniela Ramirez Butavand
- Laboratorio de Neurociencia Traslacional, Instituto de Biología Celular y Neurociencias "Dr. Eduardo De Robertis" (IBCN), CONICET-Universidad de Buenos Aires, Buenos Aires, BA, Argentina
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT, CONICET-Fundación INECO-Universidad de Favaloro, Buenos Aires, BA, Argentina
| | - María Virginia Cifuentes
- CICPBA, PLADEMA, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina
| | - Pedro Bekinschtein
- Instituto de Neurociencia Cognitiva y Traslacional (INCyT, CONICET-Fundación INECO-Universidad de Favaloro, Buenos Aires, BA, Argentina
| | - Fabricio Ballarini
- Laboratorio de Neurociencia Traslacional, Instituto de Biología Celular y Neurociencias "Dr. Eduardo De Robertis" (IBCN), CONICET-Universidad de Buenos Aires, Buenos Aires, BA, Argentina
- Departamento de Ciencias de la Vida, ITBA, Buenos Aires, BA, Argentina
| | - Cristian García Bauza
- CONICET, PLADEMA, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina
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12
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Dammen LV, Finseth TT, McCurdy BH, Barnett NP, Conrady RA, Leach AG, Deick AF, Van Steenis AL, Gardner R, Smith BL, Kay A, Shirtcliff EA. Evoking stress reactivity in virtual reality: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 138:104709. [PMID: 35644278 DOI: 10.1016/j.neubiorev.2022.104709] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/08/2022] [Accepted: 05/21/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Virtual reality (VR) research probes stress environments that are infeasible to create in the real world. However, because research simulations are applied to narrow populations, it remains unclear if VR simulations can stimulate a broadly applicable stress-response. This systematic review and meta-analysis was conducted on studies using VR stress tasks and biomarkers. METHODS Included papers (N = 52) measured cortisol, heart rate (HR), galvanic skin response (GSR), systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory sinus arrhythmia (RSA), parasympathetic activity (RMSSD), sympathovagal balance (LF/HF), and/or salivary alpha-amylase (sAA). Effect sizes (ES) and confidence intervals (CI) were calculated based on standardized mean change of baseline-to-peak biomarker levels. RESULTS From baseline-to-peak (ES, CI), analyses showed a statistically significant change in cortisol (0.56, 0.28-0.83), HR (0.68, 0.53-0.82), GSR (0.59, 0.36-0.82), SBP (.55, 0.19-0.90), DBP (.64, 0.23-1.05), RSA (-0.59, -0.88 to -0.30), and sAA (0.27, 0.092-0.45). There was no effect for RMSSD and LF/HF. CONCLUSION VR stress tasks elicited a varied magnitude of physiological stress reactivity. VR may be an effective tool in stress research.
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Affiliation(s)
- Lotte van Dammen
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Tor T Finseth
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA.
| | - Bethany H McCurdy
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Neil P Barnett
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Roselynn A Conrady
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Alexis G Leach
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Andrew F Deick
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | | | - Reece Gardner
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Brandon L Smith
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
| | - Anita Kay
- Iowa State University, Virtual Reality Applications Center, Ames, IA, USA
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13
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Planert J, Machulska A, Hildebrand AS, Roesmann K, Otto E, Klucken T. Self-guided digital treatment with virtual reality for panic disorder and agoraphobia: a study protocol for a randomized controlled trial. Trials 2022; 23:426. [PMID: 35597959 PMCID: PMC9123669 DOI: 10.1186/s13063-022-06366-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cognitive behavioral therapy is the first-line treatment for patients with panic disorder (PD) and agoraphobia (AG). Yet, many patients remain untreated due to limited treatment resources. Digital self-guided short-term treatment applications may help to overcome this issue. While some therapeutic applications are already supported by health insurance companies, data on their efficacy is limited. The current study investigates the effect of self-guided digital treatment comprising psychoeducation and virtual reality exposure therapy (VRET). Methods Thirty patients diagnosed with PD, AG, or panic disorder with agoraphobia (PDA) will be randomly assigned to either the experimental group (EG) or the control group (CG). Participants of both groups will undergo baseline diagnostics in the first two sessions. The subsequent treatment for the EG consists of a self-guided 6-week phase of application-based psychoeducation, one therapy session preparing for the VRET, and 4 weeks of application-based self-guided VRET. To control for the potential effects of the therapy session with the therapist, the CG will receive relaxation and stress-reduction training instead. All patients will then undergo a closing session which terminates with the post-assessment (~ 10 weeks after baseline assessment) and a follow-up assessment 6 weeks following the closing session. Symptom severity (primary outcome) will be assessed at baseline, interim, post-treatment, and follow-up. Additionally, remission status (secondary outcome) will be obtained at follow-up. Both measures will be compared between the groups. Discussion The current study aims at providing insights into the efficacy of short-term treatment applications including psychoeducation and self-guided VRET. If successful, this approach might be a feasible and promising way to ease the burden of PD, AG, and PDA on the public health system and contribute to a faster access to treatment. Trial registration ISRCTN ISRCTN10661970. Prospectively registered on 17 January 2022. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06366-x.
