Publications
Search
21.
Malta, Loretta S.; Giosan, Cezar; Szkodny, Lauren E.; Altemus, Margaret M.; Rizzo, Albert A.; Silbersweig, David A.; Difede, JoAnn
Predictors of involuntary and voluntary emotional episodic memories of virtual reality scenarios in Veterans with and without PTSD Journal Article
In: Memory, pp. 1–17, 2020, ISSN: 0965-8211, 1464-0686.
@article{malta_predictors_2020,
title = {Predictors of involuntary and voluntary emotional episodic memories of virtual reality scenarios in Veterans with and without PTSD},
author = {Loretta S. Malta and Cezar Giosan and Lauren E. Szkodny and Margaret M. Altemus and Albert A. Rizzo and David A. Silbersweig and JoAnn Difede},
url = {https://www.tandfonline.com/doi/full/10.1080/09658211.2020.1770289},
doi = {10.1080/09658211.2020.1770289},
issn = {0965-8211, 1464-0686},
year = {2020},
date = {2020-05-01},
journal = {Memory},
pages = {1--17},
abstract = {This study investigated predictors of involuntary and voluntary memories of stressful virtual reality scenarios. Thirty-two veterans of the two Persian Gulf Wars completed verbal memory tests and diagnostic assessments. They were randomly assigned to a Recounting (16) or a Suppression (16) condition. After immersion in the VR scenarios, the Recounting group described the scenarios and the Suppression group suppressed thoughts of the scenarios. One week later, participants completed surprise voluntary memory tests and another thought suppression task. The best predictors of voluntary memory were verbal memory ability, dissociation, and to a lesser extent, physiological arousal before and after scenarios. Dissociation and physiological stress responses selectively affected memory for neutral elements. Higher distress during scenarios impaired voluntary memory but increased the frequency of involuntary memories. Physiological stress responses promoted more frequent involuntary memories immediately after the scenarios. More frequent initial involuntary memories, tonic physiological arousal, and stronger emotional responses to dangerous events predicted difficulty inhibiting involuntary memories at follow-up. The effects of thought suppression were transient and weaker than those of other variables. The findings suggest that posttraumatic amnesia and involuntary memories of adverse events are more related to memory ability and emotional and physiological stress responses than to postexposure suppression.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This study investigated predictors of involuntary and voluntary memories of stressful virtual reality scenarios. Thirty-two veterans of the two Persian Gulf Wars completed verbal memory tests and diagnostic assessments. They were randomly assigned to a Recounting (16) or a Suppression (16) condition. After immersion in the VR scenarios, the Recounting group described the scenarios and the Suppression group suppressed thoughts of the scenarios. One week later, participants completed surprise voluntary memory tests and another thought suppression task. The best predictors of voluntary memory were verbal memory ability, dissociation, and to a lesser extent, physiological arousal before and after scenarios. Dissociation and physiological stress responses selectively affected memory for neutral elements. Higher distress during scenarios impaired voluntary memory but increased the frequency of involuntary memories. Physiological stress responses promoted more frequent involuntary memories immediately after the scenarios. More frequent initial involuntary memories, tonic physiological arousal, and stronger emotional responses to dangerous events predicted difficulty inhibiting involuntary memories at follow-up. The effects of thought suppression were transient and weaker than those of other variables. The findings suggest that posttraumatic amnesia and involuntary memories of adverse events are more related to memory ability and emotional and physiological stress responses than to postexposure suppression.
22.
Chang, Chen-Wei; Li, Mengtong; Yeh, Shih-Ching; Chen, Yijing; Rizzo, Albert
In: IEEE Access, vol. 8, pp. 69566–69578, 2020, ISSN: 2169-3536.
@article{chang_examining_2020,
title = {Examining the Effects of HMDs/FSDs and Gender Differences on Cognitive Processing Ability and User Experience of the Stroop Task-Embedded Virtual Reality Driving System (STEVRDS)},
author = {Chen-Wei Chang and Mengtong Li and Shih-Ching Yeh and Yijing Chen and Albert Rizzo},
url = {https://ieeexplore.ieee.org/document/8959194/},
doi = {10.1109/ACCESS.2020.2966564},
issn = {2169-3536},
year = {2020},
date = {2020-04-01},
journal = {IEEE Access},
volume = {8},
pages = {69566--69578},
abstract = {The advent of virtual reality technology has provided a new approach for assessing and training cognitive processing ability, with the design of simulations used to replicate real events in everyday lives. To better understand how head mounted displays/flat screen displays (HMDs/FSDs) and differences in the individuals who use them affect cognitive performance and the use of VR systems, our research group created the Stroop task-embedded virtual reality driving system (STEVRDS) and conducted a 2 × 2 between-group factorial design experiment among college students. The study examined the effects of HMDs and FSDs that differ in monovision/stereovision and field of view, the impact of gender (males vs. females) on users’ performances in virtual driving and Stroop trials, and users’ psychophysiological responses while using the system. The participants’ subjective perceptions toward STEVRDS were also assessed to support the analyses/interpretations of cognitive performance, as well as provide empirical data relating to user experiences. The statistical analyses showed both main and interaction effects of HMDs/FSDs and gender on task performance, psychophysiological responses, and user evaluations of the system. The psychophysiological patterns exhibited during the use of STEVRDS further extended the findings. Overall, our results were comparable with cognitive phenomena reported in other studies/in real-life experiences or explained by logical reasoning, which suggests that the design/development of the STEVRDS is suitable for cognitive assessment/training. Practical implications are discussed for the application of HMDs and FSDs in evaluating and enhancing cognitive processing ability and the need for specific tailoring for male and female users.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The advent of virtual reality technology has provided a new approach for assessing and training cognitive processing ability, with the design of simulations used to replicate real events in everyday lives. To better understand how head mounted displays/flat screen displays (HMDs/FSDs) and differences in the individuals who use them affect cognitive performance and the use of VR systems, our research group created the Stroop task-embedded virtual reality driving system (STEVRDS) and conducted a 2 × 2 between-group factorial design experiment among college students. The study examined the effects of HMDs and FSDs that differ in monovision/stereovision and field of view, the impact of gender (males vs. females) on users’ performances in virtual driving and Stroop trials, and users’ psychophysiological responses while using the system. The participants’ subjective perceptions toward STEVRDS were also assessed to support the analyses/interpretations of cognitive performance, as well as provide empirical data relating to user experiences. The statistical analyses showed both main and interaction effects of HMDs/FSDs and gender on task performance, psychophysiological responses, and user evaluations of the system. The psychophysiological patterns exhibited during the use of STEVRDS further extended the findings. Overall, our results were comparable with cognitive phenomena reported in other studies/in real-life experiences or explained by logical reasoning, which suggests that the design/development of the STEVRDS is suitable for cognitive assessment/training. Practical implications are discussed for the application of HMDs and FSDs in evaluating and enhancing cognitive processing ability and the need for specific tailoring for male and female users.
23.
Katz, Andrea C.; Norr, Aaron M.; Buck, Benjamin; Fantelli, Emily; Edwards-Stewart, Amanda; Koenen-Woods, Patricia; Zetocha, Kimberlee; Smolenski, Derek J.; Holloway, Kevin; Rothbaum, Barbara O.; Difede, JoAnn; Rizzo, Albert; Skopp, Nancy; Mishkind, Matt; Gahm, Gregory; Reger, Greg M.; Andrasik, Frank
In: Psychological Trauma: Theory, Research, Practice, and Policy, 2020, ISSN: 1942-969X, 1942-9681.
@article{katz_changes_2020,
title = {Changes in physiological reactivity in response to the trauma memory during prolonged exposure and virtual reality exposure therapy for posttraumatic stress disorder.},
author = {Andrea C. Katz and Aaron M. Norr and Benjamin Buck and Emily Fantelli and Amanda Edwards-Stewart and Patricia Koenen-Woods and Kimberlee Zetocha and Derek J. Smolenski and Kevin Holloway and Barbara O. Rothbaum and JoAnn Difede and Albert Rizzo and Nancy Skopp and Matt Mishkind and Gregory Gahm and Greg M. Reger and Frank Andrasik},
url = {http://doi.apa.org/getdoi.cfm?doi=10.1037/tra0000567},
doi = {10.1037/tra0000567},
issn = {1942-969X, 1942-9681},
year = {2020},
date = {2020-04-01},
journal = {Psychological Trauma: Theory, Research, Practice, and Policy},
abstract = {This study is among the first to examine how physiological processes change throughout PTSD treatment and the first to compare standard exposure therapy to therapy augmented with virtual reality (VR) in active-duty soldiers with PTSD. Results showed that soldiers in VR therapy had smaller physical reactions to trauma memories compared to those who did not receive treatment, whereas those who got standard treatment did not. These findings provide insight into possible mechanisms of PTSD treatment, point to potential objective indicators of early treatment response in active-duty soldiers, and suggest that VR treatment might lead to earlier symptom reduction.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This study is among the first to examine how physiological processes change throughout PTSD treatment and the first to compare standard exposure therapy to therapy augmented with virtual reality (VR) in active-duty soldiers with PTSD. Results showed that soldiers in VR therapy had smaller physical reactions to trauma memories compared to those who did not receive treatment, whereas those who got standard treatment did not. These findings provide insight into possible mechanisms of PTSD treatment, point to potential objective indicators of early treatment response in active-duty soldiers, and suggest that VR treatment might lead to earlier symptom reduction.
24.
Mozgai, Sharon; Hartholt, Arno; Leeds, Andrew; Rizzo, Albert ‘Skip’
Iterative Participatory Design for VRET Domain Transfer: From Combat Exposure to Military Sexual Trauma Inproceedings
In: Proceedings of the 2020 CHI Conference of Human Factors in Computing Systems, pp. 8, ACM, Honolulu, HI, 2020.
@inproceedings{mozgai_iterative_2020,
title = {Iterative Participatory Design for VRET Domain Transfer: From Combat Exposure to Military Sexual Trauma},
author = {Sharon Mozgai and Arno Hartholt and Andrew Leeds and Albert ‘Skip’ Rizzo},
url = {https://dl.acm.org/doi/abs/10.1145/3334480.3375219},
doi = {10.1145/3334480.3375219},
year = {2020},
date = {2020-04-01},
booktitle = {Proceedings of the 2020 CHI Conference of Human Factors in Computing Systems},
pages = {8},
publisher = {ACM},
address = {Honolulu, HI},
abstract = {This case study describes the expansion of the BRAVEMIND virtual reality exposure therapy (VRET) system from the domain of combat-related posttraumatic stress disorder (PTSD) to the domain of PTSD due to Military Sexual Trauma (MST). As VRET continues to demonstrate efficacy in treating PTSD across multiple trauma types and anxiety disorders, adapting existing systems and content to new domains while simultaneously maintaining clinical integrity is becoming a high priority. To develop BRAVEMIND-MST we engaged in an iterative participatory design process with psychologists, engineers, and artists. This first-person account of our collaborative development process focuses on three key areas (1) VR Environment, (2) User-Avatar State, and (3) Events, while detailing the challenges we encountered and lessons learned. This process culminated in eight design guidelines as a first-step in defining a VRET domain transfer methodology.},
keywords = {},
pubstate = {published},
tppubtype = {inproceedings}
}
This case study describes the expansion of the BRAVEMIND virtual reality exposure therapy (VRET) system from the domain of combat-related posttraumatic stress disorder (PTSD) to the domain of PTSD due to Military Sexual Trauma (MST). As VRET continues to demonstrate efficacy in treating PTSD across multiple trauma types and anxiety disorders, adapting existing systems and content to new domains while simultaneously maintaining clinical integrity is becoming a high priority. To develop BRAVEMIND-MST we engaged in an iterative participatory design process with psychologists, engineers, and artists. This first-person account of our collaborative development process focuses on three key areas (1) VR Environment, (2) User-Avatar State, and (3) Events, while detailing the challenges we encountered and lessons learned. This process culminated in eight design guidelines as a first-step in defining a VRET domain transfer methodology.
25.
Mozgai, Sharon; Hartholt, Arno; Rizzo, Albert "Skip"
An Adaptive Agent-Based Interface for Personalized Health Interventions Inproceedings
In: Proceedings of the 25th International Conference on Intelligent User Interfaces Companion, pp. 118–119, ACM, Cagliari Italy, 2020, ISBN: 978-1-4503-7513-9.
@inproceedings{mozgai_adaptive_2020,
title = {An Adaptive Agent-Based Interface for Personalized Health Interventions},
author = {Sharon Mozgai and Arno Hartholt and Albert "Skip" Rizzo},
url = {https://dl.acm.org/doi/10.1145/3379336.3381467},
doi = {10.1145/3379336.3381467},
isbn = {978-1-4503-7513-9},
year = {2020},
date = {2020-03-01},
booktitle = {Proceedings of the 25th International Conference on Intelligent User Interfaces Companion},
pages = {118--119},
publisher = {ACM},
address = {Cagliari Italy},
abstract = {This demo introduces a novel mHealth application with an agentbased interface designed to collect multimodal data with passive sensors native to popular wearables (e.g., Apple Watch, FitBit, and Garmin) as well as through user self-report. This mHealth application delivers personalized and adaptive multimedia content via smartphone application specifically tailored to the user in the interdependent domains of physical, cognitive, and emotional health via novel adaptive logic-based algorithms while employing behavior change techniques (e.g., goal-setting, barrier identification, etc.). A virtual human coach leads all interactions to improve adherence.},
keywords = {},
pubstate = {published},
tppubtype = {inproceedings}
}
This demo introduces a novel mHealth application with an agentbased interface designed to collect multimodal data with passive sensors native to popular wearables (e.g., Apple Watch, FitBit, and Garmin) as well as through user self-report. This mHealth application delivers personalized and adaptive multimedia content via smartphone application specifically tailored to the user in the interdependent domains of physical, cognitive, and emotional health via novel adaptive logic-based algorithms while employing behavior change techniques (e.g., goal-setting, barrier identification, etc.). A virtual human coach leads all interactions to improve adherence.
26.
Saredakis, Dimitrios; Szpak, Ancret; Birckhead, Brandon; Keage, Hannah A. D.; Rizzo, Albert; Loetscher, Tobias
Factors Associated With Virtual Reality Sickness in Head-Mounted Displays: A Systematic Review and Meta-Analysis Journal Article
In: Frontiers in Human Neuroscience, vol. 14, pp. 96, 2020, ISSN: 1662-5161.
@article{saredakis_factors_2020,
title = {Factors Associated With Virtual Reality Sickness in Head-Mounted Displays: A Systematic Review and Meta-Analysis},
author = {Dimitrios Saredakis and Ancret Szpak and Brandon Birckhead and Hannah A. D. Keage and Albert Rizzo and Tobias Loetscher},
url = {https://www.frontiersin.org/article/10.3389/fnhum.2020.00096/full},
doi = {10.3389/fnhum.2020.00096},
issn = {1662-5161},
year = {2020},
date = {2020-03-01},
journal = {Frontiers in Human Neuroscience},
volume = {14},
pages = {96},
abstract = {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.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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.
27.
Mozgai, Sharon; Hartholt, Arno; Rizzo, Albert
The Passive Sensing Agent: A Multimodal Adaptive mHealth Application Inproceedings
In: Proceedings of the 2020 IEEE International Conference on Pervasive Computing and Communications Workshops (PerCom Workshops), pp. 1–3, IEEE, Austin, TX, USA, 2020, ISBN: 978-1-72814-716-1.
@inproceedings{mozgai_passive_2020,
title = {The Passive Sensing Agent: A Multimodal Adaptive mHealth Application},
author = {Sharon Mozgai and Arno Hartholt and Albert Rizzo},
url = {https://ieeexplore.ieee.org/document/9156177/},
doi = {10.1109/PerComWorkshops48775.2020.9156177},
isbn = {978-1-72814-716-1},
year = {2020},
date = {2020-03-01},
booktitle = {Proceedings of the 2020 IEEE International Conference on Pervasive Computing and Communications Workshops (PerCom Workshops)},
pages = {1--3},
publisher = {IEEE},
address = {Austin, TX, USA},
abstract = {We are demoing the Passive Sensing Agent (PSA), an mHealth virtual human coach, that collects multimodal data through passive sensors native to popular wearables (e.g., Apple Watch, FitBit, and Garmin). This virtual human interface delivers adaptive multi-media content via smartphone application that is specifically tailored to the user in the interdependent domains of physical, cognitive, and emotional health. Initially developed for the military, the PSA delivers health interventions (e.g., educational exercises, physical challenges, and performance feedback) matched to the individual user via novel adaptive logic-based algorithms while employing various behavior change techniques (e.g., goal-setting, barrier identification, rewards, modeling, etc.). A virtual human coach leads all interactions including the firsttime user experience and the brief daily sessions. All interactions were specifically designed to engage and motivate the user while continuously collecting data on their cognitive, emotional, and physical fitness. This multi-component application is integrated and deployed on an iPhone and Apple Watch prototype; a civilian version is currently in-development.},
keywords = {},
pubstate = {published},
tppubtype = {inproceedings}
}
We are demoing the Passive Sensing Agent (PSA), an mHealth virtual human coach, that collects multimodal data through passive sensors native to popular wearables (e.g., Apple Watch, FitBit, and Garmin). This virtual human interface delivers adaptive multi-media content via smartphone application that is specifically tailored to the user in the interdependent domains of physical, cognitive, and emotional health. Initially developed for the military, the PSA delivers health interventions (e.g., educational exercises, physical challenges, and performance feedback) matched to the individual user via novel adaptive logic-based algorithms while employing various behavior change techniques (e.g., goal-setting, barrier identification, rewards, modeling, etc.). A virtual human coach leads all interactions including the firsttime user experience and the brief daily sessions. All interactions were specifically designed to engage and motivate the user while continuously collecting data on their cognitive, emotional, and physical fitness. This multi-component application is integrated and deployed on an iPhone and Apple Watch prototype; a civilian version is currently in-development.
28.
An, Capt Eric; Nolty, Anne A T; Amano, Stacy S; Rizzo, Albert A; Buckwalter, J Galen; Rensberger, Jared
Heart Rate Variability as an Index of Resilience Journal Article
In: Military Medicine, 2019, ISSN: 0026-4075, 1930-613X.
@article{an_heart_2019,
title = {Heart Rate Variability as an Index of Resilience},
author = {Capt Eric An and Anne A T Nolty and Stacy S Amano and Albert A Rizzo and J Galen Buckwalter and Jared Rensberger},
url = {https://academic.oup.com/milmed/advance-article/doi/10.1093/milmed/usz325/5586497},
doi = {10.1093/milmed/usz325},
issn = {0026-4075, 1930-613X},
year = {2019},
date = {2019-10-01},
journal = {Military Medicine},
abstract = {Introduction: Resilience is the ability to maintain or quickly return to a stable physical and psychological equilibrium despite experiencing stressful events. Flexibility of the autonomic nervous system is particularly important for adaptive stress responses and may contribute to individual differences in resilience. Power spectrum analysis of heart rate variability (HRV) allows measurement of sympathovagal balance, which helps to evaluate autonomic flexibility. The present study investigated HRV as a broad index of resilience. Materials and Methods: Twenty-four male participants from the Army National Guard Special Forces completed psychological measures known to relate to resilience and had HRV measured while undergoing stressful virtual environment scenarios. Pearson product-moment correlations were used to explore the relationships between HRV and resilience factors. All research was conducted with the oversight of the Human Subjects Review Committee of Fuller Theological Seminary. Results: Trends toward significance were reported in order to provide results that would reasonably be expected in a study of higher power. Trends between resilience factors and HRV were found only during specific stress-inducing simulations (see Tables III). Conclusion: Greater resilience to stress was associated with HRV during nonstress periods. Higher levels of resilience to traumatic events were associated with HRV during circumstances that were more stressful and emotionally distressing. Post hoc analysis revealed that specific factors including flexibility, emotional control, and spirituality were driving the relationship between general resilience and HRV following emotionally laden stressors. Less stress vulnerability was associated with HRV following intermittent brief stressors. In sum, HRV appears to represent some aspects of an individual’s overall resilience profile. Although resilience remains a complex, multidimensional construct, HRV shows promise as a global psychophysiological index of resilience. This study also offers important perspectives concerning ways to optimize both physical and psychological health.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: Resilience is the ability to maintain or quickly return to a stable physical and psychological equilibrium despite experiencing stressful events. Flexibility of the autonomic nervous system is particularly important for adaptive stress responses and may contribute to individual differences in resilience. Power spectrum analysis of heart rate variability (HRV) allows measurement of sympathovagal balance, which helps to evaluate autonomic flexibility. The present study investigated HRV as a broad index of resilience. Materials and Methods: Twenty-four male participants from the Army National Guard Special Forces completed psychological measures known to relate to resilience and had HRV measured while undergoing stressful virtual environment scenarios. Pearson product-moment correlations were used to explore the relationships between HRV and resilience factors. All research was conducted with the oversight of the Human Subjects Review Committee of Fuller Theological Seminary. Results: Trends toward significance were reported in order to provide results that would reasonably be expected in a study of higher power. Trends between resilience factors and HRV were found only during specific stress-inducing simulations (see Tables III). Conclusion: Greater resilience to stress was associated with HRV during nonstress periods. Higher levels of resilience to traumatic events were associated with HRV during circumstances that were more stressful and emotionally distressing. Post hoc analysis revealed that specific factors including flexibility, emotional control, and spirituality were driving the relationship between general resilience and HRV following emotionally laden stressors. Less stress vulnerability was associated with HRV following intermittent brief stressors. In sum, HRV appears to represent some aspects of an individual’s overall resilience profile. Although resilience remains a complex, multidimensional construct, HRV shows promise as a global psychophysiological index of resilience. This study also offers important perspectives concerning ways to optimize both physical and psychological health.
