Virtual Reality Exposure Therapy in the Treatment of Fear of Flying

A new and innovative approach to treating fear of flying has been developed using Virtual Reality Exposure Therapy. This article discusses the development of Virtual Reality Exposure Therapy and reviews a case study of a fear of flying patient seen in our practice. Early results are very promising and may indicate that Virtual Reality Exposure Therapy may also lead to creative interventions with other anxiety disorders.     

虚拟现实技术在心理治疗中的应用

虚拟现实系统具有良好的沉浸性、互动性和构想性而被广泛应用于军事、工业、建筑、教育等诸多领域。近年来,国外一些研究者将虚拟现实技术用于恐惧症、社交焦虑症、创伤后应激性障碍和厌食症等心理疾病的治疗,并取得了良好效果。本文简要介绍了国外在方面开展的主要工作,并对未来的研究趋势进行了展望。     

The Use of the Term Virtual Reality in Post-Stroke Rehabilitation: A Scoping Review and Commentary

Virtual reality (VR) offers many opportunities for post-stroke rehabilitation. However, “VR” can refer to several types of computer-based rehabilitation systems. Since these systems may impact the feasibility and the efficacy of VR interventions, consistent terminology is important. In this study, we aimed to optimize the terminology for VR-based post-stroke rehabilitation by assessing whether and how review papers on this topic defined VR and what types of mixed reality systems were discussed. In addition, this review can inspire the use of consistent terminology for other researchers working with VR. We assessed the use of the term VR in review papers on post-stroke rehabilitation extracted from Scopus, Web of Science and PubMed. We also developed a taxonomy distinguishing 16 mixed reality systems based on three factors: immersive versus semi-immersive displays, the way in which real and virtual information is mixed, and the main input device. 64% of the included review papers (N = 121) explicitly defined VR and 33% of them described different subtypes of VR, with immersive and non-immersive VR as the most common distinction. The most frequently discussed input devices were motion-capture cameras and handheld devices, while regular 2D monitors were the most frequently mentioned output devices. Our analysis revealed that reviews on post-stroke VR rehabilitation did not or only broadly defined “VR” and did not focus on a specific system. Since the efficacy and feasibility of rehabilitation may depend on the specific system, we propose a new data-driven taxonomy to distinguish different systems, which is expected to facilitate communication amongst researchers and clinicians working with virtual reality.     

虚拟学习环境下图形加工的认知负荷研究

基于单探测变化觉察和双任务范式,采用项目数量（3）×呈现时间（2）×文字线索（2）混合实验设计,对沉浸式虚拟学习环境图形加工特征和认知负荷进行探讨,以任务绩效法与主观测量法评定认知负荷。44名大学生的实验结果显示：（1）项目数量对虚拟空间图形识记主任务绩效和主观认知负荷有显著影响,项目数量越多,主任务正确率越低,反应时越长,主观评定认知负荷越高,同时加工刺激数量以4个为宜;（2）呈现时间对虚拟空间图形识记次任务绩效有显著影响,呈现时间越长,次任务正确率越高,呈现时间超过0.5s有利于次任务加工;（3）文字线索对虚拟图形识记认知负荷有显著影响,重复性文字线索会增加认知负荷。结果表明,在沉浸式虚拟环境中,图形加工的认知负荷特点与平面和三维图形基本一致,项目数量多、呈现时间短以及有重复性文字线索时,认知负荷更高;任务绩效和主观测量评定指标在反映认知负荷强度上不完全一致。     

虚拟路径整合的学习效应

路径整合指通过自身运动信息对自身位置进行更新的过程。本研究使用头盔式虚拟现实系统和分段式迷宫, 在两个实验中检验在同样布局的外出路径上重复地进行路径完成任务是否会改善被试的反应表现。实验1中的外出路径具有相对较简单的空间布局, 实验结果表明, 男性和女性被试均在反应时、位置误差、角度误差上表现出了学习效应, 即第二次在同样空间布局的外出路径上进行路径完成任务时的表现比第一次有了显著的改善。实验2中的外出路径具有更复杂多样化的空间布局, 而实验结果表明, 男性和女性被试均在反应时和比例位置误差上表现出了学习效应, 但是路径更复杂时要求更多次数的重复才可以提高路径整合成绩。这些研究结果为路径整合能力训练的可行性提供了初步的实证依据。     

