Publications

@article{lahav_virtual_2019,

title = {Virtual interactive consulting agent to support freshman students in transition to higher education},

author = {Orly Lahav and Vadim Talis and Rachel Gali Cinamon and Albert Rizzo},

url = {http://link.springer.com/10.1007/s12528-019-09237-8},

doi = {10.1007/s12528-019-09237-8},

issn = {1042-1726, 1867-1233},

year  = {2019},

date = {2019-08-01},

journal = {Journal of Computing in Higher Education},

pages = {1–35},

abstract = {The virtual interactive consulting agent system is an online virtual career center that supports freshman students in transition to higher education. This virtual counseling system, based on accumulative empirical knowledge for working students and knowledge about effective career intervention, aims to guide first-year university students in combining study and work effectively. Three main aspects of career interventions are supplied by this virtual interactive consulting agent system: personal assessment, information, and personal encouragement and relatedness. The virtual interactive consulting agent is based on the SimCoach system. The current research includes two studies that examine acceptability and satisfaction from two perspectives: that of the counselors (the experts) and of the consultees (the target consumers). Both studies included 87 participants divided into two research groups: 45 counselors and 42 counseled freshman students. The data were collected through four data collection tools: acceptability and satisfaction questionnaire, an openended question, Google Docs, and screen recording applications. The participants’ answers were analyzed using quantitative software. The results show that the majority of the counselors were satisfied with the usability of the system but not with the process of counseling through the virtual agent, with some expressing concern about the impact on the profession. In contrast, most of the consultees were satisfied with the counseling process and some stated that the virtual agent helped them to determine how to integrate work and study more effectively.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{coleman_virtual_2019,

title = {Virtual Reality Assessment of Classroom – Related Attention: An Ecologically Relevant Approach to Evaluating the Effectiveness of Working Memory Training},

author = {Benjamin Coleman and Sarah Marion and Albert Rizzo and Janiece Turnbull and Anne Nolty},

url = {https://www.frontiersin.org/article/10.3389/fpsyg.2019.01851/full},

doi = {10.3389/fpsyg.2019.01851},

issn = {1664-1078},

year  = {2019},

date = {2019-08-01},

journal = {Frontiers in Psychology},

volume = {10},

abstract = {Computerized cognitive interventions to improve working memory also purport to improve ADHD-related inattention and off task behavior. Such interventions have been shown to improve working memory, executive functioning, and fluid reasoning on standardized neuropsychological measures. However, debate continues as to whether such programs lead to improvement on ecologically relevant outcomes, such as classroom behavior. This study sought to propose a novel, ecologically relevant approach to evaluate the effectiveness of working memory training on real-world attention performance. Participants included 15 children, aged 6–15, identified as having attention problems were assessed via the virtual classroom continuous performance task (VCCPT) before and after completing 5 weeks of Cogmed working memory training. The VCCPT is a validated measure of sustained and selective attention set within a virtual reality (VR) environment. Several key areas of attention performance were observed to improve, including omission errors, reaction time, reaction time variability, and hit variability. Results suggest that working memory training led to substantial improvements in sustained attention in a real-life scenario of classroom learning. Moreover, the use of psychometrically validated VR measurement provides incremental validity beyond that of teacher or parent report of behavior. Observing such improvements on ecologically relevant measures of attention adds to the discussion around how to evaluate the effectiveness of working memory training as it pertains to real-life improvements and serves to inform consumer awareness of such products and their claims.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{yeom_investigation_2019,

title = {Investigation of the physiological differences in the immersive virtual reality environment and real indoor environment: Focused on skin temperature and thermal sensation},

author = {Dongwoo Yeom and Joon-Ho Choi and Sin-Hwa Kang},

url = {https://linkinghub.elsevier.com/retrieve/pii/S0360132319301672},

doi = {10.1016/j.buildenv.2019.03.013},

issn = {03601323},

year  = {2019},

date = {2019-05-01},

journal = {Building and Environment},

volume = {154},

pages = {44–54},

abstract = {The goal of this research is to investigate and determine whether the effect of an IVE condition on an occupant's environmental sensations and physiological responses is different from the effect of a real environmental condition in the indoor environment. The research included a series of human subject experiments, with 16 participants in an environmental chamber. A thermal quality condition was selected as a primary environmental parameter, based on current IEQ-relevant studies. While the ambient thermal condition was gradually changed from 20 °C to 30 °C, the participants were asked to report their overall thermal sensations. Their skin temperatures were also continuously measured to collect physiological signal information in real time. The results of this experimental study revealed that the participants mostly generated higher skin temperature at the selected seven skin areas. Their reported thermal sensations were significantly higher in the IVE condition, than in the real environment, showing a difference of 12%.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{trahan_past_2019,

title = {Past, Present, and Future: Editorial on Virtual Reality Applications to Human Services},

