A VR-Based Serious Game for Studying Emotional Regulation in Adolescents

[EN] We all use more or less adapted strategies to confront adverse emotional situations in our lives without being psychologically affected. Emotional Regulation (ER) strategies that we use determine the way in which we feel, express and behave. Moreover, ER strategies are particularly important in adolescents, a population in the age when the deficits of ER strategies can be linked to the appearance of numerous mental health disorders such as depression or anxiety, or disruptive behaviors. Thus, the early detection of dysfunctional ER strategies and the training in adaptive ER strategies will help us to prevent the future occurrence of possible behavioral and psychosocial disorders. In this paper, we present the GAMETEEN SYSTEM (GT-System), a novel instrument based on Virtual Reality and serious games for the assessment and training of ER strategies in adolescent population. The results of our preliminary evaluation suggest that this system is effective in training and evaluating emotional regulation strategies in the adolescent population.Rodriguez Ortega, A.; Rey, B.; Vara, MD.; Wrzesien, M.; Alcañiz Raya, ML.; Baños, RM.; Pérez Lopez, DC. (2015). A VR-Based Serious Game for Studying Emotional Regulation in Adolescents. IEEE Computer Graphics and Applications. 35(1):65-73. doi:10.1109/MCG.2015.8S657335

GameTeen: new tools for evaluating and training emotional regulation strategies

The aim of this paper is to describe GameTeen, a novel instrument for the assessment and training of Emotional Regulation (ER) strategies in adolescent population. These new tools are based on the use of 3D serious games that can be played under different settings. The evolution of ER strategies will be monitored in two ways depending on the setting where the tool is presented. Firstly, in the laboratory, physiological signals and facial expressions of participants will be recorded. Secondly, in real life settings, ecological momentary assessment tools will be used to obtain answers from the subjects using their mobile phone. The goal is to obtain more attractive and reliable tools to evaluate and train ER strategies.This study was funded by Ministerio de Educación y Ciencia Spain, Project Game Teen (TIN2010-20187) and partially by projects Consolider-C (SEJ2006-14301/PSIC), “CIBER of Physiopathology of Obesity and Nutrition, an initiative of ISCIII” and Excellence Research Program PROMETEO (Generalitat Valenciana. Consellería de Educación, 2008-157). The work of A. Rodríguez was supported by the Spanish MEC under an FPI Grant BES-2011-043316.Rodríguez Ortega, A.; Rey, B.; Alcañiz Raya, ML.; Baños, R.; Guixeres Provinciale, J.; Wrzesien, M.; Gómez Martínez, M.... (2012). GameTeen: new tools for evaluating and training emotional regulation strategies. En Annual Review of Cybertherapy and Telemedicine 2012. IOS Press. 334-338. https://doi.org/10.3233/978-1-61499-121-2-334S33433