29.
Difede, JoAnn; Rothbaum, Barbara O.; Rizzo, Albert A.; Wyka, Katarzyna; Spielman, Lisa; Jovanovic, Tanja; Reist, Christopher; Roy, Michael J.; Norrholm, Seth D.; Glatt, Charles; Lee, Francis
Enhanced exposure therapy for combat-related Posttraumatic Stress Disorder (PTSD): Study protocol for a randomized controlled trial Journal Article
In: Contemporary Clinical Trials, pp. 105857, 2019, ISSN: 15517144.
@article{difede_enhanced_2019,
title = {Enhanced exposure therapy for combat-related Posttraumatic Stress Disorder (PTSD): Study protocol for a randomized controlled trial},
author = {JoAnn Difede and Barbara O. Rothbaum and Albert A. Rizzo and Katarzyna Wyka and Lisa Spielman and Tanja Jovanovic and Christopher Reist and Michael J. Roy and Seth D. Norrholm and Charles Glatt and Francis Lee},
url = {https://linkinghub.elsevier.com/retrieve/pii/S1551714419305725},
doi = {10.1016/j.cct.2019.105857},
issn = {15517144},
year = {2019},
date = {2019-10-01},
journal = {Contemporary Clinical Trials},
pages = {105857},
abstract = {Background: PTSD, which has been identified in up to 23% of post-9-11 veterans, often results in a chronic, pernicious course. Thus, effective treatments are imperative. The Institute of Medicine (IOM) concluded that the only intervention for PTSD with sufficient evidence to conclude efficacy is exposure therapy. This Phase III trial compares the efficacy of exposure therapy for combat-related PTSD delivered in two different formats- via virtual reality exposure therapy (VRE) or prolonged exposure therapy (PE)- combined with D-Cycloserine (DCS), a cognitive enhancer shown to facilitate the extinction of fear.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: PTSD, which has been identified in up to 23% of post-9-11 veterans, often results in a chronic, pernicious course. Thus, effective treatments are imperative. The Institute of Medicine (IOM) concluded that the only intervention for PTSD with sufficient evidence to conclude efficacy is exposure therapy. This Phase III trial compares the efficacy of exposure therapy for combat-related PTSD delivered in two different formats- via virtual reality exposure therapy (VRE) or prolonged exposure therapy (PE)- combined with D-Cycloserine (DCS), a cognitive enhancer shown to facilitate the extinction of fear.
30.
Mozgai, Sharon; Hartholt, Arno; Rizzo, Albert “Skip”
Systematic Representative Design and Clinical Virtual Reality Journal Article
In: Psychological Inquiry, vol. 30, no. 4, pp. 231–245, 2019, ISSN: 1047-840X, 1532-7965.
@article{mozgai_systematic_2019,
title = {Systematic Representative Design and Clinical Virtual Reality},
author = {Sharon Mozgai and Arno Hartholt and Albert “Skip” Rizzo},
url = {https://www.tandfonline.com/doi/full/10.1080/1047840X.2019.1693873},
doi = {10.1080/1047840X.2019.1693873},
issn = {1047-840X, 1532-7965},
year = {2019},
date = {2019-10-01},
journal = {Psychological Inquiry},
volume = {30},
number = {4},
pages = {231--245},
abstract = {The authors of the article, “Causal Inference in Generalizable Environments: Systematic Representative Design”, boldly announce their core point in the opening line of the abstract stating that, “Causal inference and generalizability both matter.” While a surface glance might suggest this to be a simple notion, a closer examination reveals the complexity of what they are proposing. This complexity is apparent when one considers that the bulk of human experimental research has always been challenged in its inability to concurrently deliver on both of these aims. This is no slight on the tens of 1000’s of human researchers and behavioral scientists who have devoted long careers to highly controlled human psychological and social science laboratory research. Rather, it reflects the sheer enormity of the challenges for conducting human studies designed to specify human function with physics-informed lab methods, while at the same time producing results that lead to enhanced understanding and prediction of how people will operate in the complex and ever-changing contexts that make up everyday life. At the core of this issue is a methodological and philosophical challenge that is relevant to all areas of human subjects’ research, beyond the social science focus of the Miller et al. (this issue) article. It is our aim to discuss the central topics in their article through the lens of our own work using Virtual/Augmented Reality and Virtual Human simulation technologies for clinical and training applications},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The authors of the article, “Causal Inference in Generalizable Environments: Systematic Representative Design”, boldly announce their core point in the opening line of the abstract stating that, “Causal inference and generalizability both matter.” While a surface glance might suggest this to be a simple notion, a closer examination reveals the complexity of what they are proposing. This complexity is apparent when one considers that the bulk of human experimental research has always been challenged in its inability to concurrently deliver on both of these aims. This is no slight on the tens of 1000’s of human researchers and behavioral scientists who have devoted long careers to highly controlled human psychological and social science laboratory research. Rather, it reflects the sheer enormity of the challenges for conducting human studies designed to specify human function with physics-informed lab methods, while at the same time producing results that lead to enhanced understanding and prediction of how people will operate in the complex and ever-changing contexts that make up everyday life. At the core of this issue is a methodological and philosophical challenge that is relevant to all areas of human subjects’ research, beyond the social science focus of the Miller et al. (this issue) article. It is our aim to discuss the central topics in their article through the lens of our own work using Virtual/Augmented Reality and Virtual Human simulation technologies for clinical and training applications
31.
Hartholt, Arno; Mozgai, Sharon; Fast, Ed; Liewer, Matt; Reilly, Adam; Whitcup, Wendy; Rizzo, Albert "Skip"
Virtual Humans in Augmented Reality: A First Step towards Real-World Embedded Virtual Roleplayers Inproceedings
In: Proceedings of the 7th International Conference on Human-Agent Interaction - HAI '19, pp. 205–207, ACM Press, Kyoto, Japan, 2019, ISBN: 978-1-4503-6922-0.
@inproceedings{hartholt_virtual_2019-1,
title = {Virtual Humans in Augmented Reality: A First Step towards Real-World Embedded Virtual Roleplayers},
author = {Arno Hartholt and Sharon Mozgai and Ed Fast and Matt Liewer and Adam Reilly and Wendy Whitcup and Albert "Skip" Rizzo},
url = {http://dl.acm.org/citation.cfm?doid=3349537.3352766},
doi = {10.1145/3349537.3352766},
isbn = {978-1-4503-6922-0},
year = {2019},
date = {2019-10-01},
booktitle = {Proceedings of the 7th International Conference on Human-Agent Interaction - HAI '19},
pages = {205--207},
publisher = {ACM Press},
address = {Kyoto, Japan},
abstract = {We present one of the first applications of virtual humans in Augmented Reality (AR), which allows young adults with Autism Spectrum Disorder (ASD) the opportunity to practice job interviews. It uses the Magic Leap’s AR hardware sensors to provide users with immediate feedback on six different metrics, including eye gaze, blink rate and head orientation. The system provides two characters, with three conversational modes each. Ported from an existing desktop application, the main development lessons learned were: 1) provide users with navigation instructions in the user interface, 2) avoid dark colors as they are rendered transparently, 3) use dynamic gaze so characters maintain eye contact with the user, 4) use hardware sensors like eye gaze to provide user feedback, and 5) use surface detection to place characters dynamically in the world.},
keywords = {},
pubstate = {published},
tppubtype = {inproceedings}
}
We present one of the first applications of virtual humans in Augmented Reality (AR), which allows young adults with Autism Spectrum Disorder (ASD) the opportunity to practice job interviews. It uses the Magic Leap’s AR hardware sensors to provide users with immediate feedback on six different metrics, including eye gaze, blink rate and head orientation. The system provides two characters, with three conversational modes each. Ported from an existing desktop application, the main development lessons learned were: 1) provide users with navigation instructions in the user interface, 2) avoid dark colors as they are rendered transparently, 3) use dynamic gaze so characters maintain eye contact with the user, 4) use hardware sensors like eye gaze to provide user feedback, and 5) use surface detection to place characters dynamically in the world.
32.
Pynadath, David V.; Wang, Ning; Kamireddy, Sreekar
A Markovian Method for Predicting Trust Behavior in Human-Agent Interaction Inproceedings
In: Proceedings of the 7th International Conference on Human-Agent Interaction - HAI '19, pp. 171–178, ACM Press, Kyoto, Japan, 2019, ISBN: 978-1-4503-6922-0.
@inproceedings{pynadath_markovian_2019,
title = {A Markovian Method for Predicting Trust Behavior in Human-Agent Interaction},
author = {David V. Pynadath and Ning Wang and Sreekar Kamireddy},
url = {http://dl.acm.org/citation.cfm?doid=3349537.3351905},
doi = {10.1145/3349537.3351905},
isbn = {978-1-4503-6922-0},
year = {2019},
date = {2019-10-01},
booktitle = {Proceedings of the 7th International Conference on Human-Agent Interaction - HAI '19},
pages = {171--178},
publisher = {ACM Press},
address = {Kyoto, Japan},
abstract = {Trust calibration is critical to the success of human-agent interaction (HAI). However, individual differences are ubiquitous in people’s trust relationships with autonomous systems. To assist its heterogeneous human teammates calibrate their trust in it, an agent must first dynamically model them as individuals, rather than communicating with them all in the same manner. It can then generate expectations of its teammates’ behavior and optimize its own communication based on the current state of the trust relationship it has with them. In this work, we examine how an agent can generate accurate expectations given observations of only the teammate’s trust-related behaviors (e.g., did the person follow or ignore its advice?). In addition to this limited input, we also seek a specific output: accurately predicting its human teammate’s future trust behavior (e.g., will the person follow or ignore my next suggestion?). In this investigation, we construct a model capable of generating such expectations using data gathered in a humansubject study of behavior in a simulated human-robot interaction (HRI) scenario. We first analyze the ability of measures from a presurvey on trust-related traits to accurately predict subsequent trust behaviors. However, as the interaction progresses, this effect is dwarfed by the direct experience. We therefore analyze the ability of sequences of prior behavior by the teammate to accurately predict subsequent trust behaviors. Such behavioral sequences have shown to be indicative of the subjective beliefs of other teammates, and we show here that they have a predictive power as well.},
keywords = {},
pubstate = {published},
tppubtype = {inproceedings}
}
Trust calibration is critical to the success of human-agent interaction (HAI). However, individual differences are ubiquitous in people’s trust relationships with autonomous systems. To assist its heterogeneous human teammates calibrate their trust in it, an agent must first dynamically model them as individuals, rather than communicating with them all in the same manner. It can then generate expectations of its teammates’ behavior and optimize its own communication based on the current state of the trust relationship it has with them. In this work, we examine how an agent can generate accurate expectations given observations of only the teammate’s trust-related behaviors (e.g., did the person follow or ignore its advice?). In addition to this limited input, we also seek a specific output: accurately predicting its human teammate’s future trust behavior (e.g., will the person follow or ignore my next suggestion?). In this investigation, we construct a model capable of generating such expectations using data gathered in a humansubject study of behavior in a simulated human-robot interaction (HRI) scenario. We first analyze the ability of measures from a presurvey on trust-related traits to accurately predict subsequent trust behaviors. However, as the interaction progresses, this effect is dwarfed by the direct experience. We therefore analyze the ability of sequences of prior behavior by the teammate to accurately predict subsequent trust behaviors. Such behavioral sequences have shown to be indicative of the subjective beliefs of other teammates, and we show here that they have a predictive power as well.
33.
Lucas, Gale M.; Rizzo, Albert; Gratch, Jonathan; Scherer, Stefan; Stratou, Giota; Boberg, Jill; Morency, Louis-Philippe
Reporting Mental Health Symptoms: Breaking Down Barriers to Care with Virtual Human Interviewers Incollection
In: The Impact of Virtual and Augmented Reality on Individuals and Society, pp. 256–264, Frontiers Media SA, 2019.
@incollection{lucas_reporting_2019,
title = {Reporting Mental Health Symptoms: Breaking Down Barriers to Care with Virtual Human Interviewers},
author = {Gale M. Lucas and Albert Rizzo and Jonathan Gratch and Stefan Scherer and Giota Stratou and Jill Boberg and Louis-Philippe Morency},
url = {https://books.google.com/books?hl=en&lr=&id=N724DwAAQBAJ&oi=fnd&pg=PP1&dq=The+Impact+of+Virtual+and+Augmented+Reality+on+Individuals+and+Society&ots=ZMD1P9T-K5&sig=Qqh7iHZ4Xq2iRyYecrECHwNNE38#v=onepage&q=The%20Impact%20of%20Virtual%20and%20Augmented%20Reality%20on%20Individuals%20and%20Society&f=false},
year = {2019},
date = {2019-09-01},
booktitle = {The Impact of Virtual and Augmented Reality on Individuals and Society},
pages = {256--264},
publisher = {Frontiers Media SA},
abstract = {A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTSD). However, research shows (increased reporting by service members when anonymous assessments are used. For example, service members report more symptoms of PTSD when they anonymously answer the Post-Deployment Health Assessment (PDHA) symptom checklist compared to the official PDHA, which is identifiable and linked to their military records. To investigate the factors that influence reporting of psychological symptoms by service members, we used a transformative technology: automated virtual humans that interview people about their symptoms. Such virtual human interviewers allow simultaneous use of two techniques for eliciting disclosure that would otherwise be incompatible; they afford anonymity while also building rapport. We examined whether virtual human interviewers could increase disclosure of mental health symptoms among active-duty service members that just returned from a year-long deployment in Afghanistan. Service members reported more symptoms during a conversation with a virtual human interviewer than on the official PDHA. They also reported more to a virtual human interviewer than on an anonymized PDHA. A second, larger sample of active-duty and former service members found a similar effect that approached statistical significance. Because respondents in both studies shared more with virtual human interviewers than an anonymized PDHA—even though both conditions control for stigma and ramifications for service members’ military records—virtual human interviewers that build rapport may provide a superior option to encourage reporting.},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTSD). However, research shows (increased reporting by service members when anonymous assessments are used. For example, service members report more symptoms of PTSD when they anonymously answer the Post-Deployment Health Assessment (PDHA) symptom checklist compared to the official PDHA, which is identifiable and linked to their military records. To investigate the factors that influence reporting of psychological symptoms by service members, we used a transformative technology: automated virtual humans that interview people about their symptoms. Such virtual human interviewers allow simultaneous use of two techniques for eliciting disclosure that would otherwise be incompatible; they afford anonymity while also building rapport. We examined whether virtual human interviewers could increase disclosure of mental health symptoms among active-duty service members that just returned from a year-long deployment in Afghanistan. Service members reported more symptoms during a conversation with a virtual human interviewer than on the official PDHA. They also reported more to a virtual human interviewer than on an anonymized PDHA. A second, larger sample of active-duty and former service members found a similar effect that approached statistical significance. Because respondents in both studies shared more with virtual human interviewers than an anonymized PDHA—even though both conditions control for stigma and ramifications for service members’ military records—virtual human interviewers that build rapport may provide a superior option to encourage reporting.
34.
Bond, William F; Lynch, Theresa J.; Mischler, Matthew J.; Fish, Jessica L.; McGarvey, Jeremy S.; Taylor, Jason T.; Kumar, Dipen M.; Mou, Kyle M.; Ebert-Allen, Rebecca A.; Mahale, Dilip N.; Talbot, Thomas B.; Aiyer, Meenakshy
Virtual Standardized Patient Simulation Journal Article
In: Simulation in Healthcare, vol. 14, no. 4, pp. 10, 2019.
@article{bond_virtual_2019,
title = {Virtual Standardized Patient Simulation},
author = {William F Bond and Theresa J. Lynch and Matthew J. Mischler and Jessica L. Fish and Jeremy S. McGarvey and Jason T. Taylor and Dipen M. Kumar and Kyle M. Mou and Rebecca A. Ebert-Allen and Dilip N. Mahale and Thomas B. Talbot and Meenakshy Aiyer},
url = {https://journals.lww.com/simulationinhealthcare/Fulltext/2019/08000/Virtual_Standardized_Patient_Simulation__Case.6.aspx#pdf-link},
year = {2019},
date = {2019-08-01},
journal = {Simulation in Healthcare},
volume = {14},
number = {4},
pages = {10},
abstract = {Introduction: High-value care (HVC) suggests that good history taking and physical examination should lead to risk stratification that drives the use or withholding of diagnostic testing. This study describes the development of a series of virtual standardized patient (VSP) cases and provides preliminary evidence that supports their ability to provide experiential learning in HVC. Methods: This pilot study used VSPs, or natural language processing–based patient avatars, within the USC Standard Patient platform. Faculty consensus was used to develop the cases, including the optimal diagnostic testing strategies, treatment options, and scored content areas. First-year resident physician learners experienced two 90-minute didactic sessions before completing the cases in a computer laboratory, using typed text to interview the avatar for history taking, then completing physical examination, differential diagnosis, diagnostic testing, and treatment modules for each case. Learners chose a primary and 2 alternative “possible” diagnoses from a list of 6 to 7 choices, diagnostic testing options from an extensive list, and treatments from a brief list ranging from 6 to 9 choices. For the historytaking module, both faculty and the platform scored the learners, and faculty assessed the appropriateness of avatar responses. Four randomly selected learner-avatar interview transcripts for each case were double rated by faculty for interrater reliability calculations. Intraclass correlations were calculated for interrater reliability, and Spearman ρ was used to determine the correlation between the platform and faculty ranking of learners' historytaking scores. Results: Eight VSP cases were experienced by 14 learners. Investigators reviewed 112 transcripts (4646 learner query-avatar responses). Interrater reliability means were 0.87 for learner query scoring and 0.83 for avatar response. Mean learner success for history taking was scored by the faculty at 57% and by the platform at 51% (ρ correlation of learner rankings = 0.80},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: High-value care (HVC) suggests that good history taking and physical examination should lead to risk stratification that drives the use or withholding of diagnostic testing. This study describes the development of a series of virtual standardized patient (VSP) cases and provides preliminary evidence that supports their ability to provide experiential learning in HVC. Methods: This pilot study used VSPs, or natural language processing–based patient avatars, within the USC Standard Patient platform. Faculty consensus was used to develop the cases, including the optimal diagnostic testing strategies, treatment options, and scored content areas. First-year resident physician learners experienced two 90-minute didactic sessions before completing the cases in a computer laboratory, using typed text to interview the avatar for history taking, then completing physical examination, differential diagnosis, diagnostic testing, and treatment modules for each case. Learners chose a primary and 2 alternative “possible” diagnoses from a list of 6 to 7 choices, diagnostic testing options from an extensive list, and treatments from a brief list ranging from 6 to 9 choices. For the historytaking module, both faculty and the platform scored the learners, and faculty assessed the appropriateness of avatar responses. Four randomly selected learner-avatar interview transcripts for each case were double rated by faculty for interrater reliability calculations. Intraclass correlations were calculated for interrater reliability, and Spearman ρ was used to determine the correlation between the platform and faculty ranking of learners' historytaking scores. Results: Eight VSP cases were experienced by 14 learners. Investigators reviewed 112 transcripts (4646 learner query-avatar responses). Interrater reliability means were 0.87 for learner query scoring and 0.83 for avatar response. Mean learner success for history taking was scored by the faculty at 57% and by the platform at 51% (ρ correlation of learner rankings = 0.80
35.
