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.     

The effects of the presence of others during a rowing exercise in a virtual reality environment

ObjectivesThe aim of the study was to test the performance, motivational, and affective impact of aerobic exercise within an immersive virtual reality environment experienced alone or with another individual.DesignSixty female participants aged 18–30 years were assigned to one of three conditions: no virtual reality (NVR), individual virtual reality (IVR), or companion virtual reality (CVR).MethodParticipants completed 9 min of self-paced rowing on an ergometer without any visual input or performance feedback (NVR), individually within a virtual reality environment (IVR), or within a virtual reality environment that included a companion depicted as an avatar (CVR).ResultsThe two virtual reality groups rowed a further distance and at a higher power output than the NVR group. Furthermore, the CVR group outperformed the IVR group in distance and had a higher heart rate. Participants in the virtual reality groups did not perceive themselves to be exerting more physical effort and rated the task as more enjoyable than participants in the NVR group.ConclusionsVirtual reality improves performance and the affective response to aerobic exercise, and performance effects are further enhanced by the presence of others in the virtual environment.     

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.     

The use of virtual reality in the study, assessment, and treatment of body image in eating disorders and nonclinical samples: a review of the literature

This article reviews research into the use of virtual reality in the study, assessment, and treatment of body image disturbances in eating disorders and nonclinical samples. During the last decade, virtual reality has emerged as a technology that is especially suitable not only for the assessment of body image disturbances but also for its treatment. Indeed, several virtual environment-based software systems have been developed for this purpose. Furthermore, virtual reality seems to be a good alternative to guided imagery and in vivo exposure, and is therefore very useful for studies that require exposure to life-like situations but which are difficult to conduct in the real world. Nevertheless, review highlights the lack of published controlled studies and the presence of methodological drawbacks that should be considered in future studies. This article also discusses the implications of the results obtained and proposes directions for future research.     

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.     

Effectiveness of virtual reality distraction during a painful medical procedure in pediatric oncology patients

The effectiveness of virtual reality (VR) as a behavioral intervention designed to decrease distress during port access procedure was examined in 20 7- to 14-year-old pediatric oncology patients. Children were randomized to either engage in an immersive VR environment during the procedure or to a no VR control condition. Children's distress was assessed through subjective self-ratings and objective physiological and behavioral ratings. Narrative accounts of the experience were used as a measure of how well the child coped with the procedure. VR was effective in reducing children's distress on all measures. Implications of these findings for intervention are discussed.     

Cautious behaviors of pedestrians while crossing narrow streets: Exploration of behaviors using virtual reality experiments

This study explores the cautious behaviors of pedestrians in a typical local street environment using virtual reality (VR)-based experiments under various physical safety design scenarios for roadways. The built environment of this study focused on narrow local roads where frequent daily walking occurs within a neighborhood. VR experiments can provide an objective and accurate measurement of pedestrian behaviors, thus improving the understanding of complicated pedestrian behaviors. Based on experimental data from 200 university students, we identified pedestrians’ crossing behavior that is cautionary or risky concerning various physical safety designs of streets. This study found that there are trade-off relationships between various behaviors which should be systematically studied to produce safer street design guidelines. Furthermore, as the contexts and sequences matter in behaviors for intersection crossing, the interpretation of behaviors should carefully consider the context of built environments and sequential decisions made by pedestrians. This sequential understanding of before- and during-crossing behaviors and their connections expands our knowledge of pedestrians’ crossing behaviors.     

Virtually the same? Analysing pedestrian behaviour by means of virtual reality

Thanks to technological advancements, virtual reality has become increasingly flexible and affordable, resulting in a growing number of user studies conducted in virtual environments. Pedestrian simulators, visualizing traffic scenarios from a pedestrians’ perspective, have thereby emerged as a powerful tool in traffic safety research. However, while both the interest in this technology and the concern for vulnerable road users is high, a systematic overview of research employing pedestrian simulators has not been provided so far.The present literature survey is based on 87 studies published during the past decade, investigating pedestrian behaviour by means of virtual traffic scenarios. Results were categorized according to the research question, technical setup, experimental task, and participant sample. Identifying trends and gaps in knowledge and highlighting differences between methodological approaches, this work serves as an assessment of the current state and a baseline from which to develop future research questions. It aims to demonstrate both opportunities and challenges of this relatively new methodology. Thereby, it is hoped to foster the awareness of existing limitations, support the reasonable interpretation of the available data, and guide pedestrian research towards reliable and generalizable insights enhancing pedestrian mobility, comfort, and safety.     