author = {Mark H. Trahan and Kenneth Scott Smith and Thomas B. Talbot},

url = {https://www.tandfonline.com/doi/full/10.1080/15228835.2019.1587334},

doi = {10.1080/15228835.2019.1587334},

issn = {1522-8835, 1522-8991},

year  = {2019},

date = {2019-04-01},

journal = {Journal of Technology in Human Services},

volume = {37},

number = {1},

pages = {1–12},

abstract = {"Virtual Reality” interventions in human services may include 360 video, augmented reality, mixed reality, and fully immersive 3-dimensional virtual reality simulations. A variety of applications have been evaluated in various fields of study, including medicine, social work, psychology, and human performance training. Currently, the state of research of VR interventions in human services has primarily focused on efficacy and effectiveness research, with few studies evaluating “scaling up” or implementation of VR interventions in larger populations. Unfortunately, the state of efficacy and effectiveness studies of VR interventions still remains weak with some applications due to smaller sample sizes, lack of randomized control trials, and a gap in reporting key intervention qualities, dosage, and outcomes. With new developments in combining artificial intelligence with VR, realism and the potential for human interaction with computer generated simulations may boost presence and immersion within these applications. This editorial provides an overview of the state of virtual reality applications in human service provision, potential gaps to be addressed by research in the future, and the development of AI based interactive sequences that may boost use presence.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{tielman_considering_2019,

title = {Considering patient safety in autonomous e-mental health systems – detecting risk situations and referring patients back to human care},

author = {Myrthe L. Tielman and Mark A. Neerincx and Claudia Pagliari and Albert Rizzo and Willem-Paul Brinkman},

url = {https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-019-0796-x},

doi = {10.1186/s12911-019-0796-x},

issn = {1472-6947},

year  = {2019},

date = {2019-03-01},

journal = {BMC Medical Informatics and Decision Making},

volume = {19},

number = {1},

abstract = {Background: Digital health interventions can fill gaps in mental healthcare provision. However, autonomous emental health (AEMH) systems also present challenges for effective risk management. To balance autonomy and safety, AEMH systems need to detect risk situations and act on these appropriately. One option is sending automatic alerts to carers, but such ‘auto-referral’ could lead to missed cases or false alerts. Requiring users to actively self-refer offers an alternative, but this can also be risky as it relies on their motivation to do so. This study set out with two objectives. Firstly, to develop guidelines for risk detection and auto-referral systems. Secondly, to understand how persuasive techniques, mediated by a virtual agent, can facilitate self-referral. Methods: In a formative phase, interviews with experts, alongside a literature review, were used to develop a risk detection protocol. Two referral protocols were developed – one involving auto-referral, the other motivating users to self-refer. This latter was tested via crowd-sourcing (n = 160). Participants were asked to imagine they had sleeping problems with differing severity and user stance on seeking help. They then chatted with a virtual agent, who either directly facilitated referral, tried to persuade the user, or accepted that they did not want help. After the conversation, participants rated their intention to self-refer, to chat with the agent again, and their feeling of being heard by the agent. Results: Whether the virtual agent facilitated, persuaded or accepted, influenced all of these measures. Users who were initially negative or doubtful about self-referral could be persuaded. For users who were initially positive about seeking human care, this persuasion did not affect their intentions, indicating that a simply facilitating referral without persuasion was sufficient. Conclusion: This paper presents a protocol that elucidates the steps and decisions involved in risk detection, something that is relevant for all types of AEMH systems. In the case of self-referral, our study shows that a virtual agent can increase users’ intention to self-refer. Moreover, the strategy of the agent influenced the intentions of the user afterwards. This highlights the importance of a personalised approach to promote the user’s access to appropriate care.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{lerner_transcranial_2019,

title = {Transcranial Current Stimulation During Sleep Facilitates Insight into Temporal Rules, but does not Consolidate Memories of Individual Sequential Experiences},

author = {Itamar Lerner and Nicholas A. Ketz and Aaron P. Jones and Natalie B. Bryant and Bradley Robert and Steven W. Skorheim and Arno Hartholt and Albert S. Rizzo and Mark A. Gluck and Vincent P. Clark and Praveen K. Pilly},