Talbot, Thomas; Rizzo, Albert “Skip”
Virtual Human Standardized Patients for Clinical Training Incollection
In: Virtual Reality for Psychological and Neurocognitive Interventions, pp. 387–405, Springer New York, New York, NY, 2019, ISBN: 978-1-4939-9480-9 978-1-4939-9482-3.
@incollection{talbot_virtual_2019-1,
title = {Virtual Human Standardized Patients for Clinical Training},
author = {Thomas Talbot and Albert “Skip” Rizzo},
url = {http://link.springer.com/10.1007/978-1-4939-9482-3_17},
doi = {10.1007/978-1-4939-9482-3_17},
isbn = {978-1-4939-9480-9 978-1-4939-9482-3},
year = {2019},
date = {2019-08-01},
booktitle = {Virtual Reality for Psychological and Neurocognitive Interventions},
pages = {387--405},
publisher = {Springer New York},
address = {New York, NY},
abstract = {Since Dr. Howard Barrows (1964) introduced the human standardized patient in 1963, there have been attempts to game a computer-based simulacrum of a patient encounter; the first being a heart attack simulation using the online PLATO system (Bitzer M, Nursing Research 15:144–150, 1966). With the now ubiquitous use of computers in medicine, interest and effort have expended in the area of Virtual Patients (VPs). There are excellent summaries in the literature (Talbot TB, International Journal of Gaming and Computer Mediated Simulations 4:1–19, 2012) that explain the different types of virtual patients along with their best case applications, strengths and limitations.},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
Since Dr. Howard Barrows (1964) introduced the human standardized patient in 1963, there have been attempts to game a computer-based simulacrum of a patient encounter; the first being a heart attack simulation using the online PLATO system (Bitzer M, Nursing Research 15:144–150, 1966). With the now ubiquitous use of computers in medicine, interest and effort have expended in the area of Virtual Patients (VPs). There are excellent summaries in the literature (Talbot TB, International Journal of Gaming and Computer Mediated Simulations 4:1–19, 2012) that explain the different types of virtual patients along with their best case applications, strengths and limitations.
36.
Lahav, Orly; Talis, Vadim; Cinamon, Rachel Gali; Rizzo, Albert
Virtual interactive consulting agent to support freshman students in transition to higher education Journal Article
In: Journal of Computing in Higher Education, pp. 1–35, 2019, ISSN: 1042-1726, 1867-1233.
@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 = {},
pubstate = {published},
tppubtype = {article}
}
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.
37.
Parsons, Thomas D.; Rizzo, Albert “Skip”
A Review of Virtual Classroom Environments for Neuropsychological Assessment Incollection
In: Virtual Reality for Psychological and Neurocognitive Interventions, pp. 247–265, Springer New York, New York, NY, 2019, ISBN: 978-1-4939-9480-9 978-1-4939-9482-3.
@incollection{parsons_review_2019,
title = {A Review of Virtual Classroom Environments for Neuropsychological Assessment},
author = {Thomas D. Parsons and Albert “Skip” Rizzo},
url = {http://link.springer.com/10.1007/978-1-4939-9482-3_11},
doi = {10.1007/978-1-4939-9482-3_11},
isbn = {978-1-4939-9480-9 978-1-4939-9482-3},
year = {2019},
date = {2019-08-01},
booktitle = {Virtual Reality for Psychological and Neurocognitive Interventions},
pages = {247--265},
publisher = {Springer New York},
address = {New York, NY},
abstract = {Differential diagnosis and treatment of neuropsychological disorders require assessments that can differentiate overlapping symptoms. Previous research has most often relied on paper-and-pencil as well as computerized psychometric tests of cognitive functions. Although these approaches provide highly systematic control and delivery of performance challenges, they have also been criticized as limited in the area of ecological validity. A possible answer to the problems of ecological validity in assessment of cognitive functioning in neurological populations is to immerse the participant in a virtual environment. This chapter reviews the potential of various virtual classroom environments that have been developed for neuropsychological assessment.},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
Differential diagnosis and treatment of neuropsychological disorders require assessments that can differentiate overlapping symptoms. Previous research has most often relied on paper-and-pencil as well as computerized psychometric tests of cognitive functions. Although these approaches provide highly systematic control and delivery of performance challenges, they have also been criticized as limited in the area of ecological validity. A possible answer to the problems of ecological validity in assessment of cognitive functioning in neurological populations is to immerse the participant in a virtual environment. This chapter reviews the potential of various virtual classroom environments that have been developed for neuropsychological assessment.
38.
Rizzo, Albert "Skip"; Bouchard, Stéphane (Ed.)
Virtual Reality for Psychological and Neurocognitive Interventions Book
Springer New York, New York, NY, 2019, ISBN: 978-1-4939-9480-9 978-1-4939-9482-3.
@book{rizzo_virtual_2019,
title = {Virtual Reality for Psychological and Neurocognitive Interventions},
editor = {Albert "Skip" Rizzo and Stéphane Bouchard},
url = {http://link.springer.com/10.1007/978-1-4939-9482-3},
doi = {10.1007/978-1-4939-9482-3},
isbn = {978-1-4939-9480-9 978-1-4939-9482-3},
year = {2019},
date = {2019-08-01},
publisher = {Springer New York},
address = {New York, NY},
series = {Virtual Reality Technologies for Health and Clinical Applications},
abstract = {This exciting collection tours virtual reality in both its current therapeutic forms and its potential to transform a wide range of medical and mental health-related fields. Extensive findings track the contributions of VR devices, systems, and methods to accurate assessment, evidence-based and client-centered treatment methods, and—as described in a stimulating discussion of virtual patient technologies—innovative clinical training. Immersive digital technologies are shown enhancing opportunities for patients to react to situations, therapists to process patients’ physiological responses, and scientists to have greater control over test conditions and access to results. Expert coverage details leading-edge applications of VR across a broad spectrum of psychological and neurocognitive conditions, including: Treating anxiety disorders and PTSD. Treating developmental and learning disorders, including Autism Spectrum Disorder, Assessment of and rehabilitation from stroke and traumatic brain injuries. Assessment and treatment of substance abuse. Assessment of deviant sexual interests. Treating obsessive-compulsive and related disorders. Augmenting learning skills for blind persons. Readable and relevant, Virtual Reality for Psychological and Neurocognitive Interventions is an essential idea book for neuropsychologists, rehabilitation specialists (including physical, speech, vocational, and occupational therapists), and neurologists. Researchers across the behavioral and social sciences will find it a roadmap toward new and emerging areas of study.},
keywords = {},
pubstate = {published},
tppubtype = {book}
}
This exciting collection tours virtual reality in both its current therapeutic forms and its potential to transform a wide range of medical and mental health-related fields. Extensive findings track the contributions of VR devices, systems, and methods to accurate assessment, evidence-based and client-centered treatment methods, and—as described in a stimulating discussion of virtual patient technologies—innovative clinical training. Immersive digital technologies are shown enhancing opportunities for patients to react to situations, therapists to process patients’ physiological responses, and scientists to have greater control over test conditions and access to results. Expert coverage details leading-edge applications of VR across a broad spectrum of psychological and neurocognitive conditions, including: Treating anxiety disorders and PTSD. Treating developmental and learning disorders, including Autism Spectrum Disorder, Assessment of and rehabilitation from stroke and traumatic brain injuries. Assessment and treatment of substance abuse. Assessment of deviant sexual interests. Treating obsessive-compulsive and related disorders. Augmenting learning skills for blind persons. Readable and relevant, Virtual Reality for Psychological and Neurocognitive Interventions is an essential idea book for neuropsychologists, rehabilitation specialists (including physical, speech, vocational, and occupational therapists), and neurologists. Researchers across the behavioral and social sciences will find it a roadmap toward new and emerging areas of study.
39.
Bouchard, Stéphane; Rizzo, Albert “Skip”
Applications of Virtual Reality in Clinical Psychology and Clinical Cognitive Neuroscience–An Introduction Incollection
In: Virtual Reality for Psychological and Neurocognitive Interventions, pp. 1–13, Springer New York, New York, NY, 2019, ISBN: 978-1-4939-9480-9 978-1-4939-9482-3.
@incollection{bouchard_applications_2019,
title = {Applications of Virtual Reality in Clinical Psychology and Clinical Cognitive Neuroscience–An Introduction},
author = {Stéphane Bouchard and Albert “Skip” Rizzo},
url = {http://link.springer.com/10.1007/978-1-4939-9482-3_1},
doi = {10.1007/978-1-4939-9482-3_1},
isbn = {978-1-4939-9480-9 978-1-4939-9482-3},
year = {2019},
date = {2019-08-01},
booktitle = {Virtual Reality for Psychological and Neurocognitive Interventions},
pages = {1--13},
publisher = {Springer New York},
address = {New York, NY},
abstract = {Simulation technology has a long history of adding value in aviation, military training, automotive/aircraft design, and surgical planning. In clinical psychology, Norcross et al. (2013) surveyed 70 therapy experts regarding interventions they predicted to increase in the next decade and virtual reality (VR) was ranked 4th out of 45 options, with other computer-supported methods occupying 4 out of the top 5 positions. The increased popularity of VR in the news, social media, conferences, and from innovative start-ups may give the impression that VR is something new. However, it is important to look back in time and recognize that as early as the 1960’s, Heilig proposed a multisensory immersive experienced called the Sensorama, and Sutherland and Sproull had created a stereoscopic head mounted display (HMD) (Berryman 2012; Srivastava et al. 2014). The term VR was coined more than 30 years ago by Jaron Lanier and commercial games were distributed to the public as early as 1989 by Mattel (in the US, and by PAX in Japan) for its PowerGlove™ and Nintendo’s failed Virtual Boy™ was released in 1995. Clinical VR applications were proposed as early as the mid 1990’s by Lamson, Pugnetti, Rothbaum, Riva, Rizzo, Weiss, and Wiederhold (named in alphabetical order), among others. Moreover, several scientific journals, conferences, and handbooks dedicated to the subject have been reporting scientific findings for decades.},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
Simulation technology has a long history of adding value in aviation, military training, automotive/aircraft design, and surgical planning. In clinical psychology, Norcross et al. (2013) surveyed 70 therapy experts regarding interventions they predicted to increase in the next decade and virtual reality (VR) was ranked 4th out of 45 options, with other computer-supported methods occupying 4 out of the top 5 positions. The increased popularity of VR in the news, social media, conferences, and from innovative start-ups may give the impression that VR is something new. However, it is important to look back in time and recognize that as early as the 1960’s, Heilig proposed a multisensory immersive experienced called the Sensorama, and Sutherland and Sproull had created a stereoscopic head mounted display (HMD) (Berryman 2012; Srivastava et al. 2014). The term VR was coined more than 30 years ago by Jaron Lanier and commercial games were distributed to the public as early as 1989 by Mattel (in the US, and by PAX in Japan) for its PowerGlove™ and Nintendo’s failed Virtual Boy™ was released in 1995. Clinical VR applications were proposed as early as the mid 1990’s by Lamson, Pugnetti, Rothbaum, Riva, Rizzo, Weiss, and Wiederhold (named in alphabetical order), among others. Moreover, several scientific journals, conferences, and handbooks dedicated to the subject have been reporting scientific findings for decades.
40.
Coleman, Benjamin; Marion, Sarah; Rizzo, Albert; Turnbull, Janiece; Nolty, Anne
In: Frontiers in Psychology, vol. 10, 2019, ISSN: 1664-1078.
@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 = {},
pubstate = {published},
tppubtype = {article}
}
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.
Filter
2019
Chu, Veronica C.; Lucas, Gale M.; Lei, Su; Mozgai, Sharon; Khooshabeh, Peter; Gratch, Jonathan
Emotion Regulation in the Prisoner’s Dilemma: Effects of Reappraisal on Behavioral Measures and Cardiovascular Measures of Challenge and Threat Journal Article
In: Frontiers in Human Neuroscience, vol. 13, 2019, ISSN: 1662-5161.
Abstract | Links | BibTeX | Tags: ARL, DoD, MedVR, UARC, Virtual Humans
@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, Virtual Humans},
pubstate = {published},
tppubtype = {article}
}
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.
Green, C. Shawn; Bavelier, Daphne; Kramer, Arthur F.; Vinogradov, Sophia; Ansorge, Ulrich; Ball, Karlene K.; Bingel, Ulrike; Chein, Jason M.; Colzato, Lorenza S.; Edwards, Jerri D.; Facoetti, Andrea; Gazzaley, Adam; Gathercole, Susan E.; Ghisletta, Paolo; Gori, Simone; Granic, Isabela; Hillman, Charles H.; Hommel, Bernhard; Jaeggi, Susanne M.; Kanske, Philipp; Karbach, Julia; Kingstone, Alan; Kliegel, Matthias; Klingberg, Torkel; Kühn, Simone; Levi, Dennis M.; Mayer, Richard E.; McLaughlin, Anne Collins; McNamara, Danielle S.; Morris, Martha Clare; Nahum, Mor; Newcombe, Nora S.; Panizzutti, Rogerio; Prakash, Ruchika Shaurya; Rizzo, Albert; Schubert, Torsten; Seitz, Aaron R.; Short, Sarah J.; Singh, Ilina; Slotta, James D.; Strobach, Tilo; Thomas, Michael S. C.; Tipton, Elizabeth; Tong, Xin; Vlach, Haley A.; Wetherell, Julie Loebach; Wexler, Anna; Witt, Claudia M.
Improving Methodological Standards in Behavioral Interventions for Cognitive Enhancement Journal Article
In: Journal of Cognitive Enhancement, 2019, ISSN: 2509-3290, 2509-3304.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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.
Talbot, Thomas B.; Rizzo, Albert Skip
Virtual Standardized Patients for Interactive Conversational Training: A Grand Experiment and New Approach Incollection
In: Exploring the Cognitive, Social, Cultural, and Psychological Aspects of Gaming and Simulations:, IGI Global, Hershey, PA, 2019, ISBN: 978-1-5225-7461-3 978-1-5225-7462-0.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@incollection{talbot_virtual_2019,
title = {Virtual Standardized Patients for Interactive Conversational Training: A Grand Experiment and New Approach},
author = {Thomas B. Talbot and Albert Skip Rizzo},
url = {http://services.igi-global.com/resolvedoi/resolve.aspx?doi=10.4018/978-1-5225-7461-3},
doi = {10.4018/978-1-5225-7461-3},
isbn = {978-1-5225-7461-3 978-1-5225-7462-0},
year = {2019},
date = {2019-01-01},
booktitle = {Exploring the Cognitive, Social, Cultural, and Psychological Aspects of Gaming and Simulations:},
publisher = {IGI Global},
address = {Hershey, PA},
series = {Advances in Game-Based Learning},
abstract = {The USC Standard Patient is a virtual human-based conversational agent serving in the role of a simulated medical patient, also known as a virtual standardized patient (VSP). This research identified deficiencies of extant VSP systems, defined a robust set of requirements, and successfully achieved nearly all of them. Markedly impressive advancements were made in virtual human technology, techniques to apply natural language processing, automated assessment artificial intelligence, and pedagogical design. The effort succeeded with performance parameters of high conversational performance, accurate assessment, and strongly demonstrated user training effect. Although working well within its confined are of expertise, the ability for computers to create authentic mixed initiative conversations remains elusive. This effort leaves behind many lessons for interactive serious games, clinical virtual humans, and conversational virtual human training applications.},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {incollection}
}
The USC Standard Patient is a virtual human-based conversational agent serving in the role of a simulated medical patient, also known as a virtual standardized patient (VSP). This research identified deficiencies of extant VSP systems, defined a robust set of requirements, and successfully achieved nearly all of them. Markedly impressive advancements were made in virtual human technology, techniques to apply natural language processing, automated assessment artificial intelligence, and pedagogical design. The effort succeeded with performance parameters of high conversational performance, accurate assessment, and strongly demonstrated user training effect. Although working well within its confined are of expertise, the ability for computers to create authentic mixed initiative conversations remains elusive. This effort leaves behind many lessons for interactive serious games, clinical virtual humans, and conversational virtual human training applications.
Birckhead, Brandon; Khalil, Carine; Liu, Xiaoyu; Conovitz, Samuel; Rizzo, Albert; Danovitch, Itai; Bullock, Kim; Spiegel, Brennan
Recommendations for Methodology of Virtual Reality Clinical Trials in Health Care by an International Working Group: Iterative Study Journal Article
In: JMIR Mental Health, vol. 6, no. 1, pp. e11973, 2019, ISSN: 2368-7959.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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.
2018
Maples-Keller, Jessica L.; Jovanovic, Tanja; Dunlop, Boadie W.; Rauch, Sheila; Yasinski, Carly; Michopoulos, Vasiliki; Coghlan, Callan; Norrholm, Seth; Rizzo, Albert Skip; Ressler, Kerry; Rothbaum, Barbara O.
When translational neuroscience fails in the clinic: Dexamethasone prior to virtual reality exposure therapy increases drop-out rates Journal Article
In: Journal of Anxiety Disorders, 2018, ISSN: 08876185.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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
Reger, Greg M.; Smolenski, Derek; Edwards-Stewart, Amanda; Skopp, Nancy A.; Rizzo, Albert "Skip"; Norr, Aaron
Does Virtual Reality Increase Simulator Sickness During Exposure Therapy for Post-Traumatic Stress Disorder? Journal Article
In: Telemedicine and eHealth, 2018.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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.
Rizzo, Albert "Skip"; Koenig, Sebastian Thomas; Talbot, Thomas B
Clinical Virtual Reality: Emerging Opportunities for Psychiatry Journal Article
In: Focus: The Journal of Lifelong Learning in Psychiatry, 2018.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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.
Lineberry, Matthew; Dev, Parvati; Lane, H. Chad; Talbot, Thomas B.
Learner-Adaptive Educational Technology for Simulation in Healthcare: Foundations and Opportunities Journal Article
In: Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, pp. 1, 2018, ISSN: 1559-2332.
Abstract | Links | BibTeX | Tags: MedVR
@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=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},
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}
}
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.
Loucks, Laura; Yasinski, Carly; Norrholm, Seth D.; Maples-Keller, Jessica; Post, Loren; Zwiebach, Liza; Fiorillo, Devika; Goodlin, Megan; Jovanovic, Tanja; Rizzo, Albert A.; Rothbaum, Barbara O.
You can do that⁈: Feasibility of virtual reality exposure therapy in the treatment of PTSD due to military sexual trauma Journal Article
In: Journal of Anxiety Disorders, 2018, ISSN: 08876185.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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
Norr, Aaron M.; Smolenski, Derek J.; Katz, Andrea C.; Rizzo, Albert A.; Rothbaum, Barbara O.; Difede, JoAnn; Koenen-Woods, Patricia; Reger, Mark A.; Reger, Greg M.
Virtual reality exposure versus prolonged exposure for PTSD: Which treatment for whom? Journal Article
In: Depression and Anxiety, vol. 35, no. 6, pp. 523–529, 2018, ISSN: 10914269.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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.
Wang, Ning; Shapiro, Ari; Feng, Andrew; Zhuang, Cindy; Merchant, Chirag; Schwartz, David; Goldberg, Stephen L.
Learning by Explaining to a Digital Doppelganger Incollection
In: Intelligent Tutoring Systems, vol. 10858, pp. 256–264, Springer International Publishing, Cham, Switzerland, 2018, ISBN: 978-3-319-91463-3 978-3-319-91464-0.