Digital technologies to support mental health among young people

The aim of this study was to describe how digital technologies can support young people in mental health services. An explorative mixed methods study was conducted in three phases. First, a systematic literature review was carried out between 2011 and 2013, followed by a meta-analysis of three studies to examine the effectiveness of a virtual reality intervention used in specialized psychiatric care. Second, the use of an electronic diary (e-diary) was explored among young people (n=89) who were clients of adolescent psychiatric outpatient clinics between 2008 and 2010 due to depressive symptoms. Third, the use of web-based community services aimed at young people (n=2,193) in 2018 was explored. In the second and third stages, quantitative data were analyzed with descriptive analysis and qualitative data with inductive thematic analysis. No quality evidence for or against virtual reality usage among people with serious mental health problems was found in the systematic review and meta- analysis. The young people’s long-term use of the e-diary was low, and nearly half of the participants did not use it at all. Those who did use the e-diary had previous experiences in mental health services and had more severe symptoms of depression than those who did not use it. Most of the young people who used digital technologies during treatment at the adolescent psychiatric outpatient clinics and in the community were females. According to the study results, digital technologies were most often used in the evenings and during the school year. Young people openly discussed their mental health and their personal issues such as relationships, identity, social life, health and illnesses, and self-perception. Digital technologies have the potential to help young people monitor their behavior, symptoms, and experiences and get support when they need it. When developing and implementing mental health support based on digital technologies, it is important to consider the different mental health and gender-specific needs of young people, as well as their readiness to use digital technologies to support their own mental health and well-being.Digitaaliset teknologiat nuorten mielenterveyden tukena Tämän tutkimuksen tavoitteena oli kuvata, miten digitaalisia teknologioita voidaan käyttää nuorten mielenterveyden tukena mielenterveyspalveluissa. Tutkimus toteutettiin kolmessa vaiheessa. Ensimmäisessä vaiheessa systemaattinen kirjallisuuskatsaus tehtiin vuosina 2011–2013, jonka jälkeen tehtiin meta-analyysi kolmesta tutkimuksesta, joissa tutkittiin virtuaalitodellisuusintervention tehokkuutta psykiatrian erityispalveluissa. Toisessa vaiheessa sähköisen päiväkirjan (e-päiväkirjan) käyttöä tutkittiin nuorisopsykiatrian poliklinikoilla masennusoireiden takia vuosina 2008–2010 asiakkaina olleiden nuorten (n=89) keskuudessa. Kolmannessa vaiheessa tutkittiin vuonna 2018 nuorille (n=2,193) suunnattujen verkkopohjaisten palvelujen käyttöä. Toisessa ja kolmannessa vaiheessa kvantitatiivisia tietoja analysoitiin kuvailevalla analyysillä ja kvalitatiivisia tietoja induktiivisella temaattisella analyysillä. Systemaattisen katsauksen ja meta-analyysin perusteella virtuaalitodellisuus-interventioiden hyödyistä tai haitoista vakavien mielenterveysongelmien hoidossa ei löytynyt laadukasta näyttöä. Nuorten pitkäaikainen e-päiväkirjan käyttö oli vähäistä ja lähes puolet osallistujista eivät käyttäneet sitä lainkaan. E-päiväkirjaa käyttäneillä oli aiempaa kokemusta mielenterveyspalveluista ja heillä oli vakavampia masennusoireita kuin heillä, jotka eivät sitä käyttäneet. Nuoret, jotka käyttivät digitaalisia teknologioita nuorisopsykiatrisen polikliinisen hoidon aikana tai verkkopohjaisissa palveluissa, olivat pääasiassa naispuolisia. Tämän tutkimuksen tulosten mukaan digitaalisia teknologioita käytettiin useimmiten iltaisin ja kouluvuoden aikana. Nuoret keskustelivat avoimesti mielenterveydestään ja henkilökohtaisista asioistaan, kuten ihmissuhteistaan, identiteetistään, sosiaalisesta elämästään, terveydestään ja sairauksistaan sekä miten he näkivät ja kokivat itsensä. Digitaaliset teknologiat luovat mahdollisuuksia auttaa nuoria seuraamaan käyttäytymistään, oireitaan tai kokemuksiaan sekä saamaan tukea, silloin kun he sitä tarvitsevat. Digitaaliseen teknologiaan perustuvaa tukea kehitettäessä ja toteutettaessa on tärkeää ottaa huomioon nuorten erilaiset mielenterveys- ja sukupuolikohtaiset tarpeet sekä heidän valmiutensa käyttää digitaalista teknologiaa oman mielenterveyden ja hyvinvoinnin tukemiseen

An Exploration of the Role of Virtual Reality in Early Childhood: A Qualitative Study Focusing on Parents’ and Carers’ Perspectives

