Publications
Search
1.
Difede, JoAnn; Rothbaum, Barbara O.; Rizzo, Albert A.; Wyka, Katarzyna; Spielman, Lisa; Reist, Christopher; Roy, Michael J.; Jovanovic, Tanja; Norrholm, Seth D.; Cukor, Judith; Olden, Megan; Glatt, Charles E.; Lee, Francis S.
In: Transl Psychiatry, vol. 12, no. 1, pp. 299, 2022, ISSN: 2158-3188.
@article{difede_enhancing_2022,
title = {Enhancing exposure therapy for posttraumatic stress disorder (PTSD): a randomized clinical trial of virtual reality and imaginal exposure with a cognitive enhancer},
author = {JoAnn Difede and Barbara O. Rothbaum and Albert A. Rizzo and Katarzyna Wyka and Lisa Spielman and Christopher Reist and Michael J. Roy and Tanja Jovanovic and Seth D. Norrholm and Judith Cukor and Megan Olden and Charles E. Glatt and Francis S. Lee},
url = {https://www.nature.com/articles/s41398-022-02066-x},
doi = {10.1038/s41398-022-02066-x},
issn = {2158-3188},
year = {2022},
date = {2022-12-01},
urldate = {2022-09-13},
journal = {Transl Psychiatry},
volume = {12},
number = {1},
pages = {299},
abstract = {Abstract Posttraumatic stress disorder (PTSD) is a significant public health issue. Yet, there are limited treatment options and no data to suggest which treatment will work for whom. We tested the efficacy of virtual reality exposure (VRE) or prolonged imaginal exposure (PE), augmented with D-cycloserine (DCS) for combat-related PTSD. As an exploratory aim, we examined whether brain-derived neurotrophic factor (BDNF) and fatty acid amide hydrolase (FAAH) moderated treatment response. Military personnel with PTSD ( n = 192) were recruited into a multisite double-blind randomized controlled trial to receive nine weeks of VRE or PE, with DCS or placebo. Primary outcome was the improvement in symptom severity. Randomization was stratified by comorbid depression (MDD) and site. Participants in both VRE and PE showed similar meaningful clinical improvement with no difference between the treatment groups. A significant interaction ( p = 0.45) suggested VRE was more effective for depressed participants (CAPS difference M = 3.51 [95% CI 1.17–5.86]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Abstract Posttraumatic stress disorder (PTSD) is a significant public health issue. Yet, there are limited treatment options and no data to suggest which treatment will work for whom. We tested the efficacy of virtual reality exposure (VRE) or prolonged imaginal exposure (PE), augmented with D-cycloserine (DCS) for combat-related PTSD. As an exploratory aim, we examined whether brain-derived neurotrophic factor (BDNF) and fatty acid amide hydrolase (FAAH) moderated treatment response. Military personnel with PTSD ( n = 192) were recruited into a multisite double-blind randomized controlled trial to receive nine weeks of VRE or PE, with DCS or placebo. Primary outcome was the improvement in symptom severity. Randomization was stratified by comorbid depression (MDD) and site. Participants in both VRE and PE showed similar meaningful clinical improvement with no difference between the treatment groups. A significant interaction ( p = 0.45) suggested VRE was more effective for depressed participants (CAPS difference M = 3.51 [95% CI 1.17–5.86]
2.
Korand, Sridevi; Fung, Cha Chi; Cohen, Sammy; Talbot, Thomas B.; Fischer, Susan; Luu, Cindy; Sargsyan, Mariam; Ben-Isaac, Eyal; Espinoza, Juan; Chang, Todd P.
In: Simulation & Gaming, vol. 53, no. 4, pp. 335–352, 2022, ISSN: 1046-8781, 1552-826X.
@article{korand_association_2022,
title = {The Association Between Multitasking and Multi-Patient Care Skills in a Simulated Patient Care Video Game Among Second Year Medical Students Based on Specialty Choice},
author = {Sridevi Korand and Cha Chi Fung and Sammy Cohen and Thomas B. Talbot and Susan Fischer and Cindy Luu and Mariam Sargsyan and Eyal Ben-Isaac and Juan Espinoza and Todd P. Chang},
url = {http://journals.sagepub.com/doi/10.1177/10468781221103460},
doi = {10.1177/10468781221103460},
issn = {1046-8781, 1552-826X},
year = {2022},
date = {2022-08-01},
urldate = {2022-09-21},
journal = {Simulation & Gaming},
volume = {53},
number = {4},
pages = {335--352},
abstract = {Background and Objective Healthcare providers require multitasking and multi-patient care skills, and training programs do not formally incorporate curricula specifically for multitasking skills to trainees. The medical education community is in equipoise on whether multitasking ability is a fixed trait. Furthermore, it is unclear whether multitasking ability affects those who gravitate toward careers that demand it, particularly among medical students deciding on a specialty. We sought to define the association between specialty choice, multitasking abilities and multi-patient care delivery among pre-clinical medical students. For this study, we examined both efficiency and accuracy metrics within multitasking and whether they were different between students choosing specialties. Methods This was a planned cross-sectional sub-study focused on 2nd year medical students (MS-IIs) within a parent study evaluating multi-patient care skills using a serious game (VitalSigns:ED TM ) depicting a pediatric emergency department. Subjects completed a Multitasking Ability Test (MTAT) and five VitalSigns:ED gameplays. The predictor variable was specialty choice, categorized into multitasking and non-multitasking groups. Outcome variables measuring efficiency and diagnostic accuracy were obtained from the MTAT and the game. The primary analysis was a Mann–Whitney U test, and secondary analyses employed Spearman Rank correlations. Results Twelve students applied to multitasking specialties and 18 applied to others. Those in the multitasking specialties had faster MTAT completions than the other cohort (29.8 vs. 59.7 sec, 95%CI difference -0.9 to -39.8 sec). Differential diagnoses were higher in multitasking specialties in VitalSigns:ED (2.03 vs. 1.06, 95%CI difference +0.05 to +1.54) but efficiency metrics in the game did not differ. Conclusion Multitasking and multi-patient care performance show some association with preferred specialty choices for MS-IIs prior to clinical exposure.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background and Objective Healthcare providers require multitasking and multi-patient care skills, and training programs do not formally incorporate curricula specifically for multitasking skills to trainees. The medical education community is in equipoise on whether multitasking ability is a fixed trait. Furthermore, it is unclear whether multitasking ability affects those who gravitate toward careers that demand it, particularly among medical students deciding on a specialty. We sought to define the association between specialty choice, multitasking abilities and multi-patient care delivery among pre-clinical medical students. For this study, we examined both efficiency and accuracy metrics within multitasking and whether they were different between students choosing specialties. Methods This was a planned cross-sectional sub-study focused on 2nd year medical students (MS-IIs) within a parent study evaluating multi-patient care skills using a serious game (VitalSigns:ED TM ) depicting a pediatric emergency department. Subjects completed a Multitasking Ability Test (MTAT) and five VitalSigns:ED gameplays. The predictor variable was specialty choice, categorized into multitasking and non-multitasking groups. Outcome variables measuring efficiency and diagnostic accuracy were obtained from the MTAT and the game. The primary analysis was a Mann–Whitney U test, and secondary analyses employed Spearman Rank correlations. Results Twelve students applied to multitasking specialties and 18 applied to others. Those in the multitasking specialties had faster MTAT completions than the other cohort (29.8 vs. 59.7 sec, 95%CI difference -0.9 to -39.8 sec). Differential diagnoses were higher in multitasking specialties in VitalSigns:ED (2.03 vs. 1.06, 95%CI difference +0.05 to +1.54) but efficiency metrics in the game did not differ. Conclusion Multitasking and multi-patient care performance show some association with preferred specialty choices for MS-IIs prior to clinical exposure.
3.
Schweitzer, Julie B.; Rizzo, Albert “Skip”
Virtual Reality and ADHD: Clinical Assessment and Treatment in the Metaverse Journal Article
In: The ADHD Report, vol. 30, no. 3, pp. 1–9, 2022, ISSN: 1065-8025.
