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.     

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.     

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.     

Training with computer-supported motor imagery in post-stroke rehabilitation.

Converging lines of evidence suggest that motor imagery (the mental simulation of a motor act within working memory) is associated with subliminal activation of the motor system. This observation has led to the hypothesis that cortical activation during motor imagery may affect the acquisition of specific motor skills and help the recovery of motor function. In this paper, we describe a clinical protocol in which we use interactive tools to stimulate motor imagery in hemiplegic stroke patients, thereby helping them to recover lost motor function. The protocol consists of an inpatient and an outpatient phase, combining physical and mental practice. In the inpatient phase, patients are trained in a laboratory setting, using a custom-made interactive workbench (VR Mirror). After discharge, patients use a portable device to guide mental and physical practice in a home setting. The proposed strategy is based on the hypotheses that: (a) combined physical and mental practice can make a cost-effective contribution to the rehabilitation of stroke patients, (b) effective mental practice is not possible without some form of support, from a therapist (as in our inpatient phase) or from technology (as in the outpatient phase), (c) the inclusion of an outpatient phase will allow the patient to practice more often than would otherwise be possible, therefore increasing the speed and/or effectiveness of learning, and (d) the use of interactive technology will reduce the patient's need for skilled support, therefore improving the cost-effectiveness of training.     

Virtual reality technology in neuropsychological testing: A systematic review

Neuropsychological testing aims to measure individuals' cognitive abilities (e.g. memory, attention), analysing their performance on specific behavioural tasks. Most neuropsychological tests are administered in the so-called ‘paper-and-pencil’ modality or via computerised protocols. The adequacy of these procedures has been recently questioned, with more specific concerns about their ecological validity, i.e. the relation between test scores observed in the laboratory setting and the actual everyday cognitive functioning. In developing more ecological tasks, researchers started to implement virtual reality (VR) technology as an administration technique focused on exposing individuals to simulated but realistic stimuli and environments, maintaining at the same time a controlled laboratory setting and collecting advanced measures of cognitive functioning. This systematic review aims to present how VR procedures for neuropsychological testing have been implemented in the last years. We initially explain the rationale for supporting VR as an advanced assessment tool, but we also discuss the challenges and risks that can limit the widespread implementation of this technology. Then, we systematised the large body of studies adopting VR for neuropsychological testing, describing the VR tools' distribution amongst different cognitive functions through a PRISMA-guided systematic review. The systematic review highlighted that only very few instruments are ready for clinical use, reporting psychometric proprieties (e.g. validity) and providing normative data. Most of the tools still need to be standardised on large cohorts of participants, having published only limited data on small samples up to now. Finally, we discussed the possible future directions of the VR neuropsychological test development linked to technological advances.     

The effect of a virtual reality environment on gaze behaviour and motor skill learning

ObjectiveVirtual reality (VR) systems hold significant potential for training skilled behaviours and are currently receiving intense interest in the sporting domain. They offer both practical and pedagogical benefits, but there are concerns about the effect that perceptual deficiencies in VR systems (e.g. reduced haptic information, and stereoscopic display distortions) may have on learning and performance. ‘Specificity of learning’ theories suggest that VR could be ineffective (or even detrimental) if important differences (e.g. perceptual deficiencies) exist between practice and real task performance conditions. Nevertheless, ‘structural learning’ theories suggest VR could be a useful training tool, despite these deficiencies, because a trainee can still learn the underlying structure of the behaviour. We explored these theoretical predictions using golf putting as an exemplar skill.MethodIn Experiment 1 we used a repeated measures design to assess putting accuracy (radial error) and quiet eye duration of expert golfers (n = 18) on real putts before and after 40 VR ‘warm up’ putts. In Experiment 2, novice golfers (n = 40) were assigned to either VR or real-world putting training. Putting accuracy and quiet eye durations were then assessed on a real-world retention test.ResultsBoth visual guidance (quiet eye) and putting accuracy were disrupted temporarily when moving from VR to real putting (Experiment 1). However, real-world and VR practice produced comparable improvements in putting accuracy in novice golfers (Experiment 2).ConclusionOverall, the results suggest that: (i) underlying skill structures can be learned in VR and transferred to the real-world; (ii) perceptual deficiencies will place limits on the use of VR. These findings demonstrate the challenges and opportunities for VR as a training tool, and emphasise the need to empirically test the costs and benefits of specific systems before deploying VR training.     