Abstract | Links | BibTeX | Tags: ARL, DoD, MedVR, Social Simulation, UARC, Virtual Humans
@incollection{wang_learning_2018,
title = {Learning by Explaining to a Digital Doppelganger},
author = {Ning Wang and Ari Shapiro and Andrew Feng and Cindy Zhuang and Chirag Merchant and David Schwartz and Stephen L. Goldberg},
url = {http://link.springer.com/10.1007/978-3-319-91464-0_25},
doi = {10.1007/978-3-319-91464-0_25},
isbn = {978-3-319-91463-3 978-3-319-91464-0},
year = {2018},
date = {2018-05-01},
booktitle = {Intelligent Tutoring Systems},
volume = {10858},
pages = {256--264},
publisher = {Springer International Publishing},
address = {Cham, Switzerland},
abstract = {Digital doppelgangers are virtual humans that highly resemble the real self but behave independently. An emerging computer animation technology makes the creation of digital doppelgangers an accessible reality. This allows researchers in pedagogical agents to explore previously unexplorable research questions, such as how does increasing the similarity in appearance between the agent and the student impact learning. This paper discusses the design and evaluation of a digital doppelganger as a virtual listener in a learning-by-explaining paradigm. Results offer insight into the promise and limitation of this novel technology.},
keywords = {ARL, DoD, MedVR, Social Simulation, UARC, Virtual Humans},
pubstate = {published},
tppubtype = {incollection}
}
Digital doppelgangers are virtual humans that highly resemble the real self but behave independently. An emerging computer animation technology makes the creation of digital doppelgangers an accessible reality. This allows researchers in pedagogical agents to explore previously unexplorable research questions, such as how does increasing the similarity in appearance between the agent and the student impact learning. This paper discusses the design and evaluation of a digital doppelganger as a virtual listener in a learning-by-explaining paradigm. Results offer insight into the promise and limitation of this novel technology.
Kang, Sin-Hwa; Krum, David M.; Khooshabeh, Peter; Phan, Thai; Chang, Chien-Yen
Socio-Cultural Effects of Virtual Counseling Interviewers as Mediated by Smartphone Video Conferencing Inproceedings
In: Proceedings of the 31st International Conference on Computer Animation and Social Agents - CASA 2018, pp. 17–22, ACM Press, Beijing, China, 2018, ISBN: 978-1-4503-6376-1.
Abstract | Links | BibTeX | Tags: ARL, DoD, MedVR, MxR, UARC
@inproceedings{kang_socio-cultural_2018,
title = {Socio-Cultural Effects of Virtual Counseling Interviewers as Mediated by Smartphone Video Conferencing},
author = {Sin-Hwa Kang and David M. Krum and Peter Khooshabeh and Thai Phan and Chien-Yen Chang},
url = {http://dl.acm.org/citation.cfm?doid=3205326.3205348},
doi = {10.1145/3205326.3205348},
isbn = {978-1-4503-6376-1},
year = {2018},
date = {2018-05-01},
booktitle = {Proceedings of the 31st International Conference on Computer Animation and Social Agents - CASA 2018},
pages = {17--22},
publisher = {ACM Press},
address = {Beijing, China},
abstract = {We explored how users perceive virtual characters that performed the role of a counseling interviewer, while presenting different levels of social class, as well as single or multi-tasking behavior. To investigate this subject, we designed a 2x2 experiment (tasking type and social class of the virtual counseling interviewer). In the experiment, participants experienced the counseling interview interactions over video conferencing on a smartphone. We measured user responses to and perceptions of the virtual human interviewer. The results demonstrate that the tasking types and social class of the virtual counselor affected user responses to and perceptions of the virtual counselor. The results offer insight into the design and development of effective, realistic, and believable virtual human counselors. Furthermore, the results also address current social questions about how smartphones might mediate social interactions, including human-agent interactions.},
keywords = {ARL, DoD, MedVR, MxR, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
We explored how users perceive virtual characters that performed the role of a counseling interviewer, while presenting different levels of social class, as well as single or multi-tasking behavior. To investigate this subject, we designed a 2x2 experiment (tasking type and social class of the virtual counseling interviewer). In the experiment, participants experienced the counseling interview interactions over video conferencing on a smartphone. We measured user responses to and perceptions of the virtual human interviewer. The results demonstrate that the tasking types and social class of the virtual counselor affected user responses to and perceptions of the virtual counselor. The results offer insight into the design and development of effective, realistic, and believable virtual human counselors. Furthermore, the results also address current social questions about how smartphones might mediate social interactions, including human-agent interactions.
Krum, David M; Kang, Sin-Hwa; Phan, Thai
Influences on the Elicitation of Interpersonal Space with Virtual Humans Inproceedings
In: Proceedings of the 2018 IEEE Conference on Virtual Reality and 3D User Interfaces (VR), IEEE, Tuebingen/Reutlingen, Germany, 2018, ISBN: 978-1-5386-3365-6.
Abstract | Links | BibTeX | Tags: MedVR, MxR, UARC
@inproceedings{krum_influences_2018,
title = {Influences on the Elicitation of Interpersonal Space with Virtual Humans},
author = {David M Krum and Sin-Hwa Kang and Thai Phan},
url = {https://ieeexplore.ieee.org/document/8446235/#full-text-section},
doi = {10.1109/VR.2018.8446235},
isbn = {978-1-5386-3365-6},
year = {2018},
date = {2018-03-01},
booktitle = {Proceedings of the 2018 IEEE Conference on Virtual Reality and 3D User Interfaces (VR)},
publisher = {IEEE},
address = {Tuebingen/Reutlingen, Germany},
abstract = {The emergence of low cost virtual and augmented reality systems has encouraged the development of immersive training applications for medical, military, and many other fields. Many of the training scenarios for these various fields may require the presentation of realistic interactions with virtual humans. It is thus vital to determine the critical factors of fidelity required in those interactions to elicit naturalistic behavior on the part of trainees. Negative training may occur if trainees are inadvertently influenced to react in ways that are unexpected and unnatural, hindering proper learning and transfer of skills and knowledge back into real world contexts. In this research, we examined whether haptic priming (presenting an illusion of virtual human touch at the beginning of the virtual experience) and different locomotion techniques (either joystick or physical walking) might affect proxemic behavior in human users. The results of our study suggest that locomotion techniques can alter proxemic behavior in significant ways. Haptic priming did not appear to impact proxemic behavior, but did increase rapport and other subjective social measures. The results suggest that designers and developers of immersive training systems should carefully consider the impact of even simple design and fidelity choices on trainee reactions in social interactions.},
keywords = {MedVR, MxR, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
The emergence of low cost virtual and augmented reality systems has encouraged the development of immersive training applications for medical, military, and many other fields. Many of the training scenarios for these various fields may require the presentation of realistic interactions with virtual humans. It is thus vital to determine the critical factors of fidelity required in those interactions to elicit naturalistic behavior on the part of trainees. Negative training may occur if trainees are inadvertently influenced to react in ways that are unexpected and unnatural, hindering proper learning and transfer of skills and knowledge back into real world contexts. In this research, we examined whether haptic priming (presenting an illusion of virtual human touch at the beginning of the virtual experience) and different locomotion techniques (either joystick or physical walking) might affect proxemic behavior in human users. The results of our study suggest that locomotion techniques can alter proxemic behavior in significant ways. Haptic priming did not appear to impact proxemic behavior, but did increase rapport and other subjective social measures. The results suggest that designers and developers of immersive training systems should carefully consider the impact of even simple design and fidelity choices on trainee reactions in social interactions.
Bioulac, Stéphanie; Micoulaud-Franchi, Jean-Arthur; Maire, Jenna; Bouvard, Manuel P.; Rizzo, Albert A.; Sagaspe, Patricia; Philip, Pierre
Virtual Remediation Versus Methylphenidate to Improve Distractibility in Children With ADHD: A Controlled Randomized Clinical Trial Study Journal Article
In: Journal of attention disorders, 2018.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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.
Rizzo, Skip
Will healthcare be where the killer VR apps will emerge? Journal Article
In: VR 360, 2018.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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
Rizzo, Albert ‘Skip’; Shilling, Russell
Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD Journal Article
In: European Journal of Psychotraumatology, vol. 8, no. sup5, 2018, ISSN: 2000-8198, 2000-8066.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@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}
}
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.
2017
Rizzo, Albert; Roy, Michael J.; Hartholt, Arno; Costanzo, Michelle; Highland, Krista Beth; Jovanovic, Tanja; Norrholm, Seth D.; Reist, Chris; Rothbaum, Barbara; Difede, JoAnn
Virtual Reality Applications for the Assessment and Treatment of PTSD Incollection
In: Handbook of Military Psychology, pp. 453–471, Springer International Publishing, Cham, Switzerland, 2017, ISBN: 978-3-319-66190-2 978-3-319-66192-6.
Abstract | Links | BibTeX | Tags: MedVR, UARC, Virtual Humans
@incollection{rizzo_virtual_2017,
title = {Virtual Reality Applications for the Assessment and Treatment of PTSD},
author = {Albert Rizzo and Michael J. Roy and Arno Hartholt and Michelle Costanzo and Krista Beth Highland and Tanja Jovanovic and Seth D. Norrholm and Chris Reist and Barbara Rothbaum and JoAnn Difede},
url = {http://link.springer.com/10.1007/978-3-319-66192-6_27},
doi = {10.1007/978-3-319-66192-6_27},
isbn = {978-3-319-66190-2 978-3-319-66192-6},
year = {2017},
date = {2017-12-01},
booktitle = {Handbook of Military Psychology},
pages = {453--471},
publisher = {Springer International Publishing},
address = {Cham, Switzerland},
abstract = {War is one of the most challenging situations that a human being can encounter. The physical, emotional, cognitive, and psychological demands of a combat environment place tremendous stress on even the most well-prepared military people. It is no surprise that the stressful experiences, characteristics of operations in Iraq and Afghanistan, have produced significant numbers of service members (SMs) and veterans at risk for posttraumatic stress disorder (PTSD), as well as other psychosocial/behavioral health conditions. For example, as of June 2015, the Defense Medical Surveillance System reported 138,197 active duty SMs had been diagnosed with PTSD (Fischer, 2015). In a meta-analysis of studies published since 2001, 13.2% of infantry service members met the criteria for PTSD, with incidence rising dramatically to 25–30% in units with high levels of direct combat exposure (Kok, Herrell, Thomas, & Hoge, 2012). Moreover, as of early 2013, the prevalence of PTSD among discharged veterans receiving treatment at Veteran Affairs (VA) clinics was reported to be 29% (Fischer, 2013). These findings make a compelling case for a continued focus on developing and enhancing the availability of diverse evidence- based treatment options to address this military behavioral healthcare challenge. One emerging area of research and clinical focus is of the use of Virtual Reality (VR) simulation technology as a tool for delivering evidence-based approaches for the assessment and treatment of PTSD. Although in recent times, the popular media has lavishly reported on VR’s potential impact on all elements of our evolving digital culture, and has created the impression that VR is a novel technology, the reality is that VR is not a new concept, and many of its developmental roots are traceable to the 1980s and 1990s (Schnipper et al., 2015). Moreover, a large scientific literature has emerged over the last 20 years demonstrating the unique and added value that is accrued with the use of VR to address a wide range of clinical health conditions (Rizzo 1994; Rizzo et al., 1997; 2002; 2010; 2014; Rizzo, Cukor et al., 2015). Within that context, the present chapter will summarize the ways that researchers and clinicians have employed VR to create relevant simulations that can be applied to the assessment and treatment of PTSD.},
keywords = {MedVR, UARC, Virtual Humans},
pubstate = {published},
tppubtype = {incollection}
}
War is one of the most challenging situations that a human being can encounter. The physical, emotional, cognitive, and psychological demands of a combat environment place tremendous stress on even the most well-prepared military people. It is no surprise that the stressful experiences, characteristics of operations in Iraq and Afghanistan, have produced significant numbers of service members (SMs) and veterans at risk for posttraumatic stress disorder (PTSD), as well as other psychosocial/behavioral health conditions. For example, as of June 2015, the Defense Medical Surveillance System reported 138,197 active duty SMs had been diagnosed with PTSD (Fischer, 2015). In a meta-analysis of studies published since 2001, 13.2% of infantry service members met the criteria for PTSD, with incidence rising dramatically to 25–30% in units with high levels of direct combat exposure (Kok, Herrell, Thomas, & Hoge, 2012). Moreover, as of early 2013, the prevalence of PTSD among discharged veterans receiving treatment at Veteran Affairs (VA) clinics was reported to be 29% (Fischer, 2013). These findings make a compelling case for a continued focus on developing and enhancing the availability of diverse evidence- based treatment options to address this military behavioral healthcare challenge. One emerging area of research and clinical focus is of the use of Virtual Reality (VR) simulation technology as a tool for delivering evidence-based approaches for the assessment and treatment of PTSD. Although in recent times, the popular media has lavishly reported on VR’s potential impact on all elements of our evolving digital culture, and has created the impression that VR is a novel technology, the reality is that VR is not a new concept, and many of its developmental roots are traceable to the 1980s and 1990s (Schnipper et al., 2015). Moreover, a large scientific literature has emerged over the last 20 years demonstrating the unique and added value that is accrued with the use of VR to address a wide range of clinical health conditions (Rizzo 1994; Rizzo et al., 1997; 2002; 2010; 2014; Rizzo, Cukor et al., 2015). Within that context, the present chapter will summarize the ways that researchers and clinicians have employed VR to create relevant simulations that can be applied to the assessment and treatment of PTSD.
Rizzo, Albert
Ethically Aligned Design, Version 2 Book
IEEE, 2017.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@book{rizzo_ethically_2017,
title = {Ethically Aligned Design, Version 2},
author = {Albert Rizzo},
url = {https://standards.ieee.org/industry-connections/ec/ead-v1.html},
year = {2017},
date = {2017-12-01},
publisher = {IEEE},
abstract = {Intelligent and autonomous technical systems are specifically designed to reduce human intervention in our day-to-day lives. In so doing, these new fields are raising concerns about their impact on individuals and societies. Current discussions include advocacy for the positive impact, as well as warnings, based on the potential harm to privacy, discrimination, loss of skills, economic impacts, security of critical infrastructure, and the long-term effects on social well-being. Because of their nature, the full benefit of these technologies will be attained only if they are aligned with our defined values and ethical principles. We must therefore establish frameworks to guide and inform dialogue and debate around the non-technical implications of these technologies.},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {book}
}
Intelligent and autonomous technical systems are specifically designed to reduce human intervention in our day-to-day lives. In so doing, these new fields are raising concerns about their impact on individuals and societies. Current discussions include advocacy for the positive impact, as well as warnings, based on the potential harm to privacy, discrimination, loss of skills, economic impacts, security of critical infrastructure, and the long-term effects on social well-being. Because of their nature, the full benefit of these technologies will be attained only if they are aligned with our defined values and ethical principles. We must therefore establish frameworks to guide and inform dialogue and debate around the non-technical implications of these technologies.
Thomas, Jerald; Azmandian, Mahdi; Grunwald, Sonia; Le, Donna; Krum, David; Kang, Sin-Hwa; Rosenberg, Evan Suma
Effects of Personalized Avatar Texture Fidelity on Identity Recognition in Virtual Reality Inproceedings
In: Proceedings of ICAT-EGVE 2017 - International Conference on Artificial Reality and Telexistence and Eurographics Symposium on Virtual Environments, The Eurographics Association, Adelaide, Australia, 2017, ISBN: 978-3-03868-038-3.
Abstract | Links | BibTeX | Tags: MedVR, MxR, UARC
@inproceedings{thomas_effects_2017,
title = {Effects of Personalized Avatar Texture Fidelity on Identity Recognition in Virtual Reality},
author = {Jerald Thomas and Mahdi Azmandian and Sonia Grunwald and Donna Le and David Krum and Sin-Hwa Kang and Evan Suma Rosenberg},
url = {https://diglib.eg.org/handle/10.2312/egve20171345},
doi = {10.2312/egve.20171345},
isbn = {978-3-03868-038-3},
year = {2017},
date = {2017-11-01},
booktitle = {Proceedings of ICAT-EGVE 2017 - International Conference on Artificial Reality and Telexistence and Eurographics Symposium on Virtual Environments},
publisher = {The Eurographics Association},
address = {Adelaide, Australia},
abstract = {Recent advances in 3D scanning, reconstruction, and animation techniques have made it possible to rapidly create photorealistic avatars based on real people. While it is now possible to create personalized avatars automatically with consumer-level technology, their visual fidelity still falls far short of 3D avatars created with professional cameras and manual artist effort. To evaluate the importance of investing resources in the creation of high-quality personalized avatars, we conducted an experiment to investigate the effects of varying their visual texture fidelity, specifically focusing on identity recognition of specific individuals. We designed two virtual reality experimental scenarios: (1) selecting a specific avatar from a virtual lineup and (2) searching for an avatar in a virtual crowd. Our results showed that visual fidelity had a significant impact on participants’ abilities to identify specific avatars from a lineup wearing a head-mounted display. We also investigated gender effects for both the participants and the confederates from which the avatars were created.},
keywords = {MedVR, MxR, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
Recent advances in 3D scanning, reconstruction, and animation techniques have made it possible to rapidly create photorealistic avatars based on real people. While it is now possible to create personalized avatars automatically with consumer-level technology, their visual fidelity still falls far short of 3D avatars created with professional cameras and manual artist effort. To evaluate the importance of investing resources in the creation of high-quality personalized avatars, we conducted an experiment to investigate the effects of varying their visual texture fidelity, specifically focusing on identity recognition of specific individuals. We designed two virtual reality experimental scenarios: (1) selecting a specific avatar from a virtual lineup and (2) searching for an avatar in a virtual crowd. Our results showed that visual fidelity had a significant impact on participants’ abilities to identify specific avatars from a lineup wearing a head-mounted display. We also investigated gender effects for both the participants and the confederates from which the avatars were created.
Rizzo, Albert “Skip”; Koenig, Sebastian Thomas
Is clinical virtual reality ready for primetime? Journal Article
In: Neuropsychology, vol. 31, no. 8, pp. 877–899, 2017, ISSN: 1931-1559, 0894-4105.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@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}
}
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
Schnurr, Paula P.; Bryant, Richard; Berliner, Lucy; Kilpatrick, Dean G.; Rizzo, Albert; Ruzek, Josef I.
What I have changed my mind about and why: public health and technology perspectives in the field of trauma studies Journal Article
In: European Journal of Psychotraumatology, vol. 8, no. sup5, 2017, ISSN: 2000-8198, 2000-8066.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@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}
}
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.
Talbot, T. B.; Christofferson, K.
Method for Live Production of Synthetic Lung Sounds in an Online Auscultation Simulator Inproceedings
In: Proceedings of the ILSA Conference, Tromso, Norway, 2017.