@article{schweitzer_virtual_2022,
title = {Virtual Reality and ADHD: Clinical Assessment and Treatment in the Metaverse},
author = {Julie B. Schweitzer and Albert “Skip” Rizzo},
url = {https://guilfordjournals.com/doi/abs/10.1521/adhd.2022.30.3.1},
doi = {10.1521/adhd.2022.30.3.1},
issn = {1065-8025},
year = {2022},
date = {2022-05-01},
urldate = {2022-09-13},
journal = {The ADHD Report},
volume = {30},
number = {3},
pages = {1--9},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
4.
Talbot, Thomas Brett; Chinara, Chinmay
In: 2022.
@inproceedings{brett_talbot_open_2022,
title = {Open Medical Gesture: An Open-Source Experiment in Naturalistic Physical Interactions for Mixed and Virtual Reality Simulations},
author = {Thomas Brett Talbot and Chinmay Chinara},
url = {https://openaccess.cms-conferences.org/#/publications/book/978-1-958651-26-1/article/978-1-958651-26-1_0},
doi = {10.54941/ahfe1002054},
year = {2022},
date = {2022-01-01},
urldate = {2022-09-13},
abstract = {Mixed (MR) and Virtual Reality (VR) simulations are hampered by requirements for hand controllers or attempts to perseverate in use of two-dimensional computer interface paradigms from the 1980s. From our efforts to produce more naturalistic interactions for combat medic training for the military, we have developed an open-source toolkit that enables direct hand controlled responsive interactions that is sensor independent and can function with depth sensing cameras, webcams or sensory gloves. From this research and review of current literature, we have discerned several best approaches for hand-based human computer interactions which provide intuitive, responsive, useful, and low frustration experiences for VR users. The center of an effective gesture system is a universal hand model that can map to inputs from several different kinds of sensors rather than depending on a specific commercial product. Parts of the hand are effectors in simulation space with a physics-based model. Therefore, translational and rotational forces from the hands will impact physical objects in VR which varies based on the mass of the virtual objects. We incorporate computer code w/ objects, calling them “Smart Objects”, which allows such objects to have movement properties and collision detection for expected manipulation. Examples of smart objects include scissors, a ball, a turning knob, a moving lever, or a human figure with moving limbs. Articulation points contain collision detectors and code to assist in expected hand actions. We include a library of more than 40 Smart Objects in the toolkit. Thus, is it possible to throw a ball, hit that ball with a bat, cut a bandage, turn on a ventilator or to lift and inspect a human arm.We mediate the interaction of the hands with virtual objects. Hands often violate the rules of a virtual world simply by passing through objects. One must interpret user intent. This can be achieved by introducing stickiness of the hands to objects. If the human’s hands overshoot an object, we place the hand onto that object’s surface unless the hand passes the object by a significant distance. We also make hands and fingers contact an object according to the object’s contours and do not allow fingers to sink into the interior of an object. Haptics, or a sense of physical resistance and tactile sensation from contacting physical objects is a supremely difficult technical challenge and is an expensive pursuit. Our approach ignores true haptics, but we have experimented with an alternative approach, called audio tactile synesthesia where we substitute the sensation of touch for that of sound. The idea is to associate parts of each hand with a tone of a specific frequency upon contacting objects. The attack rate of the sound envelope varies with the velocity of contact and hardness of the object being ‘touched’. Such sounds can feel softer or harder depending on the nature of ‘touch’ being experienced. This substitution technique can provide tactile feedback through indirect, yet still naturalistic means. The artificial intelligence (AI) technique to determine discrete hand gestures and motions within the physical space is a special form of AI called Long Short Term Memory (LSTM). LSTM allows much faster and flexible recognition than other machine learning approaches. LSTM is particularly effective with points in motion. Latency of recognition is very low. In addition to LSTM, we employ other synthetic vision & object recognition AI to the discrimination of real-world objects. This allows for methods to conduct virtual simulations. For example, it is possible to pick up a virtual syringe and inject a medication into a virtual patient through hand motions. We track the hand points to contact with the virtual syringe. We also detect when the hand is compressing the syringe plunger. We could also use virtual medications & instruments on human actors or manikins, not just on virtual objects. With object recognition AI, we can place a syringe on a tray in the physical world. The human user can pick up the syringe and use it on a virtual patient. Thus, we are able to blend physical and virtual simulation together seamlessly in a highly intuitive and naturalistic manner.The techniques and technologies explained here represent a baseline capability whereby interacting in mixed and virtual reality can now be much more natural and intuitive than it has ever been. We have now passed a threshold where we can do away with game controllers and magnetic trackers for VR. This advancement will contribute to greater adoption of VR solutions. To foster this, our team has committed to freely sharing these technologies for all purposes and at no cost as an open-source tool. We encourage the scientific, research, educational and medical communities to adopt these resources and determine their effectiveness and utilize these tools and practices to grow the body of useful VR applications.},
keywords = {},
pubstate = {published},
tppubtype = {inproceedings}
}
Mixed (MR) and Virtual Reality (VR) simulations are hampered by requirements for hand controllers or attempts to perseverate in use of two-dimensional computer interface paradigms from the 1980s. From our efforts to produce more naturalistic interactions for combat medic training for the military, we have developed an open-source toolkit that enables direct hand controlled responsive interactions that is sensor independent and can function with depth sensing cameras, webcams or sensory gloves. From this research and review of current literature, we have discerned several best approaches for hand-based human computer interactions which provide intuitive, responsive, useful, and low frustration experiences for VR users. The center of an effective gesture system is a universal hand model that can map to inputs from several different kinds of sensors rather than depending on a specific commercial product. Parts of the hand are effectors in simulation space with a physics-based model. Therefore, translational and rotational forces from the hands will impact physical objects in VR which varies based on the mass of the virtual objects. We incorporate computer code w/ objects, calling them “Smart Objects”, which allows such objects to have movement properties and collision detection for expected manipulation. Examples of smart objects include scissors, a ball, a turning knob, a moving lever, or a human figure with moving limbs. Articulation points contain collision detectors and code to assist in expected hand actions. We include a library of more than 40 Smart Objects in the toolkit. Thus, is it possible to throw a ball, hit that ball with a bat, cut a bandage, turn on a ventilator or to lift and inspect a human arm.We mediate the interaction of the hands with virtual objects. Hands often violate the rules of a virtual world simply by passing through objects. One must interpret user intent. This can be achieved by introducing stickiness of the hands to objects. If the human’s hands overshoot an object, we place the hand onto that object’s surface unless the hand passes the object by a significant distance. We also make hands and fingers contact an object according to the object’s contours and do not allow fingers to sink into the interior of an object. Haptics, or a sense of physical resistance and tactile sensation from contacting physical objects is a supremely difficult technical challenge and is an expensive pursuit. Our approach ignores true haptics, but we have experimented with an alternative approach, called audio tactile synesthesia where we substitute the sensation of touch for that of sound. The idea is to associate parts of each hand with a tone of a specific frequency upon contacting objects. The attack rate of the sound envelope varies with the velocity of contact and hardness of the object being ‘touched’. Such sounds can feel softer or harder depending on the nature of ‘touch’ being experienced. This substitution technique can provide tactile feedback through indirect, yet still naturalistic means. The artificial intelligence (AI) technique to determine discrete hand gestures and motions within the physical space is a special form of AI called Long Short Term Memory (LSTM). LSTM allows much faster and flexible recognition than other machine learning approaches. LSTM is particularly effective with points in motion. Latency of recognition is very low. In addition to LSTM, we employ other synthetic vision & object recognition AI to the discrimination of real-world objects. This allows for methods to conduct virtual simulations. For example, it is possible to pick up a virtual syringe and inject a medication into a virtual patient through hand motions. We track the hand points to contact with the virtual syringe. We also detect when the hand is compressing the syringe plunger. We could also use virtual medications & instruments on human actors or manikins, not just on virtual objects. With object recognition AI, we can place a syringe on a tray in the physical world. The human user can pick up the syringe and use it on a virtual patient. Thus, we are able to blend physical and virtual simulation together seamlessly in a highly intuitive and naturalistic manner.The techniques and technologies explained here represent a baseline capability whereby interacting in mixed and virtual reality can now be much more natural and intuitive than it has ever been. We have now passed a threshold where we can do away with game controllers and magnetic trackers for VR. This advancement will contribute to greater adoption of VR solutions. To foster this, our team has committed to freely sharing these technologies for all purposes and at no cost as an open-source tool. We encourage the scientific, research, educational and medical communities to adopt these resources and determine their effectiveness and utilize these tools and practices to grow the body of useful VR applications.