Misplacing memories? An enactive approach to the virtual memory palace

In this paper, we evaluate the pragmatic turn towards embodied, enactive thinking in cognitive science, in the context of recent empirical research on the memory palace technique. The memory palace is a powerful method for remembering yet it faces two problems. First, cognitive scientists are currently unable to clarify its efficacy. Second, the technique faces significant practical challenges to its users. Virtual reality devices are sometimes presented as a way to solve these practical challenges, but currently fall short of delivering on that promise. We address both issues in this paper. First, we argue that an embodied, enactive approach to memory can better help us understand the effectiveness of the memory palace. Second, we present design recommendations for a virtual memory palace. Our theoretical proposal and design recommendations contribute to solving both problems and provide reasons for preferring an embodied, enactive account over an information-processing treatment of the memory palace.     

Testing reality during adolescence: the contribution of Erikson's concepts of fidelity and developmental actuality

The process of reality testing can be thought of as a lifespan developmental line, where adolescence provides a critical developmental advance but not an endpoint. Erikson's concepts of fidelity and developmental actuality provide a frame of reference for considering this. Three means of reality testing are identified--contemplation, action, and conversation--where these modes of approach can be used separately or in concert to clarify the reality status of situations and phenomena. These methods of testing reality are illustrated within four arenas of adolescent functioning-thought, time, parental representations, and the experience of the embodied self.     

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.     

A standardized set of 3-D objects for virtual reality research and applications

The use of immersive virtual reality as a research tool is rapidly increasing in numerous scientific disciplines. By combining ecological validity with strict experimental control, immersive virtual reality provides the potential to develop and test scientific theories in rich environments that closely resemble everyday settings. This article introduces the first standardized database of colored three-dimensional (3-D) objects that can be used in virtual reality and augmented reality research and applications. The 147 objects have been normed for name agreement, image agreement, familiarity, visual complexity, and corresponding lexical characteristics of the modal object names. The availability of standardized 3-D objects for virtual reality research is important, because reaching valid theoretical conclusions hinges critically on the use of well-controlled experimental stimuli. Sharing standardized 3-D objects across different virtual reality labs will allow for science to move forward more quickly.     

Réalité virtuelle et santé des personnes âgées institutionnalisées. Vers un EHPAD 2.0 ?

Virtual reality (VR) is used in general health care: prevention, physical medicine, chronic and acute pain, quality of life in palliative care, and in psychiatry: anxiety, depression, addiction, psychosis. Our objective is showing VR using among elderly people in French retirement home. Virtual reality is showing efficacy as distraction, anti-pain, tranquillising, antidepressant methods. It should be an answer to many elderly health problems. VR is easy to use, with low side effects. Non-drug treatments among elderly people are recommended. Used as complementary or alternative medicine, VR must be shaped for using with old and fragile people in retirement home.     

Manipulating body representations with virtual reality: Clinical implications for anorexia nervosa

Anorexia nervosa patients exhibit distorted body-representations. Specifically, they represent their bodies as larger than reality. Given that this distortion likely exacerbates the condition, there is an obligation to further understand and, if possible, rectify it. In pursuit of this, experimental paradigms are needed which manipulate the spatial content of these representations. In this essay, I discuss how virtual reality technology that implements full-body variants of the rubber-hand illusion may prove useful in this regard, and I discuss some issues related to the clinical application of this method.     

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.     