url = {http://www.nature.com/articles/s41598-018-36107-7},

doi = {10.1038/s41598-018-36107-7},

issn = {2045-2322},

year  = {2019},

date = {2019-02-01},

journal = {Scientific Reports},

volume = {9},

number = {1},

abstract = {Slow-wave sleep (SWS) is known to contribute to memory consolidation, likely through the reactivation of previously encoded waking experiences. Contemporary studies demonstrate that when auditory or olfactory stimulation is administered during memory encoding and then reapplied during SWS, memory consolidation can be enhanced, an effect that is believed to rely on targeted memory reactivation (TMR) induced by the sensory stimulation. Here, we show that transcranial current stimulations (tCS) during sleep can also be used to induce TMR, resulting in the facilitation of high-level cognitive processes. Participants were exposed to repeating sequences in a realistic 3D immersive environment while being stimulated with particular tCS patterns. A subset of these tCS patterns was then reapplied during sleep stages N2 and SWS coupled to slow oscillations in a closed-loop manner. We found that in contrast to our initial hypothesis, performance for the sequences corresponding to the reapplied tCS patterns was no better than for other sequences that received stimulations only during wake or not at all. In contrast, we found that the more stimulations participants received overnight, the more likely they were to detect temporal regularities governing the learned sequences the following morning, with tCS-induced beta power modulations during sleep mediating this effect.},

keywords = {MedVR, Virtual Humans},

pubstate = {published},

tppubtype = {article}

}

@article{rizzo_clinical_2019-1,

title = {Clinical Results Using Virtual Reality},

author = {Albert Rizzo and Sebastian Thomas Koenig and Thomas B. Talbot},

editor = {Gabor F. Fulop and Charles M. Hanson and Bjørn F. Andresen},

url = {https://www.tandfonline.com/doi/full/10.1080/15228835.2019.1604292},

doi = {10.1080/15228835.2019.1604292},

issn = {1522-8835, 1522-8991},

year  = {2019},

date = {2019-02-01},

booktitle = {Infrared Technology and Applications XLV},

journal = {Journal of Technology in Human Services},

volume = {37},

number = {1},

pages = {51–74},

publisher = {SPIE},

address = {Baltimore, United States},

abstract = {Virtual Reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible to deliver using traditional methods are now being developed that take advantage of the assets that are available with VR technology. As research evidence continues to indicate clinical efficacy, VR applications are being increasingly regarded as providing innovative options for targeting the cognitive, psychological, motor, and functional impairments that result from various clinical health conditions. VR allows for the precise presentation and control of stimuli within dynamic multisensory 3-D computer generated simulations as well as providing advanced methods for capturing and quantifying behavioral responses. These characteristics support the rationale for the use of VR applications in clinical assessment, intervention, and training. This article begins with a brief review of the history and rationale for the use of VR with clinical populations. We then detail one use-case for the clinical application of VR—the exposure therapy treatment of anxiety disorders and post-traumatic stress disorder. While significant work is cited in other areas of Clinical VR (e.g., pain management, cognitive/physical assessment/rehabilitation, eating disorders, social skills/clinical training, etc.), a full overview of such a broad literature is beyond the scope of this article. Thus, we have opted to provide more in-depth analysis of one specific clinical area that clearly illustrates how VR has been successfully applied and is supported by an encouraging and evolving scientific literature.},

keywords = {MedVR, UARC},

pubstate = {published},

tppubtype = {article}

}

@article{chu_emotion_2019,

title = {Emotion Regulation in the Prisoner’s Dilemma: Effects of Reappraisal on Behavioral Measures and Cardiovascular Measures of Challenge and Threat},

author = {Veronica C. Chu and Gale M. Lucas and Su Lei and Sharon Mozgai and Peter Khooshabeh and Jonathan Gratch},

url = {https://www.frontiersin.org/article/10.3389/fnhum.2019.00050/full},

doi = {10.3389/fnhum.2019.00050},

issn = {1662-5161},

year  = {2019},

date = {2019-02-01},

journal = {Frontiers in Human Neuroscience},

volume = {13},

abstract = {The current study examines cooperation and cardiovascular responses in individuals that were defected on by their opponent in the first round of an iterated Prisoner’s Dilemma. In this scenario, participants were either primed with the emotion regulation strategy of reappraisal or no emotion regulation strategy, and their opponent either expressed an amused smile or a polite smile after the results were presented. We found that cooperation behavior decreased in the no emotion regulation group when the opponent expressed an amused smile compared to a polite smile. In the cardiovascular measures, we found significant differences between the emotion regulation conditions using the biopsychosocial (BPS) model of challenge and threat. However, the cardiovascular measures of participants instructed with the reappraisal strategy were only weakly comparable with a threat state of the BPS model, which involves decreased blood flow and perception of greater task demands than resources to cope with those demands. Conversely, the cardiovascular measures of participants without an emotion regulation were only weakly comparable with a challenge state of the BPS model, which involves increased blood flow and perception of having enough or more resources to cope with task demands.},

keywords = {ARL, DoD, MedVR, UARC, VHTL, Virtual Humans},

pubstate = {published},

tppubtype = {article}

}

@article{shawn_green_improving_2019,

title = {Improving Methodological Standards in Behavioral Interventions for Cognitive Enhancement},