5.
Stokes, Jared D.; Rizzo, Albert; Geng, Joy J.; Schweitzer, Julie B.
Measuring Attentional Distraction in Children With ADHD Using Virtual Reality Technology With Eye-Tracking Journal Article
In: Frontiers in Virtual Reality, vol. 3, 2022, ISSN: 2673-4192.
@article{stokes_measuring_2022,
title = {Measuring Attentional Distraction in Children With ADHD Using Virtual Reality Technology With Eye-Tracking},
author = {Jared D. Stokes and Albert Rizzo and Joy J. Geng and Julie B. Schweitzer},
url = {https://www.frontiersin.org/articles/10.3389/frvir.2022.855895},
issn = {2673-4192},
year = {2022},
date = {2022-01-01},
urldate = {2022-09-13},
journal = {Frontiers in Virtual Reality},
volume = {3},
abstract = {Objective: Distractions inordinately impair attention in children with Attention-Deficit Hyperactivity Disorder (ADHD) but examining this behavior under real-life conditions poses a challenge for researchers and clinicians. Virtual reality (VR) technologies may mitigate the limitations of traditional laboratory methods by providing a more ecologically relevant experience. The use of eye-tracking measures to assess attentional functioning in a VR context in ADHD is novel. In this proof of principle project, we evaluate the temporal dynamics of distraction via eye-tracking measures in a VR classroom setting with 20 children diagnosed with ADHD between 8 and 12 years of age.Method: We recorded continuous eye movements while participants performed math, Stroop, and continuous performance test (CPT) tasks with a series of “real-world” classroom distractors presented. We analyzed the impact of the distractors on rates of on-task performance and on-task, eye-gaze (i.e., looking at a classroom whiteboard) versus off-task eye-gaze (i.e., looking away from the whiteboard).Results: We found that while children did not always look at distractors themselves for long periods of time, the presence of a distractor disrupted on-task gaze at task-relevant whiteboard stimuli and lowered rates of task performance. This suggests that children with attention deficits may have a hard time returning to tasks once those tasks are interrupted, even if the distractor itself does not hold attention. Eye-tracking measures within the VR context can reveal rich information about attentional disruption.Conclusions: Leveraging virtual reality technology in combination with eye-tracking measures is well-suited to advance the understanding of mechanisms underlying attentional impairment in naturalistic settings. Assessment within these immersive and well-controlled simulated environments provides new options for increasing our understanding of distractibility and its potential impact on the development of interventions for children with ADHD.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Objective: Distractions inordinately impair attention in children with Attention-Deficit Hyperactivity Disorder (ADHD) but examining this behavior under real-life conditions poses a challenge for researchers and clinicians. Virtual reality (VR) technologies may mitigate the limitations of traditional laboratory methods by providing a more ecologically relevant experience. The use of eye-tracking measures to assess attentional functioning in a VR context in ADHD is novel. In this proof of principle project, we evaluate the temporal dynamics of distraction via eye-tracking measures in a VR classroom setting with 20 children diagnosed with ADHD between 8 and 12 years of age.Method: We recorded continuous eye movements while participants performed math, Stroop, and continuous performance test (CPT) tasks with a series of “real-world” classroom distractors presented. We analyzed the impact of the distractors on rates of on-task performance and on-task, eye-gaze (i.e., looking at a classroom whiteboard) versus off-task eye-gaze (i.e., looking away from the whiteboard).Results: We found that while children did not always look at distractors themselves for long periods of time, the presence of a distractor disrupted on-task gaze at task-relevant whiteboard stimuli and lowered rates of task performance. This suggests that children with attention deficits may have a hard time returning to tasks once those tasks are interrupted, even if the distractor itself does not hold attention. Eye-tracking measures within the VR context can reveal rich information about attentional disruption.Conclusions: Leveraging virtual reality technology in combination with eye-tracking measures is well-suited to advance the understanding of mechanisms underlying attentional impairment in naturalistic settings. Assessment within these immersive and well-controlled simulated environments provides new options for increasing our understanding of distractibility and its potential impact on the development of interventions for children with ADHD.
6.
Aster, Hans-Christoph; Romanos, Marcel; Walitza, Susanne; Gerlach, Manfred; Mühlberger, Andreas; Rizzo, Albert; Andreatta, Marta; Hasenauer, Natalie; Hartrampf, Philipp E.; Nerlich, Kai; Reiners, Christoph; Lorenz, Reinhard; Buck, Andreas K.; Deserno, Lorenz
In: Frontiers in Psychiatry, vol. 13, 2022, ISSN: 1664-0640.
@article{aster_responsivity_2022,
title = {Responsivity of the Striatal Dopamine System to Methylphenidate—A Within-Subject I-123-β-CIT-SPECT Study in Male Children and Adolescents With Attention-Deficit/Hyperactivity Disorder},
author = {Hans-Christoph Aster and Marcel Romanos and Susanne Walitza and Manfred Gerlach and Andreas Mühlberger and Albert Rizzo and Marta Andreatta and Natalie Hasenauer and Philipp E. Hartrampf and Kai Nerlich and Christoph Reiners and Reinhard Lorenz and Andreas K. Buck and Lorenz Deserno},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2022.804730},
issn = {1664-0640},
year = {2022},
date = {2022-01-01},
urldate = {2022-09-13},
journal = {Frontiers in Psychiatry},
volume = {13},
abstract = {Background:Methylphenidate (MPH) is the first-line pharmacological treatment of attention-deficit/hyperactivity disorder (ADHD). MPH binds to the dopamine (DA) transporter (DAT), which has high density in the striatum. Assessments of the striatal dopamine transporter by single positron emission computed tomography (SPECT) in childhood and adolescent patients are rare but can provide insight on how the effects of MPH affect DAT availability. The aim of our within-subject study was to investigate the effect of MPH on DAT availability and how responsivity to MPH in DAT availability is linked to clinical symptoms and cognitive functioning.MethodsThirteen adolescent male patients (9–16 years) with a diagnosis of ADHD according to the DSM-IV and long-term stimulant medication (for at least 6 months) with MPH were assessed twice within 7 days using SPECT after application of I-123-β-CIT to examine DAT binding potential (DAT BP). SPECT measures took place in an on- and off-MPH status balanced for order across participants. A virtual reality continuous performance test was performed at each time point. Further clinical symptoms were assessed for baseline off-MPH.ResultsOn-MPH status was associated with a highly significant change (−29.9%) of striatal DAT BP as compared to off-MPH (t = −4.12},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background:Methylphenidate (MPH) is the first-line pharmacological treatment of attention-deficit/hyperactivity disorder (ADHD). MPH binds to the dopamine (DA) transporter (DAT), which has high density in the striatum. Assessments of the striatal dopamine transporter by single positron emission computed tomography (SPECT) in childhood and adolescent patients are rare but can provide insight on how the effects of MPH affect DAT availability. The aim of our within-subject study was to investigate the effect of MPH on DAT availability and how responsivity to MPH in DAT availability is linked to clinical symptoms and cognitive functioning.MethodsThirteen adolescent male patients (9–16 years) with a diagnosis of ADHD according to the DSM-IV and long-term stimulant medication (for at least 6 months) with MPH were assessed twice within 7 days using SPECT after application of I-123-β-CIT to examine DAT binding potential (DAT BP). SPECT measures took place in an on- and off-MPH status balanced for order across participants. A virtual reality continuous performance test was performed at each time point. Further clinical symptoms were assessed for baseline off-MPH.ResultsOn-MPH status was associated with a highly significant change (−29.9%) of striatal DAT BP as compared to off-MPH (t = −4.12
7.
