This paper analyzes in the use of virtual reality when used to induce full-body ownership in violent offenders in order to elicit empathetic feelings by allowing them to embody the virtual body of a victim of domestic abuse. The authors explore potentially harmful effects to individuals participating in this kind of therapy and question whether consent is fully informed. The paper concludes with guidelines for ethical research and rehabilitation using this innovative technology.

In recent years, the field of virtual reality (VR) has shown tremendous advancements and is utilized in fields ranging from entertainment, scientific research, social networks, artistic creation as well as numerous approaches to employ VR for psychotherapy. While the use of VR in psychotherapy has been widely discussed, little attention has been given to the potential of this new medium for art therapy. Artistic expression in virtual reality is a novel medium which offers unique possibilities, extending (...) beyond classical expressive art mediums. Creation in virtual reality includes options such as three-dimensional painting, an immersive creative experience, dynamic scaling and embodied expression. In this perspective paper, we present the potentials and challenges of virtual reality for art therapy and outline basic principles for its implementation. We focus on the novel qualities offered by this creative medium (the virtual environment, virtual materials and unreal characteristics) and on the core aspects of virtual reality (such as presence, Immersivity, point of view and perspective) for the practice of art therapy. (shrink)

Immersive virtual environments can produce a state of behaviour referred to as ‘presence’, during which the individual responds to the virtual environment as if it were real. Presence can be arranged to scientifically evaluate and affect our consciousness within a controlled virtual environment. This phenomenon makes the use of virtual environments amenable to existing and in-development forms of therapy for various conditions. Delirium in the intensive care unit (ICU) is one such condition for which virtual (...) reality (VR) technology has not been evaluated to date. We are currently assessing the feasibility and utility of a delirium prevention and treatment system, which implements VR to improve quality of sleep, reduce pain, lower usage of sedatives, and stimulate cognition. The proposed system will consist of 3-axis wearable accelerometers, 6-DOF position trackers, a VR system and apps designed to promote sleep quality and mindfulness. Our a priori hypothesis is that our VR therapy system would lower the occurrence of delirium in patients admitted to ICUs. (shrink)

BackgroundAcrophobia is a specific phobia characterized by a severe fear of heights. The purpose of the present study was to investigate the efficacy of two therapies that may ameliorate symptoms of acrophobia and anxiety sensitivity, i.e., virtual reality exposure therapy (VRET) and eye movement desensitization and reprocessing (EMDR) therapy with a Waiting List Control Condition (WLCC).MethodsWe applied a three-armed randomized controlled pre-post-test design with 45 female adolescent students. Students who met DSM-5 criteria for acrophobia were randomly assigned to (...) either VRET (N = 15;Mage = 17.26; SD = 1.32), EMDR (N = 15;Mage = 17.15; SD = 1.57), or a WLCC (N = 15;Mage = 17.50; SD = 1.26). The study groups were evaluated one week before the intervention and one week after the last intervention session regarding symptoms of acrophobia (Severity Measure for Acrophobia) and anxiety sensitivity (Anxiety Sensitivity Index).ResultsThe data showed that both the application of VRET and EMDR therapy were associated with significantly reduced symptoms of acrophobia (d = 1.03 for VRET and d = 1.08 for EMDR) and anxiety sensitivity (d = 1.15 for VRET and d = 1.13 for EMDR) in comparison to the Waiting List.LimitationsThe sample consisted only of adolescent women. Due to the recognizable differences between the two interventions, the therapists and the participants were not blind to the conditions.ConclusionThe results suggest that both VRET and EMDR are interventions that can significantly improve symptoms of acrophobia and anxiety sensitivity in female adolescents.Clinical Trial Registrationhttps://www.irct.ir/trial/57391, identifier: IRCT20210213050343N1. (shrink)

In recent years, the field of art therapy has sought to adapt traditional treatment approaches to today’s innovative technological environments when working with adolescent “digital natives.” In their clinic, art therapists often struggle with lack of cooperation when treating adolescents during sessions. This article presents two case studies that explore how Virtual Reality technology can be combined with traditional art therapy to treat adolescents suffering from anxiety and social difficulties. It is suggested that this type of technology may (...) lead to a better understanding of the needs of adolescents by adopting their vantage point and hence better outcomes. (shrink)

Exposure Therapy (ET) has demonstrated its efficacy in the treatment of phobias, anxiety and Post-traumatic Stress Disorder (PTSD), however, it suffers a high drop-out rate because of too low or too high patient engagement in treatment. Virtual Reality Exposure Therapy (VRET) is comparably effective regarding symptom reduction and offers an alternative tool to facilitate engagement for avoidant participants. Neuroimaging studies have demonstrated that both ET and VRET normalize brain activity within a fear circuit. However, previous studies have employed (...) brain imaging technology which restricts people’s movement and hides their body, surroundings and therapist from view. This is at odds with the way engagement is typically controlled. We used a novel combination of neural imaging and VR technology—Functional Near-Infrared Spectroscopy (fNIRS) and Immersive Projection Technology (IPT), to avoid these limitations. Although there are a few studies that have investigated the effect of VRET on a brain function after the treatment, the present study utilized technologies which promote ecological validity to measure brain changes after VRET treatment. Furthermore, there are no studies that have measured brain activity within VRET session. In this study brain activity within the prefrontal cortex (PFC) was measured during three consecutive exposure sessions. N = 13 acrophobic volunteers were asked to walk on a virtual plank with a 6 m drop below. Changes in oxygenated (HbO) hemogl... (shrink)