Using a virtual reality cricket simulator to explore the effects of pressure,competition anxiety on batting performance in cricket

Virtual reality (VR) has created opportunities to innovatively re-imagine the way we examine the relations between pressure, competition anxiety and performance. This study aimed to determine the efficacy of VR as a means of measuring the effects of competition anxiety when pressure manipulations are applied while participants bat in a cricket batting VR simulator. The twenty-eight male participants who took part in two experiments were divided into a high (14, mean age: 22.94, SD: 5.4) and a low skill group (14; mean age: 23.55, SD: 9.9). The aim of the first experiment was to validate the VR simulator as a tool that could capture differences in batting performance between a high and low skilled group. The results showed that high skill participants not only scored significantly higher run rates than low skill participants, but they outperformed the low skill group in all performance measures including higher incidences of correct foot placements that reflect better anticipatory responses. Having established the VR batting simulator as being a reliable tool for capturing batting dynamics, experiment 2 aimed to explore the effects of a pressure manipulation on competition anxiety and batting performance. All measures of competition anxiety were significantly greater for both groups in the high-pressure condition compared to the two low-pressure conditions (p < 0.001). The magnitude of this effect was greater in the low skill group for cognitive (0.59) and somatic (0.794) anxiety. Despite anxiety levels significantly increasing in the high-pressure condition, no significant negative changes to batting performance were found for either group, with both groups actually demonstrating performance improvements. Overall, the findings show how a cricket batting virtual reality simulator can be used as a tool to measure the effects of pressure on competition anxiety and batting performance in tasks involving dynamic skill execution.     

The therapeutic relationship as a paradoxical experience

The therapeutic relationship exists within multiple levels of reality—including that of ordinary life and that of the therapeutic frame. This interplay between these two levels of reality gives rise to paradoxical experiences for both participants. Certain “principles”; or “rules”; of technique can be understood as a means of enabling the therapist to cope with what is usually referred to as “boundary”; issues. It is essential that the analyst or therapist demonstrate capacity to shift playfully from one level of reality to another. The “rule”; of abstinence and the asymmetry of desire that exists between the two participants are discussed. Gratification within the therapeutic frame is paradoxical in that gratification at one level of reality leads to privation at another level of reality. These paradoxical experiences for both patient and analyst are examined in relation to projective identification and to the analyst's countertransference.     

Assessing human reorientation ability inside virtual reality environments: the effects of retention interval and landmark characteristics

The purpose of the present study was to assess the navigational behaviour of adult humans following a disorientation procedure that perturbed their egocentric frame of reference. The assessment was carried out in a virtual reality (VR) environment by manipulating the disorientation procedure, the retention interval, the relative positions of target and landmark. The results of experiment I demonstrated that adding a physical rotation to a virtual disorientation procedure did not yield an additional decrease in searching performance. The results of experiment II showed that shortening the delay between study and test phase decreased the errors more markedly for geometric than landmark ones. An orientation specificity effect due to the manipulation of the relative position between target and landmark was discussed across the experiments. In conclusion, VR seemed to be a valuable method for studying human reorientation. Moreover, the virtual experimental setting involved here promoted knowledge of the relationship between working memory and spatial reorientation paradigm.     

Putting yourself in the skin of a black avatar reduces implicit racial bias

Although it has been shown that immersive virtual reality (IVR) can be used to induce illusions of ownership over a virtual body (VB), information on whether this changes implicit interpersonal attitudes is meager. Here we demonstrate that embodiment of light-skinned participants in a dark-skinned VB significantly reduced implicit racial bias against dark-skinned people, in contrast to embodiment in light-skinned, purple-skinned or with no VB. 60 females participated in this between-groups experiment, with a VB substituting their own, with full-body visuomotor synchrony, reflected also in a virtual mirror. A racial Implicit Association Test (IAT) was administered at least three days prior to the experiment, and immediately after the IVR exposure. The change from pre- to post-experience IAT scores suggests that the dark-skinned embodied condition decreased implicit racial bias more than the other conditions. Thus, embodiment may change negative interpersonal attitudes and thus represent a powerful tool for exploring such fundamental psychological and societal phenomena.     

Definitional deficit: a model of senile dementia in context

This article presents some general theoretical concepts that can be used to consider processes of reality construction in interpersonal contexts. I developed a model of family context that taps affective dimensions of reality construction and used this model to explore these processes as highlighted by the labeling of symptoms of senile dementia. Ethnographic observations of 45 families with aged members were used to sketch a dichotomous typology of family-context patterns that promote symptom identification versus patterns that do not. The model suggests that the categorization of behavior as symptomatic or normal in context may be related to the extent to which reality construction processes are shared among members.