Assessing the Clinical Efficacy of a Virtual Reality Tool for the Treatment of Obesity: Randomized Controlled Trial.

BACKGROUND: Virtual reality (VR) interventions, based on cognitive behavioral therapy principles, have been proven effective as complementary tools in managing obesity and have been associated with promoting healthy behaviors and addressing body image concerns. However, they have not fully addressed certain underlying causes of obesity, such as a lack of motivation to change, low self-efficacy, and the impact of weight stigma interiorization, which often impede treatment adherence and long-term lifestyle habit changes. To tackle these concerns, this study introduces the VR self-counseling paradigm, which incorporates embodiment and body-swapping techniques, along with motivational strategies, to help people living with obesity effectively address some of the root causes of their condition. OBJECTIVE: This study aims to assess the clinical efficacy of ConVRself (Virtual Reality self-talk), a VR platform that allows participants to engage in motivational self-conversations. METHODS: A randomized controlled trial was conducted with 68 participants from the bariatric surgery waiting list from the obesity unit of the Vall d'Hebron University Hospital in Barcelona, Spain. Participants were assigned to 1 of 3 groups: a control group (CG), which only received treatment as usual from the obesity unit; experimental group 1 (EG1), which, after intensive motivational interviewing training, engaged in 4 sessions of VR-based self-conversations with ConVRself, and underwent embodiment and body-swapping techniques; and experimental group 2 (EG2), which engaged in 4 VR-based sessions led by a virtual counselor with a prerecorded discourse, and only underwent the embodiment technique. In the case of both EG1 and EG2, the VR interventions were assisted by a clinical researcher. Readiness to change habits, eating habits, and psychological variables, as well as adherence and satisfaction with ConVRself were measured at baseline, after the intervention, 1 week after the intervention, and 4 weeks after the intervention. RESULTS: Regarding the primary outcomes, EG1 (24/68, 35%) and EG2 (22/68, 32%) showed significant improvements in confidence to lose weight compared to the CG (22/68, 32%) at all assessment points (ß=-.16; P=.02). Similarly, EG1 demonstrated a significant increase after the intervention in readiness to exercise more compared to the CG (ß=-.17; P=.03). Regarding the secondary outcomes, EG1 participants showed a significant reduction in uncontrolled eating (ß=.71; P=.01) and emotional eating (ß=.29; P=.03) compared to the CG participants, as well as in their anxiety levels compared to EG2 and CG participants (ß=.65; P=.01). In addition, participants from the experimental groups reported high adherence and satisfaction with the VR platform (EG1: mean 59.82, SD 4.00; EG2: mean 58.43, SD 5.22; d=0.30, 95% CI -0.30 to 0.89). CONCLUSIONS: This study revealed that using VR self-conversations, based on motivational interviewing principles, may have benefits in helping people with obesity to enhance their readiness to change habits and self-efficacy, as well as reduce dysfunctional eating behaviors and anxiety. TRIAL REGISTRATION: ClinicalTrials.gov NCT05094557; https://www.clinicaltrials.gov/study/NCT05094557.

The Making of a Newspaper Interview in Virtual Reality: Realistic Avatars, Philosophy, and Sushi.

VR United is a virtual reality application that we have developed to support multiple people simultaneously interacting in the same environment. Each person is represented with a virtual body that looks like themselves. Such immersive shared environments have existed and been the subject of research for the past 30 years. Here, we demonstrate how VR United meets criteria for successful interaction, where a journalist from the Financial Times in London interviewed a professor in New York for two hours. The virtual location of the interview was a restaurant, in line with the series of interviews published as "Lunch with the FT." We show how the interview was successful, as a substitute for a physically present one. The article based on the interview was published in the Financial Times as normal for the series. We finally consider the future development of such systems, including some implications for immersive journalism.

3D objects reconstruction from frontal images: an example with guitars.

This work deals with the automatic 3D reconstruction of objects from frontal RGB images. This aims at a better understanding of the reconstruction of 3D objects from RGB images and their use in immersive virtual environments. We propose a complete workflow that can be easily adapted to almost any other family of rigid objects. To explain and validate our method, we focus on guitars. First, we detect and segment the guitars present in the image using semantic segmentation methods based on convolutional neural networks. In a second step, we perform the final 3D reconstruction of the guitar by warping the rendered depth maps of a fitted 3D template in 2D image space to match the input silhouette. We validated our method by obtaining guitar reconstructions from real input images and renders of all guitar models available in the ShapeNet database. Numerical results for different object families were obtained by computing standard mesh evaluation metrics such as Intersection over Union, Chamfer Distance, and the F-score. The results of this study show that our method can automatically generate high-quality 3D object reconstructions from frontal images using various segmentation and 3D reconstruction techniques.