Ionescu, Alina; Daele, Tom Van; Rizzo, Albert; Blair, Carolyn; Best, Paul
360° Videos for Immersive Mental Health Interventions: a Systematic Review Journal Article
In: J. technol. behav. sci., vol. 6, no. 4, pp. 631–651, 2021, ISSN: 2366-5963.
@article{ionescu_360_2021,
title = {360° Videos for Immersive Mental Health Interventions: a Systematic Review},
author = {Alina Ionescu and Tom Van Daele and Albert Rizzo and Carolyn Blair and Paul Best},
url = {https://doi.org/10.1007/s41347-021-00221-7},
doi = {10.1007/s41347-021-00221-7},
issn = {2366-5963},
year = {2021},
date = {2021-12-01},
urldate = {2022-09-13},
journal = {J. technol. behav. sci.},
volume = {6},
number = {4},
pages = {631--651},
abstract = {Virtual reality is increasingly recognized as a powerful method for clinical interventions in the mental health field, but has yet to achieve mainstream adoption in routine mental healthcare settings. A similar, yet slightly different technology, immersive 360° videos might have the potential to cover this gap, by requiring both lower costs and less technical skills to construct and operate such virtual environments. This systematic review therefore aims to identify, evaluate, and summarize mental health interventions using immersive 360° videos to support an understanding of their implementation in daily clinical practice. The quality of the 14 selected studies was evaluated using a critical appraisal tool, addressing populations with clinical levels of psychopathological symptoms, somatic conditions associated with psychological implications, and other at-risk groups. Immersive 360° videos successfully increased users’ feelings of presence, given their realistic features, and therefore yielded positive outcomes in clinical interventions where presence is considered as an essential precondition. Because the technical skills required to create immersive 360° video footage are fairly limited, most of the interventions using this approach have been created by mental health researchers or clinicians themselves. Immersive 360° videos are still in an early phase of implementation as a tool for clinical interventions for mental health, resulting in high heterogeneity in focus, procedures, and research designs. An important next step for making use of this technology may therefore involve the creation of standardized procedures, as a means to increase the quality of research and evidence-based interventions.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Virtual reality is increasingly recognized as a powerful method for clinical interventions in the mental health field, but has yet to achieve mainstream adoption in routine mental healthcare settings. A similar, yet slightly different technology, immersive 360° videos might have the potential to cover this gap, by requiring both lower costs and less technical skills to construct and operate such virtual environments. This systematic review therefore aims to identify, evaluate, and summarize mental health interventions using immersive 360° videos to support an understanding of their implementation in daily clinical practice. The quality of the 14 selected studies was evaluated using a critical appraisal tool, addressing populations with clinical levels of psychopathological symptoms, somatic conditions associated with psychological implications, and other at-risk groups. Immersive 360° videos successfully increased users’ feelings of presence, given their realistic features, and therefore yielded positive outcomes in clinical interventions where presence is considered as an essential precondition. Because the technical skills required to create immersive 360° video footage are fairly limited, most of the interventions using this approach have been created by mental health researchers or clinicians themselves. Immersive 360° videos are still in an early phase of implementation as a tool for clinical interventions for mental health, resulting in high heterogeneity in focus, procedures, and research designs. An important next step for making use of this technology may therefore involve the creation of standardized procedures, as a means to increase the quality of research and evidence-based interventions.
8.
Mozgai, Sharon; Leeds, Andrew; Kwok, David; Fast, Ed; Rizzo, Albert Skip; Hartholt, Arno
Building BRAVEMIND Vietnam: User-Centered Design for Virtual Reality Exposure Therapy Inproceedings
In: 2021 IEEE International Conference on Artificial Intelligence and Virtual Reality (AIVR), pp. 247–250, 2021.
@inproceedings{mozgai_building_2021,
title = {Building BRAVEMIND Vietnam: User-Centered Design for Virtual Reality Exposure Therapy},
author = {Sharon Mozgai and Andrew Leeds and David Kwok and Ed Fast and Albert Skip Rizzo and Arno Hartholt},
doi = {10.1109/AIVR52153.2021.00056},
year = {2021},
date = {2021-11-01},
booktitle = {2021 IEEE International Conference on Artificial Intelligence and Virtual Reality (AIVR)},
pages = {247--250},
abstract = {There has been a recent resurgence of Vietnam-era Veterans seeking Veteran Affairs (VA) services for post-traumatic stress disorder (PTSD). Multiple studies have reported positive outcomes using Virtual Reality Exposure Therapy (VRET) with Iraq/Afghanistan Veteran PTSD patients, but there have been fewer investigations into the acceptability and feasibility of VRET with older Veterans. We have extended an established VRET system, BRAVEMIND, to include Vietnam relevant content following a user-centered iterative design methodology. This paper will present the BRAVEMIND Vietnam VRET system, including setup, content, and technical architecture along with the findings of an initial focus group with Vietnam Veterans. These Veterans rated this system to be acceptable as a treatment tool for combat-related PTSD and provided valuable first-person accounts of their time in Vietnam to help guide the evolution of the VR content.},
keywords = {},
pubstate = {published},
tppubtype = {inproceedings}
}
There has been a recent resurgence of Vietnam-era Veterans seeking Veteran Affairs (VA) services for post-traumatic stress disorder (PTSD). Multiple studies have reported positive outcomes using Virtual Reality Exposure Therapy (VRET) with Iraq/Afghanistan Veteran PTSD patients, but there have been fewer investigations into the acceptability and feasibility of VRET with older Veterans. We have extended an established VRET system, BRAVEMIND, to include Vietnam relevant content following a user-centered iterative design methodology. This paper will present the BRAVEMIND Vietnam VRET system, including setup, content, and technical architecture along with the findings of an initial focus group with Vietnam Veterans. These Veterans rated this system to be acceptable as a treatment tool for combat-related PTSD and provided valuable first-person accounts of their time in Vietnam to help guide the evolution of the VR content.
9.
et al A Rizzo,
Normative Data for a Next Generation Virtual Classroom for Attention Assessment in Children with ADHD and Beyond! Inproceedings
In: Proceedings of the 13th International Conference on Disability, Virtual Reality and Associated Technologies (ICDVRAT 2021), Serpa, Portugal, 2021.
@inproceedings{a_rizzo_et_al_normative_2021,
title = {Normative Data for a Next Generation Virtual Classroom for Attention Assessment in Children with ADHD and Beyond!},
author = {et al A Rizzo},
url = {http://studio.hei-lab.ulusofona.pt/archive/},
year = {2021},
date = {2021-09-01},
booktitle = {Proceedings of the 13th International Conference on Disability, Virtual Reality and Associated Technologies (ICDVRAT 2021)},
address = {Serpa, Portugal},
keywords = {},
pubstate = {published},
tppubtype = {inproceedings}
}
10.
Rizzo, Albert “Skip”; Goodwin, Grace J.; Vito, Alyssa N. De; Bell, Joshua D.
Recent advances in virtual reality and psychology: Introduction to the special issue. Journal Article
In: Translational Issues in Psychological Science, vol. 7, no. 3, pp. 213–217, 2021, ISSN: 2332-2179, 2332-2136.
@article{rizzo_recent_2021,
title = {Recent advances in virtual reality and psychology: Introduction to the special issue.},
author = {Albert “Skip” Rizzo and Grace J. Goodwin and Alyssa N. De Vito and Joshua D. Bell},
url = {http://doi.apa.org/getdoi.cfm?doi=10.1037/tps0000316},
doi = {10.1037/tps0000316},
issn = {2332-2179, 2332-2136},
year = {2021},
date = {2021-09-01},
urldate = {2022-09-13},
journal = {Translational Issues in Psychological Science},
volume = {7},
number = {3},
pages = {213--217},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
11.
Gramlich, Michael A.; Smolenski, Derek J.; Norr, Aaron M.; Rothbaum, Barbara O.; Rizzo, Albert A.; Andrasik, Frank; Fantelli, Emily; Reger, Greg M.
In: Depression and Anxiety, pp. da.23141, 2021, ISSN: 1091-4269, 1520-6394.
