Virtual reality applications to agoraphobia: a protocol.

Recently, educators and instructional designers have focused on the development and implementation of virtual learning environments that effectively combine theoretical and applied knowledge to teach university students. One of the trusts of the Psychology Virtual Teaching Laboratory in collaboration with the IXTLI observatory is to develop dissemination programs to promote the insertion of virtual reality (VR) technologies applied to rehabilitation in their clinical practice. This paper describes the development of (1) agoraphobia VR learning objects to be use as a teaching support tools in class and (2) a multimedia teaching program that incorporate digital video and VR scenarios address to students in the field of mental health. Promotion among professors and students about the use of this technology will allow us to initiate research in our country as well as to validate contextualized applications for our culture, therefore contributing with new advances in this field.     

A virtual reality assessment and training system for unilateral neglect.

Patients with unilateral neglect have problems reporting, responding, or orienting to novel or meaningful stimuli that is presented to the side opposite to that of a brain lesion. This creates a serous problem in regards to daily living activities. However, the established methods for assessing and training of unilateral neglect patients have several deficits. Recently, virtual reality (VR) technologies have been used as an assessment and treatment tool for rehabilitation. Hence, this study designed a VR system to assess and train unilateral neglect patients. In addition, the suitability and feasibility of our VR system for unilateral neglect patients was verified.     

Virtual reality in psychotherapy: review.

Virtual reality (VR) has recently emerged as a potentially effective way to provide general and specialty health care services, and appears poised to enter mainstream psychotherapy delivery. Because VR could be part of the future of clinical psychology, it is critical to all psychotherapists that it be defined broadly. To ensure appropriate development of VR applications, clinicians must have a clear understanding of the opportunities and challenges it will provide in professional practice. This review outlines the current state of clinical research relevant to the development of virtual environments for use in psychotherapy. In particular, the paper focuses its analysis on both actual applications of VR in clinical psychology and how different clinical perspectives can use this approach to improve the process of therapeutic change.     

Immersive virtual reality as a rehabilitative technology for phantom limb experience: a protocol.

This paper describes a study protocol to investigate the use of immersive virtual reality as a treatment for amputees' phantom limb pain. This work builds upon prior research using mirror box therapy to induce vivid sensations of movement originating from the muscles and joints of amputees' phantom limbs. The present project transposes movements of amputees' anatomical limbs into movements of a virtual limb presented in the phenomenal space of their phantom limb. It is anticipated that the protocol described here will help reduce phantom limb pain.     

Simulation and virtual reality in medical education and therapy: a protocol.

Continuing medical education has historically been provided primarily by didactic lectures, though adult learners prefer experiential or self-directed learning. Young physicians have extensive experience with computer-based or "video" games, priming them for medical education--and treating their patients--via new technologies. We report our use of standardized patients (SPs) to educate physicians on the diagnosis and treatment of biological and chemical warfare agent exposure. We trained professional actors to serve as SPs representing exposure to biological agents such as anthrax and smallpox. We rotated workshop participants through teaching stations to interview, examine, diagnose and treat SPs. We also trained SPs to simulate a chemical mass casualty (MASCAL) incident. Workshop participants worked together to treat MASCAL victims, followed by discussion of key teaching points. More recently, we developed computer-based simulation (CBS) modules of patients exposed to biological agents. We compare the strengths and weaknesses of CBS vs. live SPs. Finally, we detail plans for a randomized controlled trial to assess the efficacy of virtual reality (VR) exposure therapy compared to pharmacotherapy for post-traumatic stress disorder (PTSD). PTSD is associated with significant disability and healthcare costs, which may be ameliorated by the identification of more effective therapy.     

Virtual reality in brain damage rehabilitation: review.

Given the high incidence of brain injury in the population, brain damage rehabilitation is still a relatively undeveloped field. Virtual reality (VR) has the potential to assist current rehabilitation techniques in addressing the impairments, disabilities, and handicaps associated with brain damage. The main focus of much of the exploratory research performed to date has been to investigate the use of VR in the assessment of cognitive abilities, but there is now a trend for more studies to encompass rehabilitation training strategies. This review describes studies that have used VR in the assessment and rehabilitation of specific disabilities resulting from brain injury, including executive dysfunction, memory impairments, spatial ability impairments, attention deficits, and unilateral visual neglect. In addition, it describes studies that have used VR to try to offset some of the handicaps that people experience after brain injury. Finally, a table is included which, although not an exhaustive list of everything that has been published, includes many more studies that are relevant to the use of VR in the assessment and rehabilitation of brain damage. The review concludes that the use of VR in brain damage rehabilitation is expanding dramatically and will become an integral part of cognitive assessment and rehabilitation in the future.     

Virtual reality and acrophobia: one-year follow-up and case study.

We present a study with 10 subjects being exposed to three sessions of simulated heights in a virtual reality (VR) system. Among the participants we highlight a 66-year-old man blind in his left eye. The participants show significant progress in anxiety, avoidance, and behavior measurements when confronted with real height circumstances. The results obtained 1 year later at follow-up are statistically significant in the Behavioral Avoidance Test (BAT) and the Attitudes Toward Heights Questionnaire (ATHQ), but not the Acrophobia Questionnaire (AQ).     