author = {C. Shawn Green and Daphne Bavelier and Arthur F. Kramer and Sophia Vinogradov and Ulrich Ansorge and Karlene K. Ball and Ulrike Bingel and Jason M. Chein and Lorenza S. Colzato and Jerri D. Edwards and Andrea Facoetti and Adam Gazzaley and Susan E. Gathercole and Paolo Ghisletta and Simone Gori and Isabela Granic and Charles H. Hillman and Bernhard Hommel and Susanne M. Jaeggi and Philipp Kanske and Julia Karbach and Alan Kingstone and Matthias Kliegel and Torkel Klingberg and Simone Kühn and Dennis M. Levi and Richard E. Mayer and Anne Collins McLaughlin and Danielle S. McNamara and Martha Clare Morris and Mor Nahum and Nora S. Newcombe and Rogerio Panizzutti and Ruchika Shaurya Prakash and Albert Rizzo and Torsten Schubert and Aaron R. Seitz and Sarah J. Short and Ilina Singh and James D. Slotta and Tilo Strobach and Michael S. C. Thomas and Elizabeth Tipton and Xin Tong and Haley A. Vlach and Julie Loebach Wetherell and Anna Wexler and Claudia M. Witt},

url = {http://link.springer.com/10.1007/s41465-018-0115-y},

doi = {10.1007/s41465-018-0115-y},

issn = {2509-3290, 2509-3304},

year  = {2019},

date = {2019-01-01},

journal = {Journal of Cognitive Enhancement},

abstract = {There is substantial interest in the possibility that cognitive skills can be improved by dedicated behavioral training. Yet despite the large amount of work being conducted in this domain, there is not an explicit and widely agreed upon consensus around the best methodological practices. This document seeks to fill this gap. We start from the perspective that there are many types of studies that are important in this domain—e.g., feasibility, mechanistic, efficacy, and effectiveness. These studies have fundamentally different goals, and, as such, the best-practice methods to meet those goals will also differ. We thus make suggestions in topics ranging from the design and implementation of control groups, to reporting of results, to dissemination and communication, taking the perspective that the best practices are not necessarily uniform across all study types. We also explicitly recognize and discuss the fact that there are methodological issues around which we currently lack the theoretical and/or empirical foundation to determine best practices (e.g., as pertains to assessing participant expectations). For these, we suggest important routes forward, including greater interdisciplinary collaboration with individuals from domains that face related concerns. Our hope is that these recommendations will greatly increase the rate at which science in this domain advances.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{birckhead_recommendations_2019,

title = {Recommendations for Methodology of Virtual Reality Clinical Trials in Health Care by an International Working Group: Iterative Study},

author = {Brandon Birckhead and Carine Khalil and Xiaoyu Liu and Samuel Conovitz and Albert Rizzo and Itai Danovitch and Kim Bullock and Brennan Spiegel},

url = {https://mental.jmir.org/2019/1/e11973/},

doi = {10.2196/11973},

issn = {2368-7959},

year  = {2019},

date = {2019-01-01},

journal = {JMIR Mental Health},

volume = {6},

number = {1},

pages = {e11973},

abstract = {Background: Therapeutic virtual reality (VR) has emerged as an efficacious treatment modality for a wide range of health conditions. However, despite encouraging outcomes from early stage research, a consensus for the best way to develop and evaluate VR treatments within a scientific framework is needed. Objective: We aimed to develop a methodological framework with input from an international working group in order to guide the design, implementation, analysis, interpretation, and communication of trials that develop and test VR treatments. Methods: A group of 21 international experts was recruited based on their contributions to the VR literature. The resulting Virtual Reality Clinical Outcomes Research Experts held iterative meetings to seek consensus on best practices for the development and testing of VR treatments. Results: The interactions were transcribed, and key themes were identified to develop a scientific framework in order to support best practices in methodology of clinical VR trials. Using the Food and Drug Administration Phase I-III pharmacotherapy model as guidance, a framework emerged to support three phases of VR clinical study designs—VR1, VR2, and VR3. VR1 studies focus on content development by working with patients and providers through the principles of human-centered design. VR2 trials conduct early testing with a focus on feasibility, acceptability, tolerability, and initial clinical efficacy. VR3 trials are randomized, controlled studies that evaluate efficacy against a control condition. Best practice recommendations for each trial were provided. Conclusions: Patients, providers, payers, and regulators should consider this best practice framework when assessing the validity of VR treatments.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{maples-keller_when_2018,

title = {When translational neuroscience fails in the clinic: Dexamethasone prior to virtual reality exposure therapy increases drop-out rates},

author = {Jessica L. Maples-Keller and Tanja Jovanovic and Boadie W. Dunlop and Sheila Rauch and Carly Yasinski and Vasiliki Michopoulos and Callan Coghlan and Seth Norrholm and Albert Skip Rizzo and Kerry Ressler and Barbara O. Rothbaum},

