Attention and Social Cognition in Virtual Reality:The effect of engagement mode and character eye-gaze

Technical developments in virtual humans are manifest in modern character design. Specifically, eye gaze offers a significant aspect of such design. There is need to consider the contribution of participant control of engagement. In the current study, we manipulated participants’ engagement with an interactive virtual reality narrative called Coffee without Words. Participants sat over coffee opposite a character in a virtual café, where they waited for their bus to be repaired. We manipulated character eye-contact with the participant. For half the participants in each condition, the character made no eye-contact for the duration of the story. For the other half, the character responded to participant eye-gaze by making and holding eye contact in return. To explore how participant engagement interacted with this manipulation, half the participants in each condition were instructed to appraise their experience as an artefact (i.e., drawing attention to technical features), while the other half were introduced to the fictional character, the narrative, and the setting as though they were real. This study allowed us to explore the contributions of character features (interactivity through eye-gaze) and cognition (attention/engagement) to the participants’ perception of realism, feelings of presence, time duration, and the extent to which they engaged with the character and represented their mental states (Theory of Mind). Importantly it does so using a highly controlled yet ecologically valid virtual experience

Eye-Tracking and Virtual Reality-based Attentional Bias Modification Training to Improve Mirror Exposure Therapy: preliminary findings from a multiple case study with Anorexia Nervosa patients

Attentional bias modification training (ABMT) is an effective technique for reducing the dysfunctional body-related attentional bias (AB) that may be responsible for reducing the effectiveness of mirror exposure therapy (MET), which has been proposed as an effective treatment for anorexia nervosa ( AN). This multiple-case study provides evidence of the usefulness of incorporating ABMT into virtual reality ( VR) and eye-tracking (ET)-based MET to improve its efficacy in the treatment of four female adolescents with AN. Over five exposure sessions, patients were immersed in a virtual environment and were embodied in a real-size body virtual avatar reflected in a mirror that gradually increased body mass index (BMI) until reaching a healthy BMI in the last session. In every session, the participants completed the ABMT followed by the MET. This augmentation of MET using VRET-based ABMT achieved promising results for targeting AN symptomatology by reducing body dissatisfaction, drive for thinness, weight-related body parts anxiety, body checking behaviors, fear of gaining weight, and anxiety, and increasing body appreciation. Two patients who did not show a reduction in fear of gaining weight during the sessions also showed high anxiety levels, which could have affected its reduction. To advance this preliminary study and evaluate the effectiveness of incorporating ABMT into MET, a controlled clinical trial will be conducted

Critical Success Factors for Electronic Therapy—A Delphi Study

E-therapy employs a cross-section of online psychotherapies that use many of the same traditional face-to-face techniques as psychotherapy by exploiting electronic synchronous communication between a patient and trained therapists (counselors, psychoanalyst’s, or other licensed practitioners). A Delphi study of practicing therapists revealed five critical success factors (CSFs) (technological, managerial, empathic, service quality, and legal) that are important influences in the implementation of e-therapy services. Results suggest that managerial and legal factors hinder wider acceptance of e-therapy services. Secure and effective communication channels and protection of patient data emerge as important themes in the context of the five CSFs as concerns of potential e-therapists in wanting to provide effective care to patients

Virtual Reality Treatment for Public Speaking Anxiety in Students. Advancements and Results in Personalized Medicine

Public speaking anxiety (PSA) is a common phobia in the student population. Traditionally, exposure therapy has been used as a treatment. However, the use of virtual reality (VR) is increasingly common to treat PSA. The purpose of this paper was to analyze the published scientific literature on VR as a treatment for PSA in students. The articles indexed in two databases (Web of Science and Scopus) were analyzed, with a time period from the beginning of the first publications until 2019 included. The systematic literature review was based on fixed inclusion and exclusion criteria. A total of 13 studies were identified which included 481 students. The results collected indicate that the duration of treatments to have positive effects was at least one week, where the number of sessions was between one and twelve. Furthermore, most VR treatments reported positive effects. Finally, this study showed evidence that VR treatment for PSA is effective while being less invasive than in vivo exposure.Ministry of Education, Culture and Sport of the Government of Spain (Project reference: FPU16/01762)

Gender differences in attentional bias after owning a virtual avatar with increased weight