@article{gramlich_psychophysiology_2021,
title = {Psychophysiology during exposure to trauma memories: Comparative effects of virtual reality and imaginal exposure for posttraumatic stress disorder},
author = {Michael A. Gramlich and Derek J. Smolenski and Aaron M. Norr and Barbara O. Rothbaum and Albert A. Rizzo and Frank Andrasik and Emily Fantelli and Greg M. Reger},
url = {https://onlinelibrary.wiley.com/doi/10.1002/da.23141},
doi = {10.1002/da.23141},
issn = {1091-4269, 1520-6394},
year = {2021},
date = {2021-03-01},
urldate = {2021-04-14},
journal = {Depression and Anxiety},
pages = {da.23141},
abstract = {Background: This investigation involved an in‐depth examination of psychophysiological responses during exposure to the trauma memory across 10 sessions among active duty soldiers with combat‐related posttraumatic stress disorder (PTSD) treated by Prolonged Exposure (PE) or Virtual Reality Exposure (VRE). We compared psychophysiological changes, session‐by‐session, between VRE and traditional imaginal exposure. Methods: Heart rate (HR), galvanic skin response (GSR), and peripheral skin temperature were collected every 5 min during exposure sessions with 61 combat veterans of Iraq/Afghanistan and compared to the PTSD Checklist (PCL‐C) and Clinician‐Administered PTSD Scale (CAPS) outcomes using multilevel modeling. Results: Over the course of treatment, participants in the PE group had higher HR arousal compared to participants in the VRE group. With reference to GSR, in earlier sessions, participants demonstrated a within‐session increase, whereas, in later sessions, participants showed a within‐session habituation response. A significant interaction was found for GSR and treatment assignment for within‐session change, withinperson effect, predicting CAPS (d = 0.70) and PCL‐C (d = 0.66) outcomes. Conclusion: Overall, these findings suggest that exposure to traumatic memories activates arousal across sessions, with GSR being most associated with reductions in PTSD symptoms for participants in the PE group.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: This investigation involved an in‐depth examination of psychophysiological responses during exposure to the trauma memory across 10 sessions among active duty soldiers with combat‐related posttraumatic stress disorder (PTSD) treated by Prolonged Exposure (PE) or Virtual Reality Exposure (VRE). We compared psychophysiological changes, session‐by‐session, between VRE and traditional imaginal exposure. Methods: Heart rate (HR), galvanic skin response (GSR), and peripheral skin temperature were collected every 5 min during exposure sessions with 61 combat veterans of Iraq/Afghanistan and compared to the PTSD Checklist (PCL‐C) and Clinician‐Administered PTSD Scale (CAPS) outcomes using multilevel modeling. Results: Over the course of treatment, participants in the PE group had higher HR arousal compared to participants in the VRE group. With reference to GSR, in earlier sessions, participants demonstrated a within‐session increase, whereas, in later sessions, participants showed a within‐session habituation response. A significant interaction was found for GSR and treatment assignment for within‐session change, withinperson effect, predicting CAPS (d = 0.70) and PCL‐C (d = 0.66) outcomes. Conclusion: Overall, these findings suggest that exposure to traumatic memories activates arousal across sessions, with GSR being most associated with reductions in PTSD symptoms for participants in the PE group.
12.
Mozgai, Sharon; Femminella, Brian; Hartholt, Arno; Rizzo, Skip
User-Centered Design Model for Mobile Health (mHealth) Applications: A Military Case Study in Rapid Assessment Process (RAP) Journal Article
In: pp. 10, 2021.
@article{mozgai_user-centered_2021,
title = {User-Centered Design Model for Mobile Health (mHealth) Applications: A Military Case Study in Rapid Assessment Process (RAP)},
author = {Sharon Mozgai and Brian Femminella and Arno Hartholt and Skip Rizzo},
url = {https://uploads-ssl.webflow.com/5f11f7e80d5a3b6dfdeeb614/5f9b3284d3d73e1da6a8f848_CHI_2021_Battle%20Buddy.pdf},
year = {2021},
date = {2021-01-01},
pages = {10},
abstract = {CCS Concepts: • Human-centered computing → Ubiquitous and mobile computing design and evaluation methods; HCI design and evaluation methods; User centered design; • Applied computing → Military; • Computing methodologies → Intelligent agents.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
CCS Concepts: • Human-centered computing → Ubiquitous and mobile computing design and evaluation methods; HCI design and evaluation methods; User centered design; • Applied computing → Military; • Computing methodologies → Intelligent agents.
13.
Reger, Greg M.; Norr, Aaron M.; Rizzo, Albert “Skip”; Sylvers, Patrick; Peltan, Jessica; Fischer, Daniel; Trimmer, Matthew; Porter, Shelan; Gant, Pamela; Baer, John S.
In: JAMA Network Open, vol. 3, no. 10, 2020, ISSN: 2574-3805.
@article{reger_virtual_2020,
title = {Virtual Standardized Patients vs Academic Training for Learning Motivational Interviewing Skills in the US Department of Veterans Affairs and the US Military: A Randomized Trial},
author = {Greg M. Reger and Aaron M. Norr and Albert “Skip” Rizzo and Patrick Sylvers and Jessica Peltan and Daniel Fischer and Matthew Trimmer and Shelan Porter and Pamela Gant and John S. Baer},
url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771733},
doi = {10.1001/jamanetworkopen.2020.17348},
issn = {2574-3805},
year = {2020},
date = {2020-10-01},
journal = {JAMA Network Open},
volume = {3},
number = {10},
abstract = {OBJECTIVE To evaluate the efficacy of training with a VSP on the acquisition and maintenance of MI skills compared with traditional academic study. DESIGN, SETTING, AND PARTICIPANTS This study was a 2-group, parallel-training randomized trial of 120 volunteer health care professionals recruited from a Department of Veterans Affairs and Department of Defense medical facility. Motivational interviewing skill was coded by external experts blinded to training group and skill assessment time points. Data were collected from October 17, 2016, to August 12, 2019. INTERVENTIONS After a computer course on MI, participants trained during two 45-minute sessions separated by 3 months. The 2 randomized training conditions included a branching storyline VSP, which provided MI skill rehearsal with immediate and summative feedback, and a control condition, which included academic study of content from the computerized MI course. MAIN OUTCOMES AND MEASURES Measurement of MI skill was based on recorded conversations with human standardized patients, assessed using the Motivational Interviewing Treatment Integrity 4.2.1 coding system, measured at baseline, after training, and after additional training in the randomized condition 3 months later. RESULTS A total of 120 volunteers (83 [69%] women), with a mean (SD) of 13.6 (10.3) years of health care experience, participated in the study; 61 were randomized to receive the intervention, and 59 were randomized to the control group. Those assigned to VSP training had significantly greater posttraining improvement in technical global scores (0.23; 95% CI, 0.03-0.44; P = .02), relational global scores (0.57; 95% CI, 0.33-0.81; P = .001), and the reflection-to-question ratio (0.23; 95% CI, 0.15-0.31; P = .001). Differences were maintained after the 3-month additional training session, with more improvements achieved after the 3-month training for the VSP trainees on the reflection-to- question ratio (0.15; 95% CI, 0.07-0.24; P = .001). CONCLUSIONS AND RELEVANCE This randomized trial demonstrated a successful transfer of training from a VSP to human standardized patients. The VSP MI skill outcomes were better than those achieved with academic study and were maintained over time. Virtual standardized patients},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE To evaluate the efficacy of training with a VSP on the acquisition and maintenance of MI skills compared with traditional academic study. DESIGN, SETTING, AND PARTICIPANTS This study was a 2-group, parallel-training randomized trial of 120 volunteer health care professionals recruited from a Department of Veterans Affairs and Department of Defense medical facility. Motivational interviewing skill was coded by external experts blinded to training group and skill assessment time points. Data were collected from October 17, 2016, to August 12, 2019. INTERVENTIONS After a computer course on MI, participants trained during two 45-minute sessions separated by 3 months. The 2 randomized training conditions included a branching storyline VSP, which provided MI skill rehearsal with immediate and summative feedback, and a control condition, which included academic study of content from the computerized MI course. MAIN OUTCOMES AND MEASURES Measurement of MI skill was based on recorded conversations with human standardized patients, assessed using the Motivational Interviewing Treatment Integrity 4.2.1 coding system, measured at baseline, after training, and after additional training in the randomized condition 3 months later. RESULTS A total of 120 volunteers (83 [69%] women), with a mean (SD) of 13.6 (10.3) years of health care experience, participated in the study; 61 were randomized to receive the intervention, and 59 were randomized to the control group. Those assigned to VSP training had significantly greater posttraining improvement in technical global scores (0.23; 95% CI, 0.03-0.44; P = .02), relational global scores (0.57; 95% CI, 0.33-0.81; P = .001), and the reflection-to-question ratio (0.23; 95% CI, 0.15-0.31; P = .001). Differences were maintained after the 3-month additional training session, with more improvements achieved after the 3-month training for the VSP trainees on the reflection-to- question ratio (0.15; 95% CI, 0.07-0.24; P = .001). CONCLUSIONS AND RELEVANCE This randomized trial demonstrated a successful transfer of training from a VSP to human standardized patients. The VSP MI skill outcomes were better than those achieved with academic study and were maintained over time. Virtual standardized patients
14.