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Affiliation(s)
- Jari Planert
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Obergraben 23, 57072, Siegen, Germany.
| | - Alla Machulska
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Obergraben 23, 57072, Siegen, Germany
| | - Anne-Sophie Hildebrand
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Obergraben 23, 57072, Siegen, Germany
| | - Kati Roesmann
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Obergraben 23, 57072, Siegen, Germany
| | - Esra Otto
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Obergraben 23, 57072, Siegen, Germany
| | - Tim Klucken
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Obergraben 23, 57072, Siegen, Germany
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14
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Quezada-Scholz VE, Laborda MA, San Martín C, Miguez G, Alfaro F, Mallea J, Díaz F. Cued fear conditioning in humans using immersive Virtual Reality. LEARNING AND MOTIVATION 2022. [DOI: 10.1016/j.lmot.2022.101803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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15
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de With LA, Thammasan N, Poel M. Detecting Fear of Heights Response to a Virtual Reality Environment Using Functional Near-Infrared Spectroscopy. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2021.652550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To enable virtual reality exposure therapy (VRET) that treats anxiety disorders by gradually exposing the patient to fear using virtual reality (VR), it is important to monitor the patient's fear levels during the exposure. Despite the evidence of a fear circuit in the brain as reflected by functional near-infrared spectroscopy (fNIRS), the measurement of fear response in highly immersive VR using fNIRS is limited, especially in combination with a head-mounted display (HMD). In particular, it is unclear to what extent fNIRS can differentiate users with and without anxiety disorders and detect fear response in a highly ecological setting using an HMD. In this study, we investigated fNIRS signals captured from participants with and without a fear of height response. To examine the extent to which fNIRS signals of both groups differ, we conducted an experiment during which participants with moderate fear of heights and participants without it were exposed to VR scenarios involving heights and no heights. The between-group statistical analysis shows that the fNIRS data of the control group and the experimental group are significantly different only in the channel located close to right frontotemporal lobe, where the grand average oxygenated hemoglobin Δ[HbO] contrast signal of the experimental group exceeds that of the control group. The within-group statistical analysis shows significant differences between the grand average Δ[HbO] contrast values during fear responses and those during no-fear responses, where the Δ[HbO] contrast values of the fear responses were significantly higher than those of the no-fear responses in the channels located towards the frontal part of the prefrontal cortex. Also, the channel located close to frontocentral lobe was found to show significant difference for the grand average deoxygenated hemoglobin contrast signals. Support vector machine-based classifier could detect fear responses at an accuracy up to 70% and 74% in subject-dependent and subject-independent classifications, respectively. The results demonstrate that cortical hemodynamic responses of a control group and an experimental group are different to a considerable extent, exhibiting the feasibility and ecological validity of the combination of VR-HMD and fNIRS to elicit and detect fear responses. This research thus paves a way toward the a brain-computer interface to effectively manipulate and control VRET.