Imperceptible body transformation in virtual reality: Saliency of self representation.

Change blindness (CB) is the perceptual phenomenon whereby people are blind to dramatic changes in their visual environment. In virtual reality (VR) a person's body can be substituted by a life-sized virtual one that moves synchronously with their real body movements as their self-representation. We consider whether CB occurs in VR, and whether there are differences in the case of changes to their own virtual body compared with the body of another. Forty people took part in a Qi Gong lesson in VR led by a virtual instructor. During the lesson both their own and the instructor's face dramatically changed in appearance. Overall, 73% and 85% did not notice the changes to their own and instructor's face respectively. People make iconic inferences about their visual surroundings without sampling detail, and reduced CB in the case of their own body may be a marker for self-representation.

Automated virtual reality cognitive therapy versus virtual reality mental relaxation therapy for the treatment of persistent persecutory delusions in patients with psychosis (THRIVE): a parallel-group, single-blind, randomised controlled trial in England with mediation analyses.

BACKGROUND: Persecutory delusions are a major psychiatric problem that often do not respond sufficiently to standard pharmacological or psychological treatments. We developed a new brief automated virtual reality (VR) cognitive treatment that has the potential to be used easily in clinical services. We aimed to compare VR cognitive therapy with an alternative VR therapy (mental relaxation), with an emphasis on understanding potential mechanisms of action. METHODS: THRIVE was a parallel-group, single-blind, randomised controlled trial across four UK National Health Service trusts in England. Participants were included if they were aged 16 years or older, had a persistent (at least 3 months) persecutory delusion held with at least 50% conviction, reported feeling threatened when outside with other people, and had a primary diagnosis from the referring clinical team of a non-affective psychotic disorder. We randomly assigned (1:1) patients to either THRIVE VR cognitive therapy or VR mental relaxation, using a permuted blocks algorithm with randomly varying block size, stratified by severity of delusion. Usual care continued for all participants. Each VR therapy was provided in four sessions over approximately 4 weeks, supported by an assistant psychologist or clinical psychologist. Trial assessors were masked to group allocation. Outcomes were assessed at 0, 2 (therapy mid-point), 4 (primary endpoint, end of treatment), 8, 16, and 24 weeks. The primary outcome was persecutory delusion conviction, assessed by the Psychotic Symptoms Rating Scale (PSYRATS; rated 0-100%). Outcome analyses were done in the intention-to-treat population. We assessed the treatment credibility and expectancy of the interventions and the two mechanisms (defence behaviours and safety beliefs) that the cognitive intervention was designed to target. This trial is prospectively registered with the ISRCTN registry, ISRCTN12497310. FINDINGS: From Sept 21, 2018, to May 13, 2021 (with a pause due to COVID-19 pandemic restrictions from March 16, 2020, to Sept 14, 2020), we recruited 80 participants with persistent persecutory delusions (49 [61%] men, 31 [39%] women, with a mean age of 40 years [SD 13, range 18-73], 64 [80%] White, six [8%] Black, one [1%] Indian, three [4%] Pakistani, and six [8%] other race or ethnicity). We randomly assigned 39 (49%) participants assigned to VR cognitive therapy and 41 (51%) participants to VR mental relaxation. 33 (85%) participants who were assigned to VR cognitive therapy attended all four sessions, and 35 (85%) participants assigned to VR mental relaxation attended all four sessions. We found no significant differences between the two VR interventions in participant ratings of treatment credibility (adjusted mean difference -1·55 [95% CI -3·68 to 0·58]; p=0·15) and outcome expectancy (-0·91 [-3·42 to 1·61]; p=0·47). 77 (96%) participants provided follow-up data at the primary timepoint. Compared with VR mental relaxation, VR cognitive therapy did not lead to a greater improvement in persecutory delusions (adjusted mean difference -2·16 [-12·77 to 8·44]; p=0·69). Compared with VR mental relaxation, VR cognitive therapy did not lead to a greater reduction in use of defence behaviours (adjusted mean difference -0·71 [-4·21 to 2·79]; p=0·69) or a greater increase in belief in safety (-5·89 [-16·83 to 5·05]; p=0·29). There were 17 serious adverse events unrelated to the trial (ten events in seven participants in the VR cognitive therapy group and seven events in five participants in the VR mental relaxation group). INTERPRETATION: The two VR interventions performed similarly, despite the fact that they had been designed to affect different mechanisms. Both interventions had high uptake rates and were associated with large improvements in persecutory delusions but it cannot be determined that the treatments accounted for the change. Immersive technologies hold promise for the treatment of severe mental health problems. However, their use will likely benefit from experimental research on the application of different therapeutic techniques and the effects on a range of potential mechanisms of action. FUNDING: Medical Research Council Developmental Pathway Funding Scheme and National Institute for Health and Care Research Oxford Health Biomedical Research Centre.