Yeh, Shih-Ching; Lin, Sheng-Yang; Wu, Eric Hsiao-Kuang; Zhang, Kai-Feng; Xiu, Xu; Rizzo, Albert; Chung, Chia-Ru
A Virtual-Reality System Integrated With Neuro-Behavior Sensing for Attention-Deficit/Hyperactivity Disorder Intelligent Assessment Journal Article
In: IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 28, no. 9, pp. 1899–1907, 2020, ISSN: 1534-4320, 1558-0210.
@article{yeh_virtual-reality_2020,
title = {A Virtual-Reality System Integrated With Neuro-Behavior Sensing for Attention-Deficit/Hyperactivity Disorder Intelligent Assessment},
author = {Shih-Ching Yeh and Sheng-Yang Lin and Eric Hsiao-Kuang Wu and Kai-Feng Zhang and Xu Xiu and Albert Rizzo and Chia-Ru Chung},
url = {https://ieeexplore.ieee.org/document/9123917/},
doi = {10.1109/TNSRE.2020.3004545},
issn = {1534-4320, 1558-0210},
year = {2020},
date = {2020-09-01},
journal = {IEEE Transactions on Neural Systems and Rehabilitation Engineering},
volume = {28},
number = {9},
pages = {1899--1907},
abstract = {Attention-deficit/Hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children. Traditional assessment methods generally rely on behavioral rating scales (BRS) performed by clinicians, and sometimes parents or teachers. However, BRS assessment is time consuming, and the subjective ratings may lead to bias for the evaluation. Therefore, the major purpose of this study was to develop a Virtual Reality (VR) classroom associated with an intelligent assessment model to assist clinicians for the diagnosis of ADHD. In this study, an immersive VR classroom embedded with sustained and selective attention tasks was developed in which visual, audio, and visual-audio hybrid distractions, were triggered while attention tasks were conducted. A clinical experiment with 37 ADHD and 31 healthy subjects was performed. Data from BRS was compared with VR task performance and analyzed by rank-sum tests and Pearson Correlation. Results showed that 23 features out of total 28 were related to distinguish the ADHD and non-ADHD children. Several features of task performance and neuro-behavioral measurements were also correlated with features of the BRSs. Additionally, the machine learning models incorporating task performance and neuro-behavior were used to classify ADHD and non-ADHD children. The mean accuracy for the repeated cross-validation reached to 83.2%, which demonstrated a great potential for our system to provide more help for clinicians on assessment of ADHD.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Attention-deficit/Hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children. Traditional assessment methods generally rely on behavioral rating scales (BRS) performed by clinicians, and sometimes parents or teachers. However, BRS assessment is time consuming, and the subjective ratings may lead to bias for the evaluation. Therefore, the major purpose of this study was to develop a Virtual Reality (VR) classroom associated with an intelligent assessment model to assist clinicians for the diagnosis of ADHD. In this study, an immersive VR classroom embedded with sustained and selective attention tasks was developed in which visual, audio, and visual-audio hybrid distractions, were triggered while attention tasks were conducted. A clinical experiment with 37 ADHD and 31 healthy subjects was performed. Data from BRS was compared with VR task performance and analyzed by rank-sum tests and Pearson Correlation. Results showed that 23 features out of total 28 were related to distinguish the ADHD and non-ADHD children. Several features of task performance and neuro-behavioral measurements were also correlated with features of the BRSs. Additionally, the machine learning models incorporating task performance and neuro-behavior were used to classify ADHD and non-ADHD children. The mean accuracy for the repeated cross-validation reached to 83.2%, which demonstrated a great potential for our system to provide more help for clinicians on assessment of ADHD.
15.
Luu, Cindy; Talbot, Thomas B.; Fung, Cha Chi; Ben-Isaac, Eyal; Espinoza, Juan; Fischer, Susan; Cho, Christine S.; Sargsyan, Mariam; Korand, Sridevi; Chang, Todd P.
In: Simulation & Gaming, vol. 51, no. 4, pp. 550–570, 2020, ISSN: 1046-8781, 1552-826X.
@article{luu_development_2020,
title = {Development and Performance Assessment of a Digital Serious Game to Assess Multi-Patient Care Skills in a Simulated Pediatric Emergency Department},
author = {Cindy Luu and Thomas B. Talbot and Cha Chi Fung and Eyal Ben-Isaac and Juan Espinoza and Susan Fischer and Christine S. Cho and Mariam Sargsyan and Sridevi Korand and Todd P. Chang},
url = {http://journals.sagepub.com/doi/10.1177/1046878120904984},
doi = {10.1177/1046878120904984},
issn = {1046-8781, 1552-826X},
year = {2020},
date = {2020-08-01},
journal = {Simulation & Gaming},
volume = {51},
number = {4},
pages = {550--570},
abstract = {Objective. Multi-patient care is important among medical trainees in an emergency department (ED). While resident efficiency is a typically measured metric, multi-patient care involves both efficiency and diagnostic / treatment accuracy. Multi-patient care ability is difficult to assess, though simulation is a potential alternative. Our objective was to generate validity evidence for a serious game in assessing multi-patient care skills among a variety of learners.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Objective. Multi-patient care is important among medical trainees in an emergency department (ED). While resident efficiency is a typically measured metric, multi-patient care involves both efficiency and diagnostic / treatment accuracy. Multi-patient care ability is difficult to assess, though simulation is a potential alternative. Our objective was to generate validity evidence for a serious game in assessing multi-patient care skills among a variety of learners.
16.
Rakofsky, Jeffrey J.; Talbot, Thomas B.; Dunlop, Boadie W.
A Virtual Standardized Patient–Based Assessment Tool to Evaluate Psychiatric Residents’ Psychopharmacology Proficiency Journal Article
In: Academic Psychiatry, 2020, ISSN: 1042-9670, 1545-7230.
@article{rakofsky_virtual_2020,
title = {A Virtual Standardized Patient–Based Assessment Tool to Evaluate Psychiatric Residents’ Psychopharmacology Proficiency},
author = {Jeffrey J. Rakofsky and Thomas B. Talbot and Boadie W. Dunlop},
url = {http://link.springer.com/10.1007/s40596-020-01286-x},
doi = {10.1007/s40596-020-01286-x},
issn = {1042-9670, 1545-7230},
year = {2020},
date = {2020-07-01},
journal = {Academic Psychiatry},
abstract = {Objectives A virtual standardized patient-based assessment simulator was developed to address biases and practical limitations in existing methods for evaluating residents’ proficiency in psychopharmacological knowledge and practice. Methods The simulator was designed to replicate an outpatient psychiatric clinic experience. The virtual patient reported symptoms of a treatment-resistant form of major depressive disorder (MDD), requiring the learner to use various antidepressants in order for the patient to fully remit. Test scores were based on the proportion of correct responses to questions asked by the virtual patient about possible side effects, dosing, and titration decisions, which depended upon the patient’s tolerability and response to the learner’s selected medications. The validation paradigm included a novice-expert performance comparison across 4th year medical students, psychiatric residents from all four post-graduate year classes, and psychiatry department faculty, and a correlational analysis of simulator performance with the PRITE Somatic Treatments subscale score. Post-test surveys evaluated the test takers’ subjective impressions of the simulator. Results Forty-three subjects completed the online exam and survey. Total mean scores on the exam differed significantly across all the learner groups in a step-wise manner from students to faculty (F = 6.10},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Objectives A virtual standardized patient-based assessment simulator was developed to address biases and practical limitations in existing methods for evaluating residents’ proficiency in psychopharmacological knowledge and practice. Methods The simulator was designed to replicate an outpatient psychiatric clinic experience. The virtual patient reported symptoms of a treatment-resistant form of major depressive disorder (MDD), requiring the learner to use various antidepressants in order for the patient to fully remit. Test scores were based on the proportion of correct responses to questions asked by the virtual patient about possible side effects, dosing, and titration decisions, which depended upon the patient’s tolerability and response to the learner’s selected medications. The validation paradigm included a novice-expert performance comparison across 4th year medical students, psychiatric residents from all four post-graduate year classes, and psychiatry department faculty, and a correlational analysis of simulator performance with the PRITE Somatic Treatments subscale score. Post-test surveys evaluated the test takers’ subjective impressions of the simulator. Results Forty-three subjects completed the online exam and survey. Total mean scores on the exam differed significantly across all the learner groups in a step-wise manner from students to faculty (F = 6.10
17.