This book examines the ethics of virtual reality technologies. New forms of virtual reality are emerging in society, not just from low-cost gaming headsets, or augmented reality apps on phones, but from simulated “deep fake” images and videos on social media. This book subjects the new VR technological landscape to ethical scrutiny: assessing the benefits, risks and regulatory practices that shape it. Though often associated with gaming, education and therapy, VR can also be used for (...) moral enhancement. Journalists, artists, philanthropic and non-governmental organisations are using VR films, games and installations to stimulate user empathy to marginalised peoples through a combination of immersion, embodiment and persuasion. This book critically assesses the use of VR for empathy arousal and pro-social behaviour change, culminating in the development of a VR “ethical tool” – a device to facilitate reflective ethical judgement. Drawing upon the pragmatist philosophy of John Dewey, virtual reality is reshaped as “dramatic rehearsal”. This book explains how a combination of immersive environment-building, moral imagination, choice architecture and reflective engagement can stimulate a future-focused and empathic ethics for users of the technology. (shrink)

Anhedonia is a risk factor for suicide and poor treatment response in depressed individuals. Most evidence-based psychological therapies target symptoms of heightened negative affect instead of deficits in positive affect and typically show little benefit for anhedonia. Viewing positive scenes through virtual reality has been shown to increase positive affect and holds great promise for addressing anhedonic symptoms. In this pilot study, six participants with clinically significant depression completed 13 sessions of exposure to positive scenes in a controlled (...) VR environment. Significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up. Negative affect decreased over all 13 sessions, and positive affect increased over sessions 8–13. Results suggest that positive experiences in VR may be a novel avenue for the treatment of anhedonia in depressed individuals. (shrink)

Virtual reality constitutes an alternative, effective, and increasingly utilized treatment option for people suffering from psychiatric and neurological illnesses. However, the currently available VR simulations provide a predetermined simulative framework that does not take into account the unique personality traits of each individual; this could result in inaccurate, extreme, or unpredictable responses driven by patients who may be overly exposed and in an abrupt manner to the predetermined stimuli, or result in indifferent, almost non-existing, reactions when the stimuli (...) do not affect the patients adequately and thus stronger stimuli are recommended. In this study, we present a VR system that can recognize the individual differences and readjust the VR scenarios during the simulation according to the treatment aims. To investigate and present this dynamically adaptive VR system we employ an Anxiety Disorder condition as a case study, namely arachnophobia. This system consists of distinct anxiety states, aiming to dynamically modify the VR environment in such a way that it can keep the individual within a controlled, and appropriate for the therapy needs, anxiety state, which will be called “desired states” for the study. This happens by adjusting the VR stimulus, in real-time, according to the electrophysiological responses of each individual. These electrophysiological responses are collected by an external electrodermal activity biosensor that serves as a tracker of physiological changes. Thirty-six diagnosed arachnophobic individuals participated in a one-session trial. Participants were divided into two groups, the Experimental Group which was exposed to the proposed real-time adaptive virtual simulation, and the Control Group which was exposed to a pre-recorded static virtual simulation as proposed in the literature. These results demonstrate the proposed system’s ability to continuously construct an updated and adapted virtual environment that keeps the users within the appropriately chosen state for approximately twice the time compared to the pre-recorded static virtual simulation. Thus, such a system can increase the efficiency of VR stimulations for the treatment of central nervous system dysfunctions, as it provides numerically more controlled sessions without unexpected variations. (shrink)

Aims: Attentional bias, alcohol craving, and anxiety have important implications in the development and maintenance of alcohol use disorder. The current study aims to test the effectiveness of a Virtual Reality Cue-Exposure Therapy to reduce levels of alcohol craving and anxiety and prompt changes in AB toward alcohol content.Method: A 49-year-old male participated in this study, diagnosed with severe AUD, who also used tobacco and illicit substances on an occasional basis and who made several failed attempts to cease (...) substance misuse. The protocol consisted of six VR-CET booster sessions and two assessment sessions over the course of 5 weeks. The VR-CET program consisted of booster therapy sessions based on virtual reality exposure to preferred alcohol-related cues and contexts. The initial and final assessment sessions were focused on exploring AB, alcohol craving, and anxiety using paper-and-pencil instruments and the eye-tracking and VR technologies at different time points.Results: Pre and post assessment sessions indicated falls on the scores of all instruments assessing alcohol craving, anxiety, and AB.Conclusions: This case report, part of a larger project, demonstrates the effectiveness of the VR-CET booster sessions in AUD. In the post-treatment measurements, a variety of instruments showed a change in the AB pattern and an improvement in craving and anxiety responses. As a result of the systematic desensitization, virtual exposure gradually reduced the responses to significant alcohol-related cues and contexts. The implications for AB, anxiety and craving are discussed. (shrink)