The Effect of Interactivity on Learning Physical Actions in Virtual Reality

Virtual reality (VR) offers new possibilities for learning, specifically for training individuals to perform physical movements such as physical therapy and exercise. The current article examines two aspects of VR that uniquely contribute to media interactivity: the ability to capture and review physical behavior and the ability to see one's avatar rendered in real time from third person points of view. In two studies, we utilized a state-of-the-art, image-based tele-immersive system, capable of tracking and rendering many degrees of freedom of human motion in real time. In Experiment 1, participants learned better in VR than in a video learning condition according to self-report measures, and the cause of the advantage was seeing one's avatar stereoscopically in the third person. In Experiment 2, we added a virtual mirror in the learning environment to further leverage the ability to see oneself from novel angles in real time. Participants learned better in VR than in video according to objective performance measures. Implications for learning via interactive digital media are discussed.     

虚拟现实技术应用于神经心理评估的研究概述

传统神经心理评估的实验控制和生态效度的平衡问题日益受到研究人员的关注,而新兴的虚拟现实(Virtual Reality,VR)技术为问题的改善带来了希望,它不仅可以模拟现实环境并支持被试的直接交互,而且能对传统测试进行再现和扩展。它所形成的评估系统能对刺激的内容和表象、任务的复杂度和被试的响应进行灵活控制,所获取的信息更丰富、准确。在初步评估注意过程(注意、单侧空间忽略)、记忆(前瞻记忆、情景记忆、空间记忆、地形定向)和执行功能方面已获得了令人满意的效果。然而目前VR评估的应用仍存在技术和设备方面的不足,以及对评估者和被试不同操作要求的局限,因此今后除了要规范化现有VR评估系统,还应该进一步发展基础条件来推动系统的广泛应用。     

Virtual Reality Exposure for Veterans with Posttraumatic Stress Disorder

Abstract

Two open trials of Virtual Reality based exposure therapy (VRE) to desensitize Vietnam veterans with Posttraumatic Stress Disorder (PTSD) to some of their traumatic memories are described. A total of 21 patients were exposed to one of two virtual Vietnam computer-generated environments in which their individual traumatic experiences were simulated in response to their recounting these events. Although two patients experienced significant increases in symptoms during VRE, all patients' PTSD symptoms were below baseline by the 3-month post-treatment assessment. When the data from the two open trials was combined, clinically meaningful and statistically significant reductions in PTSD symptoms were found. These changes were long lasting as evidenced by the 6-month follow-up assessments. Two case examples are provided and future applications of this treatment are discussed.     

Virtual reality is more efficient in learning human heart anatomy especially for subjects with low baseline knowledge

New technologies make their way into education and one of the most prominent of them is the immersive Virtual Reality (IVR). But the scientific data about its efficiency in the educational process is controversial. In the present study three randomized groups of students, who did not have biological and medical classes amongst their courses, studied human heart anatomy using three different learning methods – a paper (text and images); a 3D interactive human heart model presented on a computer display; an IVR human heart model. Prior and after learning session students performed the test of human heart anatomy with 28 open questions. The IVR group showed the increase of correct answers within the group and compared with other groups. Also, the subjects with lesser baseline knowledge in IVR group showed the greater increase of correct answers following IVR session. The structure and the way how the learning material should be presented in IVR and how it affects the learning outcomes are discussed.     