Malta, Loretta S.; Giosan, Cezar; Szkodny, Lauren E.; Altemus, Margaret M.; Rizzo, Albert A.; Silbersweig, David A.; Difede, JoAnn
Development of a virtual reality laboratory stressor Journal Article
In: Virtual Reality, 2020, ISSN: 1359-4338, 1434-9957.
@article{malta_development_2020,
title = {Development of a virtual reality laboratory stressor},
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 = {http://link.springer.com/10.1007/s10055-020-00455-5},
doi = {10.1007/s10055-020-00455-5},
issn = {1359-4338, 1434-9957},
year = {2020},
date = {2020-07-01},
journal = {Virtual Reality},
abstract = {This research report describes the development of a virtual reality (VR) laboratory stressor to study the effects of exposure to stressful events. The aim of the research was to develop a VR simulation that would evoke stressor responses at a level that was tolerable for participants. Veterans with and without warzone-related posttraumatic stress disorder (PTSD) were presented with VR simulations of combat stressors. There was one complaint of feeling hot during simulations but no incidents of simulator sickness. Participants denied experiencing the simulations as overly distressing, and there were no reports of any distress or problems related to study participation when they were contacted two weeks after the VR challenge. Simulations elicited moderate levels of anxiety and mild levels of dissociation that were significantly greater in Veterans with PTSD. Simulations were less successful in eliciting differential heart rate reactivity and stress hormone secretion, though history of civilian trauma exposure was associated with elevated heart rates during the second simulation. The study demonstrated that the VR paradigm was feasible and tolerable and that it holds promise as a new method with which to conduct controlled laboratory research on the effects of exposure to stressful events.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This research report describes the development of a virtual reality (VR) laboratory stressor to study the effects of exposure to stressful events. The aim of the research was to develop a VR simulation that would evoke stressor responses at a level that was tolerable for participants. Veterans with and without warzone-related posttraumatic stress disorder (PTSD) were presented with VR simulations of combat stressors. There was one complaint of feeling hot during simulations but no incidents of simulator sickness. Participants denied experiencing the simulations as overly distressing, and there were no reports of any distress or problems related to study participation when they were contacted two weeks after the VR challenge. Simulations elicited moderate levels of anxiety and mild levels of dissociation that were significantly greater in Veterans with PTSD. Simulations were less successful in eliciting differential heart rate reactivity and stress hormone secretion, though history of civilian trauma exposure was associated with elevated heart rates during the second simulation. The study demonstrated that the VR paradigm was feasible and tolerable and that it holds promise as a new method with which to conduct controlled laboratory research on the effects of exposure to stressful events.
18.
Talbot, Thomas Brett; Thiry, Katherine Elizabeth; Jenkins, Michael
In: Advances in Usability, User Experience, Wearable and Assistive Technology, vol. 1217, pp. 129–135, Springer International Publishing, Cham, Switzerland, 2020, ISBN: 978-3-030-51827-1 978-3-030-51828-8.
@incollection{talbot_storyboarding_2020,
title = {Storyboarding the Virtuality: Methods and Best Practices to Depict Scenes and Interactive Stories in Virtual and Mixed Reality},
author = {Thomas Brett Talbot and Katherine Elizabeth Thiry and Michael Jenkins},
url = {http://link.springer.com/10.1007/978-3-030-51828-8_17},
doi = {10.1007/978-3-030-51828-8_17},
isbn = {978-3-030-51827-1 978-3-030-51828-8},
year = {2020},
date = {2020-07-01},
booktitle = {Advances in Usability, User Experience, Wearable and Assistive Technology},
volume = {1217},
pages = {129--135},
publisher = {Springer International Publishing},
address = {Cham, Switzerland},
abstract = {Storyboarding is a cinematic prototyping technique to visualize settings, event sequences, dialogues & character depictions. Interactive VR/MR experiences benefit from storyboarding as part of the creation process, yet free movement & immersive 3D introduce challenges. Techniques to visualize 3D settings are explored with methods to conduct traditional storyboarding while requiring multiple viewpoints within a single timestep are elaborated. This is possible w/ perspective scene views. Even with 3D prototyping tools, it is important to maintain practices which optimize VR storyboarding and maintain spatial efficiency, allow storyboards to be hand drawn and be intuitive to read. A powerful solution is to bind several perspectives together to represent a specific time while reverting to a traditional single viewpoint when not necessary, therefore balancing three dimensionality, spatial efficiency & ease of creation.},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
Storyboarding is a cinematic prototyping technique to visualize settings, event sequences, dialogues & character depictions. Interactive VR/MR experiences benefit from storyboarding as part of the creation process, yet free movement & immersive 3D introduce challenges. Techniques to visualize 3D settings are explored with methods to conduct traditional storyboarding while requiring multiple viewpoints within a single timestep are elaborated. This is possible w/ perspective scene views. Even with 3D prototyping tools, it is important to maintain practices which optimize VR storyboarding and maintain spatial efficiency, allow storyboards to be hand drawn and be intuitive to read. A powerful solution is to bind several perspectives together to represent a specific time while reverting to a traditional single viewpoint when not necessary, therefore balancing three dimensionality, spatial efficiency & ease of creation.
19.
Mozgai, Sharon; Hartholt, Arno; Akinyemi, Dayo; Kubicek, Katarina; Rizzo, Albert (Skip); Kipke, Michele
In: HCI International 2020 - Posters, vol. 1225, pp. 304–307, Springer International Publishing, Cham, Switzerland, 2020, ISBN: 978-3-030-50728-2 978-3-030-50729-9.
@incollection{mozgai_development_2020,
title = {Development and Initial Feasibility Testing of the Virtual Research Navigator (VRN): A Public-Facing Agent-Based Educational System for Clinical Research Participation},
author = {Sharon Mozgai and Arno Hartholt and Dayo Akinyemi and Katarina Kubicek and Albert (Skip) Rizzo and Michele Kipke},
url = {http://link.springer.com/10.1007/978-3-030-50729-9_43},
doi = {10.1007/978-3-030-50729-9_43},
isbn = {978-3-030-50728-2 978-3-030-50729-9},
year = {2020},
date = {2020-07-01},
booktitle = {HCI International 2020 - Posters},
volume = {1225},
pages = {304--307},
publisher = {Springer International Publishing},
address = {Cham, Switzerland},
abstract = {The overall goal of VRN is to develop a novel technology solution at Children’s Hospital Los Angeles (CHLA) to overcome barriers that prevent the recruitment of diverse patient populations to clinical trials by providing both caregivers and children with an interactive educational experience. This system consists of 1) an intelligent agent called Zippy that users interact with by keyboard or voice input, 2) a series of videos covering topics including Privacy, Consent and Benefits, and 3) a UI that guides users through all available content. Pre- and post-questionnaires assessed willingness to participate in clinical research and found participants either increased or maintained their level of willingness to participate in research studies. Additionally, qualitative analysis of interview data revealed participants rated the overall interaction favorably and believed Zippy to be more fun, less judgmental and less threatening than interacting with a human. Future iterations are in-progress based on the user-feedback},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
The overall goal of VRN is to develop a novel technology solution at Children’s Hospital Los Angeles (CHLA) to overcome barriers that prevent the recruitment of diverse patient populations to clinical trials by providing both caregivers and children with an interactive educational experience. This system consists of 1) an intelligent agent called Zippy that users interact with by keyboard or voice input, 2) a series of videos covering topics including Privacy, Consent and Benefits, and 3) a UI that guides users through all available content. Pre- and post-questionnaires assessed willingness to participate in clinical research and found participants either increased or maintained their level of willingness to participate in research studies. Additionally, qualitative analysis of interview data revealed participants rated the overall interaction favorably and believed Zippy to be more fun, less judgmental and less threatening than interacting with a human. Future iterations are in-progress based on the user-feedback
20.