The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate, however, VR content also plays a significant role. The primary objective of this systematic review and meta-analysis was to examine the literature on HMDs that report Simulator Sickness Questionnaire (SSQ) scores to determine (...) the impact of content. User factors associated with VR sickness were also examined. A systematic search was conducted according to PRISMA guidelines. Fifty-five articles met inclusion criteria, representing 3,016 participants (mean age range 19.5-80; 41% female). Findings show gaming content recorded the highest total SSQ mean 34.26 (95%CI 29.57-38.95). VR sickness profiles were also influenced by visual stimulation, locomotion and exposure times. Older samples (mean age ≥35 years) scored significantly lower total SSQ means than younger samples, however, these findings are based on a small evidence base as a limited number of studies included older users. No sex differences were found. Across all types of content, the pooled total SSQ mean was relatively high 28.00 (95%CI 24.66-31.35) compared with recommended SSQ cut-off scores. These findings are of relevance for informing future research and the application of VR in different contexts. (shrink)

ObjectiveThe studies showed the benefits of virtual reality training for functional mobility and balance in older adults. However, a large variance in the study design and results is presented. We, thus, completed a systematic review and meta-analysis to quantitatively examine the effects of VRT on functional mobility and balance in healthy older adults.MethodsWe systematically reviewed the publications in five databases. Studies that examine the effects of VRT on the measures of functional mobility and balance in healthy older adults (...) were screened and included if eligible. Subgroup analyses were completed to explore the effects of different metrics of the intervention design on those outcomes related to functional mobility and balance.ResultsFifteen studies of 704 participants were included. The quality of these studies was good. Compared to traditional physical therapy, VRT induced greater improvement in TUG and one-leg stance with open eyes. Subgroup analyses revealed that immersive VRT with more than 800 min of total intervention time over 8 weeks and at least 120 min per week and/or designed by the two motor-learning principles was optimal for functional mobility and balance.ConclusionVirtual reality training can significantly improve functional mobility and balance in healthy older adults compared to TPT, and the findings provided critical knowledge of the optimized design of VRT that can inform future studies with more rigorous designs.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021297085]. (shrink)

Background: Dementia is one the major problems of aging societies, and, novel and effective non-drug therapies are required as interventions in the oldest-old to prevent cognitive decline.Objective: This study aims to examine the efficacy and safety of reminiscence using immersive virtual reality focusing on anxiety that often appears with cognitive decline. The secondary objective is to reveal the preference for VR image types for reminiscence: live-action or computer graphics.Methods: This was a pilot, open-label, and randomized crossover study which (...) was conducted on January 2020 at a single nursing home. The subjects were randomly divided into two groups in equal numbers, and they alternately viewed two types of VR images themed on the mid- to late Showa era in Japan. In group A, the CG images were viewed first, and then the LA images were viewed. In group B, the images were viewed in the opposite order. Before VR viewing, subjects responded to Mini-Mental State Examination Japanese version and State-Trait Anxiety Inventory Japanese version. After viewing the first and second VR, subjects responded to STAI and the numerical rating scale for satisfaction and side effects.Results: Ten subjects participated in this study. The values of analyses are presented in the mean. The age was 87.1 years, and the MMSE was 28.5. The total STAI score before VR viewing was 36.1, but it significantly decreased to 26.8 after the first VR viewing, and further decreased to 23.4 after the second VR viewing. The NRS score for satisfaction tended to be higher after viewing LA in group A vs. 8.6, P = 0.0993), while in group B, the score after CG was slightly lower than that after LA. There were no serious side effects.Conclusions: This study suggests that iVR reminiscence can reduce anxiety in the oldest-old without causing serious side effects. Furthermore, the impacts might be better with LA images. (shrink)

Virtual Reality Therapy has been shown to be effective in treating anxiety disorders and phobias, but has not yet been widely tested for Substance Use Disorders and it is not known whether health care practitioners working with SUDs would use VRT if it were available. We report the results of an interview study exploring practitioners’ and researchers’ views on the utility of VRT for SUD treatment. Practitioners and researchers with at least two years’ experience delivering or researching and (...) designing SUD treatments were recruited. Interviews were thematically analyzed, resulting in themes relating to the safety and realism of VRT, and the opportunity for the additional insight it could offer to during SUD treatment. Participants were positive about employing VRT as an additional treatment for SUD. VRT was thought suitable for treating adults and people with mental health issues or trauma, provided that risks were appropriately managed. Subsequent relapse, trauma and over-confidence in the success of treatment were identified as risks. The opportunity VRT offered to include other actors in therapy, and observe reactions, were benefits that could not currently be achieved with other forms of therapy. Overall, VRT was thought to offer the potential for safe, realistic, personalized and insightful exposure to diverse triggering scenarios, and to be acceptable for integration into a wide range of SUD treatments. (shrink)