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16
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Andreatta M, Pauli P. Contextual modulation of conditioned responses in humans: A review on virtual reality studies. Clin Psychol Rev 2021; 90:102095. [PMID: 34763127 DOI: 10.1016/j.cpr.2021.102095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
Conditioned response (CRs) triggered by stimuli predicting aversive consequences have been confirmed across various species including humans, and were found to be exaggerated in anxious individuals and anxiety disorder patients. Importantly, contextual information may strongly modulate such conditioned responses (CR), however, there are several methodological boundaries in the translation of animal findings to humans, and from healthy individuals to patients. Virtual Reality (VR) is a useful technological tool for overcoming such boundaries. In this review, we summarize and evaluate human VR conditioning studies exploring the role of the context as conditioned stimulus or occasion setter for CRs. We observe that VR allows successful acquisition of conditioned anxiety and conditioned fear in response to virtual contexts and virtual cues, respectively. VR studies also revealed that spatial or temporal contextual information determine whether conditioned anxiety and conditioned fear become extinguished and/or return. Novel contexts resembling the threatening context foster conditioned fear but not conditioned anxiety, suggesting distinct context-related generalization processes. We conclude VR contexts are able to strongly modulate CRs and therefore allow a comprehensive investigation of the modulatory role of the context over CR in humans leading to conclusions relevant for non-VR and clinical studies.
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Affiliation(s)
- Marta Andreatta
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany; Department of Psychology, Educational Sciences, and Child Studies, Erasmus University Rotterdam, the Netherlands.
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany; Center of Mental Health, University of Würzburg, Würzburg, Germany.
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17
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Rimer E, Husby LV, Solem S. Virtual Reality Exposure Therapy for Fear of Heights: Clinicians' Attitudes Become More Positive After Trying VRET. Front Psychol 2021; 12:671871. [PMID: 34335386 PMCID: PMC8319686 DOI: 10.3389/fpsyg.2021.671871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/23/2021] [Indexed: 12/24/2022] Open
Abstract
Background Virtual reality exposure therapy (VRET) has the potential to solve logistic challenges when treating specific phobias. However, VRET has yet to see a large-scale implementation in clinical settings despite positive findings in treatment trials. This may partly be due to attitudes and lack of experience among clinicians, but also because of expensive and stationary VR solutions. Objective This study tested whether modern, wireless, commercially available VR equipment with controller-free hand tracking could induce and reduce discomfort using scenarios designed for fear of heights. Also, the study tested if clinicians’ attitudes toward using VR in therapy changed after trying it themselves. Method Attitudes to using VR in therapy and discomfort ratings were assessed for 74 clinicians before and after completing two VR scenarios. In addition, 54 non-clinicians completed the same scenarios. Participants were not diagnosed with acrophobia. Results The VR scenarios induced discomfort comparable to participants’ reported fear of heights in real life. Repeated training reduced discomfort. Positive attitudes toward use of VR in therapy was predicted by previous experience with VR, as well as positive attitudes toward novel technology and exposure therapy. Clinicians’ attitudes became more favorable after trying VRET themselves. Clinicians reported a range of possible advantages and disadvantages of using VR in therapy. Conclusion VRET for fear of heights was able to induce and reduce discomfort in clinicians and non-clinicians, and clinicians’ attitudes toward using VRET become more positive after trying VRET for themselves. The latest generation of VR solutions has potential to improve clinical availability and treatment options. Future research should explore how VRET can be implemented in clinical settings.