Abstract | Links | BibTeX | Tags: MedVR
@inproceedings{talbot_method_2017,
title = {Method for Live Production of Synthetic Lung Sounds in an Online Auscultation Simulator},
author = {T. B. Talbot and K. Christofferson},
url = {http://ict.usc.edu/pubs/Method%20for%20Live%20Production%20of%20Synthetic%20Lung%20Sounds%20in%20an%20Online%20Auscultation%20Simulator.pdf},
year = {2017},
date = {2017-09-01},
booktitle = {Proceedings of the ILSA Conference},
address = {Tromso, Norway},
abstract = {We are researching the development of an advanced auscultation simulator [1] that will provide for a dynamic examination with varying acoustic output based upon listening location [2], respiratory effort & phase. The simulator will be delivered online through web browsers and support a novel pedagogical approach [3]. Most extant lung sound samples are recorded at a single location and are rife with noise contamination [4], making them unsuitable. Thus, we employ synthetic lung & breath sounds with a clean acoustic profile so that numerous sounds can be mixed without degradation. Two categories of sounds are created: vesicular and adventitious. Vesicular sounds [5] include normal breath, diminished breath, tracheal, & bronchovesicular sounds plus variants. Inspiratory & Expiratory vesicular sounds are selected separately and are combined to produce the desired rate & I:E ratio (Figure 1). Vesicular sounds form the basis of the respiratory loop and represent the ‘base note’ of the exam. Adventitious sounds include varieties of fine crackles, course crackles, wheezes, rhonchi, pleural rubs, and squalks [6,7]. One or more sounds are mixed over vesicular sounds. The adventitious sounds must be very clean as there will already be audible airflow. Sounds are intended to be clear and distinct for the benefit of the learner. At a point within the defined respiratory loop, adventitious sounds are placed at will by a case author (Figure 2). The author may set the effective spatial area of the sounds in order to provide for localized findings which are a common finding in the pulmonary exam [8]. With control over the respiratory loop, spatial & temporal presentation, and access to a variety of synthetic lung sounds, a wide variety of clinical presentations may be created. The next problem involves the live coordination & mixing of sounds during the simulation. A challenge because our simulator runs on web browsers, we employ the new open-source Web Audio API [9] to handle sound processing. The API uses Audio Nodes that provide for Sound Sources, Gain Nodes, Filters, Processors and Mixers (Figure 3). A Biquad Filter has many modes including Low Pass which can simulate the 200Hz attenuation of healthy lung tissue and vary the effect by listening locale. Other filters provide for phase, frequency, wave-shaping and environmental acoustic effects. Listening locale presentation is customized by manipulating Gain Nodes. This method allows for a clean auscultation exam with clear and easily identifiable sounds which should aid in the learning process. Single sounds can be isolated during the dynamic exam as a teaching tool. Conversely, more complex and challenging presentations can be created. One drawback to this approach is the expense and effort of creating the synthetic sounds, though once made they can be reused a great deal. When completed, our synthetic sounds will be posted on an open-source exchange [10]. Eventually, it may be possible to use high-quality processed lung recordings with this method.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {inproceedings}
}
We are researching the development of an advanced auscultation simulator [1] that will provide for a dynamic examination with varying acoustic output based upon listening location [2], respiratory effort & phase. The simulator will be delivered online through web browsers and support a novel pedagogical approach [3]. Most extant lung sound samples are recorded at a single location and are rife with noise contamination [4], making them unsuitable. Thus, we employ synthetic lung & breath sounds with a clean acoustic profile so that numerous sounds can be mixed without degradation. Two categories of sounds are created: vesicular and adventitious. Vesicular sounds [5] include normal breath, diminished breath, tracheal, & bronchovesicular sounds plus variants. Inspiratory & Expiratory vesicular sounds are selected separately and are combined to produce the desired rate & I:E ratio (Figure 1). Vesicular sounds form the basis of the respiratory loop and represent the ‘base note’ of the exam. Adventitious sounds include varieties of fine crackles, course crackles, wheezes, rhonchi, pleural rubs, and squalks [6,7]. One or more sounds are mixed over vesicular sounds. The adventitious sounds must be very clean as there will already be audible airflow. Sounds are intended to be clear and distinct for the benefit of the learner. At a point within the defined respiratory loop, adventitious sounds are placed at will by a case author (Figure 2). The author may set the effective spatial area of the sounds in order to provide for localized findings which are a common finding in the pulmonary exam [8]. With control over the respiratory loop, spatial & temporal presentation, and access to a variety of synthetic lung sounds, a wide variety of clinical presentations may be created. The next problem involves the live coordination & mixing of sounds during the simulation. A challenge because our simulator runs on web browsers, we employ the new open-source Web Audio API [9] to handle sound processing. The API uses Audio Nodes that provide for Sound Sources, Gain Nodes, Filters, Processors and Mixers (Figure 3). A Biquad Filter has many modes including Low Pass which can simulate the 200Hz attenuation of healthy lung tissue and vary the effect by listening locale. Other filters provide for phase, frequency, wave-shaping and environmental acoustic effects. Listening locale presentation is customized by manipulating Gain Nodes. This method allows for a clean auscultation exam with clear and easily identifiable sounds which should aid in the learning process. Single sounds can be isolated during the dynamic exam as a teaching tool. Conversely, more complex and challenging presentations can be created. One drawback to this approach is the expense and effort of creating the synthetic sounds, though once made they can be reused a great deal. When completed, our synthetic sounds will be posted on an open-source exchange [10]. Eventually, it may be possible to use high-quality processed lung recordings with this method.
Powell, Wendy; Rizzo, Albert; Sharkey, Paul; Merrick, Joav (Ed.)
Virtual reality: recent advances in virtual rehabilitation system design Book
Nova Science Publishers, New York, NY, 2017, ISBN: 978-1-5361-2040-0.
Abstract | Links | BibTeX | Tags: MedVR
@book{powell_virtual_2017,
title = {Virtual reality: recent advances in virtual rehabilitation system design},
editor = {Wendy Powell and Albert Rizzo and Paul Sharkey and Joav Merrick},
url = {https://researchportal.port.ac.uk/portal/en/publications/virtual-reality(9f0b8e00-c449-40e5-8d36-d8994f25a5ea)/export.html},
isbn = {978-1-5361-2040-0},
year = {2017},
date = {2017-09-01},
publisher = {Nova Science Publishers},
address = {New York, NY},
abstract = {In recent years we have seen a trend towards the use of virtual reality (VR) technologies for rehabilitation and disability support. This is partly driven by the decreasing cost and improved accessibility to the technology, but also by the growth in expertise of virtual rehabilitation researchers and practitioners. The benefits of virtual reality are becoming well established in a number of areas such as pain management, physical rehabilitation and cognitive interventions, and research studies have demonstrated benefits across a range of conditions including Parkinson's disease, cerebral palsy, autism and anxiety disorders. However, the diversity of hardware and software available currently has little standardisation, and patients with disabilities or health conditions often have unique interaction needs which differ from the general population. In this book we explore a number of these issues, presenting recent research findings and technical developments which help us to understand the unique challenges of virtual rehabilitation design and guide future VR system development},
keywords = {MedVR},
pubstate = {published},
tppubtype = {book}
}
In recent years we have seen a trend towards the use of virtual reality (VR) technologies for rehabilitation and disability support. This is partly driven by the decreasing cost and improved accessibility to the technology, but also by the growth in expertise of virtual rehabilitation researchers and practitioners. The benefits of virtual reality are becoming well established in a number of areas such as pain management, physical rehabilitation and cognitive interventions, and research studies have demonstrated benefits across a range of conditions including Parkinson's disease, cerebral palsy, autism and anxiety disorders. However, the diversity of hardware and software available currently has little standardisation, and patients with disabilities or health conditions often have unique interaction needs which differ from the general population. In this book we explore a number of these issues, presenting recent research findings and technical developments which help us to understand the unique challenges of virtual rehabilitation design and guide future VR system development
Powell, Wendy; Rizzo, Albert; Sharkey, Paul; Merrick, Joav (Ed.)
Rehabilitation: innovations and challenges in the use of virtual reality technologies Book
Nova Science Publishers, New York, NY, 2017, ISBN: 978-1-5361-2080-6.
Abstract | Links | BibTeX | Tags: MedVR
@book{powell_rehabilitation_2017,
title = {Rehabilitation: innovations and challenges in the use of virtual reality technologies},
editor = {Wendy Powell and Albert Rizzo and Paul Sharkey and Joav Merrick},
url = {https://researchportal.port.ac.uk/portal/en/publications/rehabilitation(629f8c25-1a84-4741-8ca7-f293109d7140)/export.html},
isbn = {978-1-5361-2080-6},
year = {2017},
date = {2017-09-01},
publisher = {Nova Science Publishers},
address = {New York, NY},
abstract = {Virtual rehabilitation has been the focus of considerable research for many years, but the recent upsurge in consumer-ready virtual reality hardware and software has led to an increase in interest in its use in a variety of clinical and home settings. Balancing the upsurge in demand for innovative technological healthcare tools is the need for a credible evidence base for its use and guidance for practitioners on which systems and applications are suitable for different patient populations and rehabilitation goals. This promising branch of healthcare is already being used to benefit many patients in homes and clinics around the world, but it is evident that there is still much more to learn if we are to continue to push the boundaries of clinical innovation and excellence. In this book we present recent research addressing a number of these important topics, adding to our understanding of the complex issues and clinical considerations in virtual rehabilitation research and application.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {book}
}
Virtual rehabilitation has been the focus of considerable research for many years, but the recent upsurge in consumer-ready virtual reality hardware and software has led to an increase in interest in its use in a variety of clinical and home settings. Balancing the upsurge in demand for innovative technological healthcare tools is the need for a credible evidence base for its use and guidance for practitioners on which systems and applications are suitable for different patient populations and rehabilitation goals. This promising branch of healthcare is already being used to benefit many patients in homes and clinics around the world, but it is evident that there is still much more to learn if we are to continue to push the boundaries of clinical innovation and excellence. In this book we present recent research addressing a number of these important topics, adding to our understanding of the complex issues and clinical considerations in virtual rehabilitation research and application.
Bernardet, Ulysses; Kang, Sin-hwa; Feng, Andrew; DiPaola, Steve; Shapiro, Ari
A Dynamic Speech Breathing System for Virtual Characters Inproceedings
In: Proceedings of the 17th International Conference on Intelligent Virtual Agents, pp. 43–52, Springer, Stockholm, Sweden, 2017, ISBN: 978-3-319-67401-8.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@inproceedings{bernardet_dynamic_2017,
title = {A Dynamic Speech Breathing System for Virtual Characters},
author = {Ulysses Bernardet and Sin-hwa Kang and Andrew Feng and Steve DiPaola and Ari Shapiro},
url = {https://link.springer.com/chapter/10.1007/978-3-319-67401-8_5},
doi = {10.1007/978-3-319-67401-8_5},
isbn = {978-3-319-67401-8},
year = {2017},
date = {2017-08-01},
booktitle = {Proceedings of the 17th International Conference on Intelligent Virtual Agents},
pages = {43--52},
publisher = {Springer},
address = {Stockholm, Sweden},
abstract = {Human speech production requires the dynamic regulation of air through the vocal system. While virtual character systems commonly are capable of speech output, they rarely take breathing during speaking - speech breathing - into account. We believe that integrating dynamic speech breathing systems in virtual characters can signi cantly contribute to augmenting their realism. Here, we present a novel control architecture aimed at generating speech breathing in virtual characters. This architecture is informed by behavioral, linguistic and anatomical knowledge of human speech breathing. Based on textual input and controlled by a set of low- and high-level parameters, the system produces dynamic signals in real-time that control the virtual character's anatomy (thorax, abdomen, head, nostrils, and mouth) and sound production (speech and breathing). The system is implemented in Python, o ers a graphical user interface for easy parameter control, and simultaneously controls the visual and auditory aspects of speech breathing through the integration of the character animation system SmartBody [1] and the audio synthesis platform SuperCollider [2]. Beyond contributing to realism, the presented system allows for a exible generation of a wide range of speech breathing behaviors that can convey information about the speaker such as mood, age, and health.},
keywords = {MedVR, Virtual Humans},
pubstate = {published},
tppubtype = {inproceedings}
}
Human speech production requires the dynamic regulation of air through the vocal system. While virtual character systems commonly are capable of speech output, they rarely take breathing during speaking - speech breathing - into account. We believe that integrating dynamic speech breathing systems in virtual characters can signi cantly contribute to augmenting their realism. Here, we present a novel control architecture aimed at generating speech breathing in virtual characters. This architecture is informed by behavioral, linguistic and anatomical knowledge of human speech breathing. Based on textual input and controlled by a set of low- and high-level parameters, the system produces dynamic signals in real-time that control the virtual character's anatomy (thorax, abdomen, head, nostrils, and mouth) and sound production (speech and breathing). The system is implemented in Python, o ers a graphical user interface for easy parameter control, and simultaneously controls the visual and auditory aspects of speech breathing through the integration of the character animation system SmartBody [1] and the audio synthesis platform SuperCollider [2]. Beyond contributing to realism, the presented system allows for a exible generation of a wide range of speech breathing behaviors that can convey information about the speaker such as mood, age, and health.
Wang, Ning; Pynadath, David V.; Hill, Susan G.; Merchant, Chirag
The Dynamics of Human-Agent Trust with POMDP-Generated Explanations Inproceedings
In: Proceedings of the 17th International Conference on Intelligent Virtual Agents (IVA 2017), Springer International Publishing, Stockholm, Sweden, 2017, ISBN: 978-3-319-67400-1 978-3-319-67401-8.
Abstract | Links | BibTeX | Tags: ARL, DoD, MedVR, Social Simulation, UARC
@inproceedings{wang_dynamics_2017,
title = {The Dynamics of Human-Agent Trust with POMDP-Generated Explanations},
author = {Ning Wang and David V. Pynadath and Susan G. Hill and Chirag Merchant},
url = {https://link.springer.com/chapter/10.1007/978-3-319-67401-8_58},
isbn = {978-3-319-67400-1 978-3-319-67401-8},
year = {2017},
date = {2017-08-01},
booktitle = {Proceedings of the 17th International Conference on Intelligent Virtual Agents (IVA 2017)},
publisher = {Springer International Publishing},
address = {Stockholm, Sweden},
abstract = {Partially Observable Markov Decision Processes (POMDPs) enable optimized decision making by robots, agents, and other autonomous systems. This quantitative optimization can also be a limitation in human-agent interaction, as the resulting autonomous behavior, while possibly optimal, is often impenetrable to human teammates, leading to improper trust and, subsequently, disuse or misuse of such systems [1]. Automatically generated explanations of POMDP-based decisions have shown promise in calibrating human-agent trust [3]. However, these “one-size-fits-all” static explanation policies are insufficient to accommodate different communication preferences across people. In this work, we analyze human behavior in a human-robot interaction (HRI) scenario, to find behavioral indicators of trust in the agent’s ability. We evaluate four hypothesized behavioral measures that an agent could potentially use to dynamically infer its teammate’s current trust level. The conclusions drawn can potentially inform the design of intelligent agents that can automatically adapt their explanation policies as they observe the behavioral responses of their human teammates.},
keywords = {ARL, DoD, MedVR, Social Simulation, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
Partially Observable Markov Decision Processes (POMDPs) enable optimized decision making by robots, agents, and other autonomous systems. This quantitative optimization can also be a limitation in human-agent interaction, as the resulting autonomous behavior, while possibly optimal, is often impenetrable to human teammates, leading to improper trust and, subsequently, disuse or misuse of such systems [1]. Automatically generated explanations of POMDP-based decisions have shown promise in calibrating human-agent trust [3]. However, these “one-size-fits-all” static explanation policies are insufficient to accommodate different communication preferences across people. In this work, we analyze human behavior in a human-robot interaction (HRI) scenario, to find behavioral indicators of trust in the agent’s ability. We evaluate four hypothesized behavioral measures that an agent could potentially use to dynamically infer its teammate’s current trust level. The conclusions drawn can potentially inform the design of intelligent agents that can automatically adapt their explanation policies as they observe the behavioral responses of their human teammates.
Powell, Wendy; Sharkey, Paul; Rizzo, Albert; Merrick, Joav (Ed.)
Virtual reality: recent advances for health and wellbeing Book
Nova Science Publishers, New York, NY, 2017, ISBN: 978-1-5361-2454-5.
Abstract | Links | BibTeX | Tags: MedVR
@book{powell_virtual_2017-1,
title = {Virtual reality: recent advances for health and wellbeing},
editor = {Wendy Powell and Paul Sharkey and Albert Rizzo and Joav Merrick},
url = {https://researchportal.port.ac.uk/portal/en/publications/virtual-reality(f56cf1d4-6f04-4cda-84f3-b8bfacf585af)/export.html},
isbn = {978-1-5361-2454-5},
year = {2017},
date = {2017-07-01},
publisher = {Nova Science Publishers},
address = {New York, NY},
abstract = {Virtual reality and human interaction with it is a complex topic, and certainly not one which will be mastered overnight; but across the world, there is excellent research being carried out for all of these important domains. As humanity extends its understanding of the interplay with these system components, developers will be well-positioned to design better and more effective virtual reality interventions and come closer to realising the full potential of virtual reality for health and well-being. In this book, the authors present a number of short papers from research groups around the world working in this important and complex field. The chapters explore a range of issues, suggesting routes forward and offering insights into both the potential and the challenges of this rapidly maturing technology.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {book}
}
Virtual reality and human interaction with it is a complex topic, and certainly not one which will be mastered overnight; but across the world, there is excellent research being carried out for all of these important domains. As humanity extends its understanding of the interplay with these system components, developers will be well-positioned to design better and more effective virtual reality interventions and come closer to realising the full potential of virtual reality for health and well-being. In this book, the authors present a number of short papers from research groups around the world working in this important and complex field. The chapters explore a range of issues, suggesting routes forward and offering insights into both the potential and the challenges of this rapidly maturing technology.
Krum, David M.; Kang, Sin-Hwa; Phan, Thai; Dukes, Lauren Cairco; Bolas, Mark
Social Impact of Enhanced Gaze Presentation Using Head Mounted Projection Inproceedings
In: Proceedings of the Human-Computer Interaction International Conference, Springer International Publishing, Vancouver, Canada, 2017, ISBN: 978-3-319-58696-0 978-3-319-58697-7.
Abstract | Links | BibTeX | Tags: MedVR, MxR, UARC
@inproceedings{krum_social_2017,
title = {Social Impact of Enhanced Gaze Presentation Using Head Mounted Projection},
author = {David M. Krum and Sin-Hwa Kang and Thai Phan and Lauren Cairco Dukes and Mark Bolas},
url = {https://link.springer.com/chapter/10.1007/978-3-319-58697-7_5},
isbn = {978-3-319-58696-0 978-3-319-58697-7},
year = {2017},
date = {2017-05-01},
booktitle = {Proceedings of the Human-Computer Interaction International Conference},
publisher = {Springer International Publishing},
address = {Vancouver, Canada},
abstract = {Projected displays can present life-sized imagery of a virtual human character that can be seen by multiple observers. However, typical projected displays can only render that virtual human from a single viewpoint, regardless of whether head tracking is employed. This results in the virtual human being rendered from an incorrect perspective for most individuals in a group of observers. This could result in perceptual miscues, such as the “Mona Lisa” effect, causing the virtual human to appear as if it is simultaneously gazing and pointing at all observers in the room regardless of their location. This may be detrimental to training scenarios in which all trainees must accurately assess where the virtual human is looking or pointing a weapon. In this paper, we discuss our investigations into the presentation of eye gaze using REFLCT, a previously introduced head mounted projective display. REFLCT uses head tracked, head mounted projectors and retroreflective screens to present personalized, perspective correct imagery to multiple users without the occlusion of a traditional head mounted display. We examined how head mounted projection for enhanced presentation of eye gaze might facilitate or otherwise affect social interactions during a multi-person guessing game of “Twenty Questions.”},
keywords = {MedVR, MxR, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
Projected displays can present life-sized imagery of a virtual human character that can be seen by multiple observers. However, typical projected displays can only render that virtual human from a single viewpoint, regardless of whether head tracking is employed. This results in the virtual human being rendered from an incorrect perspective for most individuals in a group of observers. This could result in perceptual miscues, such as the “Mona Lisa” effect, causing the virtual human to appear as if it is simultaneously gazing and pointing at all observers in the room regardless of their location. This may be detrimental to training scenarios in which all trainees must accurately assess where the virtual human is looking or pointing a weapon. In this paper, we discuss our investigations into the presentation of eye gaze using REFLCT, a previously introduced head mounted projective display. REFLCT uses head tracked, head mounted projectors and retroreflective screens to present personalized, perspective correct imagery to multiple users without the occlusion of a traditional head mounted display. We examined how head mounted projection for enhanced presentation of eye gaze might facilitate or otherwise affect social interactions during a multi-person guessing game of “Twenty Questions.”
Kang, Sin-Hwa; Krum, David M.; Khooshabeh, Peter; Phan, Thai; Chang, Chien-Yen; Amir, Ori; Lin, Rebecca
Social influence of humor in virtual human counselor's self-disclosure Journal Article
In: Computer Animation and Virtual Worlds, vol. 28, no. 3-4, 2017, ISSN: 15464261.
Abstract | Links | BibTeX | Tags: ARL, DoD, MedVR, MxR, UARC
@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}
}
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.
Krum, David M.; Phan, Thai; Kang, Sin-Hwa
Motor Adaptation in Response to Scaling and Diminished Feedback in Virtual Reality Inproceedings
In: Proceedings of Virtual Reality (VR), 2017 IEEE, pp. 233–234, IEEE, Los Angeles, CA, 2017, ISBN: 978-1-5090-6647-6.