Background: The new human coronavirus that leads to COVID-19 has spread rapidly around the world and has a high degree of lethality. In more severe cases, patients remain hospitalized for several days under treatment of the health team. Thus, it is important to develop and use technologies with the aim to strengthen conventional therapy by encouraging movement, physical activity, and improving cardiorespiratory fitness for patients. In this sense, therapies for exposure to virtual reality are promising and have been (...) shown to be an adequate and equivalent alternative to conventional exercise programs.Aim: This is a study protocol with the aim of comparing the conventional physical therapy intervention with the use of a non-immersive VR software during COVID-19 hospitalization.Methods: Fifty patients hospitalized with confirmed diagnosis of COVID-19 will be divided in two groups under physiotherapy treatment using conventional or VR intervention: Group A: participants with COVID-19 will start the first day of the protocol with VR tasks in the morning and then in the second period, in the afternoon, will perform the conventional exercises and Group B: participants with COVID-19 will start the first day with conventional exercises in the morning and in the second period, in the afternoon, will perform activity with VR. All participants will be evaluated with different motor and physiologic scales before and after the treatment to measure improvements.Conclusion: Considering the importance of benefits from physical activity during hospitalization, VR software shows promise as a potential mechanism for improving physical activity. The results of this study may provide new insights into hospital rehabilitation.Trial Registration:ClinicalTrials.gov, identifier: NCT04537858. Registered on 01 September 2020. (shrink)

This study discusses the potential of virtual reality therapy to treat traumatic experiences. It considers the main advantages of exposure therapy through virtual reality in comparison with traditional exposure therapy. In order to explain the effectiveness of using virtual reality to treat trauma, the main research question that was asked was how to conceptualize it. It was assumed that the trauma was a deviation from the normal narrative that people create for a particular crisis (...) event. The results of the empirical research prove that virtual reality therapy can be considered a powerful tool for treating traumatic experiences, as cyberspace allows reformulation of self-images, experimenting and practicing coping skills, creating a new life story, and finding meaning in certain crisis events. (shrink)

This work is developed to explore the form of mental health education, strengthen scientific educational ideas, and improve the effect of psychological therapy. Virtual reality technology is innovatively applied in adolescent mental health treatment and education. Based on this, the mental health treatment and system design based on virtual reality technology are discussed, and the feasibility of applying VR technology to adolescent mental health education is explored. Second, the research concept of adolescent mental health is discussed. (...) Based on the VR platform setup, questionnaire survey is implemented to analyze the factors influencing the mental health of primary and secondary school students in Xi’an, Shaanxi Province, and five factors are obtained. Based on this, the adolescent mental health treatment system based on VR is designed, and the effectiveness of the system is tested and evaluated. The results show that the integrated delay of the VR equipment used is 29 ms, which can effectively provide service. There are significant differences in mental health status among adolescents of different genders, different ages, only children and non-only children, parents’ accompaniment during growing up, and urban and rural adolescents. Finally, after 3 months of psychological treatment, the mental health score of the experimental group of teenagers is 50–55 points. However, the mental health scores of the control group remain at 56–65 points, indicating that the mental health treatment system designed in this work can effectively help the adolescents to improve their mental health, thus proving the effectiveness of the system. To sum up, this work provides scientific reference for adolescent mental health education in schools. Psychological treatment system can help teenagers improve their psychological problems and promote the development of mental health education. (shrink)

The vision of an art masterpiece is associated with brain arousal by neural processes occurring quite spontaneously in the viewer. This aesthetic experience may even elicit a response in the motor areas of the observers. In the neurorehabilitation of patients with stroke, art observation has been used for reducing psychological disorders, and creative art therapy for enhancing physical functions and cognitive abilities. Here, we developed a virtual reality task which allows patients, by moving their hand on a (...) class='Hi'>virtual canvas, to have the illusion of painting some art masterpieces, such as The Creation of Adam of Michelangelo or The birth of Venus of Botticelli. Twenty healthy subjects and four patients with stroke performed this task and a control one in which they simply colored the virtual canvas. Results from User Satisfaction Evaluation Questionnaire and the NASA Task Load Index highlighted an appropriate level of usability. Moreover, despite the motor task was the same for art and control stimuli, the art condition was performed by healthy subjects with shorter trajectories and with a lower perception of physical demand. In experiment 2, only the patients treated with artistic stimuli showed a reduction in the erroneous movements performed orthogonally to the canvas. This finding reminds the so-called Mozart effect that improves the performance of subjects when they listen to classic music. Thus, we called this improvement in the performance when interacting with an artistic stimulus as Michelangelo effect. (shrink)