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Affiliation(s)
- Elise Rimer
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Vågsholm Husby
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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18
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Gromer D, Kiser DP, Pauli P. Thigmotaxis in a virtual human open field test. Sci Rep 2021; 11:6670. [PMID: 33758204 PMCID: PMC7988123 DOI: 10.1038/s41598-021-85678-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/04/2021] [Indexed: 11/16/2022] Open
Abstract
Animal models are used to study neurobiological mechanisms in mental disorders. Although there has been significant progress in the understanding of neurobiological underpinnings of threat-related behaviors and anxiety, little progress was made with regard to new or improved treatments for mental disorders. A possible reason for this lack of success is the unknown predictive and cross-species translational validity of animal models used in preclinical studies. Re-translational approaches, therefore, seek to establish cross-species translational validity by identifying behavioral operations shared across species. To this end, we implemented a human open field test in virtual reality and measured behavioral indices derived from animal studies in three experiments (\documentclass[12pt]{minimal}
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\begin{document}$$\textit{N}=80$$\end{document}N=80). In addition, we investigated the associations between anxious traits and such behaviors. Results indicated a strong similarity in behavior across species, i.e., participants in our study—like rodents in animal studies—preferred to stay in the outer region of the open field, as indexed by multiple behavioral parameters. However, correlational analyses did not clearly indicate that these behaviors were a function of anxious traits of participants. We conclude that the realized virtual open field test is able to elicit thigmotaxis and thus demonstrates cross-species validity of this aspect of the test. Modulatory effects of anxiety on human open field behavior should be examined further by incorporating possible threats in the virtual scenario and/or by examining participants with higher anxiety levels or anxiety disorder patients.
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Affiliation(s)
- Daniel Gromer
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany.
| | - Dominik P Kiser
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany.,Center of Mental Health, Medical Faculty, University of Würzburg, Würzburg, Germany
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19
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Wang Q, Wang H, Hu F, Hua C, Wang D. Using convolutional neural networks to decode EEG-based functional brain network with different severity of acrophobia. J Neural Eng 2021; 18. [DOI: 10.1088/1741-2552/abcdbd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 11/25/2020] [Indexed: 12/11/2022]
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20
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Andreatta M, Neueder D, Herzog K, Genheimer H, Schiele MA, Deckert J, Domschke K, Reif A, Wieser MJ, Pauli P. Generalization of Conditioned Contextual Anxiety and the Modulatory Effects of Anxiety Sensitivity. Neurotherapeutics 2020; 17:1239-1252. [PMID: 31933066 PMCID: PMC7609477 DOI: 10.1007/s13311-020-00831-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Anxiety patients overgeneralize fear responses, possibly because they cannot distinguish between cues never been associated with a threat (i.e., safe) and threat-associated cues. However, as contexts and not cues are discussed as the relevant triggers for prolonged anxiety responses characterizing many anxiety disorders, we speculated that it is rather overgeneralization of contextual anxiety, which constitutes a risk factor for anxiety disorders. To this end, we investigated generalization of conditioned contextual anxiety and explored modulatory effects of anxiety sensitivity, a risk factor for anxiety disorders. Fifty-five participants underwent context conditioning in a virtual reality paradigm. On Day 1 (acquisition), participants received unpredictable mildly painful electric stimuli (unconditioned stimulus, US) in one virtual office (anxiety context, CTX+), but never in a second office (safety context, CTX-). Successful acquisition of conditioned anxiety was indicated by aversive ratings and defensive physiological responses (i.e., SCR) to CTX+ vs CTX-. On Day 2 (generalization), participants re-visited both the anxiety and the safety contexts plus three generalization contexts (G-CTX), which were gradually dissimilar to CTX+ (from 75 to 25%). Generalization of conditioned anxiety was evident for ratings, but less clear for physiological responses. The observed dissociation between generalization of verbal and physiological responses suggests that these responses depend on two distinct context representations, likely elemental and contextual representations. Importantly, anxiety sensitivity was positively correlated with the generalization of reported contextual anxiety. Thus, this study demonstrates generalization gradients for conditioned contextual anxiety and that anxiety sensitivity facilitates such generalization processes suggesting the importance of generalization of contextual anxiety for the development of anxiety disorders.
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Affiliation(s)
- Marta Andreatta
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany.