TIES that BIND: an introduction to domain mapping as a visualization tool for virtual rehabilitation.

The application of virtual reality (VR) to rehabilitation is a young, interdisciplinary field where clinical implementation very rapidly follows scientific discovery and technological advancement. Implementation is often so rapid that demonstration of intervention efficacy by investigators, and establishment of research and development priorities by funding bodies tend to be more reactive than proactive. An examination of the dynamic unfolding of the history of our young discipline may help us recognize the facilitators of current practice and identify the barriers that limit greater progress. This paper presents a first step towards the examination of the past and future growth of VR-based rehabilitation by presenting the use of concept maps to explore the publication history of application of VR to rehabilitation.     

Virtual environments for motor rehabilitation: review.

In this paper, the current "state of the art" for virtual reality (VR) applications in the field of motor rehabilitation is reviewed. The paper begins with a brief overview of available equipment options. Next, a discussion of the scientific rationale for use of VR in motor rehabilitation is provided. Finally, the major portion of the paper describes the various VR systems that have been developed for use with patients, and the results of clinical studies reported to date in the literature. Areas covered include stroke rehabilitation (upper and lower extremity training, spatial and perceptual-motor training), acquired brain injury, Parkinson's disease, orthopedic rehabilitation, balance training, wheelchair mobility and functional activities of daily living training, and the newly developing field of telerehabilitation. Four major findings emerge from these studies: (1) people with disabilities appear capable of motor learning within virtual environments; (2) movements learned by people with disabilities in VR transfer to real world equivalent motor tasks in most cases, and in some cases even generalize to other untrained tasks; (3) in the few studies (n = 5) that have compared motor learning in real versus virtual environments, some advantage for VR training has been found in all cases; and (4) no occurrences of cybersickness in impaired populations have been reported to date in experiments where VR has been used to train motor abilities.     

Creating state of the art,next-generation Virtual Reality exposure therapies for anxiety disorders using consumer hardware platforms: design considerations and future directions

Decades of research and more than 20 randomized controlled trials show that Virtual Reality exposure therapy (VRET) is effective in reducing fear and anxiety. Unfortunately, few providers or patients have had access to the costly and technical equipment previously required. Recent technological advances in the form of consumer Virtual Reality (VR) systems (e.g. Oculus Rift and Samsung Gear), however, now make widespread use of VRET in clinical settings and as self-help applications possible. In this literature review, we detail the current state of VR technology and discuss important therapeutic considerations in designing self-help and clinician-led VRETs, such as platform choice, exposure progression design, inhibitory learning strategies, stimuli tailoring, gamification, virtual social learning and more. We illustrate how these therapeutic components can be incorporated and utilized in VRET applications, taking full advantage of the unique capabilities of virtual environments, and showcase some of these features by describing the development of a consumer-ready, gamified self-help VRET application for low-cost commercially available VR hardware. We also raise and discuss challenges in the planning, development, evaluation, and dissemination of VRET applications, including the need for more high-quality research. We conclude by discussing how new technology (e.g. eye-tracking) can be incorporated into future VRETs and how widespread use of VRET self-help applications will enable collection of naturalistic “Big Data” that promises to inform learning theory and behavioral therapy in general.     

虚拟现实技术在心理学领域的应用与展望

虚拟现实(VR)技术因其能够提高实验研究的生态效度、条件控制水平、可重复性以及避免实地操作带来的危险,被众多研究者引入心理学领域。VR技术除了被用于改良实验程序外,也广泛应用于注意、记忆和执行能力等神经心理测验评估,在恐惧症、焦虑症、创伤后应激障碍和精神分裂症等精神障碍的临床治疗中亦取得丰硕成果。未来研究可致力于改进VR技术本身存在的问题、扩大样本量并扩展研究方法和范围,为VR应用提供更可靠的信效度证据。     

The impact of virtual reality functions of a hotel website on travel anxiety.

This study deals with the impact of virtual reality (VR) features that are embedded in a hotel website on travelers' anxiety. Having more information is thought to be a factor in relieving anxiety in travel. A hotel website can be a good place for gathering information about the accommodation. In this study, we posit that a hotel website with VR functions should lead to a reduction in travelers' anxiety about travel. We built a website of a hotel and used VR functions to show the exterior, the lobby, a guest room, and a restaurant through an interactive and spatial shot of the hotel images. The experiment was conducted with a premise that the subjects were about to embark on a journey to an unknown place and to stay at an unknown hotel whose website contained VR functions. The subjects were asked to play with VR functions of the hotel website and then to complete a survey with questions regarding the degree of anxiety on the travel and psychological relief that might have been perceived by the subjects. The result confirms our hypothesis that there is a statistically significant relationship between the degree of travel anxiety and psychological relief caused by the use of VR functions of a hotel website.     