Virtual reality therapy versus cognitive behavior therapy for social phobia: a preliminary controlled study.

Social phobia is one of the most frequent mental disorders and is accessible to two forms of scientifically validated treatments: anti-depressant drugs and cognitive behavior therapies (CBT). In this last case, graded exposure to feared social situations is one of the fundamental therapeutic ingredients. Virtual reality technologies are an interesting alternative to the standard exposure in social phobia, especially since studies have shown its usefulness for the fear of public speaking. This paper reports a preliminary study in which a virtual reality therapy (VRT), based on exposure to virtual environments, was used to treat social phobia. The sample consisted of 36 participants diagnosed with social phobia assigned to either VRT or a group-CBT (control condition). The virtual environments used in the treatment recreate four situations dealing with social anxiety: performance, intimacy, scrutiny, and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors in order to reduce anxiety in the corresponding real situations. Both treatments lasted 12 weeks, and sessions were delivered according to a treatment manual. Results showed statistically and clinically significant improvement in both conditions. The effect-sizes comparing the efficacy of VRT to the control traditional group-CBT revealed that the differences between the two treatments are trivial.     

Virtual reality as a representative training environment for football referees

Visual experience plays an important role in facilitating referee decision-making. Video training can be used to train these perceptual-cognitive skills in discrete scenarios, for instance in foul situations in football, but is less suitable in other instances such as when seeking to make decisions in open-play scenarios due to a lack of representativeness. Recent technological advances enable the use of virtual reality (VR) to replicate game situations in a controlled and realistic manner. It is however not yet known how representative behaviour in VR would be of behaviour on-field in the natural environment. The aim of the study was therefore to examine the degree to which visual behaviour of football referees in virtual reality would reflect behaviour found when adjudicating matches on-field. Sub-elite football referees completed decision-making tasks in three experimental conditions: on-field (in a real match), in virtual reality and when observing video footage. Across the three environments we compared decision-making performance, visual behaviour (including search rate, fixation duration, and head movements) and the user experience of the referees. Results revealed that behaviour in the VR environment was indistinguishable from that on-field. In contrast, visual-motor behaviour when observing video footage was markedly different to that found on-field (and in VR). The results show that visual-motor behaviour in VR is representative of that found on-field and therefore suggests that VR offers promise as a representative training environment for sports officials to improve on-field performance in the natural environment.     

Virtual reality and the new psychophysics

Virtual reality (VR) promises methodological rigour with the extra benefit of allowing us to study the context-dependent behaviour of individuals in their natural environment. Pan and Hamilton (2018, Br. J. Psychol.) provide a useful overview of methodological recommendations for using VR. Here, we highlight some other aspects of the use of VR. Our first argument is that VR can be useful by virtue of its differences from the normal perceptual environment. That is, by virtue of its relative non-realism and poverty of its perceptual elements, it can actually offer increased clarity with respect to the features of interest for the researcher. Our second argument is that VR exerts its measurable influence more by eliciting an acceptance of the virtual world (i.e., ‘suspension of disbelief’) rather than by eliciting a true belief of the realism of the VR environment. We conclude by providing a novel suggestion for combining neuroimaging methods with embodied VR that relies on the suspension of disbelief.     

Virtual reality exposure therapy: 150-degree screen to desktop PC.

Virtual reality exposure therapy (VRET) developed using immersive or semi-immersive virtual environments present a usability problem for practitioners. To meet practitioner requirements for lower cost and portability VRET programs must often be ported onto desktop environments such as the personal computer (PC). However, success of VRET has been shown to be linked to presence, and the environment's ability to evoke the same reactions and emotions as a real experience. It is generally accepted that high-end virtual environments (VEs) are more immersive than desktop PCs, but level of immersion does not always predict level of presence. This paper reports on the impact on presence of porting a therapeutic VR application for schizophrenia from the initial research environment of a semi-immersive curved screen to PC. Presence in these two environments is measured both introspectively and across a number of causal factors thought to underlie the experience of presence. Results show that the VR exposure program successfully made users feel they were "present" in both platforms. While the desktop PC achieved higher scores on presence across causal factors participants reported they felt more present in the curved screen environment. While comparison of the two groups was statistically significant for the PQ but not for the IPQ, subjective reports of experiences in the environments should be considered in future research as the success of VRET relies heavily on the emotional response of patients to the therapeutic program.     

Virtual reality cue reactivity assessment in cigarette smokers.

Drug craving has purportedly been linked to relapse and to substance use. For over two decades, cue reactivity has been a viable method to assess craving and physiological reactions to drug stimuli. However, traditional cue reactivity has faced the following limitations: austere situations or stimuli, lack of complex cues, lack of standardization, and limited generalization outside of the lab setting. In order to improve cue methodologies, a virtual reality (VR) nicotine cue reactivity assessment system (VR-NCRAS) was developed and tested in a controlled experimental trial. Ten nicotine dependent smokers were exposed to VR smoking cues and VR neutral cues in a standardized, timed, computer controlled experiment. Subjective craving and physiological responses were recorded and compared across VR-NCRAS stimuli. Subjective cigarette craving increased significantly and corresponding physiological reactivity was observed in response to VR smoking cues. VR neutral cues did not result in subjective or physiological changes consistent with craving. Implications of these findings on substance abuse research and treatment are discussed.     

