Longitudinal links between adolescent social anxiety and depressive symptoms: testing the mediational effects of cybervictimization

This study focuses on the temporal sequence between social anxiety and depressive symptoms, and whether cybervictimization might mediate these links. We used a longitudinal sample of 501 early adolescents (51.9% girls; Mage = 13.96) followed at three time points. Using a cross-lagged path model in MPlus, we found that social anxiety predicted depressive symptoms over time, but not the other way around. Time-1 depressive symptoms also predicted cybervictimization, but only for boys and not for girls. No mediating effects of cybervictimization emerged; however, Time-2 social anxiety was a significant mediator between Time-1 social anxiety and depressive symptoms, whereas Time-2 depressive symptoms significantly mediated the link between Time-1 social anxiety and Time-3 depressive symptoms. In sum, social anxiety was a strong predictor of depressive symptoms over time but not vice versa-irrespective of cybervictimization

Virtual reality exposure therapy for reducing social anxiety in stuttering: a randomized controlled pilot trial

We report on findings from the first randomized controlled pilot trial of virtual reality exposure therapy (VRET) developed specifically for reducing social anxiety associated with stuttering. People who stutter with heightened social anxiety were recruited from online adverts and randomly allocated to receive VRET (n = 13) or be put on a waitlist (n = 12). Treatment was delivered remotely using a smartphone-based VR headset. It consisted of three weekly sessions, each comprising both performative and interactive exposure exercises, and was guided by a virtual therapist. Multilevel model analyses failed to demonstrate the effectiveness of VRET at reducing social anxiety between pre- and post-treatment. We found similar results for fear of negative evaluation, negative thoughts associated with stuttering, and stuttering characteristics. However, VRET was associated with reduced social anxiety between post-treatment and one-month follow-up. These pilot findings suggest that our current VRET protocol may not be effective at reducing social anxiety amongst people who stutter, though might be capable of supporting longer-term change. Future VRET protocols targeting stuttering-related social anxiety should be explored with larger samples. The results from this pilot trial provide a solid basis for further design improvements and for future research to explore appropriate techniques for widening access to social anxiety treatments in stuttering

Longitudinal links between adolescent social anxiety and depressive symptoms: stressful experiences at home, in school and with peers

Social anxiety and depressive symptoms often co-occur during early adolescence but contributing factors to this development are still a matter of debate. This study examined the role of daily stressors (peers, school and homelife) in the links between adolescent social anxiety and depressive symptoms. 7-8th graders at Time 1 (N = 2,752, Mage = 13.65; 47.5% girls) were followed across three time-points. Cross-lagged path models showed that depressive symptoms predicted later social anxiety, but not vice versa. Bidirectional links were identified between peer stress and social anxiety, and between school/homelife stress and depressive symptoms, respectively. Indirect effects of social anxiety, depressive symptoms, and daily stressors were found, though stressors did not mediate the links between social anxiety and depressive symptoms (or vice versa). Our findings indicate an intricate role of daily stressors in different domains on the links between social anxiety and depressive symptoms

Evaluating immersive teleoperation interfaces: coordinating robot radiation monitoring tasks in nuclear facilities

We present a virtual reality (VR) teleoperation interface for a ground-based robot, featuring dense 3D environment reconstruction and a low latency video stream, with which operators can immersively explore remote environments. At the UK Atomic Energy Authority's (UKAEA) Remote Applications in Challenging Environments (RACE) facility, we applied the interface in a user study where trained robotics operators completed simulated nuclear monitoring and decommissioning style tasks to compare VR and traditional teleoperation interface designs. We found that operators in the VR condition took longer to complete the experiment, had reduced collisions, and rated the generated 3D map with higher importance when compared to non-VR operators. Additional physiological data suggested that VR operators had a lower objective cognitive workload during the experiment but also experienced increased physical demand. Overall the presented results show that VR interfaces may benefit work patterns in teleoperation tasks within the nuclear industry, but further work is needed to investigate how such interfaces can be integrated into real world decommissioning workflows

Does Shyness Vary According to Attained Social Roles? Trends Across Age Groups in a Large British Sample

