Training cognitive skills in virtual reality: measuring performance.

Across a variety of operational environments, virtual reality (VR) is being increasingly used as a means of simulating hazardous work conditions in order to allow trainees to practice advanced cognitive skills such as problem-solving and decision-making. Replicating dangerous conditions particularly involving heavy machinery in the real world can be dangerous and costly. The use of VR is therefore appealing across many industries such as aviation, mining, and rail. However, while the number of training prototypes increase less focus is being given to appropriate evaluation of the training provided via this technology. Increasing skills acquisition and performance does not depend solely on the appropriate design of simulation training. Of equal importance are strong performance measures which can ultimately feedback on the success or otherwise of training and highlight any deficits to guide ongoing improvements. To ensure cognitive skills acquired in a virtual training environment (VTE) are transferable to the real world, training objectives need to be tied directly to realistic scenario events which in turn are directly linked to measures of specific required behaviors.     

Let It Go: Positive Affect Attenuates Sunk Cost Bias by Enhancing Cognitive Flexibility

Sunk cost bias is a pervasive problem in consumer decision making. It occurs when people continue to invest resources toward unsuccessful outcomes merely because they previously invested in them. This tendency exists because people devote too much attention to prior investments without considering how other factors may impact their decision outcome. While many suggested interventions to attenuate sunk cost bias involve altering cognitive processes, we examine an alternate affective route. Specifically, we propose that inducing positive affect attenuates sunk cost bias by naturally facilitating flexible thought processes. Across four studies, using hypothetical and real decision tasks, we find that positive affect induced in three different ways consistently attenuates sunk cost bias involving money, time, and effort investments. Further, we demonstrate that this occurs because people experiencing positive affect have enhanced cognitive flexibility. They consider more relevant decision factors and perceive sunk cost as having less of an influence on their decision outcomes. Then, in a fifth study, we show that a thought intervention promoting flexibility can attenuate consumers’ suboptimal commitment tendency in a field setting.     

On Virtual Transparency

Virtual worlds are notable for their realism, both for the sense of psychological immersion they provide and the apparent potential for users to perform activities and interact with objects and people “within” such worlds. This article asks whether the concept of “photographic transparency,” introduced by Kendall Walton to account for the inherent realism of photography, can be extended to account for the realism of virtual media. Specifically, I investigate whether virtual media allow for a kind of prosthetic seeing that enables users to see the real world in potentially expanded ways. The complications for the thesis of “virtual transparency” arise from the analysis of the objects and egos involved in virtual seeing. These complications show that virtual reality as a medium is not transparent, even though token uses may be.     

Virtually the ultimate research lab

Virtual reality (VR) can serve as a viable platform for psychological research. The real world with many uncontrolled variables can be masked to immerse participants in complex interactive environments that are under full experimental control. However, as any other laboratory setting, these simulations are not perceived equally to reality and they also afford different behaviour. We need a better understanding of these differences, which are often related to parameters of the technical setup, to support valid interpretations of experimental results.     

VR-based conversation training program for patients with schizophrenia: a preliminary clinical trial.

Schizophrenia is a devastating mental illness and is characterized by hallucinations and delusions as well as social skills deficits. Generally, social skills training designed to help patients develop social skills includes role-playing, but this form of training has typical shortcomings, which are largely due to a trainer's difficulties to project emotion. Virtual reality (VR)-based techniques have the potential to solve these difficulties, because they provide a computer-generated but realistic three-dimensional world and humanlike avatars that can provide emotional stimuli. In this paper, we report on a method of implementing virtual environments (VEs) in order to train people with schizophrenia to develop conversational skills in specific situations, which could overcome the shortcomings of or complement conventional role-playing techniques. The paper reports the efficacy of the proposed approach in a preliminary clinical trial with 10 patients with schizophrenia.     

Virtual social environments as a tool for psychological assessment: dynamics of interaction with a virtual spouse

Computer games are advocated as a promising tool bridging the gap between the controllability of a lab experiment and the mundane realism of a field experiment. At the same time, many authors stress the importance of observing real behavior instead of asking participants about possible or intended behaviors. In this article, the authors introduce an online virtual social environment, which is inhabited by autonomous agents including the virtual spouse of the participant. Participants can freely explore the virtual world and interact with any other inhabitant, allowing the expression of spontaneous and unprompted behavior. The authors investigated the usefulness of this game for the assessment of interactions with a virtual spouse and their relations to intimacy and autonomy motivation as well as relationship satisfaction with the real-life partner. Both the intimacy motive and the satisfaction with the real-world relationship showed significant correlations with aggregated in-game behavior, which shows that some sort of transference between the real world and the virtual world took place. In addition, a process analysis of interaction quality revealed that relationship satisfaction and intimacy motive had different effects on the initial status and the time course of the interaction quality. Implications for psychological assessment using virtual social environments are discussed.     