This study aims to investigate the potential role of virtual reality (VR) in the early childhood development (ages four to six) of Saudi children based on a qualitative approach: subjective data were collected by interviewing 20 parents or carers of Saudi children who use VR. Each child’s parents or carers were selected for the interview as a couple. A semi-structured interview was held with each mother, father or carer. Traditional views in Saudi Arabia were compared with those of Saudis living in the UK, which has a different culture. Participants reported some positive effects of VR on their children: they perceived it as a source of distraction from pain and fear, in some cases at the physiological level. Participants considered VR to be beneficial for developing cognitive and academic skills, self-awareness, self-confidence and empathy. VR also improved self-regulation at the emotional and behavioural levels, including attention control, working memory, impulse inhibition, waiting for one’s turn and task completion. However, participants also reported adverse effects, indicating specific health risks, false memories and addiction at the physiological level; reservations existed concerning inappropriate content at the cognitive level. Other undesirable effects attributed to VR included social isolation, inability to control emotional expression at the emotional and social levels and encouragement of anger at the behavioural level. These results indicate that VR is a viable choice for young children, though adult supervision is still required. However, they also offer a warning about the effects that may result from VR overuse or misuse. The study also showed a lack of meaningful content and variety in commercial VR games, and thus it would benefit from the participation of educators and specialists in developing design strategies. This project represents a novel preliminary approach for future research concerning the influence of VR on the essential aspects of early childhood development

Aportaciones de las nuevas tecnologías combinadas con monitorización fisiológica en el campo de la regulación emocional

