Psychotherapy with the use of psychedelic substances, including psilocybin, lysergic acid diethylamide (LSD), ketamine, and 3,4-methylenedioxymethamphetamine (MDMA), has demonstrated promise in treatment of post-traumatic stress disorder (PTSD), anxiety, addiction, and treatment-resistant depression. Psychedelic-assisted psychotherapy (PP) represents a unique psychopharmacological model that leverages the profound effects of the psychedelic experience. That experience is characterized by strong dependency on two key factors: participant mindset and the therapeutic environment. As such, therapeutic models that utilize psychedelics reflect the need for careful design that promotes (...) an open, flexible, trusting mindset and a supportive setting. To meet this need, the PP model is increasingly supplemented by auxiliary methods, including meditation, relaxation, visualization or spiritual practices. We suggest virtual reality (VR) as a full-spectrum tool able to capitalize on and catalyze the innately therapeutic aspects of the psychedelic experience, such as detachment from familiar reality, alteration of self-experience, augmentation of sensory perception and induction of mystical-type experiences. This is facilitated by VR’s evidenced capacity to: aid relaxation and reduce anxiety; buffer from external stimuli; promote a mindful presence; train the mind to achieve altered states of consciousness (ASC); evoke mystical states; enhance therapeutic alliance and encourage self-efficacy. While these unique VR features appear promising, VR’s potential role in PP remains speculative due to lack of empirical evidence on the combined use of VR and PP. Given the increased commercial interest in this synergy there is an urgent need to evaluate this approach. We suggest specific VR models and their role within PP protocols to inspire future direction in scientific research, and provide a list of potential disadvantages, side effects and limitations that need to be carefully considered. These include sensory overstimulation, cyber-sickness, triggering memories of past traumatic events as well as distracting from the inner experience or strongly influencing its contents. A balanced, evidence-based approach may provide continuity across all phases of treatment, support transition into and out of an ASC, deepen acute ASC experiences including mystical states and enrich the psychotherapeutic process of integration. We conclude that the potential application of VR in modulating psychedelic-assisted psychotherapy demands further exploration and an evidence-based approach to both design and implementation. (shrink)

Driving simulators are becoming increasingly common in driver training and assessment. Since virtual reality is generally regarded as an appropriate environment for measuring risk behavior, simulators are also used to assess hazard perception, which is considered to be one of the most important skills for safe driving. Simulators, which offer challenges that are indeed comparable to driving in real traffic, but at a very low risk of physical injury, have the potential to complement theoretical and practical driver trainings and tests. (...) Although configurations and fidelity differ considerably between driving simulators, studies comparing the impact of their distinct features on driving performance and test validity remain rare. In this context, prior research demonstrated that a wider field of view led to earlier speed adjustments in response to potential hazards—especially for experienced drivers. The wider field of view was assumed to cause the drivers to be more present in the virtual world, which in turn provoked more natural scanning of the road and therefore, earlier hazard detection in experienced drivers. Research on spatial presence in other contexts support this assumption. The present experiment investigated whether this effect could be enhanced by an even more immersive presentation technique for driving simulation: a head-mounted display. Moreover, we studied the interplay between display mode, sense of presence and simulation sickness. Eighty experienced and less experienced drivers completed six simulation-based hazard perception scenarios, which were displayed either via a triple-monitor set-up or an HMD. Results indicate that the experienced drivers showed very similar driving and risk behavior as the inexperienced drivers in both experimental conditions. However, there were significant differences between the two display conditions. The use of an HMD resulted in a clearer and more abrupt speed reduction, more virtual presence, and a higher degree of simulation sickness. However, the interrelation between these three variables could not be conclusively clarified in the present study and thus represents a research aim that could be addressed in future studies. (shrink)

Impairment of spatial memory, including an inability to recall previous locations and navigate the world, is often one of the first signs of functional disability on the road to cognitive impairment. While there are many screening and diagnostic tools which attempt to measure spatial memory ability, they are often not representative of real-life situations and can therefore lack applicability. One potential solution to this problem involves the use of virtual reality, which immerses individuals in a virtually-simulated environment, allowing for scenarios (...) more representative of real-life without any of the associated risks. Here, we review the evidence surrounding the use of VR for the screening and diagnosis of spatial memory impairments, including potential limitations and how it compares to standard neuropsychological tests. We will also discuss the evidence regarding the potential use of VR in the rehabilitation of spatial memory deficits, which has not been well studied, but which could be game-changing if proven successful. (shrink)