IntroductionGeneralized Anxiety Disorder is a prevalent emotional disorder associated with increased dysfunctionality, which has a lasting impact on the individual’s quality of life. Besides medication, Cognitive-Behavioral Therapy represents the golden standard psychotherapeutic approach for GAD, integrating multilevel techniques and various delivery formats that enable the development of tailored treatment protocols. The objective of this study was to compare the efficiency of a standard CBT protocol targeting worries, dysfunctional beliefs, and intolerance of uncertainty with an integrative and multimodal CBT intervention augmented (...) with Virtual Reality.Materials and methodsThis study included 66 participants with moderate GAD symptoms that were randomized to the standard CBT group and the Integrative and Multimodal CBT augmented with VR group. The interventions comprised 10 weekly sessions conducted by trained CBT therapists, including cognitive restructuring, problem-solving, behavioral exposure, and relaxation techniques. Baseline and post-assessments were conducted with both groups. Primary outcome measures included the Hamilton Anxiety Rating Scale and Penn-State Worry Questionnaire to evaluate the severity of GAD symptoms and worries, respectively. Secondary outcomes involved the administration of Automatic Thoughts Questionnaire, Dysfunctional Attitudes Scale and Unconditional Self-Acceptance Questionnaire.ResultsBoth interventions determined statistically significant effects on both primary and secondary outcomes in the expected direction. However, CBTs was associated with higher effect sizes for anxiety and worries, in contrast to IM-VRCBT. Also, secondary analyses revealed positive correlations between changes in anxiety and worries level and the reduction of dysfunctional cognitive processes.ConclusionThis research emphasized the effectiveness of CBT interventions for treating adults with moderate GAD symptomatology. Specifically, both interventions were efficient for reducing anxiety symptomatology present at individuals with GAD. However, regarding cognitive dysfunctions like worries, the standard CBT protocol performed better, as compared to the IM-VRCBT. In addition, we conclude that VR could be integrated within CBT interventions in a single protocol for GAD treatment. (shrink)

Logic-Based Therapy, a mode of philosophical counseling I invented beginning in the mid 1980s, under the auspices of Cognitive Behavior Therapy founder Albert Ellis, takes metaphysical security as a sin qua non for human happiness. The goal of LBT is to help people overcome irrational thinking that leads to metaphysical insecurity and to help build constructive, philosophical thinking that promotes metaphysical security. However, the advent of augmented and digital reality are beginning to present new challenges to obtaining metaphysical security. (...) Applying the tenets of LBT, this paper examines the implications for attaining metaphysical security in this brave new world of advancing technologies. (shrink)

Multi-user online environments involve millions of participants world-wide. In these online communities participants can use their online personas – avatars – to chat, fight, make friends, have sex, kill monsters and even get married. Unfortunately participants can also use their avatars to stalk, kill, sexually assault, steal from and torture each other. Despite attempts to minimise the likelihood of interpersonal virtual harm, programmers cannot remove all possibility of online deviant behaviour. Participants are often greatly distressed when their avatars (...) are harmed by other participants’ malicious actions, yet there is a tendency in the literature on this topic to dismiss such distress as evidence of too great an involvement in and identification with the online character. In this paper I argue that this dismissal of virtual harm is based on a set of false assumptions about the nature of avatar attachment and its relation to genuine moral harm. I argue that we cannot dismiss avatar attachment as morally insignificant without being forced to also dismiss other, more acceptable, forms of attachment such as attachment to possessions, people and cultural objects and communities. Arguments against according moral significance to virtual harm fail because they do not reflect participants’ and programmers’ experiences and expectations of virtual communities and they have the unintended consequence of failing to grant significance to attachments that we take for granted, morally speaking. Avatar attachment is expressive of identity and self-conception and should therefore be accorded the moral significance we give to real-life attachments that play a similar role. (shrink)

This chapter addresses the growing problem of unwanted sexual interactions in virtual environments. It reviews the available evidence regarding the prevalence and severity of this problem. It then argues that due to the potential harms of such interactions, as well as their nonconsensual nature, there is a good prima facie argument for viewing them as serious moral wrongs. Does this prima facie argument hold up to scrutiny? After considering three major objections – the ‘it’s not real’ objection; the ‘it’s (...) just a game’ objection; and the ‘unrestricted consent’ objection – this chapter argues that it does. The chapter closes by reviewing some of the policy options available to us in addressing the problem of virtual sexual assault. (shrink)

Virtual reality (VR) technology has emerged as a promising tool for studying and rehabilitating gait disturbances in different cohorts of patients (such as Parkinson's disease, post-stroke, or other neurological disorders) as it allows patients to be engaged in an immersive and artificial environment, which can be designed to address the particular needs of each individual. This review demonstrates the state of the art in applications of virtual walking techniques and related technologies for gait therapy and rehabilitation of (...) people with movement disorders makes recommendations for future research and discusses the use of VR in the clinic. However, the potential for using these techniques in gait rehabilitation is to provide a more personalized approach by simulate the experience of natural walking, while patients with neurological disorders are maintained localized in the real world. The goal of our work is to investigate how the human nervous system controls movement in health and neurodegenerative disease. (shrink)