Tesis por compendio[EN] Emotional regulation strategies determine the way in which people feel, express and regulate their emotions. These regulation strategies affect all aspects of life. Currently, numerous scientific studies indicate the role that these regulation strategies play in the development and maintenance of adaptive and healthy behavior. On the other hand, deficiencies or deficits in emotional regulation are considered to be relevant factors in the origin and maintenance of numerous behavioral and emotional disorders. There are different instruments that have been traditionally used to train and evaluate emotional regulation capabilities. They are usually based on subjective questionnaires. Although these questionnaires have proven to be useful, they present some limitations that make them little suitable for certain groups who are especially reluctant to be assessed, such as adolescents. Currently, new systems based on man-machine interfaces, such as virtual reality and physiological sensors, are starting to be used for training emotional regulation strategies. The purpose of the research reported in this thesis is to address the issues related to the instruments used to train and evaluate the emotional regulation strategies. Specifically, the aim of this work is to study the combined use of virtual reality and serious games with non-invasive physiological monitoring in the emotional regulation field in adolescent population. For this reason, this document shows the results obtained from three studies, with three different virtual environments where participant were able to train different emotional regulation strategies while their cardiac signal or brain activation were recorded. The aim of this thesis is to make a contribution to the emotional regulation field providing a new research framework through the use of new technologies, such as virtual reality, and through more objective assessment instruments such as physiological signals.[ES] Las estrategias de regulación emocional determinan la forma en que las personas sienten, expresan y regulan sus emociones. Estas estrategias influyen prácticamente en todos los aspectos de la vida. En la actualidad existen numerosas investigaciones que destacan el papel que juegan estas estrategias de regulación emocional en el desarrollo y el mantenimiento de una conducta sana y adaptativa. Por el contrario, carencias o déficits en dichas estrategias de regulación pueden ser consideradas como un factor relevante en el origen y mantenimiento de numerosos trastornos emocionales y de comportamiento. Existen diversos instrumentos que se han utilizado tradicionalmente para evaluar las capacidades de regulación emocional y que están basados en cuestionarios subjetivos. Estos cuestionarios, aunque son muy útiles y prácticos, presentan algunas limitaciones que los hacen poco apropiados, sobre todo para ciertos colectivos que son especialmente reacios a ser evaluados, como podrían ser los adolescentes. Actualmente están empezando a usarse nuevos sistemas basados en tecnologías hombre-máquina, como pueden ser la realidad virtual y los sensores fisiológicos, para el entrenamiento de las estrategias de regulación emocional. La investigación presentada en esta tesis tiene como propósito abordar los aspectos relacionados con los instrumentos utilizados en el entrenamiento y en la evaluación de las estrategias de regulación emocional. Concretamente, el objetivo del presente trabajo es estudiar el uso combinado de la realidad virtual y los juegos serios con la monitorización fisiológica no invasiva en el campo de la regulación emocional en población adolescente. Para ello se presentan y se detallan los resultados obtenidos de tres estudios realizados, con tres entornos virtuales diferentes, donde los participantes pudieron entrenar diferentes estrategias de regulación emocional mientras se les registraban la señal cardíaca o la activación cerebral. Con la presente Tesis Doctoral se pretende hacer una contribución al campo de la regulación emocional, proporcionando un nuevo marco de investigación a través del uso de nuevas tecnologías como la realidad virtual y a través de instrumentos de evaluación más objetivos, como son las señales fisiológicas.[CA] Les estratègies de regulació emocional determinen la manera en què les persones senten, expressen i regulen les seves emocions. Aquestes estratègies influeixen pràcticament en tots els aspectes de la vida. En l'actualitat existeixen nombroses recerques que destaquen el paper que juguen aquestes estratègies de regulació emocional en el desenvolupament i el manteniment d'una conducta sana i adaptativa. Per contra, mancances o dèficits en aquestes estratègies de regulació poden ser considerats com un factor rellevant en l'origen i manteniment de nombrosos trastorns emocionals i de comportament. Existeixen diversos instruments que s'han utilitzat tradicionalment per avaluar les capacitats de regulació emocional i que estan basats en qüestionaris subjectius. Aquests qüestionaris, encara que són molt útils i pràctics, presenten algunes limitacions que els fan poc apropiats, sobretot per a certs col¿lectius que són especialment poc inclinats a ser avaluats, com podrien ser els adolescents. Actualment, estan començant a usar-se nous sistemes basats en tecnologies home-màquina, com pot ser la realitat virtual i els sensors fisiològics, per a l'entrenament de les estratègies de regulació emocional. La investigació presentada en aquesta tesi té com a propòsit abordar els aspectes relacionats amb els instruments utilitzats en l'entrenament i en l'avaluació de les estratègies de regulació emocional. Concretament, l'objectiu del present treball és estudiar l'ús combinat de la realitat virtual i els jocs seriosos amb el monitoratge fisiològic no invasiu en el camp de la regulació emocional en població adolescent. Per a això, es presenten i es detallen els resultats obtinguts de tres estudis realitzats, amb tres entorns virtuals diferents, on els participants van poder entrenar diferents estratègies de regulació emocional mentre se'ls registraven el senyal cardíac o l'activació cerebral. Amb la present Tesi Doctoral es pretén fer una contribució al camp de la regulació emocional, proporcionant un nou marc de investigació a través de l'ús de noves tecnologies com la realitat virtual i a través d'instruments d'avaluació més objectius, com són els senyals fisiològics.Rodríguez Ortega, A. (2015). Aportaciones de las nuevas tecnologías combinadas con monitorización fisiológica en el campo de la regulación emocional [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/51588TESISCompendi

Playing With Embodied Social Interaction : A Thematic Review of Experiments on Social Aspects in Gameful Virtual Reality

Revision Published: 11 May 2022Recently, there has been a burgeoning of immersive virtual reality (VR) applications in a variety of shapes, including gameful social VR. Despite a longstanding tradition of studying social factors in gameful computing, this perspective in the specific experiences of VR is only gaining traction. This highly multidisciplinary area of interest is immensely complex with potential consequences on individuals and social groups alike. To aid in constituting and systematizing this area of research from the early days, this paper explores 14 state-of-art publications on experimental research of social aspects in gameful VR. These were analysed predominantly based on the included manipulations and the studied outcomes resulting in the extraction of five and seven thematic wholes, respectively. Finally, based on the findings, four broad avenues to consider were emphasized as suggested paths for a comprehensive future of embodied gameful social VR application and research across a variety of disciplines.Peer reviewe