Abstract | Links | BibTeX | Tags: MedVR, MxR, UARC
@inproceedings{krum_motor_2017,
title = {Motor Adaptation in Response to Scaling and Diminished Feedback in Virtual Reality},
author = {David M. Krum and Thai Phan and Sin-Hwa Kang},
url = {http://ieeexplore.ieee.org/document/7892262/#full-text-section},
doi = {10.1109/VR.2017.7892262},
isbn = {978-1-5090-6647-6},
year = {2017},
date = {2017-03-01},
booktitle = {Proceedings of Virtual Reality (VR), 2017 IEEE},
pages = {233--234},
publisher = {IEEE},
address = {Los Angeles, CA},
abstract = {As interaction techniques involving scaling of motor space in virtual reality are becoming more prevalent, it is important to understand how individuals adapt to such scalings and how they re-adapt back to non-scaled norms. This preliminary work examines how individuals, performing a targeted ball throwing task, adapted to addition and removal of a translational scaling of the ball’s forward flight. This was examined under various conditions: flight of the ball shown with no delay, hidden flight of the ball with no delay, and hidden flight with a 2 second delay. Hiding the ball’s flight, as well as the delay, created disruptions in the ability of the participants to perform the task and adapt to new scaling conditions.},
keywords = {MedVR, MxR, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
As interaction techniques involving scaling of motor space in virtual reality are becoming more prevalent, it is important to understand how individuals adapt to such scalings and how they re-adapt back to non-scaled norms. This preliminary work examines how individuals, performing a targeted ball throwing task, adapted to addition and removal of a translational scaling of the ball’s forward flight. This was examined under various conditions: flight of the ball shown with no delay, hidden flight of the ball with no delay, and hidden flight with a 2 second delay. Hiding the ball’s flight, as well as the delay, created disruptions in the ability of the participants to perform the task and adapt to new scaling conditions.
Talbot, Thomas B
Making Lifelike Medical Games in the Age of Virtual Reality An Update on “Playing Games with Biology” from 2013 Incollection
In: Transforming Gaming and Computer Simulation Technologies across Industries, pp. 103–119, IGI Global, Hershey, PA, 2017, ISBN: 978-1-5225-1817-4 978-1-5225-1818-1.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@incollection{talbot_making_2017,
title = {Making Lifelike Medical Games in the Age of Virtual Reality An Update on “Playing Games with Biology” from 2013},
author = {Thomas B Talbot},
url = {http://services.igi-global.com/resolvedoi/resolve.aspx?doi=10.4018/978-1-5225-1817-4},
doi = {10.4018/978-1-5225-1817-4},
isbn = {978-1-5225-1817-4 978-1-5225-1818-1},
year = {2017},
date = {2017-01-01},
booktitle = {Transforming Gaming and Computer Simulation Technologies across Industries},
pages = {103--119},
publisher = {IGI Global},
address = {Hershey, PA},
abstract = {Medical simulations differ from other training modalities in that life processes must be simulated as part of the experience. Biological fidelity is the degree to which character anatomical appearance and physiology behavior are represented within a game or simulation. Methods to achieve physiological fidelity include physiology engines, complex state machines, simple state machines and kinetic models. Games health scores that can be used in medical sims. Selection of technique depends upon the goals of the simulation, expected user inputs, development budget and level of fidelity required. Trends include greater availability of physiology engines rapid advances in virtual reality (VR). In VR, the expectation for a naturalistic interface is much greater, resulting in technical challenges regarding natural language and gesture-based interaction. Regardless of the technical approach, the user’s perception of biological fidelity, responsiveness to user inputs and the ability to correct mistakes is often more important than the underlying biological fidelity of the model.},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {incollection}
}
Medical simulations differ from other training modalities in that life processes must be simulated as part of the experience. Biological fidelity is the degree to which character anatomical appearance and physiology behavior are represented within a game or simulation. Methods to achieve physiological fidelity include physiology engines, complex state machines, simple state machines and kinetic models. Games health scores that can be used in medical sims. Selection of technique depends upon the goals of the simulation, expected user inputs, development budget and level of fidelity required. Trends include greater availability of physiology engines rapid advances in virtual reality (VR). In VR, the expectation for a naturalistic interface is much greater, resulting in technical challenges regarding natural language and gesture-based interaction. Regardless of the technical approach, the user’s perception of biological fidelity, responsiveness to user inputs and the ability to correct mistakes is often more important than the underlying biological fidelity of the model.
Bautista, Merrick; Leeds, Andrew; Tokel, Tugba; Talbot, Thomas B.
Spoken vs. typed questioning in a conversational medical interview with virtual standardize patients Inproceedings
In: Proceedings of the International Meeting on Simulation in Healthcare 2017, Orlando, FL, 2017.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@inproceedings{bautista_spoken_2017,
title = {Spoken vs. typed questioning in a conversational medical interview with virtual standardize patients},
author = {Merrick Bautista and Andrew Leeds and Tugba Tokel and Thomas B. Talbot},
url = {http://ict.usc.edu/pubs/SPS_IMSH%202017_Final_Talbot%20Tokel%20Leeds%20Bautista.pdf},
year = {2017},
date = {2017-01-01},
booktitle = {Proceedings of the International Meeting on Simulation in Healthcare 2017},
address = {Orlando, FL},
abstract = {There have been numerous attempts to replicate the experience of human standardized patient (Barrows & Anderson, 1964) on a computer for anytime-anywhere access to the experience. USC Standard Patient seeks to: • improve clinic-based medical encounter simulation with the goal to create engaging virtual standardized patient (VSP) encounters, • enable objective and meaningful assessment of learner interview performance and mature physician interviewing & diagnostic skills. Virtual standardized patients (VSP): • A conversational simulated patient used for medical training and capable of natural language interaction with verbal and nonverbal behavior responses • Offers consistent, objective experience and detailed user feedback to learners},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
There have been numerous attempts to replicate the experience of human standardized patient (Barrows & Anderson, 1964) on a computer for anytime-anywhere access to the experience. USC Standard Patient seeks to: • improve clinic-based medical encounter simulation with the goal to create engaging virtual standardized patient (VSP) encounters, • enable objective and meaningful assessment of learner interview performance and mature physician interviewing & diagnostic skills. Virtual standardized patients (VSP): • A conversational simulated patient used for medical training and capable of natural language interaction with verbal and nonverbal behavior responses • Offers consistent, objective experience and detailed user feedback to learners
Bautista, Merrick; Leeds, Andrew; Tokel, Tugba; Talbot, Thomas B.
Spoken vs typed questioning in a conversational medical interview with virtual standardized patients Inproceedings
In: Proceedings of the International Meeting on Simulation in Healthcare 2017, Orlando, Florida, 2017.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@inproceedings{bautista_spoken_2017-1,
title = {Spoken vs typed questioning in a conversational medical interview with virtual standardized patients},
author = {Merrick Bautista and Andrew Leeds and Tugba Tokel and Thomas B. Talbot},
url = {http://ict.usc.edu/pubs/SPS_IMSH%202017_Final_Talbot%20Tokel%20Leeds%20Bautista.pdf},
year = {2017},
date = {2017-01-01},
booktitle = {Proceedings of the International Meeting on Simulation in Healthcare 2017},
address = {Orlando, Florida},
abstract = {There here have have beenbeen beennumerous numerous numerous numerousattempts attempts to replicatereplicate replicate replicatereplicate the experienceexperience experienceexperience experienceexperienceexperience of humanhumanhuman humanstandardized standardizedstandardizedstandardizedstandardizedstandardized standardizedpatientpatientpatient patientpatientpatient(Barrows (Barrows (Barrows(Barrows&Anderson, Anderson, Anderson, Anderson, 1964 19641964)on acomputer computercomputer for anytime anytime -anywhere anywhereanywhereanywhere access access to the experience experience experience experience . USC Standard Standard Standard Patient Patient Patientseeks seeks to : • improve improve clinicclinic clinicclinic -based based medicalmedical medical medical encounter encounter simulation simulation simulation withwith withthe goal to create create engaging engagingengaging engagingvirtual virtual standardized standardized standardized standardizedstandardized patient patient patient(VSP) encounters, encounters, encounters, encounters, • enable enable objective objective objective and meaningful meaningful meaningful meaningfulassessment assessment assessment assessmentof learner learner interview interview performance performance performance performance and mature mature physician physicianphysician physicianphysicianinterviewing interviewing interviewinginterviewinginterviewing &diagnosticdiagnostic diagnosticdiagnosticdiagnosticdiagnostic skills skills skills. VirtualVirtual Virtualstandardized standardized standardized standardized patients patients patients (VSP) : • Aconversational conversational conversational simulated simulatedsimulated simulatedpatientpatient patient used usedfor medical medical medicaltraining training and capableapable apable of natural natural natural language languagelanguage languageinteraction interactioninteraction interaction withwith verbal verbal and nonverbal nonverbal nonverbal nonverbalbehavior behavior behavior behaviorresponses responses responses • OffersOffersOffers consistent, consistent, consistent, objective objective objective},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
There here have have beenbeen beennumerous numerous numerous numerousattempts attempts to replicatereplicate replicate replicatereplicate the experienceexperience experienceexperience experienceexperienceexperience of humanhumanhuman humanstandardized standardizedstandardizedstandardizedstandardizedstandardized standardizedpatientpatientpatient patientpatientpatient(Barrows (Barrows (Barrows(Barrows&Anderson, Anderson, Anderson, Anderson, 1964 19641964)on acomputer computercomputer for anytime anytime -anywhere anywhereanywhereanywhere access access to the experience experience experience experience . USC Standard Standard Standard Patient Patient Patientseeks seeks to : • improve improve clinicclinic clinicclinic -based based medicalmedical medical medical encounter encounter simulation simulation simulation withwith withthe goal to create create engaging engagingengaging engagingvirtual virtual standardized standardized standardized standardizedstandardized patient patient patient(VSP) encounters, encounters, encounters, encounters, • enable enable objective objective objective and meaningful meaningful meaningful meaningfulassessment assessment assessment assessmentof learner learner interview interview performance performance performance performance and mature mature physician physicianphysician physicianphysicianinterviewing interviewing interviewinginterviewinginterviewing &diagnosticdiagnostic diagnosticdiagnosticdiagnosticdiagnostic skills skills skills. VirtualVirtual Virtualstandardized standardized standardized standardized patients patients patients (VSP) : • Aconversational conversational conversational simulated simulatedsimulated simulatedpatientpatient patient used usedfor medical medical medicaltraining training and capableapable apable of natural natural natural language languagelanguage languageinteraction interactioninteraction interaction withwith verbal verbal and nonverbal nonverbal nonverbal nonverbalbehavior behavior behavior behaviorresponses responses responses • OffersOffersOffers consistent, consistent, consistent, objective objective objective
Rizzo, Albert "Skip"
The Ultimate Skinner Box: Clinical Virtual Reality 1990-2016 Journal Article
In: Engadget, 2017.
Abstract | Links | BibTeX | Tags: MedVR
@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}
}
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
Eini, Dalit Shefer; Ratzon, Navah Z.; Rizzo, Albert A.; Yeh, Shih-Ching; Lange, Belinda; Yaffe, Batia; Daich, Alexander; Weiss, Patrice L.; Kizony, Rachel
Camera-tracking gaming control device for evaluation of active wrist flexion and extension Journal Article
In: Journal of Hand Therapy, vol. 30, no. 1, pp. 89–96, 2017, ISSN: 08941130.
Abstract | Links | BibTeX | Tags: MedVR
@article{shefer_eini_camera-tracking_2017,
title = {Camera-tracking gaming control device for evaluation of active wrist flexion and extension},
author = {Dalit Shefer Eini and Navah Z. Ratzon and Albert A. Rizzo and Shih-Ching Yeh and Belinda Lange and Batia Yaffe and Alexander Daich and Patrice L. Weiss and Rachel Kizony},
url = {http://linkinghub.elsevier.com/retrieve/pii/S0894113016301132},
doi = {10.1016/j.jht.2016.07.002},
issn = {08941130},
year = {2017},
date = {2017-01-01},
journal = {Journal of Hand Therapy},
volume = {30},
number = {1},
pages = {89--96},
abstract = {Study Design: Cross sectional. Introduction: Measuring wrist range of motion (ROM) is an essential procedure in hand therapy clinics. Purpose of the Study: To test the reliability and validity of a dynamic ROM assessment, the Camera WristTracker (CWT). Methods: Wrist flexion and extension ROM of 15 patients with distal radius fractures and 15 matchedcontrols were assessed with the CWT and with a universal goniometer. Results: One-way model intraclass correlation coefficient analysis indicated high test-retest reliability for extension (ICC ¼ 0.92) and moderate reliability for flexion (ICC ¼ 0.49). Standard error for extension was 2.45 and for flexion was 4.07 . Repeated-measures analysis revealed a significant main effect for group; ROM was greater in the control group (F[1, 28] ¼ 47.35; P textbackslashtextbackslashtextbackslashtextless.001). The concurrent validity of the CWT was partially supported. Conclusion: The results indicate that the CWT may provide highly reliable scores for dynamic wrist extension ROM, and moderately reliable scores for flexion, in people recovering from a distal radius fracture. Level of Evidence: N/A.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Study Design: Cross sectional. Introduction: Measuring wrist range of motion (ROM) is an essential procedure in hand therapy clinics. Purpose of the Study: To test the reliability and validity of a dynamic ROM assessment, the Camera WristTracker (CWT). Methods: Wrist flexion and extension ROM of 15 patients with distal radius fractures and 15 matchedcontrols were assessed with the CWT and with a universal goniometer. Results: One-way model intraclass correlation coefficient analysis indicated high test-retest reliability for extension (ICC ¼ 0.92) and moderate reliability for flexion (ICC ¼ 0.49). Standard error for extension was 2.45 and for flexion was 4.07 . Repeated-measures analysis revealed a significant main effect for group; ROM was greater in the control group (F[1, 28] ¼ 47.35; P textbackslashtextbackslashtextbackslashtextless.001). The concurrent validity of the CWT was partially supported. Conclusion: The results indicate that the CWT may provide highly reliable scores for dynamic wrist extension ROM, and moderately reliable scores for flexion, in people recovering from a distal radius fracture. Level of Evidence: N/A.
2016
Talbot, Thomas B.; Lyon, Thomas D.; Rizzo, Albert; John, Bruce
In: Proceedings of the Interservice/Industry Training, Simulation, and Education Conference (I/ITSEC) 2016, Orlando, Florida, 2016.
Abstract | Links | BibTeX | Tags: MedVR
@inproceedings{talbot_virtual_2016,
title = {Virtual Child Witness-Effects of single and multiple use on performance with Novice and Expert cohorts in a structured virtual human interview},
author = {Thomas B. Talbot and Thomas D. Lyon and Albert Rizzo and Bruce John},
url = {http://ict.usc.edu/pubs/Virtual%20Child%20Witness%20Effects%20of%20single%20and%20multiple%20use%20on%20performance%20with%20Novice%20and%20Expert%20cohorts%20in%20a%20structured%20virtual%20human%20interview.pdf},
year = {2016},
date = {2016-12-01},
booktitle = {Proceedings of the Interservice/Industry Training, Simulation, and Education Conference (I/ITSEC) 2016},
address = {Orlando, Florida},
abstract = {Virtual human avatars can be used to train and assess a myriad of complex skills, such as interviewing, interpersonal, and clinical skills, in a safe environment that provides consistency, reduced cost, greater accessibility, and objective feedback. We created a structured virtual human interview which consisted of a conversational avatar that interacts verbally in response to on screen question choices. Our prototype was a forensic interview simulation called Virtual Child Witness (VCW). VCW provides a content-rich interview in response to open-ended questions and is designed to assess user’s interviewing strategy. In a quasi-experimental design, we evaluated 222 subjects to determine if the system could discriminate between Experts (M = .713},
keywords = {MedVR},
pubstate = {published},
tppubtype = {inproceedings}
}
Virtual human avatars can be used to train and assess a myriad of complex skills, such as interviewing, interpersonal, and clinical skills, in a safe environment that provides consistency, reduced cost, greater accessibility, and objective feedback. We created a structured virtual human interview which consisted of a conversational avatar that interacts verbally in response to on screen question choices. Our prototype was a forensic interview simulation called Virtual Child Witness (VCW). VCW provides a content-rich interview in response to open-ended questions and is designed to assess user’s interviewing strategy. In a quasi-experimental design, we evaluated 222 subjects to determine if the system could discriminate between Experts (M = .713
Rizzo, Albert; Scherer, Scherer; DeVault, David; Gratch, Jonathan; Artstein, Ronald; Hartholt, Arno; Lucas, Gale; Marsella, Stacy; Morbini, Fabrizio; Nazarian, Angela; Stratou, Giota; Traum, David; Wood, Rachel; Boberg, Jill; Morency, Louis Philippe
Detection and computational analysis of psychological signals using a virtual human interviewing agent Journal Article
In: Journal of Pain Management, pp. 311–321, 2016, ISSN: 1939-5914.
Abstract | Links | BibTeX | Tags: MedVR, UARC, Virtual Humans
@article{rizzo_detection_2016,
title = {Detection and computational analysis of psychological signals using a virtual human interviewing agent},
author = {Albert Rizzo and Scherer Scherer and David DeVault and Jonathan Gratch and Ronald Artstein and Arno Hartholt and Gale Lucas and Stacy Marsella and Fabrizio Morbini and Angela Nazarian and Giota Stratou and David Traum and Rachel Wood and Jill Boberg and Louis Philippe Morency},
url = {http://www.icdvrat.org/2014/papers/ICDVRAT2014_S03N3_Rizzo_etal.pdf},
issn = {1939-5914},
year = {2016},
date = {2016-11-01},
journal = {Journal of Pain Management},
pages = {311--321},
abstract = {It has long been recognized that facial expressions, body posture/gestures and vocal parameters play an important role in human communication and the implicit signalling of emotion. Recent advances in low cost computer vision and behavioral sensing technologies can now be applied to the process of making meaningful inferences as to user state when a person interacts with a computational device. Effective use of this additive information could serve to promote human interaction with virtual human (VH) agents that may enhance diagnostic assessment. This paper will focus on our current research in these areas within the DARPA-funded "Detection and Computational Analysis of Psychological Signals" project, with specific attention to the SimSensei application use case. SimSensei is a virtual human interaction platform that is able to sense and interpret real-time audiovisual behavioral signals from users interacting with the system. It is specifically designed for health care support and leverages years of virtual human research and development at USC-ICT. The platform enables an engaging face-to-face interaction where the virtual human automatically reacts to the state and inferred intent of the user through analysis of behavioral signals gleaned from facial expressions, body gestures and vocal parameters. Akin to how non-verbal behavioral signals have an impact on human to human interaction and communication, SimSensei aims to capture and infer from user non-verbal communication to improve engagement between a VH and a user. The system can also quantify and interpret sensed behavioral signals longitudinally that can be used to inform diagnostic assessment within a clinical context.},
keywords = {MedVR, UARC, Virtual Humans},
pubstate = {published},
tppubtype = {article}
}
It has long been recognized that facial expressions, body posture/gestures and vocal parameters play an important role in human communication and the implicit signalling of emotion. Recent advances in low cost computer vision and behavioral sensing technologies can now be applied to the process of making meaningful inferences as to user state when a person interacts with a computational device. Effective use of this additive information could serve to promote human interaction with virtual human (VH) agents that may enhance diagnostic assessment. This paper will focus on our current research in these areas within the DARPA-funded "Detection and Computational Analysis of Psychological Signals" project, with specific attention to the SimSensei application use case. SimSensei is a virtual human interaction platform that is able to sense and interpret real-time audiovisual behavioral signals from users interacting with the system. It is specifically designed for health care support and leverages years of virtual human research and development at USC-ICT. The platform enables an engaging face-to-face interaction where the virtual human automatically reacts to the state and inferred intent of the user through analysis of behavioral signals gleaned from facial expressions, body gestures and vocal parameters. Akin to how non-verbal behavioral signals have an impact on human to human interaction and communication, SimSensei aims to capture and infer from user non-verbal communication to improve engagement between a VH and a user. The system can also quantify and interpret sensed behavioral signals longitudinally that can be used to inform diagnostic assessment within a clinical context.