The influence of action on episodic memory: A virtual reality study

A range of empirical findings suggest that active learning is important for memory. However, few studies have focused on the mechanisms underlying this enactment effect in episodic memory using complex environments. Research using virtual reality has yielded inconsistent results. We postulated that the effect of action depends on the degree of interaction with the environment and freedom in the planning of an itinerary. To test these hypotheses, we disentangled the interaction and planning components of action to investigate whether each enhances factual and spatial memory. Seventy-two participants (36 male and 36 female) explored a virtual town in one of three experimental conditions: (a) a passive condition where participants were immersed as passenger of the car (no interaction, no planning); (b) a planning-only condition (the subject chose the itinerary but did not drive the car); (c) an interaction-only condition (the subject drove the car but the itinerary was fixed). We found that itinerary choice and motor control both enhanced spatial memory, while factual memory was impaired by online motor control. The role of action in memory is 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.     

焦虑障碍的虚拟现实暴露疗法研究述评

虚拟现实暴露疗法(VRET)是传统的行为疗法的一种转换形式, 也是经典的现实情境暴露疗法的替代性治疗形式。虚拟现实整合了即时计算机图形学、身体感觉传感、视觉成像技术, 给来访者提供近似真实的、可以沉浸(immersion)和交互作用的虚拟环境。研究者采用虚拟现实暴露疗法治疗幽闭恐怖症、恐高症、飞行恐怖症、创伤后应激障碍、惊恐障碍等焦虑障碍, 并且关注虚拟现实暴露疗法的认知机制以及心理生理机制。实验研究表明, 虚拟现实暴露疗法在治疗焦虑障碍时是有效的。被试经过治疗之后, 对情境的控制感和自我效能感提升, 消极自我评价降低, 对创伤事件的容忍力提高, 重新获得对情境的控制感。与心率指标相比, 皮肤电是预测虚拟现实暴露疗法治疗效果更好的指标。虚拟现实暴露疗法还处于实验验证阶段, 并没有应用到实际临床中, 需要更加规范的实验设计验证该疗法的认知机制以及心理生理机制。虚拟现实暴露疗法结合功能磁共振成像(FMRI)用于心理治疗, 会是未来发展的新方向。     

儿童早期词汇获得的跨语言/文化研究

婴儿词汇学习是国际语言发展研究的前沿领域, 但大多数研究都是以英语婴儿为研究对象。目前国内关于汉语婴儿早期语言发展研究处于起步阶段。由于汉语在词法、句法等方面具有明显的特殊性, 另外, 成人“言语输入”的语用习惯以及非言语线索都会影响婴儿早期词汇学习, 使得不同语言文化下的婴儿呈现不同的单词学习模式。本项目力图从跨语言视角考察汉语和英语婴儿的早期单词学习(包括单词的理解和产生)以及促进婴儿语言发展的成人言语和非言语输入特征。研究将综合采用实验室实验、半结构化实验室观察和量表测量等研究方法, 利用新的研究技术(如习惯化和IPLP), 从多个角度探索婴儿词汇发展, 以及不同语言文化和个体环境对婴儿早期词汇学习的影响, 揭示词汇获得的跨语言一致性和特异性。研究结果有望对儿童的语言学习提供启示。     

Virtual prejudice

According to recent theorizing in social psychology, social behavior is controlled not only by reflective, but also by impulsive systems. The latter are based on associative links that may influence behavior without intent. The current study examined how prejudiced implicit associations affect physiological and automatic behavioral responses. Our native Dutch participants were immersed in a virtual environment in which they encountered virtual persons (avatars) with either White or Moroccan facial features. In line with our predictions, participants maintained more distance and showed an increase in skin conductance level when approaching Moroccan avatars as opposed to White avatars. Participants’ implicit negative associations with Moroccans moderated both effects. Moreover, evidence was found that the relation between implicit prejudice and distance effects was fully mediated by skin conductance level effects. These data demonstrate how prejudiced implicit associations may unintentionally lead to impulsive discriminatory responses.     

Altered attention for stimuli on the hands

Attention operates in the space near the hands with unique, action-related priorities. Here, we examined how attention treats objects on the hands themselves. We tested two hypotheses. First, attention may treat stimuli on the hands like stimuli near the hands, as though the surface of the hands were the proximal case of near-hand space. Alternatively, we proposed that the surface of the hands may be attentionally distinct from the surrounding space. Specifically, we predicted that attention should be slow to orient toward the hands in order to remain entrained to near-hand space, where the targets of actions are usually located. In four experiments, we observed delayed orienting of attention on the hands compared to orienting attention near or far from the hands. Similar delayed orienting was also found for tools connected to the body compared to tools disconnected from the body. These results support our second hypothesis: attention operates differently on the functional surfaces of the hand. We suggest this effect serves a functional role in the execution of manual actions.     