Addressing Global Environmental Challenges to Mental Health Using Population Neuroscience: A Review.

Importance: Climate change, pollution, urbanization, socioeconomic inequality, and psychosocial effects of the COVID-19 pandemic have caused massive changes in environmental conditions that affect brain health during the life span, both on a population level as well as on the level of the individual. How these environmental factors influence the brain, behavior, and mental illness is not well known. Observations: A research strategy enabling population neuroscience to contribute to identify brain mechanisms underlying environment-related mental illness by leveraging innovative enrichment tools for data federation, geospatial observation, climate and pollution measures, digital health, and novel data integration techniques is described. This strategy can inform innovative treatments that target causal cognitive and molecular mechanisms of mental illness related to the environment. An example is presented of the environMENTAL Project that is leveraging federated cohort data of over 1.5 million European citizens and patients enriched with deep phenotyping data from large-scale behavioral neuroimaging cohorts to identify brain mechanisms related to environmental adversity underlying symptoms of depression, anxiety, stress, and substance misuse. Conclusions and Relevance: This research will lead to the development of objective biomarkers and evidence-based interventions that will significantly improve outcomes of environment-related mental illness.

Virtual self-conversation using motivational interviewing techniques to promote healthy eating and physical activity: A usability study.

Introduction: We aim to examine the usability of a Virtual Reality (VR) platform, called ConVRSelf, which has been designed to address the needs of People Living With Obesity (PLWO). Methods: Fourteen participants with a desire to eat healthier and exercise more (6 normal weight and 8 PLWO; Mean age = 41.86, SD = 13.89) were assigned to the experimental group (EG) or the control group (CG). EG participants, after being trained on motivational interviewing skills, engaged in a virtual self-conversation using embodiment and body swapping techniques, which aimed to normalize and resolve their ambivalence to change lifestyle habits. CG participants, embodied in their virtual bodies, participated in a pre-established discourse with a virtual counselor giving them psychoeducational advice about how to change lifestyle habits. A mixed-methods design was used, involving a semi-structured interview and self-report questionnaires, including readiness to change habits (Readiness Rulers), body ownership (Body Ownership Questionnaire, BOQ), and system usability (System Evaluation Questionnaire, SEQ). Thematic content analysis was carried out for qualitative data while statistical data analysis was carried out using SPSS 20.0. Results: Participants from both groups showed high readiness to change lifestyle (Readiness Rulers) before engaging with the virtual experiences, which was maintained at the same level after the interventions and their scores on the SEQ and BOQ were satisfactory. Regarding qualitative information obtained from the interviews, almost all participants found the VR experience to be novel, interesting, and enjoyable. A higher acceptability was observed among PLWO from the EG than normal weight participants from the same group, a promising finding for the ConVRSelf platform, which had been specifically designed to address the needs of PLWO. Conclusion: The ConVRSelf system is well-accepted by participants and is ready to be tested with PLWO in a clinical setting.

Electroencephalographic Signature of Out-of-Body Experiences Induced by Virtual Reality: A Novel Methodological Approach.