url = {https://linkinghub.elsevier.com/retrieve/pii/S0887618518301993},

doi = {10.1016/j.janxdis.2018.10.006},

issn = {08876185},

year  = {2018},

date = {2018-10-01},

journal = {Journal of Anxiety Disorders},

abstract = {Posttraumatic stress disorder (PTSD) is characterized by exaggerated expression of fear responses to danger and safety cues. Translational research suggests that dexamethasone facilitates fear extinction in animal and human fear conditioning models. For this randomized, placebo-controlled trial (N = 27), we aimed to translate these findings to the clinic by using virtual reality exposure (VRE) therapy for OEF/OIF/OND veterans with PTSD to determine whether dexamethasone will increase the efficacy of exposure therapy for VRE relative to placebo. VRE sessions involved imaginal exposure to the most traumatic war memories while viewing a computer-generated view of virtual Iraq or Afghanistan with multisensory stimulus options used to match patient’s description of the trauma. VRE was effective in reducing PTSD symptoms but there was no interaction with dexamethasone. Drop-out rate was significantly higher in the dexamethasone group, with 10 of 13 (76.9%) participants in this group discontinuing, compared to only 4 of 14 (28.5%) in the placebo group, χ2 = 6.31},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{reger_does_2018,

title = {Does Virtual Reality Increase Simulator Sickness During Exposure Therapy for Post-Traumatic Stress Disorder?},

author = {Greg M. Reger and Derek Smolenski and Amanda Edwards-Stewart and Nancy A. Skopp and Albert "Skip" Rizzo and Aaron Norr},

url = {https://www.liebertpub.com/doi/full/10.1089/tmj.2018.0175},

year  = {2018},

date = {2018-10-01},

journal = {Telemedicine and eHealth},

abstract = {Purpose: Measurement of simulator-related side effects (SSEs) is an integral component of competent and ethical use of virtual reality exposure (VRE), but common SSEs may overlap with symptoms of anxiety. Limited research exists about the frequency of SSEs during VRE treatment for PTSD and no research compares self-reported SSEs for those undergoing VRE to those participating in exposure therapy without virtual reality. This study compared the SSEs of active duty soldiers with PTSD randomly assigned to exposure therapy via traditional prolonged exposure or VRE. Methodology: A total of 108 soldiers participated in up to 10-sessions of exposure therapy. Of those, 93 provided data on simulator sickness both prior to and after initiation of imaginal exposure. Approximately half (n = 49) used the Virtual Iraq/Afghanistan system to support engagement with their trauma memory. Soldiers completed a four-item, self-reported measure of SSE after each session. Results: Controlling for age, sex, baseline anxiety symptoms, and SSE symptom counts at the first two sessions of therapy (before initiating imaginal exposure), there was no statistically significant difference between the treatment groups in SSEs at the beginning of imaginal exposure or over the course of treatment. This finding suggests that caution should be exercised in the interpretation of SSE measurements during the use of VRE for PTSD. VR did not account for any increase in self-reported SSE. It is possible that anxiety accounts for a meaningful proportion of SSE reports during VRE.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{rizzo_clinical_2018-1,

title = {Clinical Virtual Reality: Emerging Opportunities for Psychiatry},

author = {Albert "Skip" Rizzo and Sebastian Thomas Koenig and Thomas B Talbot},

url = {https://focus.psychiatryonline.org/doi/abs/10.1176/appi.focus.20180011},

year  = {2018},

date = {2018-07-01},

journal = {Focus: The Journal of Lifelong Learning in Psychiatry},

abstract = {Virtual reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible, to deliver with traditional methods are now being developed that take advantage of the assets that are available with VR technology. As research evidence continues to indicate clinical efficacy, VR applications are being increasingly regarded as providing innovative options for targeting the cognitive, psychological, motor, and functional impairments that result from various clinical health conditions. VR allows for the precise presentation and control of stimuli in dynamic, multisensory, 3D computer-generated simulations as well as providing advanced methods for capturing and quantifying behavioral responses. These characteristics support the rationale for the use of VR applications in clinical assessment, intervention, and training. This article begins with a brief review of the history of and rationale for the use of VR with clinical populations. It then details one use case for the clinical application of VR—the exposure-therapy treatment of anxiety disorders and posttraumatic stress disorder. Although significant work is cited in other areas of clinical VR (e.g., pain management, cognitive and physical assessment and rehabilitation, eating disorders, social skills, and clinical training), a full overview of such a broad literature is beyond the scope of this article. Thus, the authors have opted to provide more in-depth analysis of one specific clinical area that clearly illustrates how VR has been successfully applied and is supported by an encouraging and evolving scientific literature.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{lineberry_learner-adaptive_2018,

title = {Learner-Adaptive Educational Technology for Simulation in Healthcare: Foundations and Opportunities},

author = {Matthew Lineberry and Parvati Dev and H. Chad Lane and Thomas B. Talbot},