More and more schools begin to design simulation technology based on virtual imaging technology and virtual reality in their course contents. In particular, among these technical courses, there is a need to first strengthen the Film and Television Production education in higher institutions. This article aims to study the impact of VRT, VR, and Internet of things technology on FTP courses and audience psychology in higher institutions under the era of intelligent multimedia. How to use emerging VR (...) technology to promote the psychological wellbeing of students or patients has become a new research direction, the exploration of which has a far-reaching significance for the applications of the related technologies. First, the principle and applications of VR and IoT technology are described. Thereon, the deep learning -based training model is used to analyze the postproduction of VR-based Sand Table game, and the function and effect of the designed game model are discussed. Subsequently, VR-based Sand Play Therapy is applied to mentally ill patients to obtain its therapeutic effect. The results show that the designed VR-based Sand Table game model can be used to treat mentally ill patients and alleviate their negative psychological states. Meanwhile, the Test Anxiety Scale scores prove the significant therapeutic effect of the designed game model on the mental problems of patients. Therefore, VR-based psychological SPT can be applied in the stress relief of students and the treatment of mentally ill patients, as well as alleviate their mental health problems. This research provides a new direction and some theoretical support for the application field of VR technology. (shrink)

The use of virtual environments for the provision of health‐care is on the increase, and with each new development brings debates about their impact on care, nursing and nursing practice. Such environments offer opportunities for extending care and improvements in communication. Others believe these developments threaten aspects of nursing they hold sacrosanct. This paper explores the development of an assemblage of computer networks, databases, information systems, software programs and management systems that together work to manage health‐care in Australia, namely (...) casemix. We contend that spatial theories on network society show how this assemblage co‐ordinates and operates to manage care. We discuss how this assemblage affects care and suggest that changes in organisation may be a part of the shift in how bodily organisation occurs more generally, but more specifically in health‐care. We also suggest how nurses are enrolled in and by such networks, leading to transformation in nurses’ practices. Finally, we argue that using spatial forms of analysis allows an interpretation of such assemblages that may account for their strengths and their shortcomings. (shrink)

In 2009 Dutch judges convicted several minors for theft of virtual items in the virtual worlds of online multiplayer computer games. From a legal point of view these convictions gave rise to the question whether virtual items should count as “objects” that can be “stolen” under criminal law. This legal question has both an ontological and a moral component. The question whether or not virtual items count as “objects” that can be “stolen” is an ontological question. (...) The question whether or not they should count as such under criminal law is of a moral nature. The purpose of this paper is to answer both the ontological question and the moral question underlying the legal question. (shrink)

Obsessive-compulsive disorder (OCD) is a deeply enigmatic psychiatric condition associated with immense suffering worldwide. Efficacious therapies for OCD, like exposure and response prevention (ERP) are sometimes poorly tolerated by patients. As many as 25 percent of patients refuse to initiate ERP mainly because they are too anxious to follow exposure procedures. Accordingly, we proposed a simple and tolerable (immersive yet indirect) low-cost technique for treating OCD that we call “multisensory stimulation therapy.” This method involves contaminating a rubber hand during the (...) so-called “rubber hand illusion” (RHI) in which tactile sensations may be perceived as arising from a fake hand. Notably, Jalal and Ramachandran (2015), showed that such fake hand contamination during the RHI provokes powerful disgust reactions in healthy volunteers. In the current study, we explored the therapeutic potential of this novel approach. OCD patients (n = 29) watched as their hidden real hand was being stroked together with a visible fake hand; either synchronously (inducing the RHI) (i.e., the experimental condition; n = 16) or asynchronously (i.e., the control condition; n = 13). After 5 minutes of tactile stimulation, the rubber hand was contaminated with fake feces, simulating conventional exposure therapy. Intriguingly, results suggested sensory assimilation of contamination sensations into the body image via the RHI: patients undergoing synchronous stimulation did not report greater contamination sensations when the fake hand was initially contaminated relative to asynchronous stroking. But contrary to expectations, they did so after the rubber hand had been contaminated for 5 minutes; as assessed via disgust facial expressions (a secondary outcome) and in vivo exposure (upon discontinuing the illusion). Further to our surprise, synchronous and asynchronous stroking induced an equally vivid and fast emerging illusion, which helps explain why both conditions initially (5 minutes after initiating tactile stimulation) provoked contamination reactions of equal magnitude. This study is the first to suggest heightened malleability of body image in OCD. Importantly, it may pave the way for a tolerable technique for the treatment of OCD—highly suitable for poorly resourced and emergency settings, including low-income and developing countries with minimal access to high-tech solutions like virtual reality. (shrink)

This paper argues that there are value and design-based problems in current ambitions for the Metaverse. With the Metaverse deepening longstanding commercial surveillance practices, the paper focuses on data protection harms from biometric and emotion data, the gauging of first-person perspectives, and sensitivities around profiling of avatars. The paper advances two notions to address harms and data protection: _surveillant physics_ and _virtual realist governance_. _Surveillant physics_ refers to surveillance informing the laws of how that reality operates: this is a (...) useful concept given the granular control that platforms have over virtual worlds and the laws by which they function. _Virtual realist governance_ builds on the longstanding principle of virtual realism and David Chalmer’s recent theorising of Reality+ that demands that the virtual is taken to be real, meaning that experiences of virtual objects and what occurs in-world are treated as meaningful. The paper progresses to further consider governance questions, both around technical and ethical standards, but also data protection ideas such as personal data stores, and data trusts, that were not conceived as Metaverse-based ideas, but have greater chance of being realised as basic premises of the Metaverse are being designed. Although this paper is regretfully pessimistic, finding that a root problem of current ambitions for the Metaverse is that the public good and the commons are missing, it sees virtual realist scope for modes of resistance unseen in other digital realms. (shrink)