Why and how to use virtual reality to study human social interaction: The challenges of exploring a new research landscape

As virtual reality (VR) technology and systems become more commercially available and accessible, more and more psychologists are starting to integrate VR as part of their methods. This approach offers major advantages in experimental control, reproducibility, and ecological validity, but also has limitations and hidden pitfalls which may distract the novice user. This study aimed to guide the psychologist into the novel world of VR, reviewing available instrumentation and mapping the landscape of possible systems. We use examples of state-of-the-art research to describe challenges which research is now solving, including embodiment, uncanny valley, simulation sickness, presence, ethics, and experimental design. Finally, we propose that the biggest challenge for the field would be to build a fully interactive virtual human who can pass a VR Turing test – and that this could only be achieved if psychologists, VR technologists, and AI researchers work together.     

Transformation of flow in rehabilitation: The role of advanced communication technologies

Authentic rehabilitation requires the active participation of patients and their involvement with opportunities for action and development. Within this framework, in this article we outline the possibility of using two emerging computing and communication technologies—ambient intelligence (AmI) and virtual reality (VR)—for a new breed of rehabilitative and clinical applications based on a strategy defined astransformation of flow. Transformation of flow is a person’s ability to exploit an optimal (flow) experience to identify and use new and unexpected psychological resources as sources of involvement. We identify the feeling ofpresence—the feeling of being in a world that exists outside oneself—as the theoretical link between the technology and rehabilitation. AmI and VR are used to trigger broad empowerment processes induced by a strong sense of presence, leading to greater agency and control over one’s actions and environment.     

The Ethics of Virtual Reality Technology: Social Hazards and Public Policy Recommendations

This article explores four major areas of moral concern regarding virtual reality (VR) technologies. First, VR poses potential mental health risks, including Depersonalization/Derealization Disorder. Second, VR technology raises serious concerns related to personal neglect of users’ own actual bodies and real physical environments. Third, VR technologies may be used to record personal data which could be deployed in ways that threaten personal privacy and present a danger related to manipulation of users’ beliefs, emotions, and behaviors. Finally, there are other moral and social risks associated with the way VR blurs the distinction between the real and illusory. These concerns regarding VR naturally raise questions about public policy. The article makes several recommendations for legal regulations of VR that together address each of the above concerns. It is argued that these regulations would not seriously threaten personal liberty but rather would protect and enhance the autonomy of VR consumers.     

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.     

Acceptance by athletes of a virtual reality head-mounted display intended to enhance sport performance

While a growing number of studies have highlighted the potential of virtual reality (VR) to improve athletes’ skills, no research has yet focused on acceptance of a VR head-mounted display (VR-HMD) designed to increase sport performance. However, even if technological devices could potentially lead to performance improvement, athletes may not always accept them. To investigate this issue, the Technology Acceptance Model (TAM) examines if perceived usefulness, perceived ease of use, perceived enjoyment, and subjective norms (i.e., social influence) are positive predictors of intention to use a specific technology. The aims of the present study were to test with competitive athletes the validity of the TAM before a first use of a VR-HMD intended to enhance sport performance and to examine to what extent the level of practice and the type of sport practiced have an influence on the previous variables of the TAM. The study sample comprised 1162 French athletes (472 women, 690 men, M_age = 24.50 ± 8.51 years) who usually practiced a sport in competition (from recreational to international level). After reading a short text presenting the VR-HMD and its interests for sport performance, the participants filled out an online questionnaire assessing their acceptance of this technological device before a first use. The results of the structural equation modeling analysis revealed that perceived usefulness, perceived ease of use, perceived enjoyment, and subjective norms were positive predictors of intention to use this VR-HMD, validating the suitability of the TAM for investigating the acceptance by athletes of a VR-HMD designed to increase their sport performance. The results also showed that athletes of all sport levels (a) had a significant intention to use VR, (b) found it quite useful (except for recreational athletes), quite easy to use, and quite pleasant to use, even if their entourage would not encourage them to use it (except for international athletes), and (c) found the VR-HMD easy and pleasant to use whatever the sport practiced. Notably some athletes (e.g., triathletes, swimmers, cyclists) did not find the VR-HMD significantly useful and did not have significant intention to use it to increase their performance. Identifying acceptance by athletes of such a device may increase the likelihood that it will be used by athletes of different levels and from different sports, so that they can benefit from all its advantages related to the improvement of their sport performance. Needs-based targeted interventions may also be conducted toward athletes who might be reluctant to integrate this type of device into their training.     