McAlinden, Ryan; Kang, Sin-Hwa; Nye, Benjamin; Phillips, Artemisa; Campbell, Julia; Goldberg, Stephan L.
Cost-Effective Strategies for Producing Engaging Online Courseware Inproceedings
In: Proceedings from the Interservice/Industry Training, Simulation and Education Conference (I/ITSEC) 2016, National Training and Simulation Association, Orlando, FL, 2016.
Abstract | Links | BibTeX | Tags: ARL, DoD, Learning Sciences, MedVR, MxR, STG, UARC
@inproceedings{mcalinden_cost-effective_2016,
title = {Cost-Effective Strategies for Producing Engaging Online Courseware},
author = {Ryan McAlinden and Sin-Hwa Kang and Benjamin Nye and Artemisa Phillips and Julia Campbell and Stephan L. Goldberg},
url = {http://www.iitsecdocs.com/search},
year = {2016},
date = {2016-11-01},
booktitle = {Proceedings from the Interservice/Industry Training, Simulation and Education Conference (I/ITSEC) 2016},
publisher = {National Training and Simulation Association},
address = {Orlando, FL},
abstract = {As distributed learning (dL) and computer-based training (CBT) continue to proliferate, the methods of delivery often remain unengaging and bland for participants. Though many of the leaders in commercial online learning have improved their delivery style and quality in recent years, they continue to fall short in terms of user engagement and satisfaction. PowerPoint regurgitation and video lectures are commonplace and leave end users uninspired and wanting more. This paper discusses results from an ongoing research project, Captivating Virtual Instruction for Training (CVIT), which is aimed at understanding and improving dL through a series of recommendations and best practices for promoting and enhancing student engagement online. Though the central focus is on engagement, and how that translates to learning potential, a third variable (cost) has been examined to understand the financial and resource impacts on making content more interesting (i.e. the return on investment, or ROI). The paper presents findings from a 3-year long experiment comparing existing dL methods and techniques both within and outside of the Army. The project developed two dL versions of an existing Army course (Advanced Situational Awareness-Basic (ASA-B)) – the first was designed around producing material that was as engaging and as immersive as possible within a target budget; the second was a scaled-down version using more traditional, yet contemporary dL techniques (PowerPoint recital, video lectures). The two were then compared along three dimensions– engagement, learning and cost. The findings show that improved engagement in distributed courseware is possible without breaking the bank, though the returns on learning with these progressive approaches remain inconclusive. More importantly, it was determined that the quality and experience of the designers, production staff, writers, animators, programmers, and others cannot be underestimated, and that the familiar phrase – ‘you get what you pay for’ is as true with online learning as it is with other areas of content design and software development.},
keywords = {ARL, DoD, Learning Sciences, MedVR, MxR, STG, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
As distributed learning (dL) and computer-based training (CBT) continue to proliferate, the methods of delivery often remain unengaging and bland for participants. Though many of the leaders in commercial online learning have improved their delivery style and quality in recent years, they continue to fall short in terms of user engagement and satisfaction. PowerPoint regurgitation and video lectures are commonplace and leave end users uninspired and wanting more. This paper discusses results from an ongoing research project, Captivating Virtual Instruction for Training (CVIT), which is aimed at understanding and improving dL through a series of recommendations and best practices for promoting and enhancing student engagement online. Though the central focus is on engagement, and how that translates to learning potential, a third variable (cost) has been examined to understand the financial and resource impacts on making content more interesting (i.e. the return on investment, or ROI). The paper presents findings from a 3-year long experiment comparing existing dL methods and techniques both within and outside of the Army. The project developed two dL versions of an existing Army course (Advanced Situational Awareness-Basic (ASA-B)) – the first was designed around producing material that was as engaging and as immersive as possible within a target budget; the second was a scaled-down version using more traditional, yet contemporary dL techniques (PowerPoint recital, video lectures). The two were then compared along three dimensions– engagement, learning and cost. The findings show that improved engagement in distributed courseware is possible without breaking the bank, though the returns on learning with these progressive approaches remain inconclusive. More importantly, it was determined that the quality and experience of the designers, production staff, writers, animators, programmers, and others cannot be underestimated, and that the familiar phrase – ‘you get what you pay for’ is as true with online learning as it is with other areas of content design and software development.
Kang, Sin-Hwa; Feng, Andrew W.; Seymour, Mike; Shapiro, Ari
Study comparing video-based characters and 3D-based characters on mobile devices for chat Inproceedings
In: Proceedings of the 9th International Conference on Motion in Games, pp. 181–186, ACM Press, Burlingame, California, 2016, ISBN: 978-1-4503-4592-7.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@inproceedings{kang_study_2016,
title = {Study comparing video-based characters and 3D-based characters on mobile devices for chat},
author = {Sin-Hwa Kang and Andrew W. Feng and Mike Seymour and Ari Shapiro},
url = {http://dl.acm.org/citation.cfm?id=2994274},
doi = {10.1145/2994258.2994274},
isbn = {978-1-4503-4592-7},
year = {2016},
date = {2016-10-01},
booktitle = {Proceedings of the 9th International Conference on Motion in Games},
pages = {181--186},
publisher = {ACM Press},
address = {Burlingame, California},
abstract = {This study explores presentation techniques for a chat-based virtual human that communicates engagingly with users. Interactions with the virtual human occur via a smartphone outside of the lab in natural settings. Our work compares the responses of users who interact with an animated virtual character as opposed to a real human video character capable of displaying realistic backchannel behaviors. An audio-only interface is compared additionally with the two types of characters. The findings of our study suggest that people are socially attracted to a 3D animated character that does not display backchannel behaviors more than a real human video character that presents realistic backchannel behaviors. People engage in conversation more by talking for a longer amount of time when they interact with a 3D animated virtual human that exhibits realistic backchannel behaviors, compared to communicating with a real human video character that does not display backchannel behaviors.},
keywords = {MedVR, Virtual Humans},
pubstate = {published},
tppubtype = {inproceedings}
}
This study explores presentation techniques for a chat-based virtual human that communicates engagingly with users. Interactions with the virtual human occur via a smartphone outside of the lab in natural settings. Our work compares the responses of users who interact with an animated virtual character as opposed to a real human video character capable of displaying realistic backchannel behaviors. An audio-only interface is compared additionally with the two types of characters. The findings of our study suggest that people are socially attracted to a 3D animated character that does not display backchannel behaviors more than a real human video character that presents realistic backchannel behaviors. People engage in conversation more by talking for a longer amount of time when they interact with a 3D animated virtual human that exhibits realistic backchannel behaviors, compared to communicating with a real human video character that does not display backchannel behaviors.
Kang, Sin-Hwa; Feng, Andrew W.; Seymour, Mike; Shapiro, Ari
Smart Mobile Virtual Characters: Video Characters vs. Animated Characters Inproceedings
In: Proceedings of the Fourth International Conference on Human Agent Interaction, pp. 371–374, ACM Press, Biopolis, Singapore, 2016, ISBN: 978-1-4503-4508-8.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@inproceedings{kang_smart_2016,
title = {Smart Mobile Virtual Characters: Video Characters vs. Animated Characters},
author = {Sin-Hwa Kang and Andrew W. Feng and Mike Seymour and Ari Shapiro},
url = {http://dl.acm.org/citation.cfm?id=2980511},
doi = {10.1145/2974804.2980511},
isbn = {978-1-4503-4508-8},
year = {2016},
date = {2016-10-01},
booktitle = {Proceedings of the Fourth International Conference on Human Agent Interaction},
pages = {371--374},
publisher = {ACM Press},
address = {Biopolis, Singapore},
abstract = {This study investigates presentation techniques for a chatbased virtual human that communicates engagingly with users via a smartphone outside of the lab in natural settings. Our work compares the responses of users who interact with an animated 3D virtual character as opposed to a real human video character capable of displaying backchannel behaviors. The findings of our study demonstrate that people are socially attracted to a 3D animated character that does not display backchannel behaviors more than a real human video character that presents realistic backchannel behaviors. People engage in conversation more by talking for a longer amount of time when they interact with a 3D animated virtual human that exhibits backchannel behaviors, compared to communicating with a real human video character that does not display backchannel behaviors.},
keywords = {MedVR, Virtual Humans},
pubstate = {published},
tppubtype = {inproceedings}
}
This study investigates presentation techniques for a chatbased virtual human that communicates engagingly with users via a smartphone outside of the lab in natural settings. Our work compares the responses of users who interact with an animated 3D virtual character as opposed to a real human video character capable of displaying backchannel behaviors. The findings of our study demonstrate that people are socially attracted to a 3D animated character that does not display backchannel behaviors more than a real human video character that presents realistic backchannel behaviors. People engage in conversation more by talking for a longer amount of time when they interact with a 3D animated virtual human that exhibits backchannel behaviors, compared to communicating with a real human video character that does not display backchannel behaviors.
Bresnahan, T.; Rizzo, A.; Burke, S. L.; Partin, M.; Ahlness, R. M.; Trimmer, M.
Using Virtual Interactive Training Agents (VITA) with Adults with Autism and other Developmental Disabilities Inproceedings
In: Proceedings of the 2016 International Conference on Disability, Virtual Reality, and Associated Technology, pp. 49–56, ICDVRAT and the University of Reading, Los Angeles, CA, 2016, ISBN: 978-0-7049-1547-3.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@inproceedings{bresnahan_using_2016,
title = {Using Virtual Interactive Training Agents (VITA) with Adults with Autism and other Developmental Disabilities},
author = {T. Bresnahan and A. Rizzo and S. L. Burke and M. Partin and R. M. Ahlness and M. Trimmer},
url = {http://www.icdvrat.org/2016/papers/ICDVRAT2016_S02N2_Bresnahan_etal.pdf},
isbn = {978-0-7049-1547-3},
year = {2016},
date = {2016-09-01},
booktitle = {Proceedings of the 2016 International Conference on Disability, Virtual Reality, and Associated Technology},
pages = {49--56},
publisher = {ICDVRAT and the University of Reading},
address = {Los Angeles, CA},
abstract = {Conversational Virtual Human (VH) agents are increasingly being used to support role-play experiential learning across a range of use-cases and populations. This project examined whether use of the Virtual Interactive Training Agent (VITA) system would improve job interviewing skills in a sample of persons with autism or other developmental disability. The study examined performance differences between baseline and final interviews in face-to-face and virtual reality conditions, and whether statistically significant increases were demonstrated between interviewing conditions. Paired samples t-tests were utilized to examine mean changes in performance by interview stage and in the overall difference between baseline and final interview stages. The preliminary results indicated that VITA is a positive factor when preparing young adults with autism or other developmental disability for employment interviews. Statistically significant results were demonstrated across all pilot conditions and in all but one post-assessment condition.},
keywords = {MedVR, Virtual Humans},
pubstate = {published},
tppubtype = {inproceedings}
}
Conversational Virtual Human (VH) agents are increasingly being used to support role-play experiential learning across a range of use-cases and populations. This project examined whether use of the Virtual Interactive Training Agent (VITA) system would improve job interviewing skills in a sample of persons with autism or other developmental disability. The study examined performance differences between baseline and final interviews in face-to-face and virtual reality conditions, and whether statistically significant increases were demonstrated between interviewing conditions. Paired samples t-tests were utilized to examine mean changes in performance by interview stage and in the overall difference between baseline and final interview stages. The preliminary results indicated that VITA is a positive factor when preparing young adults with autism or other developmental disability for employment interviews. Statistically significant results were demonstrated across all pilot conditions and in all but one post-assessment condition.
Buckwalter, J. Galen; Castellani, Brian; Mcewen, Bruce; Karlamangla, Arun S.; Rizzo, Albert A.; John, Bruce; O'donnell, Kyle; Seeman, Teresa
Allostatic Load as a Complex Clinical Construct: A Case-Based Computational Modeling Approach Journal Article
In: Complexity, vol. 21, no. S1, pp. 291–306, 2016, ISSN: 10762787.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@article{galen_buckwalter_allostatic_2016,
title = {Allostatic Load as a Complex Clinical Construct: A Case-Based Computational Modeling Approach},
author = {J. Galen Buckwalter and Brian Castellani and Bruce Mcewen and Arun S. Karlamangla and Albert A. Rizzo and Bruce John and Kyle O'donnell and Teresa Seeman},
url = {http://doi.wiley.com/10.1002/cplx.21743},
doi = {10.1002/cplx.21743},
issn = {10762787},
year = {2016},
date = {2016-09-01},
journal = {Complexity},
volume = {21},
number = {S1},
pages = {291--306},
abstract = {Allostatic load (AL) is a complex clinical construct, providing a unique window into the cumulative impact of stress. However, due to its inherent complexity, AL presents two major measurement challenges to conventional statistical modeling (the field’s dominant methodology): it is comprised of a complex causal network of bioallostatic systems, represented by an even larger set of dynamic biomarkers; and, it is situated within a web of antecedent socioecological systems, linking AL to differences in health outcomes and disparities. To address these challenges, we employed casebased computational modeling (CBM), which allowed us to make four advances: (1) we developed a multisystem, 7-factor (20 biomarker) model of AL’s network of allostatic systems; (2) used it to create a catalog of nine different clinical AL profiles (causal pathways); (3) linked each clinical profile to a typology of 23 health outcomes; and (4) explored our results (post hoc) as a function of gender, a key socioecological factor. In terms of highlights, (a) the Healthy clinical profile had few health risks; (b) the pro-inflammatory profile linked to high blood pressure and diabetes; (c) Low Stress Hormones linked to heart disease, TIA/Stroke, diabetes, and circulation problems; and (d) high stress hormones linked to heart disease and high blood pressure. Post hoc analyses also found that males were overrepresented on the High Blood Pressure (61.2%), Metabolic Syndrome (63.2%), High Stress Hormones (66.4%), and High Blood Sugar (57.1%); while females were overrepresented on the Healthy (81.9%), Low Stress Hormones (66.3%), and Low Stress Antagonists (stress buffers) (95.4%) profiles.},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {article}
}
Allostatic load (AL) is a complex clinical construct, providing a unique window into the cumulative impact of stress. However, due to its inherent complexity, AL presents two major measurement challenges to conventional statistical modeling (the field’s dominant methodology): it is comprised of a complex causal network of bioallostatic systems, represented by an even larger set of dynamic biomarkers; and, it is situated within a web of antecedent socioecological systems, linking AL to differences in health outcomes and disparities. To address these challenges, we employed casebased computational modeling (CBM), which allowed us to make four advances: (1) we developed a multisystem, 7-factor (20 biomarker) model of AL’s network of allostatic systems; (2) used it to create a catalog of nine different clinical AL profiles (causal pathways); (3) linked each clinical profile to a typology of 23 health outcomes; and (4) explored our results (post hoc) as a function of gender, a key socioecological factor. In terms of highlights, (a) the Healthy clinical profile had few health risks; (b) the pro-inflammatory profile linked to high blood pressure and diabetes; (c) Low Stress Hormones linked to heart disease, TIA/Stroke, diabetes, and circulation problems; and (d) high stress hormones linked to heart disease and high blood pressure. Post hoc analyses also found that males were overrepresented on the High Blood Pressure (61.2%), Metabolic Syndrome (63.2%), High Stress Hormones (66.4%), and High Blood Sugar (57.1%); while females were overrepresented on the Healthy (81.9%), Low Stress Hormones (66.3%), and Low Stress Antagonists (stress buffers) (95.4%) profiles.
Reger, Greg M.; Koenen-Woods, Patricia; Zetocha, Kimberlee; Smolenski, Derek J.; Holloway, Kevin M.; Rothbaum, Barbara O.; Difede, JoAnn; Rizzo, Albert A.; Edwards-Stewart, Amanda; Skopp, Nancy A.; Mishkind, Matthew; Reger, Mark A.; Gahm, Gregory A.
In: Journal of Consulting and Clinical Psychology, 2016, ISSN: 1939-2117, 0022-006X.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@article{reger_randomized_2016,
title = {Randomized Controlled Trial of Prolonged Exposure Using Imaginal Exposure vs. Virtual Reality Exposure in Active Duty Soldiers With Deployment-Related Posttraumatic Stress Disorder (PTSD).},
author = {Greg M. Reger and Patricia Koenen-Woods and Kimberlee Zetocha and Derek J. Smolenski and Kevin M. Holloway and Barbara O. Rothbaum and JoAnn Difede and Albert A. Rizzo and Amanda Edwards-Stewart and Nancy A. Skopp and Matthew Mishkind and Mark A. Reger and Gregory A. Gahm},
url = {https://www.researchgate.net/profile/Amanda_Edwards-Stewart/publication/307950241_Randomized_Controlled_Trial_of_Prolonged_Exposure_Using_Imaginal_Exposure_vs_Virtual_Reality_Exposure_in_Active_Duty_Soldiers_With_Deployment-Related_Posttraumatic_Stress_Disorder_PTSD/links/57d6f13f08ae601b39ac25d9.pdf},
doi = {10.1037/ccp0000134},
issn = {1939-2117, 0022-006X},
year = {2016},
date = {2016-09-01},
journal = {Journal of Consulting and Clinical Psychology},
abstract = {Prolonged exposure (PE) is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD) but there is limited research with active-duty military populations. Virtual reality exposure (VRE) has shown promise but randomized trials are needed to evaluate efficacy relative to existing standards of care. This study evaluated the efficacy of VRE and PE for active duty soldiers with PTSD from deployments to Iraq and Afghanistan. Active-duty soldiers ( = 162) were randomized to 10-sessions of PE, VRE, or a minimal attention waitlist (WL). Blinded assessors evaluated symptoms at baseline, halfway through treatment, at posttreatment, and at 3- and 6-month follow-ups using the Clinician Administered PTSD Scale (CAPS). Intent-to-treat analyses found that both PE and VRE resulted in significant reductions in PTSD symptoms relative to those in the WL. The majority of patients demonstrated reliable change in PTSD symptoms. There was no difference between PE and VRE regarding treatment drop out before completing 10 sessions (44 and 41% for VRE and PE, respectively). Contrary to hypotheses, analyses at posttreatment did not show that VRE was superior to PE. Post hoc analyses found that PE resulted in significantly greater symptom reductions than VRE at 3- and 6-month follow-up. Both treatments significantly reduced self-reported stigma. PE is an efficacious treatment for active-duty Army soldiers with PTSD from deployments to Iraq or Afghanistan. Results extend previous evidence supporting the efficacy of PE to active-duty military personnel and raise important questions for future research on VRE},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {article}
}
Prolonged exposure (PE) is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD) but there is limited research with active-duty military populations. Virtual reality exposure (VRE) has shown promise but randomized trials are needed to evaluate efficacy relative to existing standards of care. This study evaluated the efficacy of VRE and PE for active duty soldiers with PTSD from deployments to Iraq and Afghanistan. Active-duty soldiers ( = 162) were randomized to 10-sessions of PE, VRE, or a minimal attention waitlist (WL). Blinded assessors evaluated symptoms at baseline, halfway through treatment, at posttreatment, and at 3- and 6-month follow-ups using the Clinician Administered PTSD Scale (CAPS). Intent-to-treat analyses found that both PE and VRE resulted in significant reductions in PTSD symptoms relative to those in the WL. The majority of patients demonstrated reliable change in PTSD symptoms. There was no difference between PE and VRE regarding treatment drop out before completing 10 sessions (44 and 41% for VRE and PE, respectively). Contrary to hypotheses, analyses at posttreatment did not show that VRE was superior to PE. Post hoc analyses found that PE resulted in significantly greater symptom reductions than VRE at 3- and 6-month follow-up. Both treatments significantly reduced self-reported stigma. PE is an efficacious treatment for active-duty Army soldiers with PTSD from deployments to Iraq or Afghanistan. Results extend previous evidence supporting the efficacy of PE to active-duty military personnel and raise important questions for future research on VRE
Rizzo, AA; Lucas, G; Gratch, J; Stratou, G; Morency, L-P; Shilling, R; Hartholt, A; Scherer, S
Clinical interviewing by a virtual human agent with automatic behavior analysis Inproceedings
In: Proceedings of The 2016 Proceedings of the International Conference on Disability, Virtual Reality and Associated Technologies, pp. 57–64, ICDVRAT and the University of Reading, Los Angeles, CA, 2016, ISBN: 978-0-7049-1547-3.