url = {https://ovidsp.tx.ovid.com/sp-3.32.0a/ovidweb.cgi?QS2=434f4e1a73d37e8c332e69fd91e192ae1592d89d4aca3bbf7dd8ad87273100087c6ead8855337293109ce4018315b56e205f92a47432db5e989825f0312a30ebe358c5f0aa57fc55b26e9ae7248b5ba35e0bf04606363ca8f6135980446abd6e66f7579bd148a98b896bf864ce448c0939e86b283302e0711abe66536b4c5a6297c8a3d280e6c11a318426c8eb6e8903790fbd2dd2d1faae192123f38f47277ab3d6a3dd92617db11b40cf38398b947a67d03df6cdb74fcbfc86802e33529deb18586534e2e466560267fc29064be3a999cbe07b791ffdf528a1fe7f0ec15d2d7522575ab353949fecc59f5356fd61963e109ea9dac67e8a9c6b195f7c780a099e3bf89fa222f4d8},

doi = {10.1097/SIH.0000000000000274},

issn = {1559-2332},

year  = {2018},

date = {2018-06-01},

journal = {Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare},

pages = {1},

abstract = {Despite evidence that learners vary greatly in their learning needs, practical constraints tend to favor ’’one-size-fits-all’’ educational approaches, in simulation-based education as elsewhere. Adaptive educational technologies - devices and/or software applications that capture and analyze relevant data about learners to select and present individually tailored learning stimuli - are a promising aid in learners’ and educators’ efforts to provide learning experiences that meet individual needs. In this article, we summarize and build upon the 2017 Society for Simulation in Healthcare Research Summit panel discussion on adaptive learning. First, we consider the role of adaptivity in learning broadly. We then outline the basic functions that adaptive learning technologies must implement and the unique affordances and challenges of technology-based approaches for those functions, sharing an illustrative example from healthcare simulation. Finally, we consider future directions for accelerating research, development, and deployment of effective adaptive educational technology and techniques in healthcare simulation.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{loucks_you_2018,

title = {You can do that⁈: Feasibility of virtual reality exposure therapy in the treatment of PTSD due to military sexual trauma},

author = {Laura Loucks and Carly Yasinski and Seth D. Norrholm and Jessica Maples-Keller and Loren Post and Liza Zwiebach and Devika Fiorillo and Megan Goodlin and Tanja Jovanovic and Albert A. Rizzo and Barbara O. Rothbaum},

url = {https://linkinghub.elsevier.com/retrieve/pii/S0887618517304991},

doi = {10.1016/j.janxdis.2018.06.004},

issn = {08876185},

year  = {2018},

date = {2018-06-01},

journal = {Journal of Anxiety Disorders},

abstract = {This initial feasibility study examined the use of virtual reality exposure therapy (VRE) in the treatment of MSTrelated PTSD, with newly developed content tailored to MST. Participants included 15 veterans (26% male) with MST-related PTSD. Assessment of PTSD, depression, and psychophysiological indicators of distress occurred at pre-treatment, post-treatment, and 3-month follow-up. Treatment included 6–12 VRE sessions. There were significant reductions in pre- to post-treatment PTSD (CAPS severity: t(10) = 3.69},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{norr_virtual_2018,

title = {Virtual reality exposure versus prolonged exposure for PTSD: Which treatment for whom?},

author = {Aaron M. Norr and Derek J. Smolenski and Andrea C. Katz and Albert A. Rizzo and Barbara O. Rothbaum and JoAnn Difede and Patricia Koenen-Woods and Mark A. Reger and Greg M. Reger},

url = {http://doi.wiley.com/10.1002/da.22751},

doi = {10.1002/da.22751},

issn = {10914269},

year  = {2018},

date = {2018-06-01},

journal = {Depression and Anxiety},

volume = {35},

number = {6},

pages = {523–529},

abstract = {1 Background The majority of studies comparing active psychological treatments for posttraumatic stress disorder (PTSD) do not find significant differences at posttreatment. This was the case in a recent trial examining prolonged exposure (PE) and virtual reality exposure (VRE) among active‐duty soldiers with combat‐related PTSD. Matching individual patients to specific treatments provides a potential avenue to improve significantly the public health impact of effective treatments for PTSD. A composite moderator approach was used to identify profiles of patients who would see superior PTSD symptom reduction in VRE or PE to inform future treatment matching. 2 Methods Active duty U.S. army soldiers (N = 108) were enrolled in a randomized clinical trial comparing VRE and PE in the treatment of PTSD stemming from deployments to Iraq or Afghanistan. Eighteen baseline variables were examined to identify treatment response heterogeneity in two patient groups: those with a superior response to PE and those with a superior response to VRE. The final composite moderator comprised four of 18 baseline variables. 3 Results Results revealed that patients who were predicted to see greater PTSD symptom reduction in VRE were likely to be younger, not taking antidepressant medication, had greater PTSD hyperarousal symptoms, and were more likely to have greater than minimal suicide risk. 4 Conclusions Results suggest that treatment matching based on patient profiles could meaningfully improve treatment efficacy for combat‐related PTSD. Future research can build on these results to improve our understanding of how to improve treatment matching for PTSD.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{bioulac_virtual_2018,