空间再定向任务中心理表征的多样性——来自虚拟现实实验的证据

成人和儿童完成空间再定向的具体过程与内在机制一直是研究者们关注的问题,在空间中是否形成了关于环境的整体表征是其中的一个关键。研究者们的观点并不一致,研究结果也提供了不同的证据。使用传统的空间再定向任务在此问题上难以得到明确的结论。本研究采用虚拟现实技术,让被试在虚拟现实环境中观察所在空间,然后直接向被试呈现空间的俯视视角并要求完成位置再认。通过对正确率和反应时的模式分析,发现被试反应可以划分为三种类型：整体的、独立于视角的心理表征（各方向均为高正确率低反应时）;整体的、依赖于方向的心理表征（正确率和反应时在不同方向上差异显著）和视角匹配的心理表征（各方向上均为低正确率）。三种不同的表征形式在人群中同时存在,并且在同一个体身上表现出不稳定性。     

Persistence and pleasure in VR: Enhancing Exercise Endurance and Enjoyment through Virtual Environments

Virtual Reality (VR) provides an enjoyable addition to stationary physical exercise and can improve performance while exercising. The aim of this study is to explore the effectiveness of three interactive virtual environments (i.e., social, relaxing, stressful) on enjoyment and persistence during strength-based exercises. In a within-subjects experiment, 97 healthy young adults completed four consecutive sets of two strength-based exercises. Participants completed one set as baseline and then each participant completed three more sets in three different interactive environments, experienced through a VR headset. Results showed that both the stressful virtual environment, where participants were hanging suspended over a city, and the social virtual environment where participants were audibly encouraged in a stadium, increased participants’ persistence in both exercises, when compared to the relaxing virtual environment. Specifically, the relaxing sunny beach environment caused poorer performances in a dead hang exercise among men (n = 30), and poorer performances in a core exercise among women (n = 66). Somewhat paradoxically, this relaxing virtual beach environment was considered the most enjoyable environment among both male and female participants. The potential of VR in exercise lies in its ability to provide pleasurable and performance-enhancing immersive environments that may be too expensive or dangerous in reality.     

Learning to use novel objects: a training study on the acquisition of novel action representations

Many studies have suggested that the motor system is organized in a hierarchical fashion, around the prototypical end location associated with using objects. However, most studies supporting the hierarchical view have used well-known actions and objects that are highly over-learned. Accordingly, at present it is unclear if the hierarchical principle applies to learning the use of novel objects as well. In the present study we found that when learning to use a novel object subjects acquired an action representation of the end location associated with using the object, as evidenced by slower responses in an action observation task, when the object was presented at an incorrect end location. By showing the importance of knowledge about end locations when learning to use a novel object, the present study suggests that end locations are a fundamental organizing feature of the human motor system.     

Understanding action language modulates oscillatory mu and beta rhythms in the same way as observing actions

The mu rhythms (8–13 Hz) and the beta rhythms (15 up to 30 Hz) of the EEG are observed in the central electrodes (C3, Cz and C4) in resting states, and become suppressed when participants perform a manual action or when they observe another’s action. This has led researchers to consider that these rhythms are electrophysiological markers of the motor neuron activity in humans. This study tested whether the comprehension of action language, unlike abstract language, modulates mu and low beta rhythms (15–20 Hz) in a similar way as the observation of real actions. The log-ratios were calculated for each oscillatory band between each condition and baseline resting periods. The results indicated that both action language and action videos caused mu and beta suppression (negative log-ratios), whereas abstract language did not, confirming the hypothesis that understanding action language activates motor networks in the brain. In other words, the resonance of motor areas associated with action language is compatible with the embodiment approach to linguistic meaning.