OBJECTIVE: The current study investigated (a) how a composite measure of shyness comprising introversion and neuroticism relates to other well-known constructs involving social fears, and (b) whether mean levels of shyness vary for men and women depending on the adoption of various social roles. METHOD: Study 1 used a sample of 211 UK participants aged 17–70 (64% female; Mage = 47.90). Study 2 used data from a large cross-sectional data set with UK participants aged 17–70 (Ntarget = 552,663; 64% female; Mage = 34.19 years). RESULTS: Study 1 showed that shyness measured as a composite of introversion and neuroticism was highly correlated with other constructs involving social fears. Study 2 indicated that, controlling for various sociodemographic variables, females appeared to have higher levels, whereas males appeared to have lower levels of shyness. Males and females who were in employment had the lowest shyness levels, whereas those working in unskilled jobs had the highest levels and people working in sales the lowest levels of shyness. Participants in relationships had lower levels of shyness than those not in relationships, but parenthood was not associated with shyness. CONCLUSIONS: Mean levels of shyness are likely to vary according to adopted social roles, gender, and age.Preparation of this manuscript was supported by Grant 2011-0307 from the Swedish Research Council for Health, Working Life and Welfare to Nejra Van Zalk

Facial Expression Rendering in Medical Training Simulators: Current Status and Future Directions

Recent technological advances in robotic sensing and actuation methods have prompted development of a range of new medical training simulators with multiple feedback modalities. Learning to interpret facial expressions of a patient during medical examinations or procedures has been one of the key focus areas in medical training. This paper reviews facial expression rendering systems in medical training simulators that have been reported to date. Facial expression rendering approaches in other domains are also summarized to incorporate the knowledge from those works into developing systems for medical training simulators. Classifications and comparisons of medical training simulators with facial expression rendering are presented, and important design features, merits and limitations are outlined. Medical educators, students and developers are identified as the three key stakeholders involved with these systems and their considerations and needs are presented. Physical-virtual (hybrid) approaches provide multimodal feedback, present accurate facial expression rendering, and can simulate patients of different age, gender and ethnicity group; makes it more versatile than virtual and physical systems. The overall findings of this review and proposed future directions are beneficial to researchers interested in initiating or developing such facial expression rendering systems in medical training simulators.This work was supported by the Robopatient project funded by the EPSRC Grant No EP/T00519X/

MorphFace: a hybrid morphable face for a robopatient

Physicians use pain expressions shown in a patient’s face to regulate their palpation methods during physical examination. Training to interpret patients’ facial expressions with different genders and ethnicities still remains a challenge, taking novices a long time to learn through experience. This paper presents MorphFace: a controllable 3D physical-virtual hybrid face to represent pain expressions of patients from different ethnicity-gender backgrounds. It is also an intermediate step to expose trainee physicians to the gender and ethnic diversity of patients. We extracted four principal components from the Chicago Face Database to design a four degrees of freedom (DoF) physical face controlled via tendons to span 85% of facial variations among gender and ethnicity. Details such as skin colour, skin texture, and facial expressions are synthesized by a virtual model and projected onto the 3D physical face via a frontmounted LED projector to obtain a hybrid controllable patient face simulator. A user study revealed that certain differences in ethnicity between the observer and the MorphFace lead to different perceived pain intensity for the same pain level rendered by the MorphFace. This highlights the value of having MorphFace as a controllable hybrid simulator to quantify perceptual differences during physician training