- Department of Psychology, Educational Sciences, and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 DR, Rotterdam, Netherlands.
| | - Dorothea Neueder
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Katharina Herzog
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Hannah Genheimer
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, Würzburg, Germany
- Center of Mental Health, University of Würzburg, Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Matthias J Wieser
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
- Department of Psychology, Educational Sciences, and Child Studies, Erasmus University Rotterdam, Burg. Oudlaan 50, 3062 DR, Rotterdam, Netherlands
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology and Psychotherapy), University of Würzburg, Würzburg, Germany
- Center of Mental Health, University of Würzburg, Würzburg, Germany
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21
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Krohn S, Tromp J, Quinque EM, Belger J, Klotzsche F, Rekers S, Chojecki P, de Mooij J, Akbal M, McCall C, Villringer A, Gaebler M, Finke C, Thöne-Otto A. Multidimensional Evaluation of Virtual Reality Paradigms in Clinical Neuropsychology: Application of the VR-Check Framework. J Med Internet Res 2020; 22:e16724. [PMID: 32338614 PMCID: PMC7215516 DOI: 10.2196/16724] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/07/2020] [Accepted: 02/07/2020] [Indexed: 01/16/2023] Open
Abstract
Virtual reality (VR) represents a key technology of the 21st century, attracting substantial interest from a wide range of scientific disciplines. With regard to clinical neuropsychology, a multitude of new VR applications are being developed to overcome the limitations of classical paradigms. Consequently, researchers increasingly face the challenge of systematically evaluating the characteristics and quality of VR applications to design the optimal paradigm for their specific research question and study population. However, the multifaceted character of contemporary VR is not adequately captured by the traditional quality criteria (ie, objectivity, reliability, validity), highlighting the need for an extended paradigm evaluation framework. To address this gap, we propose a multidimensional evaluation framework for VR applications in clinical neuropsychology, summarized as an easy-to-use checklist (VR-Check). This framework rests on 10 main evaluation dimensions encompassing cognitive domain specificity, ecological relevance, technical feasibility, user feasibility, user motivation, task adaptability, performance quantification, immersive capacities, training feasibility, and predictable pitfalls. We show how VR-Check enables systematic and comparative paradigm optimization by illustrating its application in an exemplary research project on the assessment of spatial cognition and executive functions with immersive VR. This application furthermore demonstrates how the framework allows researchers to identify across-domain trade-offs, makes deliberate design decisions explicit, and optimizes the allocation of study resources. Complementing recent approaches to standardize clinical VR studies, the VR-Check framework enables systematic and project-specific paradigm optimization for behavioral and cognitive research in neuropsychology.
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Affiliation(s)
- Stephan Krohn
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Johanne Tromp
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Eva M Quinque
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Julia Belger
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Felix Klotzsche
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sophia Rekers
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Paul Chojecki
- Fraunhofer Institute for Telecommunications, Heinrich Hertz Institute, Berlin, Germany
| | - Jeroen de Mooij
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Mert Akbal
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Hochschule der Bildenden Künste Saar, Saarbrücken, Germany
| | - Cade McCall
- Department of Psychology, University of York, York, United Kingdom
| | - Arno Villringer
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Michael Gaebler
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carsten Finke
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Angelika Thöne-Otto
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
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22
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Kritikos J, Zoitaki C, Tzannetos G, Mehmeti A, Douloudi M, Nikolaou G, Alevizopoulos G, Koutsouris D. Comparison between Full Body Motion Recognition Camera Interaction and Hand Controllers Interaction used in Virtual Reality Exposure Therapy for Acrophobia. SENSORS 2020; 20:s20051244. [PMID: 32106452 PMCID: PMC7085665 DOI: 10.3390/s20051244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/10/2020] [Accepted: 02/14/2020] [Indexed: 11/16/2022]
Abstract
Virtual Reality has already been proven as a useful supplementary treatment tool for anxiety disorders. However, no specific technological importance has been given so far on how to apply Virtual Reality with a way that properly stimulates the phobic stimulus and provide the necessary means for lifelike experience. Thanks to technological advancements, there is now a variety of hardware that can help enhance stronger emotions generated by Virtual Reality systems. This study aims to evaluate the feeling of presence during different hardware setups of Virtual Reality Exposure Therapy, and, particularly how the user's interaction with those setups can affects their sense of presence during the virtual simulation. An acrophobic virtual scenario is used as a case study by 20 phobic individuals and the Witmer-Singer presence questionnaire was used for presence evaluation by the users of the system. Statistical analysis on their answers revealed that the proposed full body Motion Recognition Cameras system generates a better feeling of presence compared to the Hand Controllers system. This is thanks to the Motion Recognition Cameras, which track and allow display of the user's entire body within the virtual environment. Thus, the users are enabled to interact and confront the anxiety-provoking stimulus as in real world. Further studies are recommended, in which the proposed system could be used in Virtual Reality Exposure Therapy trials with acrophobic patients and other anxiety disorders as well, since the proposed system can provide natural interaction in various simulated environments.