Out-of-body experiences (OBEs) are subjective experiences of seeing one's own body and the environment from a location outside the physical body. They can arise spontaneously or in specific conditions, such as during the intake of dissociative drug. Given its unpredictable occurrence, one way to empirically study it is to induce subjective experiences resembling an OBE using technology such as virtual reality. We employed a complex multisensory method of virtual embodiment in a virtual reality scenario with seven healthy participants to induce virtual OBE-like experiences. Participants performed two conditions in a randomly determined order. For both conditions, the participant's viewpoint was lifted out of the virtual body toward the ceiling of the virtual room, and real body movements were (visuo-tactile ON condition) or were not (visuo-tactile OFF condition) translated into movements on the virtual body below-the latter aiming to maintain a feeling of connection with the virtual body. A continuous 128-electrode EEG was recorded. Participants reported subjective experiences of floating in the air and of feeling high up in the virtual room at a strong intensity, but a weak to moderate feeling of being "out of their body" in both conditions. The EEG analysis revealed that this subjective experience was associated with a power shift that manifested in an increase of delta and a decrease of alpha relative power. A reduction of theta complexity and an increase of beta-2 connectivity were also found. This supports the growing body of evidence revealing a prominent role of delta activity during particular conscious states.

Domestic Violence From a Child Perspective: Impact of an Immersive Virtual Reality Experience on Men With a History of Intimate Partner Violent Behavior.

Domestic violence has long-term negative consequences on children. In this study, men with a history of partner aggression and a control group of non-offenders were embodied in a child's body from a first-person perspective in virtual reality (VR). From this perspective, participants witnessed a scene of domestic violence where a male avatar assaulted a female avatar. We evaluated the impact of the experience on emotion recognition skills and heart rate deceleration responses. We found that the experience mainly impacted the recognition of angry facial expressions. The results also indicate that males with a history of partner aggression had larger physiological responses during an explicit violent event (when the virtual abuser threw a telephone) compared with controls, while their physiological reactions were less pronounced when the virtual abuser invaded the victim's personal space. We show that embodiment from a child's perspective during a conflict situation in VR impacts emotion recognition, physiological reactions, and attitudes towards violence. We provide initial evidence of the potential of VR in the rehabilitation and neuropsychological assessment of males with a history of domestic violence, especially in relation to children.

The sentiment of a virtual rock concert.

We created a virtual reality version of a 1983 performance by Dire Straits, this being a highly complex scenario consisting of both the virtual band performance and the appearance and behaviour of the virtual audience surrounding the participants. Our goal was to understand the responses of participants, and to learn how this type of scenario might be improved for later reconstructions of other concerts. To understand the responses of participants we carried out two studies which used sentiment analysis of texts written by the participants. Study 1 (n = 25) (Beacco et al. in IEEE Virtual Reality: 538-545, 2021) had the unexpected finding that negative sentiment was caused by the virtual audience, where e.g. some participants were fearful of being harassed by audience members. In Study 2 (n = 26) notwithstanding some changes, the audience again led to negative sentiment-e.g. a feeling of being stared at. For Study 2 we compared sentiment with questionnaire scores, finding that the illusion of being at the concert was associated with positive sentiment for males but negative for females. Overall, we found sentiment was dominated by responses to the audience rather than the band. Participants had been placed in an unusual situation, being alone at a concert, surrounded by strangers, who seemed to pose a social threat for some  of them. We relate our findings to the concept of Plausibility, the illusion that events and situations in the VR are really happening. The results indicate high Plausibility, since the negative sentiment, for example in response to being started at, only makes sense if the events are experienced as actually happening. We conclude with the need for co-design of VR scenarios, and the use of sentiment analysis in this process, rather than sole reliance on concepts proposed by researchers, typically expressed through questionnaires, which may not reflect the experiences of participants. Supplementary Information: The online version contains supplementary material available at 10.1007/s10055-022-00685-9.

Multisensory Integration Dominates Hypnotisability and Expectations in the Rubber Hand Illusion.