title = {Virtual Remediation Versus Methylphenidate to Improve Distractibility in Children With ADHD: A Controlled Randomized Clinical Trial Study},

author = {Stéphanie Bioulac and Jean-Arthur Micoulaud-Franchi and Jenna Maire and Manuel P. Bouvard and Albert A. Rizzo and Patricia Sagaspe and Pierre Philip},

url = {http://journals.sagepub.com/doi/abs/10.1177/1087054718759751},

doi = {10.1177/1087054718759751},

year  = {2018},

date = {2018-03-01},

journal = {Journal of attention disorders},

abstract = {Objective: Virtual environments have been used to assess children with ADHD but have never been tested as therapeutic tools. We tested a new virtual classroom cognitive remediation program to improve symptoms in children with ADHD. Method: In this randomized clinical trial, 51 children with ADHD (7-11 years) were assigned to a virtual cognitive remediation group, a methylphenidate group, or a psychotherapy group. All children were evaluated before and after therapy with an ADHD Rating Scale, a Continuous Performance Test (CPT), and a virtual classroom task. Results: After therapy by virtual remediation, children exhibited significantly higher numbers of correct hits on the virtual classroom and CPT. These improvements were equivalent to those observed with methylphenidate treatment. Conclusion: Our study demonstrates for the first time that a cognitive remediation program delivered in a virtual classroom reduces distractibility in children with ADHD and could replace methylphenidate treatment in specific cases.},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{rizzo_skip_will_2018,

title = {Will healthcare be where the killer VR apps will emerge?},

author = {Skip Rizzo},

url = {https://www.virtualreality-news.net/news/2018/feb/13/will-healthcare-be-where-killer-vr-apps-will-emerge/},

year  = {2018},

date = {2018-02-01},

journal = {VR 360},

abstract = {Virtual reality (VR) technology offers new opportunities for clinical research, assessment, and intervention. Since the mid-1990s, VR-based testing, training, teaching, and treatment approaches have been developed by clinicians and researchers that would be difficult, if not impossible, to deliver using traditional methods},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}

@article{rizzo_clinical_2018,

title = {Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD},

author = {Albert ‘Skip’ Rizzo and Russell Shilling},

url = {https://www.tandfonline.com/doi/full/10.1080/20008198.2017.1414560},

doi = {10.1080/20008198.2017.1414560},

issn = {2000-8198, 2000-8066},

year  = {2018},

date = {2018-01-01},

journal = {European Journal of Psychotraumatology},

volume = {8},

number = {sup5},

abstract = {Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/ OND) military personnel has created a significant behavioural healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. The current article presents the use of Virtual Reality (VR) as a clinical tool to address the assessment, prevention, and treatment of PTSD, based on the VR projects that were evolved at the University of Southern California Institute for Creative Technologies since 2004. A brief discussion of the definition and rationale for the clinical use of VR is followed by a description of a VR application designed for the delivery of prolonged exposure (PE) for treating Service Members (SMs) and Veterans with combat- and sexual assault-related PTSD. The expansion of the virtual treatment simulations of Iraq and Afghanistan for PTSD assessment and prevention is then presented. This is followed by a forward-looking discussion that details early efforts to develop virtual human agent systems that serve the role of virtual patients for training the next generation of clinical providers, as healthcare guides that can be used to support anonymous access to trauma-relevant behavioural healthcare information, and as clinical interviewers capable of automated behaviour analysis of users to infer psychological state. The paper will conclude with a discussion of VR as a tool for breaking down barriers to care in addition to its direct application in assessment and intervention.},

keywords = {MedVR, UARC},

pubstate = {published},

tppubtype = {article}

}

@article{rizzo_is_2017,

title = {Is clinical virtual reality ready for primetime?},

author = {Albert “Skip” Rizzo and Sebastian Thomas Koenig},

url = {https://www.researchgate.net/publication/319165844_Is_Clinical_Virtual_Reality_Ready_for_Primetime},