Abstract | Links | BibTeX | Tags: MedVR, UARC, Virtual Humans
@inproceedings{rizzo_clinical_2016,
title = {Clinical interviewing by a virtual human agent with automatic behavior analysis},
author = {AA Rizzo and G Lucas and J Gratch and G Stratou and L-P Morency and R Shilling and A Hartholt and S Scherer},
url = {http://centaur.reading.ac.uk/66645/8/ICDVRAT2016_Full_Proceedings_11th%20_Conf.pdf},
isbn = {978-0-7049-1547-3},
year = {2016},
date = {2016-09-01},
booktitle = {Proceedings of The 2016 Proceedings of the International Conference on Disability, Virtual Reality and Associated Technologies},
pages = {57--64},
publisher = {ICDVRAT and the University of Reading},
address = {Los Angeles, CA},
abstract = {SimSensei is a Virtual Human (VH) interviewing platform that uses off-the-shelf sensors (i.e., webcams, Microsoft Kinect and a microphone) to capture and interpret real-time audiovisual behavioral signals from users interacting with the VH system. The system was specifically designed for clinical interviewing and health care support by providing a face-to-face interaction between a user and a VH that can automatically react to the inferred state of the user through analysis of behavioral signals gleaned from the user’s facial expressions, body gestures and vocal parameters. Akin to how non-verbal behavioral signals have an impact on human-to-human interaction and communication, SimSensei aims to capture and infer user state from signals generated from user non-verbal communication to improve engagement between a VH and a user and to quantify user state from the data captured across a 20 minute interview. As well, previous research with SimSensei indicates that users engaging with this automated system, have less fear of evaluation and self-disclose more personal information compare to when they believe the VH agent is actually an avatar being operated by a “wizard of oz” human-in-the-loop (Lucas et al., 2014). The current study presents results from a sample of military service members (SMs) who were interviewed within the SimSensei system before and after a deployment to Afghanistan. Results indicate that SMs reveal more PTSD symptoms to the SimSensei VH agent than they self-report on the Post Deployment Health Assessment. Pre/Post deployment facial expression analysis indicated more sad expressions and fewer happy expressions at post deployment.},
keywords = {MedVR, UARC, Virtual Humans},
pubstate = {published},
tppubtype = {inproceedings}
}
SimSensei is a Virtual Human (VH) interviewing platform that uses off-the-shelf sensors (i.e., webcams, Microsoft Kinect and a microphone) to capture and interpret real-time audiovisual behavioral signals from users interacting with the VH system. The system was specifically designed for clinical interviewing and health care support by providing a face-to-face interaction between a user and a VH that can automatically react to the inferred state of the user through analysis of behavioral signals gleaned from the user’s facial expressions, body gestures and vocal parameters. Akin to how non-verbal behavioral signals have an impact on human-to-human interaction and communication, SimSensei aims to capture and infer user state from signals generated from user non-verbal communication to improve engagement between a VH and a user and to quantify user state from the data captured across a 20 minute interview. As well, previous research with SimSensei indicates that users engaging with this automated system, have less fear of evaluation and self-disclose more personal information compare to when they believe the VH agent is actually an avatar being operated by a “wizard of oz” human-in-the-loop (Lucas et al., 2014). The current study presents results from a sample of military service members (SMs) who were interviewed within the SimSensei system before and after a deployment to Afghanistan. Results indicate that SMs reveal more PTSD symptoms to the SimSensei VH agent than they self-report on the Post Deployment Health Assessment. Pre/Post deployment facial expression analysis indicated more sad expressions and fewer happy expressions at post deployment.
Freed, Michael C.; Novak, Laura A.; Killgore, William D. S.; Rauch, Sheila A. M.; Koehlmoos, Tracey P.; Ginsberg, J. P.; Krupnick, Janice L.; Rizzo, Albert "Skip"; Andrews, Anne; Engel, Charles C.
IRB and Research Regulatory Delays Within the Military Health System: Do They Really Matter? And If So, Why and for Whom? Journal Article
In: The American Journal of Bioethics, vol. 16, no. 8, pp. 30–37, 2016, ISSN: 1526-5161, 1536-0075.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@article{freed_irb_2016,
title = {IRB and Research Regulatory Delays Within the Military Health System: Do They Really Matter? And If So, Why and for Whom?},
author = {Michael C. Freed and Laura A. Novak and William D. S. Killgore and Sheila A. M. Rauch and Tracey P. Koehlmoos and J. P. Ginsberg and Janice L. Krupnick and Albert "Skip" Rizzo and Anne Andrews and Charles C. Engel},
url = {http://www.tandfonline.com/doi/full/10.1080/15265161.2016.1187212},
doi = {10.1080/15265161.2016.1187212},
issn = {1526-5161, 1536-0075},
year = {2016},
date = {2016-08-01},
journal = {The American Journal of Bioethics},
volume = {16},
number = {8},
pages = {30--37},
abstract = {Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improve the IRB system and, ultimately, research within military, veteran, and civilian populations.},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {article}
}
Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improve the IRB system and, ultimately, research within military, veteran, and civilian populations.
Washburn, Micki; Bordnick, Patrick; Rizzo, Albert “Skip”
A pilot feasibility study of virtual patient simulation to enhance social work students’ brief mental health assessment skills Journal Article
In: Social Work in Health Care, pp. 1–19, 2016, ISSN: 0098-1389, 1541-034X.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@article{washburn_pilot_2016,
title = {A pilot feasibility study of virtual patient simulation to enhance social work students’ brief mental health assessment skills},
author = {Micki Washburn and Patrick Bordnick and Albert “Skip” Rizzo},
url = {https://www.tandfonline.com/doi/full/10.1080/00981389.2016.1210715},
doi = {10.1080/00981389.2016.1210715},
issn = {0098-1389, 1541-034X},
year = {2016},
date = {2016-08-01},
journal = {Social Work in Health Care},
pages = {1--19},
abstract = {This study presents preliminary feasibility and acceptability data on the use of virtual patient (VP) simulations to develop brief assessment skills within an interdisciplinary care setting. Results support the acceptability of technology-enhanced simulations and offer preliminary evidence for an association between engagement in VP practice simulations and improvements in diagnostic accuracy and clinical interviewing skills. Recommendations and next steps for research on technologyenhanced simulations within social work are discussed.},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {article}
}
This study presents preliminary feasibility and acceptability data on the use of virtual patient (VP) simulations to develop brief assessment skills within an interdisciplinary care setting. Results support the acceptability of technology-enhanced simulations and offer preliminary evidence for an association between engagement in VP practice simulations and improvements in diagnostic accuracy and clinical interviewing skills. Recommendations and next steps for research on technologyenhanced simulations within social work are discussed.
Norrholm, Seth Davin; Jovanovic, Tanja; Gerardi, Maryrose; Breazeale, Kathryn G.; Price, Matthew; Davis, Michael; Duncan, Erica; Ressler, Kerry J.; Bradley, Bekh; Rizzo, Albert; Tuerk, Peter W.; Rothbaum, Barbara O.
Baseline psychophysiological and cortisol reactivity as a predictor of PTSD treatment outcome in virtual reality exposure therapy Journal Article
In: Behaviour Research and Therapy, vol. 82, pp. 28–37, 2016, ISSN: 00057967.
Abstract | Links | BibTeX | Tags: MedVR
@article{norrholm_baseline_2016,
title = {Baseline psychophysiological and cortisol reactivity as a predictor of PTSD treatment outcome in virtual reality exposure therapy},
author = {Seth Davin Norrholm and Tanja Jovanovic and Maryrose Gerardi and Kathryn G. Breazeale and Matthew Price and Michael Davis and Erica Duncan and Kerry J. Ressler and Bekh Bradley and Albert Rizzo and Peter W. Tuerk and Barbara O. Rothbaum},
url = {http://linkinghub.elsevier.com/retrieve/pii/S0005796716300663},
doi = {10.1016/j.brat.2016.05.002},
issn = {00057967},
year = {2016},
date = {2016-07-01},
journal = {Behaviour Research and Therapy},
volume = {82},
pages = {28--37},
abstract = {Baseline cue-dependent physiological reactivity may serve as an objective measure of posttraumatic stress disorder (PTSD) symptoms. Additionally, prior animal model and psychological studies would suggest that subjects with greatest symptoms at baseline may have the greatest violation of expectancy to danger when undergoing exposure based psychotherapy; thus treatment approaches which enhanced the learning under these conditions would be optimal for those with maximal baseline cue-dependent reactivity. However methods to study this hypothesis objectively are lacking. Virtual reality (VR) methodologies have been successfully employed as an enhanced form of imaginal prolonged exposure therapy for the treatment of PTSD. Our goal was to examine the predictive nature of initial psychophysiological (e.g., startle, skin conductance, heart rate) and stress hormone responses (e.g., cortisol) during presentation of VR-based combat-related stimuli on PTSD treatment outcome. Combat veterans with PTSD underwent 6 weeks of VR exposure therapy combined with either D-cycloserine (DCS), alprazolam (ALP), or placebo (PBO). In the DCS group, startle response to VR scenes prior to initiation of treatment accounted for 76% of the variance in CAPS change scores, p textbackslashtextbackslashtextbackslashtextless 0.001, in that higher responses predicted greater changes in symptom severity over time. Additionally, baseline cortisol reactivity was inversely associated with treatment response in the ALP group},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Baseline cue-dependent physiological reactivity may serve as an objective measure of posttraumatic stress disorder (PTSD) symptoms. Additionally, prior animal model and psychological studies would suggest that subjects with greatest symptoms at baseline may have the greatest violation of expectancy to danger when undergoing exposure based psychotherapy; thus treatment approaches which enhanced the learning under these conditions would be optimal for those with maximal baseline cue-dependent reactivity. However methods to study this hypothesis objectively are lacking. Virtual reality (VR) methodologies have been successfully employed as an enhanced form of imaginal prolonged exposure therapy for the treatment of PTSD. Our goal was to examine the predictive nature of initial psychophysiological (e.g., startle, skin conductance, heart rate) and stress hormone responses (e.g., cortisol) during presentation of VR-based combat-related stimuli on PTSD treatment outcome. Combat veterans with PTSD underwent 6 weeks of VR exposure therapy combined with either D-cycloserine (DCS), alprazolam (ALP), or placebo (PBO). In the DCS group, startle response to VR scenes prior to initiation of treatment accounted for 76% of the variance in CAPS change scores, p textbackslashtextbackslashtextbackslashtextless 0.001, in that higher responses predicted greater changes in symptom severity over time. Additionally, baseline cortisol reactivity was inversely associated with treatment response in the ALP group
Kang, Sin-Hwa; Phan, Thai; Bolas, Mark; Krum, David M.
User Perceptions of a Virtual Human Over Mobile Video Chat Interactions Incollection
In: Human-Computer Interaction. Novel User Experiences, vol. 9733, pp. 107–118, Springer International Publishing, Cham, Switzerland, 2016, ISBN: 978-3-319-39512-8 978-3-319-39513-5.
Abstract | Links | BibTeX | Tags: MedVR, MxR, UARC
@incollection{kang_user_2016,
title = {User Perceptions of a Virtual Human Over Mobile Video Chat Interactions},
author = {Sin-Hwa Kang and Thai Phan and Mark Bolas and David M. Krum},
url = {http://download.springer.com/static/pdf/913/chp%253A10.1007%252F978-3-319-39513-5_10.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Fchapter%2F10.1007%2F978-3-319-39513-5_10&token2=exp=1474906977 acl=%2Fstatic%2Fpdf%2F913%2Fchp%25253A10.1007%25252F978-3-319-39513-5_10.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Fchapter%252F10.1007%252F978-3-319-39513-5_10* hmac=14d38ee320936bf1edfc65a0d3fcc0855c42e0baba46e0f3a9a81293698b8b68},
isbn = {978-3-319-39512-8 978-3-319-39513-5},
year = {2016},
date = {2016-06-01},
booktitle = {Human-Computer Interaction. Novel User Experiences},
volume = {9733},
pages = {107--118},
publisher = {Springer International Publishing},
address = {Cham, Switzerland},
abstract = {We believe that virtual humans, presented over video chat services, such as Skype, and delivered using smartphones, can be an effective way to deliver innovative applications where social interactions are important, such as counseling and coaching. To explore this subject, we have built a hardware and software apparatus that allows virtual humans to initiate, receive, and interact over video calls using Skype or any similar service. With this platform, we conducted two experiments to investigate the applications and characteristics of virtual humans that interact over mobile video. In Experiment 1, we investigated user reactions to the physical realism of the background scene in which a virtual human was displayed. In Experiment 2, we examined how virtual characters can establish and maintain longer term relationships with users, using ideas from Social Exchange Theory to strengthen bonds between interactants. Experiment 2 involved repeated interactions with a virtual human over a period of time. Both studies used counseling-style interactions with users. The results demonstrated that males were more attracted socially to a virtual human that was presented over a realistic background than a featureless background while females were more socially attracted to a virtual human with a less realistic featureless background. The results further revealed that users felt the virtual human was a compassionate partner when they interacted with the virtual human over multiple calls, rather than just a single call.},
keywords = {MedVR, MxR, UARC},
pubstate = {published},
tppubtype = {incollection}
}
We believe that virtual humans, presented over video chat services, such as Skype, and delivered using smartphones, can be an effective way to deliver innovative applications where social interactions are important, such as counseling and coaching. To explore this subject, we have built a hardware and software apparatus that allows virtual humans to initiate, receive, and interact over video calls using Skype or any similar service. With this platform, we conducted two experiments to investigate the applications and characteristics of virtual humans that interact over mobile video. In Experiment 1, we investigated user reactions to the physical realism of the background scene in which a virtual human was displayed. In Experiment 2, we examined how virtual characters can establish and maintain longer term relationships with users, using ideas from Social Exchange Theory to strengthen bonds between interactants. Experiment 2 involved repeated interactions with a virtual human over a period of time. Both studies used counseling-style interactions with users. The results demonstrated that males were more attracted socially to a virtual human that was presented over a realistic background than a featureless background while females were more socially attracted to a virtual human with a less realistic featureless background. The results further revealed that users felt the virtual human was a compassionate partner when they interacted with the virtual human over multiple calls, rather than just a single call.
Nolin, Pierre; Stipanicic, Annie; Henry, Mylène; Lachapelle, Yves; Lussier-Desrochers, Dany; Rizzo, Albert “Skip”; Allain, Philippe
ClinicaVR: Classroom-CPT: A virtual reality tool for assessing attention and inhibition in children and adolescents Journal Article
In: Computers in Human Behavior, vol. 59, pp. 327–333, 2016, ISSN: 07475632.
Abstract | Links | BibTeX | Tags: MedVR
@article{nolin_clinicavr_2016,
title = {ClinicaVR: Classroom-CPT: A virtual reality tool for assessing attention and inhibition in children and adolescents},
author = {Pierre Nolin and Annie Stipanicic and Mylène Henry and Yves Lachapelle and Dany Lussier-Desrochers and Albert “Skip” Rizzo and Philippe Allain},
url = {http://linkinghub.elsevier.com/retrieve/pii/S0747563216300759},
doi = {10.1016/j.chb.2016.02.023},
issn = {07475632},
year = {2016},
date = {2016-06-01},
journal = {Computers in Human Behavior},
volume = {59},
pages = {327--333},
abstract = {Having garnered interest both in clinic and research areas, the Virtual Classroom (Rizzo et al., 2000) assesses children's attention in a virtual context. The Digital MediaWorks team (www.dmw.ca) has evolved the original basic classroom concept over a number of iterations to form the ClinicaVR Suite containing the Classroom-CPT as one of its components. The present study has three aims: investigate certain validity and reliability aspects of the tool; examine the relationship between performance in the virtual test and the attendant sense of presence and cybersickness experienced by participants; assess potential effects of gender and age on performance in the test. The study was conducted with 102 children and adolescents from Grade 2 to Grade 10. All participants were enrolled in a regular school program. Results support both concurrent and construct validity as well as temporal stability of ClinicaVR: Classroom-Continuous Performance Test (CPT). Gender exerted no effect on performance, while age did. The test did not cause much cybersickness. We recommend ClinicaVR: Classroom-CPT as an assessment tool for selective and sustained attention, and inhibition, in clinic and research domains.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Having garnered interest both in clinic and research areas, the Virtual Classroom (Rizzo et al., 2000) assesses children's attention in a virtual context. The Digital MediaWorks team (www.dmw.ca) has evolved the original basic classroom concept over a number of iterations to form the ClinicaVR Suite containing the Classroom-CPT as one of its components. The present study has three aims: investigate certain validity and reliability aspects of the tool; examine the relationship between performance in the virtual test and the attendant sense of presence and cybersickness experienced by participants; assess potential effects of gender and age on performance in the test. The study was conducted with 102 children and adolescents from Grade 2 to Grade 10. All participants were enrolled in a regular school program. Results support both concurrent and construct validity as well as temporal stability of ClinicaVR: Classroom-Continuous Performance Test (CPT). Gender exerted no effect on performance, while age did. The test did not cause much cybersickness. We recommend ClinicaVR: Classroom-CPT as an assessment tool for selective and sustained attention, and inhibition, in clinic and research domains.
Mühlberger, Andreas; Jekel, K.; Probst, Thomas; Schecklmann, Martin; Conzelmann, A.; Andreatta, M.; Rizzo, A. A.; Pauli, P.; Romanos, M.
The Influence of Methylphenidate on Hyperactivity and Attention Deficits in Children With ADHD: A Virtual Classroom Test Journal Article
In: Journal of attention disorders, 2016.
Abstract | Links | BibTeX | Tags: MedVR
@article{muhlberger_influence_2016,
title = {The Influence of Methylphenidate on Hyperactivity and Attention Deficits in Children With ADHD: A Virtual Classroom Test},
author = {Andreas Mühlberger and K. Jekel and Thomas Probst and Martin Schecklmann and A. Conzelmann and M. Andreatta and A. A. Rizzo and P. Pauli and M. Romanos},
url = {http://journals.sagepub.com/doi/abs/10.1177/1087054716647480},
doi = {10.1177/1087054716647480},
year = {2016},
date = {2016-05-01},
journal = {Journal of attention disorders},
abstract = {This study compares the performance in a continuous performance test within a virtual reality classroom (CPT-VRC) between medicated children with ADHD, unmedicated children with ADHD, and healthy children. Method:N = 94 children with ADHD (n = 26 of them received methylphenidate and n = 68 were unmedicated) and n = 34 healthy children performed the CPT-VRC. Omission errors, reaction time/variability, commission errors, and body movements were assessed. Furthermore, ADHD questionnaires were administered and compared with the CPT-VRC measures. Results: The unmedicated ADHD group exhibited more omission errors and showed slower reaction times than the healthy group. Reaction time variability was higher in the unmedicated ADHD group compared with both the healthy and the medicated ADHD group. Omission errors and reaction time variability were associated with inattentiveness ratings of experimenters. Head movements were correlated with hyperactivity ratings of parents and experimenters. Conclusion: Virtual reality is a promising technology to assess ADHD symptoms in an ecologically valid environment.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
This study compares the performance in a continuous performance test within a virtual reality classroom (CPT-VRC) between medicated children with ADHD, unmedicated children with ADHD, and healthy children. Method:N = 94 children with ADHD (n = 26 of them received methylphenidate and n = 68 were unmedicated) and n = 34 healthy children performed the CPT-VRC. Omission errors, reaction time/variability, commission errors, and body movements were assessed. Furthermore, ADHD questionnaires were administered and compared with the CPT-VRC measures. Results: The unmedicated ADHD group exhibited more omission errors and showed slower reaction times than the healthy group. Reaction time variability was higher in the unmedicated ADHD group compared with both the healthy and the medicated ADHD group. Omission errors and reaction time variability were associated with inattentiveness ratings of experimenters. Head movements were correlated with hyperactivity ratings of parents and experimenters. Conclusion: Virtual reality is a promising technology to assess ADHD symptoms in an ecologically valid environment.