Some recent papers by P. Lush and colleagues have argued that the rubber hand illusion (RHI), where participants can feel a rubber hand as their own under appropriate multisensory stimulation, may be caused mainly by hypnotic suggestibility and expectations (demand characteristics). These papers rely primarily on a study with 353 participants who took part in a RHI experiment carried out in a classical way with brush stroking. Participants experienced a synchronous condition where the rubber hand was seen to be touched in synchrony with touch felt on their corresponding hidden real hand, or the touches were applied asynchronously as a control. Each participant had a related measure of their hypnotisability on a scale known as the Sussex-Waterloo Scale of Hypnotisability (SWASH). The authors found a correlation between the questionnaire ratings of the RHI in the synchronous condition and the SWASH score. From this, they concluded that the RHI is largely driven by suggestibility and further proposed that suggestibility and expectations may even entirely explain the RHI. Here we examine their claims in a series of extensive new analyses of their data. We find that at every level of SWASH, the synchronous stimulation results in greater levels of the illusion than the asynchronous condition; moreover, proprioceptive drift is greater in the synchronous case at every level of SWASH. Thus, while the level of hypnotisability does modestly influence the subjective reports (higher SWASH is associated with somewhat higher illusion ratings), the major difference between the synchronous and asynchronous stimulation is always present. Furthermore, by including in the model the participants' expectancy ratings of how strongly they initially believed they would experience the RHI in the two conditions, we show that expectations had a very small effect on the illusion ratings; model comparisons further demonstrate that the multisensory condition is two-to-three-times as dominant as the other factors, with hypnotisability contributing modestly and expectations negligibly. Thus, although the results indicate that trait suggestibility may modulate the RHI, presumably through intersubject variations in top-down factors, the findings also suggest that the primary explanation for the RHI is as a multisensory bodily illusion.

Clinical efficacy of a virtual reality tool for the treatment of obesity: study protocol of a randomised controlled trial.

INTRODUCTION: Previous research has shown that it is feasible to integrate motivational interviewing techniques with behavioural and psychological interventions for the treatment of obesity. Moreover, these combined interventions have the potential to improve health-related outcomes of people living with obesity (PLWO) and to afford maintenance of behavioural changes over time. In addition, the use of virtual reality (VR) embodiment techniques in the treatment of eating disorders and obesity has promising preliminary effectiveness. The objective of this study is to assess the clinical efficacy of a VR intervention that uses embodiment and body-swapping techniques and has been specifically developed to cover the needs of PLWO. METHODS AND ANALYSIS: A randomised control trial will be carried out with an estimated sample of 96 participants with body mass index (BMI)>30. The whole duration of the trial will be 12 months. Participants will be recruited from the external consultations of the Vall d'Hebron University Hospital and be randomly assigned to three groups. The experimental group 1 will engage in a virtual self-conversation using the ConVRself platform, the experimental group 2 will participate in a 'pre-established discourse' provided by the virtual counsellor, who will give psychoeducation advice, and the control group will continue with treatment as usual. Readiness to change, BMI, eating habits and physical activity, psychological well-being, body image satisfaction, quality of life in relation to body image, and weight bias internalisation will be assessed at baseline, post intervention, 1-week and 4-week follow-up. Finally, variables related to adherence and satisfaction with the VR tool will be evaluated for the experimental groups. ETHICS AND DISSEMINATION: This study was approved by the Research Projects Committee of the Vall d'Hebron University Hospital. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences and other events for the scientific and clinical community, and the general public. TRIAL REGISTRATION NUMBER: NCT05094557.

Impact of virtual embodiment and exercises on functional ability and range of motion in orthopedic rehabilitation.

Recent evidence supports the use of immersive virtual reality (immersive VR) as a means of applying visual feedback techniques in neurorehabilitation. In this study, we investigated the benefits of an embodiment-based immersive VR training program for orthopedic upper limb rehabilitation, with the aim of improving the motor functional ability of the arm and accelerating the rehabilitation process in patients with a conservatively managed distal radius fracture. We designed a rehabilitation program based on developing ownership over a virtual arm and then exercising it in immersive VR. We carried out a between 3-group controlled trial with 54 patients (mean age = 61.80 ± 14.18): 20 patients were assigned to the experimental training group (immersive VR), 20 to the conventional digit mobilization (CDM) training control group, and 14 to a non-immersive (non-immersive VR) training control group. We found that functional recovery of the arm in the immersive VR group was correlated with the ownership and agency scores over the virtual arm. We also found larger range of joint movements and lower disability of the fractured arm compared with patients in the Non-immersive VR and CDM groups. Feeling embodied in a virtual body can be used as a rehabilitation tool to speed up and improve motor functional recovery of a fractured arm after the immobilization period.

Encouraging bystander helping behaviour in a violent incident: a virtual reality study using reinforcement learning.