Acceptability of automated robotic clinical breast examination: survey study

Background: In the United Kingdom, women aged 50 to 70 years are invited to undergo mammography. However, 10% of invasive breast cancers occur in women aged ≤45 years, representing an unmet need for young women. Identifying a suitable screening modality for this population is challenging; mammography is insufficiently sensitive, whereas alternative diagnostic methods are invasive or costly. Robotic clinical breast examination (R-CBE)—using soft robotic technology and machine learning for fully automated clinical breast examination—is a theoretically promising screening modality with early prototypes under development. Understanding the perspectives of potential users and partnering with patients in the design process from the outset is essential for ensuring the patient-centered design and implementation of this technology. Objective: This study investigated the attitudes and perspectives of women regarding the use of soft robotics and intelligent systems in breast cancer screening. It aimed to determine whether such technology is theoretically acceptable to potential users and identify aspects of the technology and implementation system that are priorities for patients, allowing these to be integrated into technology design. Methods: This study used a mixed methods design. We conducted a 30-minute web-based survey with 155 women in the United Kingdom. The survey comprised an overview of the proposed concept followed by 5 open-ended questions and 17 closed questions. Respondents were recruited through a web-based survey linked to the Cancer Research United Kingdom patient involvement opportunities web page and distributed through research networks’ mailing lists. Qualitative data generated via the open-ended questions were analyzed using thematic analysis. Quantitative data were analyzed using 2-sample Kolmogorov-Smirnov tests, 1-tailed t tests, and Pearson coefficients. Results: Most respondents (143/155, 92.3%) indicated that they would definitely or probably use R-CBE, with 82.6% (128/155) willing to be examined for up to 15 minutes. The most popular location for R-CBE was at a primary care setting, whereas the most accepted method for receiving the results was an on-screen display (with an option to print information) immediately after the examination. Thematic analysis of free-text responses identified the following 7 themes: women perceive that R-CBE has the potential to address limitations in current screening services; R-CBE may facilitate increased user choice and autonomy; ethical motivations for supporting R-CBE development; accuracy (and users’ perceptions of accuracy) is essential; results management with clear communication is a priority for users; device usability is important; and integration with health services is key. Conclusions: There is a high potential for the acceptance of R-CBE in its target user group and a high concordance between user expectations and technological feasibility. Early patient participation in the design process allowed the authors to identify key development priorities for ensuring that this new technology meets the needs of users. Ongoing patient and public involvement at each development stage is essential

Early adolescent disclosure and parental knowledge regarding online activities: Social anxiety and parental rule-setting as moderators

Early adolescents spend a lot of time online, yet little is currently known about the links between parental rule-setting, adolescent disclosure about online activities, and whether social anxiety may interfere with these processes. Using a longitudinal sample of 526 adolescents (269 girls; Mage = 14.00) and their parents (79% mothers, Mage = 43.66), the results from the current study showed low correspondence between parental knowledge, adolescent disclosure, as well as parents’ and adolescents’ ratings of parental legitimacy to set boundaries about online activities. High social anxiety interacted with high adolescent-rated parental rule-setting in predicting the least disclosure about chatting with strangers and posting online content over time. Also, high social anxiety interacted with low parent-rated control to predict more adolescent disclosure about chatting with strangers and money spent online over time. Thus, social anxiety and parental rule-setting moderated the links between disclosure and knowledge for some early adolescent online activities. Our results conflict with the value typically placed on parental rule-setting in online contexts, at least for socially anxious adolescents

Involving Children and Teenagers With Bilateral Cochlear Implants in the Design of the BEARS (Both EARS) Virtual Reality Training Suite Improves Personalization

Older children and teenagers with bilateral cochlear implants often have poor spatial hearing because they cannot fuse sounds from the two ears. This deficit jeopardizes speech and language development, education, and social well-being. The lack of protocols for fitting bilateral cochlear implants and resources for spatial-hearing training contribute to these difficulties. Spatial hearing develops with bilateral experience. A large body of research demonstrates that sound localisation can improve with training, underpinned by plasticity-driven changes in the auditory pathways. Generalizing training to non-trained auditory skills is best achieved by using a multi-modal (audio-visual) implementation and multi-domain training tasks (localisation, speech-in-noise, and spatial music). The goal of this work was to develop a package of virtual-reality games (BEARS, Both EARS) to train spatial hearing in young people (8–16 years) with bilateral cochlear implants using an action-research protocol. The action research protocol used formalized cycles for participants to trial aspects of the BEARS suite, reflect on their experiences, and in turn inform changes in the game implementations. This participatory design used the stakeholder participants as co-creators. The cycles for each of the three domains (localisation, spatial speech-in-noise, and spatial music) were customized to focus on the elements that the stakeholder participants considered important. The participants agreed that the final games were appropriate and ready to be used by patients. The main areas of modification were: the variety of immersive scenarios to cover age range and interests, the number of levels of complexity to ensure small improvements were measurable, feedback, and reward schemes to ensure positive reinforcement, and an additional implementation on an iPad for those who had difficulties with the headsets due to age or balance issues. The effectiveness of the BEARS training suite will be evaluated in a large-scale clinical trial to determine if using the games lead to improvements in speech-in-noise, quality of life, perceived benefit, and cost utility. Such interventions allow patients to take control of their own management reducing the reliance on outpatient-based rehabilitation. For young people, a virtual-reality implementation is more engaging than traditional rehabilitation methods, and the participatory design used here has ensured that the BEARS games are relevant