Virtual reality in the treatment of spider phobia: a controlled study

This study explored whether virtual reality (VR) exposure therapy was effective in the treatment of spider phobia. We compared a treatment condition vs. a waiting list condition in a between group design with 23 participants. Participants in the VR treatment group received an average of four one-hour exposure therapy sessions. VR exposure was effective in treating spider phobia compared to a control condition as measured with a Fear of Spiders questionnaire, a Behavioural Avoidance Test (BAT), and severity ratings made by the clinician and an independent assessor. Eighty-three percent of patients in the VR treatment group showed clinically significant improvement compared with 0% in the waiting list group, and no patients dropped out. This study shows that VR exposure can be effective in the treatment of phobias.     

Virtual environment training system for rehabilitation of stroke patients with unilateral neglect: crossing the virtual street.

In this paper, we propose a system for training of stroke patients with unilateral neglect by using technology of virtual reality (VR). The proposed system is designed to compensate for unilateral neglect. This system contains the calibration of unilateral neglect and the training of this disease. The calibration procedure is implemented by aligning the virtual object at a subjective middle line. The training procedure is implemented by completing the missions that are used to keep the virtual avatar safe during crossing the street in a virtual environment. The results of this study show that the proposed system is effective to train unilateral neglect. The left to right ratio scores extracted from this system gradually decrease as the sessions of training are repeated. To validate the VR system parameters, the parameters are analyzed by correlation with those of traditional unilateral neglect assessment methods (such as the line bisection test and the cancellation test).     

Virtual reality in the rehabilitation of people with intellectual disabilities: review.

Virtual reality (VR) possesses many qualities that give it rehabilitative potential for people with intellectual disabilities, both as an intervention and an assessment. It can provide a safe setting in which to practice skills that might carry too many risks in the real world. Unlike human tutors, computers are infinitely patient and consistent. Virtual worlds can be manipulated in ways the real world cannot be and can convey concepts without the use of language or other symbol systems. Published applications for this client group have all been as rehabilitative interventions. These are described in three groups: promoting skills for independent living, enhancing cognitive performance, and improving social skills. Five groups of studies are reviewed that utilize virtual technology to promote skills for independent living: grocery shopping, preparing food, orientation, road safety, and manufacturing skills. Fears that skills or habits learnt in a virtual setting would not transfer to the real world setting have not been supported by the available evidence, apart from those studies with people with autistic spectrum disorders. Future directions are in the development of more applications for independent living skills, exploring interventions for promoting motor and cognitive skills, and the developments of ecologically valid forms of assessment.     

Virtual reality: A new track in psychological research

One major challenge of social interaction research is to achieve high experimental control over social interactions to allow for rigorous scientific reasoning. Virtual reality (VR) promises this level of control. Pan and Hamilton guide us with a detailed review on existing and future possibilities and challenges of using VR for social interaction research. Here, we extend the discussion to methodological and practical implications when using VR.     

Virtual reality in episodic memory research: A review

Psychonomic Bulletin & Review - Although virtual reality (VR) is a promising tool for the investigation of episodic memory phenomena, to date there has been relatively little examination of how...     

Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia

The aim of the present study was to evaluate the effectiveness of low-budget virtual reality (VR) exposure versus exposure in vivo in a between-group design in 33 patients suffering from acrophobia. The virtual environments used in treatment were exactly copied from the real environments used in the exposure in vivo program. VR exposure was found to be as effective as exposure in vivo on anxiety and avoidance as measured with the Acrophobia Questionnaire (AQ), the Attitude Towards Heights Questionnaire (ATHQ) and the Behavioral Avoidance Test (BAT). Results were maintained up to six months follow-up. The present study shows that VR exposure can be effective with relatively cheap hardware and software on stand-alone computers currently on the market. Further studies into the effectiveness of VR exposure are recommended in other clinical groups as agoraphobics and social phobics and studies in which VR exposure is compared with more emerging virtual worlds as presented in CAVE-type systems.     

Virtual brand experience in digital reality advertising: Conceptualization and measurement

This study explores virtual brand experience (VBE), a new type of brand experience, and develops a corresponding measurement scale. The VBE scale includes five dimensions (social, intellectual, sensory, behavioral, and affective), and is validated by examining the sequential relationships among VBE, brand engagement, and consumer responses to digital reality ads. A path model shows that the social dimension is the most influential factor affecting consumer engagement with brands featured in digital reality ads. The findings indicate that VBE, given its multisensory interactive nature, can be considered equivalent to a direct experience despite it being a mediated one (i.e., indirect experience). This study contributes to the digital marketing literature and highlights the practical benefits of digital reality as a compelling branding tool in digital marketing.