User-Centered Virtual Reality for Promoting Relaxation: An Innovative Approach

[EN] Virtual reality has been used effectively to promote relaxation and reduce stress. It is possible to find two main approaches to achieve such aims across the literature. The first one is focused on genetic environments filled with relaxing "narratives" to induce control over one's own body and physiological response, while the second one engages the user in virtual reality-mediated activities to empower his/her own abilities to regulate emotion. The scope of the present contribution is to extend the discourse on VR use to promote relaxation, by proposing a third approach. This would be based on VR with personalized content, based on user research to identify important life events. As a second step, distinctive features of such events may be rendered with symbols, activities or other virtual environments contents. According to literature, it is possible that such an approach would obtain more sophisticated and long-lasting relaxation in users. The present contribution explores this innovative theoretical proposal and its potential applications within future research and interventionsPizzoli, SFM.; Mazzocco, K.; Triberti, S.; Monzani, D.; Alcañiz Raya, ML.; Pravettoni, G. (2019). User-Centered Virtual Reality for Promoting Relaxation: An Innovative Approach. Frontiers in Psychology. 10:1-8. https://doi.org/10.3389/fpsyg.2019.00479S1810Alcañiz, M., Botella, C., Baños, R. M., Zaragoza, I., & Guixeres, J. (2009). The Intelligent e-Therapy system: a new paradigm for telepsychology and cybertherapy. British Journal of Guidance & Counselling, 37(3), 287-296. doi:10.1080/03069880902957015Alcañiz, M., Botella, C., Rey, B., Baños, R., Lozano, J. A., de la Vega, N. L., … Hospitaler, A. (2007). EMMA: An Adaptive Display for Virtual Therapy. Lecture Notes in Computer Science, 258-265. doi:10.1007/978-3-540-73216-7_29Anderson, A. P., Mayer, M. D., Fellows, A. M., Cowan, D. R., Hegel, M. T., & Buckey, J. C. (2017). Relaxation with Immersive Natural Scenes Presented Using Virtual Reality. Aerospace Medicine and Human Performance, 88(6), 520-526. doi:10.3357/amhp.4747.2017Annemans, L., Redekop, K., & Payne, K. (2013). Current Methodological Issues in the Economic Assessment of Personalized Medicine. Value in Health, 16(6), S20-S26. doi:10.1016/j.jval.2013.06.008Annerstedt, M., Jönsson, P., Wallergård, M., Johansson, G., Karlson, B., Grahn, P., … Währborg, P. (2013). Inducing physiological stress recovery with sounds of nature in a virtual reality forest — Results from a pilot study. Physiology & Behavior, 118, 240-250. doi:10.1016/j.physbeh.2013.05.023Baños, R. M., Botella, C., Alcañiz, M., Liaño, V., Guerrero, B., & Rey, B. (2004). Immersion and Emotion: Their Impact on the Sense of Presence. CyberPsychology & Behavior, 7(6), 734-741. doi:10.1089/cpb.2004.7.734Hoffman, H. G., Patterson, D. R., Soltani, M., Teeley, A., Miller, W., & Sharar, S. R. (2009). Virtual Reality Pain Control during Physical Therapy Range of Motion Exercises for a Patient with Multiple Blunt Force Trauma Injuries. CyberPsychology & Behavior, 12(1), 47-49. doi:10.1089/cpb.2008.0056Baños, R. M., Botella, C., Guillen, V., García-Palacios, A., Quero, S., Bretón-López, J., & Alcañiz, M. (2009). An adaptive display to treat stress-related disorders: EMMA’s World. British Journal of Guidance & Counselling, 37(3), 347-356. doi:10.1080/03069880902957064Baños, R. M., Botella, C., Rubió, I., Quero, S., García-Palacios, A., & Alcañiz, M. (2008). Presence and Emotions in Virtual Environments: The Influence of Stereoscopy. CyberPsychology & Behavior, 11(1), 1-8. doi:10.1089/cpb.2007.9936Baños, R. M., Guillen, V., Quero, S., García-Palacios, A., Alcaniz, M., & Botella, C. (2011). A virtual reality system for the treatment of stress-related disorders: A preliminary analysis of efficacy compared to a standard cognitive behavioral program. 