Using presence to improve a virtual training environment.

In the rail industry, drivers must be trained to operate complex heavy machinery while responding appropriately to rapidly unfolding events in environments that are expensive and often dangerous to replicate in the real world. Virtual training environments (VTEs) can deliver stress exposure training to improve the decision-making skills of train drivers. Higher levels of recallable knowledge in the real world have been linked directly to the degree to which trainees have been engrossed in their VTE, an experience often measured through the concept of "presence." This paper reports on the use of presence to guide improvements to a VTE developed to deliver driver training in degraded track conditions. Two surveys were used to collect data on train drivers' introspective feedback on the level of presence created by the virtual rail environment and the simulator's effectiveness in generating immersion across a range of presence causal factors. Results indicate that using presence to investigate VTEs has practical significance. Outcomes provide direct information on where future improvements and modifications to the VTE can be made.     

Psychiatric rehabilitation of schizophrenia: Unresolved issues, current trends, and future directions

Psychiatric rehabilitation refers to a treatment philosophy and to a set of assessment and treatment techniques designed to reduce disability and maximize environmental adaptation. The field of psychiatric rehabilitation of schizophrenia is now well developed, and successful interventions exist for teaching many essential community-living skills and for promoting maintenance and generalization of these gains. Recent developments include the creation of new skills-training interventions and cognitive rehabilitation techniques and improvements in the delivery of vocational and substance abuse treatments. As a field, psychiatric rehabilitation is continuing to develop in a manner that is responsive to perceived treatment needs, shortcomings of existing interventions, and developments in related fields (e.g., social psychology, neuroscience of schizophrenia). Some of these developments in theory and research point to areas of conceptual/theoretical weaknesses in existing treatments and assessment measures and suggest directions for further development. This article reviews the current status of a number of areas within the psychiatric rehabilitation of schizophrenia, highlighting future needs.     

Memory rehabilitation for older adults: preserving independent living / Rehabilitación de la memoria para adultos mayores: preservación de la autonomía de vida

Abstract

Episodic memory problems are the hallmark of cognitive ageing in normal elderly people. Learning of new material is worse in pathological cognitive ageing, such as dementia and its preliminary states (mild cognitive impairment). Because episodic learning is crucial to preserve independent living in the elderly, rehabilitation programmes for everyday memory problems are welcomed. The scope of scientific interest has switched from treatment to prevention. We claim that lifestyle interventions are the most direct way to preserve cognition. We summarize evidence for changes in nutrition and exercise. In addition, psychological interventions for elderly people with normal or pathological cognitive ageing are available. Recent meta-analyses found lacking evidence of transfer to everyday life and long-term effects. We critically assess these meta-analyses. We propose theoretically derived experimental interventions relying on spared learning mechanisms. As an example we report visual-imagery training showing positive effects in a randomized control trial, using individual memory diaries on memory improvement.     

The Inter-Life project: researching the potential of art,design and virtual worlds as a vehicle for assisting young people with key life changes and transitions

ABSTRACT

Careers work in the twenty-first century faces a key challenge in terms of digital technologies: to evaluate their potential for careers work in challenging settings. Given the rapidity of developments, technologies require evaluation in research innovations and naturalistic settings. Virtual worlds offer potential for careers and guidance work, and the therapeutic domain. To illustrate this, we present examples in which young people explore their feelings and ideas, plans and difficulties, while preparing for film-making. During this they develop important life transition skills. We argue that the power of virtual worlds – to support emotional and cognitive engagement – could be utilised in practice settings. We conclude that they are serious candidates as digital tools in the careers and guidance domain.     

Frequency of stuttering during challenging and supportive virtual reality job interviews

This paper seeks to demonstrate the possibility of manipulating the frequency of stuttering using virtual reality environments (VREs). If stuttering manifests itself in VREs similarly to the way it manifests itself in real world interactions, then VREs can provide a controlled, safe, and confidential method for treatment practice and generalization. Though many researchers and clinicians recognize the need for generalization activities in the treatment of stuttering, achieving generalization in a clinical setting poses challenges to client confidentiality, safety, and the efficient use of a professionals’ time. Virtual reality (VR) technology may allow professionals the opportunity to enhance and assess treatment generalization while protecting the safety and confidentiality of their clients. In this study, we developed a VR job interview environment which allowed experimental control over communication style and gender of interviewers. In this first trial, persons who stutter (PWS) experienced both challenging and supportive VR job interview conditions. The percentage of stuttered syllables was calculated for both interviews for each participant. Self-reported ratings of communication apprehension and confidence were also obtained, and were not significantly correlated with stuttering severity. Results indicated that interviewer communication style affected the amount of stuttering produced by participants, with more stuttering observed during challenging virtual interviews. Additionally, the amount of stuttering observed during the VR job interviews was significantly, positively correlated with the amount of stuttering observed during an interview with the investigator prior to VR exposure. Participants’ subjective reports of the VR experience indicate reactions similar to those they report experiencing in the real world. Possible implications for the use of VR in the assessment and treatment of stuttering are discussed.