Introduction: Eating Disorder (ED) patients selectively attend to appearance cues in preference to other information, in a phenomenon known as Attentional Bias (AB). The latest VR Head Mounted Displays (HMD) offer the chance to include Eye-Tracking (ET) devices, and thus provide more objective measures of body-related attention. This study aims to combine VR and ET technologies and use a VR-based embodiment technique while measuring real-time attention patterns. Specifically, we assess gender differences in eye-gaze behaviors towards specific weight-related or non-weight-related body parts when participants own a virtual avatar with different body sizes. Method: Thirty-five college students (25 women and 10 men) were exposed to an immersive virtual environment in which they were embodied in three avatars with different body sizes: first, one with the same body size as the participant; second, one larger than the participant; and finally, repetition of the avatar with the same body size as the participant. To analyze the gaze data Weight-related Areas of Interest (WAOIs) and Non-Weight-related Areas of Interest (NW-AOIs) were defined. Fixation points and complete fixation time on each AOI were recorded at the three different assessment times. Raw data from the Pupil Labs eye tracking add-on for the HTC-Vive headset were subsequently transformed into percentages for further analysis. Results: Mixed between (Gender)-within (Time) analyses of variance showednon-statistically significant interaction between gender and time (p>.05) and a non-statistically significant difference in fixation points and complete fixation times (p>.05), over the three assessment times. However, a statistically significant gender difference was found in fixation points (F (1.33) =10,030, p= .003, η2 = 0.233) and complete fixation time (F (1.33) =13,017, p= .001, η2 = 0.28. Overall, women reported significantly higher levels of fixation points and complete fixation times in W-AOIs than men. Women showed an increasing gaze pattern towards W-AOIs at the three different assessment times, while men showed an opposite gaze pattern towards NW-AOIs at the three different times. Interestingly, the greatest differences between men and women were found at the third assessment, when they once again owned an avatar with the same body size as themselves. Conclusion: This study provides useful information about gender differences in gaze pattern behaviors while participants owned a virtual avatar with different body sizes. To our knowledge, this is the first study to compare gaze pattern behaviors between women and men using VR-based embodiment techniques and ET attentional bias assessment. The use of these two technologies opens a promising new area in the assessment or treatment of Eating Disorders and body image disturbances

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

Virtual Representations for Cybertherapy: A Relaxation Experience for Dementia Patients

The development of serious games has enabled new challenges for the healthcare sector in psychological, cognitive and motor rehabilitation. Thanks to Virtual Reality, stimulating and interactive experiences can be reproduced in a safe and controlled environment. This chapter illustrates the experimentation conducted in the hospital setting for the non-pharmacological treatment of cognitive disorders associated with Dementia. The therapy aims to relax patients of the agitation cluster through a gaming approach through the immersion in multisensory and natural settings in which sound and visual stimuli are provided. The study is supported by a technological architecture, including the Virtual Wall system for stereoscopic wall projection and rigid body tracking

Virtual reality-based software for the treatment of fibromyalgia: a case study

The aim of this study was to explore the efficacy and acceptance of virtual reality-based software for pain reduction (VirtualPain) in a 53-year-old female with fibromyalgia (FM), a chronic pain syndrome. Treatment consisted of four 60-minute sessions. Each session involved 40 minutes of cognitive behavioral therapy (CBT) and 20 minutes of exposure to VirtualPain software. VirtualPain consists of a recreation of the human body in which the pain or lack of pain experienced by the participant in each body part (e.g., hand or knee) is represented by color, movement and sound. During exposure, the patient modified these characteristics to increase her sensation of control over the pain. In our study, the software was displayed on a stereoscopic laptop with a 17' screen. Pain intensity was assessed on a visual analog scale (VAS, from 0 to 10). Before and after the treatment, the patient completed the Pain Anxiety Symptoms Scale Short Form (PASS-20), the Pain Catastrophizing Scale (PCS) and the Pain Self-Efficacy Scale (CPSS). During each session, the patient reported the amount of extra medication for pain consumed during the week. Follow-up was conducted at 6 and 12 months. The patient showed a substantial reduction in anxiety, catastrophic thoughts and pain perception, and improved selfefficacy after treatment. Most importantly, at 6-month follow-up (after six months without treatment) results were maintained, but at 12-month follow-up (after the patient had been allowed to use VirtualPain at home for 6 months) the clinical improvements increased. The addition of VirtualPain to a CBT intervention reduced pain intensity and psychological symptoms (anxiety, catastrophism and low selfefficacy) in a patient with FM. Controlled studies with large samples are now needed to assess the specific additional contribution of VirtualPain to CBT in the treatment of fibromyalgia