How should a virtual agent present psychoeducation?

BACKGROUND AND OBJECTIVE: With the rise of autonomous e-mental health applications, virtual agents can play a major role in improving trustworthiness, therapy outcome and adherence. In these applications, it is important that patients adhere in the sense that they perform the tasks, but also that they adhere to the specific recommendations on how to do them well. One important construct in improving adherence is psychoeducation, information on the why and how of therapeutic interventions. In an e-mental health context, this can be delivered in two different ways: verbally by a (virtual) embodied conversational agent or just via text on the scree

Self-report questionnaires, behavioral assessment tasks, and an implicit behavior measure: do they predict social anxiety in everyday life?

Social anxiety is commonly assessed with self-report measures. This study aimed to investigate whether maximum anxiety levels during in vivo and virtual reality behavioral assessment tasks (BATs), and implicit approach-avoidance tendencies during the approach-avoidance task (AAT) explain more variation as predictors of daily social anxiety than self-report measures. A total of 62 university students (Mage = 20.79; SD = 4.91) with high levels of social anxiety completed self-report measures on fear of negative evaluation (FNE-B) as well as fear and avoidance in social situations (Liebowitz social anxiety scale-self report), in vivo and virtual reality BATs, and the AAT (independent variables) in the laboratory. On seven consecutive days, social anxiety, experiential avoidance, and negative social events (dependent variables) were assessed. The results revealed that fear of negative evaluation predicted everyday social anxiety and experiential avoidance. Fear and avoidance in social situations only predicted experiential avoidance. Neither implicit approach-avoidance tendencies during the AAT nor maximum anxiety levels during the in vivo and virtual reality BATs predicted any outcome variable. Our results support the use of self-report questionnaires in the assessment of social anxiety

Preferences for coaching strategies in a personalized virtual coach for emotional eaters: an explorative study

ObjectivesEmotional eating is recognized as a potential contributor to weight gain. Emotional eaters often hide their problems because of feelings of shame about their behavior, making it challenging to provide them with the necessary support. The introduction of a virtual coach might offer a potential solution in assisting them. To find out whether emotional eaters are receptive to online personalized coaching, we presented emotional eaters with two essential proto-typical problem situations for emotional eaters: “experiencing cravings” and “after giving in to cravings,” and asked them whether they preferred one of the three coaching strategies presented: Validating, Focus-on-Change and Dialectical.MethodsAn experimental vignette study (2 × 3 design) was carried out. The vignettes featured two distinct personas, each representing one of the two common problem scenarios experienced by emotional eaters, along with three distinct coaching strategies for each scenario. To identify potential predictors for recognition of problem situations, questionnaires on emotional eating (DEBQ), personality traits (Big-5), well-being (PANAS), and BMI were administrated.ResultsA total of 62% of the respondents identified themselves with “after giving in to cravings” and 47% with “experiencing cravings.” BMI, emotional eating and emotional stability appeared to be predictors in recognizing both the problem situations. In “experiencing cravings,” the participating women preferred Dialectical and the Validation coaching strategies. In the “after giving in to cravings” condition, they revealed a preference for the Dialectical and the Focus-on-Change coaching strategies.ConclusionUsing vignettes allowed a less threatening way of bringing up sensitive topics for emotional eaters. The personas representing the problem situations were reasonably well recognized. To further enhance this recognition, it is important for the design and content of the personas to be even more closely related to the typical problem scenarios of emotional eaters, rather than focusing on physical characteristics or social backgrounds. This way, users may be less distracted by these factors. With the knowledge gained about the predictors that may influence recognition of the problem situations, design for coaching can be more customized. The participants represented individuals with high emotional eating levels, enhancing external validity

Data underlying the publication: Home-Based Virtual Reality Exposure Therapy with Virtual Health Agent Support.

To increase the accessibility and efficiency of virtual reality exposure therapy (VRET) this paper proposes a system for home-based use where patients with social phobia are supported by a virtual health agent. We present an overview of our system design, and discuss key techniques such as (1) dialogue techniques to create automated free speech dialogue between virtual characters and patients in virtual reality worlds; (2) a multi-modal automatic anxiety feedback-loop mechanism to control patients’ anxiety level; and (3) motivational techniques applied by a virtual health agent. The system was evaluated in a pilot study where five patients with social phobia utilized our home-based VRET system. The results showed that the system was able to evoke the required anxiety in patients and that over time self-reported anxiety and heart rate gradually decreased as expected in exposure therapy