Educational objectives: After reading this article, the reader will be able to—(1) list some of the challenges to treatment generalization; (2) describe how virtual reality technology can assist in alleviating some of these challenges; (3) describe how the frequency of stuttering varies across two different virtual environments.     

Systematic evaluation of current control devices used by people with intellectual disabilities in non-immersive virtual environments.

Virtual environments have a role to play in facilitating the acquisition of living skills in people with intellectual disabilities, improving their cognitive skills and providing them with entertainment. However, the currently recommended devices to allow navigation in and interaction with the environments are difficult to use. Using a methodology established in an earlier study, the study aims to systematically document the performance of users with the currently recommended devices in order to (i) inform the design of a usable control device or devices and (ii) act as a baseline against which they can be evaluated. 40 people with severe intellectual disabilities aged 21-67 years used four environments with an equal number of sessions with the different devices being evaluated. Results indicate that when forward movement is provided by the software using the mouse for both navigation and interaction allows better performance both initially and after exposure than using the fire button on the joystick. When the user had to initiate forward movement with the navigation device, the joystick allowed better performance than the arrows on the keyboard. Preventing slippage of the joystick base would make its use much easier and it is suggested that separate devices are retained for navigation and interaction.     

Treatment of Depression and Suicide in Older Adults

This article describes a cognitive behavior therapy (CBT) intervention for suicide prevention in older adults. Although many studies have found that CBT interventions are efficacious for reducing depressive symptoms in the elderly, researchers have yet to evaluate the efficacy of such interventions for preventing suicide or reducing suicide risk in older adults. In this article we describe a 12-session CBT protocol for reducing depression, suicide ideation, and other risk factors of late-life suicide. The following aspects of the treatment are described: assessing suicide risk, conceptualizing the problem through a cognitive behavioral framework, developing a safety plan, increasing hope and reasons for living, improving social resources, improving problem-solving skills and efficacy, improving adherence to medical regimen, and relapse prevention. In addition, we review other behavioral and cognitive strategies such as activity scheduling and cognitive restructuring that are commonly associated with CBT interventions for depression. We illustrate the application of these strategies through the use of case examples.     

Executive function, intellectual decline and daily living skills

Understanding the cognitive changes associated with compromised daily living skills in elderly individuals is important for making appropriate recommendations about the capacity for independent functioning. To this end, we retrospectively examined data from 92 elderly individuals presenting with cognitive decline who were administered measures of executive functioning, general intelligence, and daily living skills. Multiple regression analyses were used to examine the relationship between executive functioning and daily living skills, while controlling for age, depression, and either IQ decline or current IQ. Executive functioning accounted for additional variance in a broad range of daily living skills after controlling for IQ decline. When FSIQ was used in the regression model rather than IQ decline, executive functioning was no longer uniquely associated with daily living skills. Executive functions appear to be important for daily living skills until a critical threshold of low intellectual functioning is reached, reflecting the combined influence of premorbid ability and the extent of intellectual decline. Our results suggest that understanding the relative contribution of different cognitive domains to functional decline in elderly individuals should take into account general intellectual functioning and estimated decline, and that the initiation and/or persistence of self-directed cognitive processes may be important for adaptive daily functioning. These findings have implications for making more evidence-based recommendations about the capacity for independent living.     

Executive Function,Intellectual Decline and Daily Living Skills

ABSTRACT

Understanding the cognitive changes associated with compromised daily living skills in elderly individuals is important for making appropriate recommendations about the capacity for independent functioning. To this end, we retrospectively examined data from 92 elderly individuals presenting with cognitive decline who were administered measures of executive functioning, general intelligence, and daily living skills. Multiple regression analyses were used to examine the relationship between executive functioning and daily living skills, while controlling for age, depression, and either IQ decline or current IQ. Executive functioning accounted for additional variance in a broad range of daily living skills after controlling for IQ decline. When FSIQ was used in the regression model rather than IQ decline, executive functioning was no longer uniquely associated with daily living skills. Executive functions appear to be important for daily living skills until a critical threshold of low intellectual functioning is reached, reflecting the combined influence of premorbid ability and the extent of intellectual decline. Our results suggest that understanding the relative contribution of different cognitive domains to functional decline in elderly individuals should take into account general intellectual functioning and estimated decline, and that the initiation and/or persistence of self-directed cognitive processes may be important for adaptive daily functioning. These findings have implications for making more evidence-based recommendations about the capacity for independent living.     