Virtual reality (VR) affords the study of the behaviour of people in social situations that would be logistically difficult or ethically problematic in reality. The laboratory-controlled setup makes it straightforward to collect multi-modal data and compare the responses across different experimental conditions. However, the scenario is typically fixed and the resulting data are usually analysed only once the VR experience has ended. Here we describe a method that allows adaptation of the environment to the behaviours of participants and where data is collected and processed during the experience. The goal was to examine the extent to which helping behaviour of participants towards the victim of a violent aggression might be encouraged, with the use of reinforcement learning (RL). In the scenario, a virtual human character represented as a supporter of the Arsenal Football Club, was attacked by another with the aggression escalating over time. (In some countries football is referred to as 'soccer', but we will use 'football' throughout). Each participant, a bystander in the scene, might intervene to help the victim or do nothing. By varying the extent to which some actions of the virtual characters during the scenario were determined by the RL we were able to examine whether the RL resulted in a greater number of helping interventions. Forty five participants took part in the study divided into three groups: with no RL, a medium level of RL, or full operation of the RL. The results show that the greater extent to which the RL operated the greater the number of interventions. We suggest that this methodology could be an alternative to full multi-factorial experimental designs, and more importantly as a way to produce adaptive VR scenarios that encourage participants towards a particular line of action.

Is Consciousness First in Virtual Reality?

The prevailing scientific paradigm is that matter is primary and everything, including consciousness can be derived from the laws governing matter. Although the scientific explanation of consciousness on these lines has not been realized, in this view it is only a matter of time before consciousness will be explained through neurobiological activity in the brain, and nothing else. There is an alternative view that holds that it is fundamentally impossible to explain how subjectivity can arise solely out of material processes-"the hard problem of consciousness"-and instead consciousness should be regarded in itself as a primary force in nature. This view attempts to derive, for example, the laws of physics from models of consciousness, instead of the other way around. While as scientists we can understand and have an intuition for the first paradigm, it is very difficult to understand what "consciousness is primary" might mean since it has no intuitive scientific grounding. Here we show that worlds experienced through virtual reality (VR) are such that consciousness is a first order phenomenon. We discuss the Interface Theory of Perception which claims that in physical reality perceptions are not veridical and that we do not see the "truth" but that perception is based on evolutionary payoffs. We show that this theory may provide an accurate description of perception and consciousness within VR, and we put forward an experimental study that could throw light on this. We conclude that VR does offer an experimental frame that provides intuition with respect to the idea that "consciousness is first" and what this might mean regarding the perceived world. However, we do not draw any conclusions about the veracity of this notion with respect to physical reality or question the emergence of consciousness from brain function.

Virtual reality for the rehabilitation and prevention of intimate partner violence - From brain to behavior: A narrative review.

Rehabilitation and prevention strategies to reduce intimate partner violence (IPV) have limited effectiveness in terms of improving key risk factors and reducing occurrence. Accumulated experimental evidence demonstrates that virtual embodiment, which results in the illusion of owning a virtual body, has a large impact on people's emotional, cognitive, and behavioral responses. This narrative review discusses work that has investigated how embodied perspective - taking in virtual reality has been used as a tool to reduce bias, to enhance recognition of the emotional state of another, and to reduce violent behaviors, in particular in the realm of IPV. Some of the potential neurological mechanisms behind these affective and behavioral changes are also discussed. The process of rehabilitation and prevention is complex and not always effective, but the integration of neuroscience-inspired and validated state-of-the-art technology into the rehabilitation process can make a positive contribution.

Self-observation of a virtual body-double engaged in social interaction reduces persecutory thoughts.

The proportion of the population who experience persecutory thoughts is 10-15%. People then engage in safety-seeking behaviours, typically avoiding social interactions, which prevents disconfirmatory experiences and hence paranoia persists. Here we show that persecutory thoughts can be reduced if prior to engaging in social interaction in VR participants first see their virtual body-double doing so. Thirty non-clinical participants were recruited to take part in a study, where they were embodied in a virtual body that closely resembled themselves, and asked to interact with members of a crowd. In the Random condition (n = 15) they observed their body-double wandering around but not engaging with the crowd. In the Targeted condition the body-double correctly interacted with members of the crowd. The Green Paranoid Thoughts Scale was measured 1 week before and 1 week after the exposure and decreased only for those in the Targeted condition. The results suggest that the observation of the body-double correctly carrying out a social interaction task in VR may lead to anxiety-reducing mental rehearsal for interaction thus overcoming safety behaviours. The results also extend knowledge of the effects of vicarious agency, suggesting that identification with the actions of body-double can influence subsequent psychological state.