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Affiliation(s)
- Jacob Kritikos
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (C.Z.); (G.T.)
- Correspondence: (J.K.); (D.K.)
| | - Chara Zoitaki
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (C.Z.); (G.T.)
| | - Giannis Tzannetos
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (C.Z.); (G.T.)
| | - Anxhelino Mehmeti
- Department of Informatics and Telecommunications, National Kapodistrian University of Athens, 15784 Athens, Greece; (A.M.); (G.N.)
| | - Marilina Douloudi
- Department of Biology, National Kapodistrian University of Athens, 15784 Athens, Greece;
| | - George Nikolaou
- Department of Informatics and Telecommunications, National Kapodistrian University of Athens, 15784 Athens, Greece; (A.M.); (G.N.)
| | | | - Dimitris Koutsouris
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (C.Z.); (G.T.)
- Correspondence: (J.K.); (D.K.)
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23
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Fernández-Álvarez J, Di Lernia D, Riva G. Virtual Reality for Anxiety Disorders: Rethinking a Field in Expansion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:389-414. [PMID: 32002939 DOI: 10.1007/978-981-32-9705-0_21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The principal aim to this chapter is to present the latest ideas in virtual reality (VR), some of which have already been applied to the field of anxiety disorders, and others are still pending to be materialized. More than 20 years ago, VR emerged as an exposure tool in order to provide patients and therapists with more appealing ways of delivering a technique that was undoubtedly effective but also rejected and thus underused. Throughout these years, many improvements were achieved. The first section of the chapter describes those improvements, both considering the research progresses and the applications in the real world. In a second part, our main interest is to expand the discussion of the new applications of VR beyond its already known role as an exposure tool. In particular, VR is enabling the materialization of numerous ideas that were previously confined to a merely philosophical discussion in the field of cognitive sciences. That is, VR has the enormous potential of providing feasible ways to explore nonclassical ways of cognition, such as embodied and situated information processing. Despite the fact that many of these developments are not fully developed, and not specifically designed for anxiety disorders, we want to introduce these new ideas in a context in which VR is experiencing an enormous transformation.
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Affiliation(s)
| | | | - Giuseppe Riva
- Universita Cattolica del Sacro Cuore, Milan, Italy. .,ATN-P Lab, Istituto Auxologico Italiano, Milan, Italy.
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24
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Heat pain modulation with virtual water during a virtual hand illusion. Sci Rep 2019; 9:19137. [PMID: 31836829 PMCID: PMC6911006 DOI: 10.1038/s41598-019-55407-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/27/2019] [Indexed: 12/27/2022] Open
Abstract
Immersive virtual reality is a powerful method to modify the environment and thereby influence experience. The present study used a virtual hand illusion and context manipulation in immersive virtual reality to examine top-down modulation of pain. Participants received painful heat stimuli on their forearm and placed an embodied virtual hand (co-located with their real one) under a virtual water tap, which dispensed virtual water under different experimental conditions. We aimed to induce a temperature illusion by a red, blue or white light suggesting warm, cold or no virtual water. In addition, the sense of agency was manipulated by allowing participants to have high or low control over the virtual hand’s movements. Most participants experienced a thermal sensation in response to the virtual water and associated the blue and red light with cool/cold or warm/hot temperatures, respectively. Importantly, the blue light condition reduced and the red light condition increased pain intensity and unpleasantness, both compared to the control condition. The control manipulation influenced the sense of agency, but did not influence pain ratings. The large effects revealed in our study suggest that context effects within an embodied setting in an immersive virtual environment should be considered within VR based pain therapy.