doi = {10.1037/neu0000405},

issn = {1931-1559, 0894-4105},

year  = {2017},

date = {2017-10-01},

journal = {Neuropsychology},

volume = {31},

number = {8},

pages = {877–899},

abstract = {Objective: Since the mid-1990s, a significant scientific literature has evolved regarding the outcomes from the use of what we now refer to as Clinical Virtual Reality (VR). This use of VR simulation technology has produced encouraging results when applied to address cognitive, psychological, motor, and functional impairments across a wide range of clinical health conditions. This article addresses the question, “Is Clinical VR Ready for Primetime?” Method: After a brief description of the various forms of VR technology, we discuss the trajectory of Clinical VR over the last 20 years and summarize the basic assets that VR offers for creating clinical applications. The discussion then addresses the question of readiness in terms of the theoretical basis for Clinical VR assets, the research to date, the pragmatic factors regarding availability, usability, and costs of Clinical VR content/systems, and the ethical issues for the safe use of VR with clinical populations. Results: Our review of the theoretical underpinnings and research findings to date leads to the prediction that Clinical VR will have a significant impact on future research and practice. Pragmatic issues that can influence adoption across many areas of psychology also appear favorable, but professional guidelines will be needed to promote its safe and ethical use. Conclusions: While there is still much research needed to advance the science in this area, we strongly believe that Clinical VR applications will become indispensable tools in the toolbox of psychological researchers and practitioners and will only grow in relevance and popularity in the future. Keywords: Clinical Virtual Reality, Psychology, Rehabilitation, Neuropsychology},

keywords = {MedVR, UARC},

pubstate = {published},

tppubtype = {article}

}

@article{schnurr_what_2017,

title = {What I have changed my mind about and why: public health and technology perspectives in the field of trauma studies},

author = {Paula P. Schnurr and Richard Bryant and Lucy Berliner and Dean G. Kilpatrick and Albert Rizzo and Josef I. Ruzek},

url = {https://www.tandfonline.com/doi/full/10.1080/20008198.2017.1372007},

doi = {10.1080/20008198.2017.1372007},

issn = {2000-8198, 2000-8066},

year  = {2017},

date = {2017-09-01},

journal = {European Journal of Psychotraumatology},

volume = {8},

number = {sup5},

abstract = {Background: This paper is based on a panel discussion at the 32nd annual meeting of the International Society for Traumatic Stress Studies in Dallas, Texas, in November 2016. Objective: Paula Schnurr convened a panel of experts in the fields of public health and technology to address the topic: ‘What I have changed my mind about and why.’ Method: The panel included Richard Bryant, Lucy Berliner, Dean Kilpatrick, Albert (‘Skip’) Rizzo, and Josef Ruzek. Results: Panellists discussed innovative strategies for the dissemination of scientific knowledge and evidence-based treatment. Conclusions: Although there are effective treatments, there is a need to enhance the effectiveness of these treatments. There also is a need to develop simpler, low-cost strategies to disseminate effective treatments. However, technology approaches also offer pathways to increased dissemination. Researchers must communicate scientific findings more effectively to impact public opinion and public policy.},

keywords = {MedVR, UARC},

pubstate = {published},

tppubtype = {article}

}

@article{kang_social_2017,

title = {Social influence of humor in virtual human counselor's self-disclosure},

author = {Sin-Hwa Kang and David M. Krum and Peter Khooshabeh and Thai Phan and Chien-Yen Chang and Ori Amir and Rebecca Lin},

url = {http://doi.wiley.com/10.1002/cav.1763},

doi = {10.1002/cav.1763},

issn = {15464261},

year  = {2017},

date = {2017-04-01},

journal = {Computer Animation and Virtual Worlds},

volume = {28},

number = {3-4},

abstract = {We explored the social influence of humor in a virtual human counselor's selfdisclosure while also varying the ethnicity of the virtual counselor. In a 2 × 3 experiment (humor and ethnicity of the virtual human counselor), participants experienced counseling interview interactions via Skype on a smartphone. We measured user responses to and perceptions of the virtual human counselor. The results demonstrate that humor positively affects user responses to and perceptions of a virtual counselor. The results further suggest that matching styles of humor with a virtual counselor's ethnicity influences user responses and perceptions. The results offer insight into the effective design and development of realistic and believable virtual human counselors. Furthermore, they illuminate the potential use of humor to enhance self‐disclosure in human–agent interactions.},

keywords = {ARL, DoD, MedVR, MxR, UARC},

pubstate = {published},

tppubtype = {article}

}

@article{rizzo_ultimate_2017,

title = {The Ultimate Skinner Box: Clinical Virtual Reality 1990-2016},

author = {Albert "Skip" Rizzo},

url = {https://www.engadget.com/2017/01/10/the-ultimate-skinner-box-clinical-virtual-reality-1990-2016/},

year  = {2017},

date = {2017-01-01},

journal = {Engadget},

abstract = {The last decade has given rise to a dramatic increase in the global adoption of innovative digital technologies. This can be seen in the rapid acceptance and growing demand for mobile devices, high speed network access, smart televisions, social media, hyper-realistic digital games, behavioral sensing devices, and now the 2nd coming of Virtual Reality! Such consumer driven technologies that were considered to be visionary just 10 years ago have now become common and increasingly essential fixtures in the current digital landscape},

keywords = {MedVR},

pubstate = {published},

tppubtype = {article}

}