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(2009). Happiness unpacked: Positive emotions increase life satisfaction by building resilience. Emotion, 9(3), 361-368. doi:10.1037/a0015952Fairbanks, R. J., & Wears, R. L. (2008). Hazards With Medical Devices: The Role of Design. Annals of Emergency Medicine, 52(5), 519-521. doi:10.1016/j.annemergmed.2008.07.008Felix, M. M. dos S., Ferreira, M. B. G., da Cruz, L. F., & Barbosa, M. H. (2019). Relaxation Therapy with Guided Imagery for Postoperative Pain Management: An Integrative Review. Pain Management Nursing, 20(1), 3-9. doi:10.1016/j.pmn.2017.10.014Felnhofer, A., Kothgassner, O. D., Schmidt, M., Heinzle, A.-K., Beutl, L., Hlavacs, H., & Kryspin-Exner, I. (2015). Is virtual reality emotionally arousing? Investigating five emotion inducing virtual park scenarios. International Journal of Human-Computer Studies, 82, 48-56. doi:10.1016/j.ijhcs.2015.05.004Ferrer-García, M., & Gutiérrez-Maldonado, J. (2012). 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J., … Patterson, D. R. (2011). Virtual Reality as an Adjunctive Non-pharmacologic Analgesic for Acute Burn Pain During Medical Procedures. Annals of Behavioral Medicine, 41(2), 183-191. doi:10.1007/s12160-010-9248-7Holland, A. C., & Kensinger, E. A. (2010). Emotion and autobiographical memory. Physics of Life Reviews, 7(1), 88-131. doi:10.1016/j.plrev.2010.01.006Ip, H. H. S., Wong, S. W. L., Chan, D. F. Y., Byrne, J., Li, C., Yuan, V. S. N., … Wong, J. Y. W. (2018). Enhance emotional and social adaptation skills for children with autism spectrum disorder: A virtual reality enabled approach. Computers & Education, 117, 1-15. doi:10.1016/j.compedu.2017.09.010Korpela, K. M., Ylén, M., Tyrväinen, L., & Silvennoinen, H. (2008). Determinants of restorative experiences in everyday favorite places. Health & Place, 14(4), 636-652. doi:10.1016/j.healthplace.2007.10.008Korpela, K. M., & Ylén, M. P. (2009). Effectiveness of Favorite-Place Prescriptions. 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Brave: A Virtual Reality Game

Virtual Reality has a wide range of applications whether it be in educational, medical or gaming. There is a huge demand for Virtual Reality in gaming industries as due to this immersive technology gamer feels he/she is part of gaming environment rather than a mere observer. VR game is a powerful tool to depict mental illness of the patient as mental illness is often underestimated and misunderstood. This will help to educate masses about it and in a way create awareness and eradicate its stigma. We trying to develop a game on the theme based on social anxiety

The use of Analog and Digital Games for Autism Interventions

Many interventions that target improvements in social communication and other cognitive, learning, and physical issues have been developed to help autistic people. The gamification of interventions offers an alternative approach to fostering and assessing desired behaviors and cognitions in a more naturalistic and emergent setting. In this scoping review aimed at educators, practitioners, and parents of those with autism, we detail studies that have tested game-based approaches to improving the lives of autistic children, adolescents, and adults, focusing on how research into gamification and autism can both progress and can be progressed and implemented. We offer parents, professionals and academics resources to incorporate game-based psycho-educational programs into their current practice