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25
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Zhang W, Chen Z, Huang J, Wan X. The influence of placing orientation on searching for food in a virtual restaurant. Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2019.103728] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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26
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Kisker J, Gruber T, Schöne B. Behavioral realism and lifelike psychophysiological responses in virtual reality by the example of a height exposure. PSYCHOLOGICAL RESEARCH 2019; 85:68-81. [PMID: 31520144 DOI: 10.1007/s00426-019-01244-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/03/2019] [Indexed: 12/20/2022]
Abstract
Virtual reality (VR) is increasingly gaining importance as a valuable methodical tool for psychological research. The greatest benefit of using VR is generating rich, complex and vivid, but still highly controllable settings. As VR has been found to elicit lifelike psychophysiological and emotional responses, we examined by means of a height exposure whether VR resembles physical reality to the necessary degree to constitute a suitable framework for investigating real-life behavior in a controlled experimental context. As hypothesized, participants behaved in VR exactly as would be appropriate in a real environment: Being exposed to great height, participants walked significantly slower across a virtual steel girder construction protruding from a high-rise building as compared to participants who traversed the very same construction on the ground level. In the height condition, this realistic behavior could be predicted on basis of the participants' trait anxiety. Aligned with the behavioral responses, they showed realistic psychophysiological responses, i.e., an elevated heart rate when exposed to height. Interestingly, participants of the height condition reported a greater sense of presence, which indicates that emotions have an elevating effect on presence. As a conclusion, our findings provide further evidence that VR evokes lifelike responses at both behavioral and psychophysiological level and therefore increases ecological validity of psychological experiments.
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Affiliation(s)
- Joanna Kisker
- Institute of Psychology, Osnabrück University, Seminarstraße 20, 49074, Osnabrück, Germany.
| | - Thomas Gruber
- Institute of Psychology, Osnabrück University, Seminarstraße 20, 49074, Osnabrück, Germany
| | - Benjamin Schöne
- Institute of Psychology, Osnabrück University, Seminarstraße 20, 49074, Osnabrück, Germany
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27
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Gromer D, Reinke M, Christner I, Pauli P. Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure. Front Psychol 2019; 10:141. [PMID: 30761054 PMCID: PMC6363698 DOI: 10.3389/fpsyg.2019.00141] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/15/2019] [Indexed: 12/13/2022] Open
Abstract
Virtual reality plays an increasingly important role in research and therapy of pathological fear. However, the mechanisms how virtual environments elicit and modify fear responses are not yet fully understood. Presence, a psychological construct referring to the ‘sense of being there’ in a virtual environment, is widely assumed to crucially influence the strength of the elicited fear responses, however, causality is still under debate. The present study is the first that experimentally manipulated both variables to unravel the causal link between presence and fear responses. Height-fearful participants (N = 49) were immersed into a virtual height situation and a neutral control situation (fear manipulation) with either high versus low sensory realism (presence manipulation). Ratings of presence and verbal and physiological (skin conductance, heart rate) fear responses were recorded. Results revealed an effect of the fear manipulation on presence, i.e., higher presence ratings in the height situation compared to the neutral control situation, but no effect of the presence manipulation on fear responses. However, the presence ratings during the first exposure to the high quality neutral environment were predictive of later fear responses in the height situation. Our findings support the hypothesis that experiencing emotional responses in a virtual environment leads to a stronger feeling of being there, i.e., increase presence. In contrast, the effects of presence on fear seem to be more complex: on the one hand, increased presence due to the quality of the virtual environment did not influence fear; on the other hand, presence variability that likely stemmed from differences in user characteristics did predict later fear responses. These findings underscore the importance of user characteristics in the emergence of presence.
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Affiliation(s)
- Daniel Gromer
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Max Reinke
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Isabel Christner
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology, Biological Psychology, Clinical Psychology and Psychotherapy, University of Würzburg, Würzburg, Germany.,Center of Mental Health, Medical Faculty, University of Würzburg, Würzburg, Germany
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