Virtual Reality Based Treatments in Eating Disorders and Obesity: A Review

Since the late 1990s the use of virtual reality (VR) has expanded in the field of mental disorders. During this time, several VR-based applications have been developed for the treatment of eating disorders (ED) and obesity. Both these pathologies involve disturbances related to eating behavior, weight, and body image. Although effective and well-established protocols are now available for the treatment of ED and obesity, relapses are frequent and a proportion of patients do not improve after intervention. In this context, VR has been shown to be a useful technology for enhancing traditional cognitive-oriented therapies. The main objective of this review was therefore to examine the evidence regarding the efficacy of VR-based treatments as a component of therapeutic interventions for ED and obesity. To this end, three databases (PsycInfo, Medline, and PsycArticles) were searched for the period 1986–2012. Only research articles and case studies were selected. Although several methodological deficiencies were detected in the reviewed studies, there is fair evidence for the effectiveness of VR-based treatments in ED and obesity. VR-based interventions usually combine exposure to VR environments with cognitive therapies. The VR component seems to be especially suitable for reducing body image disturbances, such as body image dissatisfaction, and for increasing self-esteem and self-efficacy. The rationale for the use of VR in these areas is also presented and discussed.     

Can Virtual Reality Increase the Realism of Role Plays Used to Teach College Women Sexual Coercion and Rape-Resistance Skills?

The present study evaluated whether virtual reality (VR) can enhance the realism of role plays designed to help college women resist sexual attacks. Sixty-two female undergraduate students were randomly assigned to either the Role Play (RP) or Virtual Role Play (VRP) conditions, which were differentiated only by the use of VR technology in the VRP condition. A multimethod assessment strategy was used to evaluate the effects of VR on the experienced realism of sexually threatening role plays. Realism was assessed by participant self-reports of negative affect and perceptions of realism, direct observation of participants' verbal displays of negative affect during the role plays, and measurements of participant heart rate during the role plays. Results indicated that VR can indeed heighten the realism of sexually threatening role plays. Discussion focuses on issues regarding the use of VR-enhanced role plays for helping college women resist sexual attacks.     

Understanding consumers' purchase intention in virtual reality commerce environment

Virtual reality (VR) has developed rapidly and drawn the attention of businesses. E-commerce practitioners have used VR to improve business performance and satisfy consumers' needs by enhancing the shopping experience and increasing purchase intention. To explore the effects of VR shopping platforms on purchase intention, this study developed a theoretical framework on the basis of task–technology fit. The framework comprises technological characteristics and user needs (intrinsic and extrinsic motivation) and can be used to investigate perceived needs–technology fit and identify factors affecting intention to purchase on VR platforms. This study distributed an online questionnaire and received 336 responses. Analysis was performed using partial least squares structural equation modeling. The results suggested that purchase intention is stronger when perceived needs–technology fit is closer. Hedonic needs play a vital role in perceived needs–technology fit. In terms of technological characteristics, relative advantage, and service compatibility strongly affect perceived needs–technology fit. In addition, feelings of spatial presence, a key component of VR, positively affect relative advantage, service compatibility, and trialability and negatively affect complexity. The implications of the findings are also discussed.     

Einsatz von „virtuellen Realitäten“ in der Psychotherapie

The internet, as well as various mobile media (e.g. cellular phones, handhelds, mobile paddles) have proven very useful in supporting psychotherapeutic measures in various projects. Virtual reality technologies (VR) take technical as well as intervention possibilities a step further. They enable the creation of computer-based models of the real world, with which interaction via the human-machine interface is enabled. The three-dimensional and interactively explorable environment is predominately used for exposure treatment in the behavior therapy setting. The features of VR applications are utilized as a medium between imagined and in vivo confrontation. This article illustrates various applications and compiles findings regarding effectiveness. It is concluded that the exposure treatments using this technology for various described phobias have proven effective. The use of VR for treatment of other psychological illnesses, however, for example trauma disorders, as was demonstrated in the study at hand, is viewed very critically. Finally, research necessities are indicated and psychodynamic facets of VR are discussed.