Associations between risk factors,developmental outcomes,and executive function in neonatal intensive care unit graduates at 2 years: A retrospective study

This study explores the extent to which medical and sociodemographic variables and cognitive and language skills are associated with executive function (EF) skills in neonatal intensive care unit (NICU) graduates at 24 months of adjusted age. We explored cognitive, language, and EF skills in 42 NICU graduates who participated in a NICU follow-up programme clinic. The association between risk factors and EF and the completion of the EF assessment were explored. Correlational analyses revealed that child gender was associated with EF scores. Analyses revealed cognitive skills, language skills, and multiple gestational births were associated with EF assessment completion. Our findings are among the first to examine EF skills in NICU graduates as young as 24 months of age using a multidimensional, child completed measure. Implications for NICU follow up programmes, the consideration of early interventions aimed to positively affect EF skills, and considerations for future studies are discussed.     

A Role for Cognitive Rehabilitation in Increasing the Effectiveness of Treatment for Alcohol Use Disorders

Neurocognitive impairments are prevalent in persons seeking treatment for alcohol use disorders (AUDs). These impairments and their physical, social, psychological and occupational consequences vary in severity across persons, much like those resulting from traumatic brain injury; however, due to their slower course of onset, alcohol-related cognitive impairments are often overlooked both within and outside of the treatment setting. Evidence suggests that cognitive impairments can impede treatment goals through their effects on treatment processes. Although some recovery of alcohol-related cognitive impairments often occurs after cessation of drinking (time-dependent recovery), the rate and extent of recovery is variable across cognitive domains and individuals. Following a long hiatus in scientific interest, a new generation of research aims to facilitate treatment process and improve AUD treatment outcomes by directly promoting cognitive recovery (experience-dependent recovery). This review updates knowledge about the nature and course of cognitive and brain impairments associated with AUD, including cognitive effects of adolescent AUD. We summarize current evidence for indirect and moderating relationships of cognitive impairment to treatment outcome, and discuss how advances in conceptual frameworks of brain-behavior relationships are fueling the development of novel AUD interventions that include techniques for cognitive remediation. Emerging evidence suggests that such interventions can be effective in promoting cognitive recovery in persons with AUD and other substance use disorders, and potentially increasing the efficacy of AUD treatments. Finally, translational approaches based on cognitive science, neurophysiology, and neuroscience research are considered as promising future directions for effective treatment development that includes cognitive rehabilitation.     

Exploring Predictors of Outcome in the Psychosis Prodrome: Implications for Early Identification and Intervention

Functional disability is a key component of many psychiatric illnesses, particularly schizophrenia. Impairments in social and role functioning are linked to cognitive deficits, a core feature of psychosis. Retrospective analyses demonstrate that substantial functional decline precedes the onset of psychosis. Recent investigations reveal that individuals at clinical-high-risk (CHR) for psychosis show impairments in social relationships, work/school functioning and daily living skills. CHR youth also demonstrate a pattern of impairment across a range of cognitive domains, including social cognition, which is qualitatively similar to that of individuals with schizophrenia. While many studies have sought to elucidate predictors of clinical deterioration, specifically the development of schizophrenia, in such CHR samples, few have investigated factors relevant to psychosocial outcome. This review integrates recent findings regarding cognitive and social-cognitive predictors of outcome in CHR individuals, and proposes potential directions for future research that will contribute to targeted interventions and improved outcome for at-risk youth.     

Characteristics of social perception assessed in schizophrenia using virtual reality.

Impairment in social skills is one of the few criteria that all individuals diagnosed with schizophrenia must meet. Successful social skills require the coordination of many abilities, including social perception, which involves the decoding and interpretation of social cues from others. In this study, we examined the potential for virtual reality (VR) in social skill training. We attempted to determine if VR can be used to measure social skills and social perception, and to determine which VR parameters are related to schizophrenic symptoms. Some of these results have clear clinical relevance, while other observations need further study. The VR system appears to be useful in assessing the social perception of schizophrenics and normal people, and could be more widely used in the future for social training and in the assessment of social problem-solving abilities, assertiveness skills, and general social skills.     

Psychometric properties of a Multidimensional Scale of Social Expression to assess social skills in the Internet context

The increase in the use of New Technologies in social relationships could be generating a new paradigm in social skills. Valid and reliable instruments to assess these changes are needed. The aim of this study is to analyze the psychometric properties of the Multidimensional Scale of Social Expression (EMES) in the assessment of social skills on the Internet and Social Networks. A total of 413 college students from the province of Alicante participated on this study. The scale was applied according to two contexts: Real and Internet/Virtual. High internal consistency was shown. The 12-factor structure found for the Virtual Context scale is similar to that of the original study. The scale had shown to be a good predictor of hours of Internet use. In conclusion, EMES-C is useful for assessing real context and Internet context social skills.