Within dramatherapy and psychodrama, the term ‘de-roling’ indicates a set of activities that assist the subjects of therapy in ‘disrobing’ themselves from their fictional characters. Starting from the psychological needs and the therapeutic goals that ‘de-roling’ techniques address in dramatherapy and psychodrama, this text provides a broader understanding of procedures and exercises that define and ease transitional experiences across cultural practices such as religious rituals and spatial design. After this introductory section, we propose a tentative answer as to why game (...) studies and virtual world research largely ignored processes of ‘roling’ and ‘de-roling’ that separate the lived experience of role-play from our everyday sense of the self. The concluding sections argue that de-roling techniques are likely to become more relevant, both academically and in terms of their practical applications, with the growing diffusion of virtual technologies in social practices. The relationships we can establish with ourselves and with our surroundings in digital virtual worlds are, we argue, only partially comparable with similar occurrences in pre-digital practices of subjectification. We propose a perspective according to which the accessibility and immersive phenomenological richness of virtual reality technologies are likely to exacerbate the potentially dissociative effects of virtual reality applications. This text constitutes an initial step towards framing specific socio-technical concerns and starting a timely conversation that binds together dramatherapy, psychodrama, game studies, and the design of digital virtual worlds. (shrink)

The Republic’s ban on poetry is a major reason for the prominent place that liberal critics assign to Plato among the enemies of the open society, Friedrich Nietzsche's description of Plato as “the greatest enemy of art Europe has yet produced” being often cited. In this article, I argue that, while Plato's ethical stance remains unacceptable for most readers today, his understanding of aesthetic experience in the Republic appears highly perceptive when seen in the light of cognitive studies and can (...) be thought‐provoking for current debates. As I try to show in the first half of the article, Plato's assessment of responses to poetry and theater resonate with embodied and enactive views of cognition. To corroborate this thesis, I point out in the second half that while theory has been blind to the significance of Plato's aesthetics, its major ideas are substantiated in practice. Contemporary psychotherapy and its increasing deployment of virtual reality unknowingly and with the opposite intent realize Plato's approach to the cognitive dynamics and ethical potential of aesthetic experience. (shrink)

This paper will philosophically extend Julian Leff’s Avatar therapy paradigm (AT) for voice-like hallucinations that was initially proposed for treatment-resistant Schizophrenia patients into the realm of gesture-enhanced embodied cognition and Virtual Reality (VR), entitled g+TA (gesture-enhanced Avatar Therapy). I propose an philosophy of technology approach of embodied rhetorics of triadic kinetic “actions” in the sense of Charles Sanders Peirce that transforms the voice hallucination incorporated by an avatar- and that can confront acousmatic voice-like hallucinations with a method of (...) gesture synchronization and dyssynchronization and gestural refusal of interaction that the player with the Avatar can resist in full embodiment. This paper therefore introduces a gesture-enhanced, extended version of Cybertherapy with Avatars that tackle multimodal bodily experience of voice-like hallucinations beyond mere visual or auditory stimulation. This is put forward theoretically in a 4E-cognition approach that expands Avatar Therapy with gestures into VR. (shrink)

The history of humankind is full of examples that indicate a constant desire to make human beings more moral. Nowadays, technological breakthroughs might have a significant impact on our moral character and abilities. This is the case of Virtual Reality (VR) technologies. The aim of this paper is to consider the ethical aspects of the use of VR in enhancing empathy. First, we will offer an introduction to VR, explaining its fundamental features, devices and concepts. Then, we will (...) approach the characterization of VR as an “empathy machine,” showing why this medium has aroused so much interest and why, nevertheless, we do not believe it is the ideal way to enhance empathy. As an alternative, we will consider fostering empathy-related abilities through virtual embodiment in avatars. In the conclusion, however, we will, we will examine some of the serious concerns related to the ethical relevance of empathy and will defend the philosophical case for a reason-guided empathy, also suggesting specific guidelines for possible future developments of empathy enhancement projects through VR embodied experiences. (shrink)

Is virtual reality the latest grand narrative that humanity has produced? This book attempts to disentangle the common characteristics of human reality and posthuman virtual reality by examining discourses on psychoanalysis, gene-technology, globalization, and contemporary art.