Evaluating participant responses to a virtual reality experience using reinforcement learning.

Virtual reality applications depend on multiple factors, for example, quality of rendering, responsiveness, and interfaces. In order to evaluate the relative contributions of different factors to quality of experience, post-exposure questionnaires are typically used. Questionnaires are problematic as the questions can frame how participants think about their experience and cannot easily take account of non-additivity among the various factors. Traditional experimental design can incorporate non-additivity but with a large factorial design table beyond two factors. Here, we extend a previous method by introducing a reinforcement learning (RL) agent that proposes possible changes to factor levels during the exposure and requires the participant to either accept these or not. Eventually, the RL converges on a policy where no further proposed changes are accepted. An experiment was carried out with 20 participants where four binary factors were considered. A consistent configuration of factors emerged where participants preferred to use a teleportation technique for navigation (compared to walking-in-place), a full-body representation (rather than hands only), the responsiveness of virtual human characters (compared to being ignored) and realistic compared to cartoon rendering. We propose this new method to evaluate participant choices and discuss various extensions.

Being the victim of virtual abuse changes default mode network responses to emotional expressions.

Recent behavioural studies have provided evidence that virtual reality (VR) experiences have an impact on socio-affective processes, and a number of findings now underscore the potential of VR for therapeutic interventions. An interesting recent result is that when male offenders experience a violent situation as a female victim of domestic violence in VR, their sensitivity for recognition of fearful facial expressions improves. A timely question now concerns the underlying brain mechanisms of these behavioural effects as these are still largely unknown. The current study used fMRI to measure the impact of a VR intervention in which participants experienced a violent aggression from the specific vantage point of the victim. We compared brain processes related to facial and bodily emotion perception before and after the VR experience. Our results show that the virtual abuse experience led to an enhancement of Default Mode Network (DMN) activity, specifically associated with changes in the processing of ambiguous emotional stimuli. In contrast, DMN activity was decreased when observing fully fearful expressions. Finally, we observed increased variability in brain activity for male versus female facial expressions. Taken together, these results suggest that the first-person perspective of a virtual violent situation impacts emotion recognition through modifications in DMN activity. Our study contributes to a better understanding of the brain mechanisms associated with the behavioural effects of VR interventions in the context of a violent confrontation with the male participant embodied as a female victim. Furthermore, this research also consolidates the use of VR embodied perspective-taking interventions for addressing socio-affective impairments.

Exploring the Effect of Cooperation in Reducing Implicit Racial Bias and Its Relationship With Dispositional Empathy and Political Attitudes.

Previous research using immersive virtual reality (VR) has shown that after a short period of embodiment by White people in a Black virtual body, their implicit racial bias against Black people diminishes. Here we tested the effects of some socio-cognitive variables that could contribute to enhancing or reducing the implicit racial bias. The first aim of the study was to assess the beneficial effects of cooperation within a VR scenario, the second aim was to provide preliminary testing of the hypothesis that empathy and political attitudes could contribute to implicit bias about race, while the third aim was to explore the relationship between political attitudes and empathy. We had (Caucasian) participants embodied in a Black virtual body and engaged either in a cooperative (Coop group) or in a non-cooperative (Neutral group) activity with a confederate experimenter embodying another Black avatar. Before and after VR, we measured participants' implicit racial bias by means of Implicit Association Test (IAT) and their perceived closeness toward the confederate experimenter. Before VR we also assessed participants' political attitudes and empathy traits. Results revealed that, as compared to the Neutral group, the Coop group showed lower IAT scores after the social interaction. Interestingly, in the Neutral but not the Coop group the perceived closeness toward the confederate experimenter was associated with the initial racial bias: the more the participants reduced their distance, the more they reduced their IAT score. Moreover, reported traits of empathy and political attitudes significantly explained the variance observed in the initial implicit bias, with perspective-taking, empathic concern, and personal distress being significant predictors of the IAT scores. Finally, there was a relationship between political attitudes and empathy: the more participants considered themselves as left-wing voters, the higher their perspective-taking and empathic concern scores. We discuss these findings within the neuroscientific and social cognition field and encourage scholars from different domains to further explore whether and under which conditions a given manipulation for reducing racial bias could be efficiently transposed in VR.