It is commonly assumed that a virtual life would be less meaningful (perhaps even meaningless). As virtual reality technologies develop and become more integrated into our everyday lives, this poses a challenge for those that care about meaning in life. In this chapter, it is argued that the common assumption about meaninglessness and virtuality is mistaken. After clarifying the distinction between two different visions of virtual reality, four arguments are presented for thinking that meaning is (...) possible in virtual reality. Following this, four objections are discussed and rebutted. The chapter concludes that we can be cautiously optimistic about the possibility of meaning in virtual worlds. (shrink)

In developed countries, companies are now substantially reliant on the skills and abilities of their leaders to tackle a variety of complex issues. There is a growing consensus that leadership development training and assessment methods should adopt more holistic methodologies, including those associated with the emotional and neuroendocrine aspects of learning. Recent research into the assessment of leadership competencies has proposed the use of objective methods and measurements based on neuroscience. One of the challenges to be faced in the development (...) of a performance-based methodology to measure leadership skills is how to generate real-life situations with triggers that allow us to study management competencies under controlled laboratory conditions. A way to address this question is to take advantage of virtual environments to recreate real-life situations that might arise in performance-based assessments. We propose virtual reality (VR) as a very promising tool to observe various leadership related behavioral patterns during dynamic, complex and realistic situations. By seamlessly embedding assessment methods into virtual learning environments, VR can provide objective assessment methods with high ecological validity. VR also holds unlimited opportunities for leadership training providing subjects with intelligent tutoring systems that adapts situations in real time according to the observed behaviors. (shrink)

The prelims comprise: Introduction Virtual Reality Virtual Metaphysics Virtual Identity Economic Reality.

Understanding how people behave when facing hazardous situations, how intrinsic and extrinsic factors influence the risk taking (RT) decision making process and to what extent it is possible to modify their reactions externally, are questions that have long interested academics and society in general. In the spheres of Occupational Safety and Health (OSH), the military, finance and sociology, this topic has multidisciplinary implications because we all constantly face risk taking situations. Researchers have hitherto assessed risk taking profiles by conducting questionnaires (...) prior to and after the presentation of stimuli; however, this can lead to the production of biased, non-realistic, risk taking profiles. This is due to the reflexive nature of choosing an answer in a questionnaire, which is remote from the reactive, emotional and impulsive decision making processes inherent to real, risky situations. One way to address this question is to exploit VR capabilities to generate immersive environments that recreate realistic seeming but simulated hazardous situations. We propose VR as the next-generation tool to study risk taking processes, taking advantage of the big four families of metrics which can provide objective assessment methods with high ecological validity: the real-world risks approach (high presence VR environments triggering real-world reactions), embodied interactions (more natural interactions eliciting natural behaviours), stealth assessment (unnoticed real-time assessments offering efficient behavioural metrics) and physiological real-time measurement (physiological signals avoiding subjective bias). Additionally, VR can provide an invaluable tool, after the assessment phase, to train in skills related to risk taking due to its transferability to real-world situations. (shrink)

Are the objects and events that take place in Virtual Reality genuinely real? Those who answer this question in the affirmative are realists, and those who answer in the negative are irrealists. In this paper we argue against the realist position, as given by Chalmers (2017), and present our own preferred irrealist account of the virtual. We start by disambiguating two potential versions of the realist position—weak and strong— and then go on to argue that neither is (...) plausible. We then introduce a Waltonian variety of ictionalism about the virtual, arguing that this sort of irrealist approach avoids the problems of the realist positions, fits with a unifying theory of representational works, and offers a better account of the phenomenology of engaging in virtual experiences. (shrink)

While many scholars have decried the erasure of the body in virtual reality (VR), this paper focuses on the body – and the physical reality for which it stands – as a critical component of any experience of virtual reality. Specifically, studying VR from the perspective of the physical body allows for a more nuanced appreciation of the unique reality of this «virtual» reality. Moreover, this paper argues that the body should not (...) be seen as a distraction from the immersive potential of VR, but rather as a potential tool for augmenting what virtual reality can currently offer. (shrink)

A virtual reality module that incorporates a training room (for subjects to become accommodated to virtual environments) and VR translations of Philippa Foot's Trolley Problem and Judith Thomson's Violinist thought experiment. -/- These modules are free to use for classroom or research/x-phi purposes. This set of modules is optimized for the HTC Vive. If you have an Oculus Rift, please see our VR modules optimized for the rift. -/- *Requires an HTC Vive and VR capable computer. To (...) access the simulation, uncompress the .zip folder and run the executable (.exe) file. (shrink)

I discuss how virtual reality can be used to acquire self-knowledge. Lawlor (Philos Phenomenol Res 79(1):47–75, 2009) and Cassam (Vices of the mind: from the intellectual to the political. OUP, Oxford, 2014) develop inferential accounts of self-knowledge in which one can use imagination to acquire self-knowledge. This is done by actively prompting imaginary scenarios and observing one’s reactions to those scenarios. These reactions are then used as the inferential basis for acquiring self-knowledge. I suggest that the imaginary scenarios (...) can be in principle replaced with scenarios in virtual reality in a way that still provides an inferential basis for self-knowledge. Instead of internal prompting in imagination, I call this external prompting in virtual reality. I discuss the advantages and disadvantages of external prompting. On one hand, external prompting avoids some of the common biases that can intervene with internal prompting in imagination. On the other hand, external prompting comes with some challenges of its own. External prompting might be more time-consuming and might be open to a game-like approach of the agent leading to a different sort of distortion that gets in the way of self-knowledge. I suggest that these are practical challenges, but nevertheless, external prompting seems worthwhile for self-knowledge that is otherwise especially difficult to acquire. (shrink)