Hilty, Donald M.; Randhawa, Karan; Maheu, Marlene M.; McKean, Alastair J. S.; Pantera, Richard; Mishkind, Matthew C.; Rizzo, Albert “Skip”
A Review of Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care Journal Article
In: Journal of Technology in Behavioral Science, vol. 5, no. 2, pp. 178–205, 2020, ISSN: 2366-5963.
@article{hilty_review_2020,
title = {A Review of Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care},
author = {Donald M. Hilty and Karan Randhawa and Marlene M. Maheu and Alastair J. S. McKean and Richard Pantera and Matthew C. Mishkind and Albert “Skip” Rizzo},
url = {http://link.springer.com/10.1007/s41347-020-00126-x},
doi = {10.1007/s41347-020-00126-x},
issn = {2366-5963},
year = {2020},
date = {2020-06-01},
journal = {Journal of Technology in Behavioral Science},
volume = {5},
number = {2},
pages = {178--205},
abstract = {This scoping review article explores the application of telepresence (TPr), virtual reality (VR), and augmented reality (AR) to clinical care. A literature search of key words was conducted from January 1990 through May 2019 of the following databases: PubMed/ Medline, American Psychological Association PsycNET, Pubmed/Medline, Cochrane, Embase, PsycINFO, Web of Science, Scopus, OTSeeker, ABI/INFORM, computer-mediated communication (CMC), technology-mediated communications, Arts & Humanities Citation Index, Project Muse, ProQuest Research Library Plus, Sociological abstracts, Computers and Applied Sciences Complete and IT Source. It focused on concept areas: (1) TPr related to technologies; (2) virtual, augmented, reality, environment; (3) technology or computer-mediated communication; (4) clinical therapeutic relationship (boundaries, care, communication, connect, engagement, empathy, intimacy, trust); (5) telebehavioral health; (6) psychotherapy via technology; and (7) medicine/health care. Inclusion criteria were concept area 1 in combination with 2–7 and 2 or 3 in combination with any of 4–7. From a total of 5214 potential references, the authors found 512 eligible for full-text review and found 85 papers directly relevant to the concepts. From papers’ references and a review of books and popular literature about TPr, virtual reality (VR), and augmented reality (AR), 13 other sources of information were found. The historical evolution of TPr, VR, and AR shows that definitions, foci of studies (e.g., social neuroscience to business), and applications vary; assessments of TPr also vary widely. Studies discuss VR, AR, and TPr in medicine (e.g., rehabilitation, robotics), experimental psychology (laboratory, field, mixed), and behavioral health. Virtual environment (VE) designs aid the study of interpersonal communication and behavior, using standardized social interaction partners, virtual standardized patients, and/or virtual humans—all contingent on the participants’ experience of presence and the ability to engage. Additional research is needed to standardize experimental and clinical interventions, while maintaining ecological validity. Technology can significantly improve quality of care, access to new treatments and training, if ethical and reimbursement issues are better explored.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This scoping review article explores the application of telepresence (TPr), virtual reality (VR), and augmented reality (AR) to clinical care. A literature search of key words was conducted from January 1990 through May 2019 of the following databases: PubMed/ Medline, American Psychological Association PsycNET, Pubmed/Medline, Cochrane, Embase, PsycINFO, Web of Science, Scopus, OTSeeker, ABI/INFORM, computer-mediated communication (CMC), technology-mediated communications, Arts & Humanities Citation Index, Project Muse, ProQuest Research Library Plus, Sociological abstracts, Computers and Applied Sciences Complete and IT Source. It focused on concept areas: (1) TPr related to technologies; (2) virtual, augmented, reality, environment; (3) technology or computer-mediated communication; (4) clinical therapeutic relationship (boundaries, care, communication, connect, engagement, empathy, intimacy, trust); (5) telebehavioral health; (6) psychotherapy via technology; and (7) medicine/health care. Inclusion criteria were concept area 1 in combination with 2–7 and 2 or 3 in combination with any of 4–7. From a total of 5214 potential references, the authors found 512 eligible for full-text review and found 85 papers directly relevant to the concepts. From papers’ references and a review of books and popular literature about TPr, virtual reality (VR), and augmented reality (AR), 13 other sources of information were found. The historical evolution of TPr, VR, and AR shows that definitions, foci of studies (e.g., social neuroscience to business), and applications vary; assessments of TPr also vary widely. Studies discuss VR, AR, and TPr in medicine (e.g., rehabilitation, robotics), experimental psychology (laboratory, field, mixed), and behavioral health. Virtual environment (VE) designs aid the study of interpersonal communication and behavior, using standardized social interaction partners, virtual standardized patients, and/or virtual humans—all contingent on the participants’ experience of presence and the ability to engage. Additional research is needed to standardize experimental and clinical interventions, while maintaining ecological validity. Technology can significantly improve quality of care, access to new treatments and training, if ethical and reimbursement issues are better explored.
Filter
2022
Difede, JoAnn; Rothbaum, Barbara O.; Rizzo, Albert A.; Wyka, Katarzyna; Spielman, Lisa; Reist, Christopher; Roy, Michael J.; Jovanovic, Tanja; Norrholm, Seth D.; Cukor, Judith; Olden, Megan; Glatt, Charles E.; Lee, Francis S.
In: Transl Psychiatry, vol. 12, no. 1, pp. 299, 2022, ISSN: 2158-3188.
Abstract | Links | BibTeX | Tags: DTIC, MedVR, Virtual Humans
@article{difede_enhancing_2022,
title = {Enhancing exposure therapy for posttraumatic stress disorder (PTSD): a randomized clinical trial of virtual reality and imaginal exposure with a cognitive enhancer},
author = {JoAnn Difede and Barbara O. Rothbaum and Albert A. Rizzo and Katarzyna Wyka and Lisa Spielman and Christopher Reist and Michael J. Roy and Tanja Jovanovic and Seth D. Norrholm and Judith Cukor and Megan Olden and Charles E. Glatt and Francis S. Lee},
url = {https://www.nature.com/articles/s41398-022-02066-x},
doi = {10.1038/s41398-022-02066-x},
issn = {2158-3188},
year = {2022},
date = {2022-12-01},
urldate = {2022-09-13},
journal = {Transl Psychiatry},
volume = {12},
number = {1},
pages = {299},
abstract = {Abstract Posttraumatic stress disorder (PTSD) is a significant public health issue. Yet, there are limited treatment options and no data to suggest which treatment will work for whom. We tested the efficacy of virtual reality exposure (VRE) or prolonged imaginal exposure (PE), augmented with D-cycloserine (DCS) for combat-related PTSD. As an exploratory aim, we examined whether brain-derived neurotrophic factor (BDNF) and fatty acid amide hydrolase (FAAH) moderated treatment response. Military personnel with PTSD ( n = 192) were recruited into a multisite double-blind randomized controlled trial to receive nine weeks of VRE or PE, with DCS or placebo. Primary outcome was the improvement in symptom severity. Randomization was stratified by comorbid depression (MDD) and site. Participants in both VRE and PE showed similar meaningful clinical improvement with no difference between the treatment groups. A significant interaction ( p = 0.45) suggested VRE was more effective for depressed participants (CAPS difference M = 3.51 [95% CI 1.17–5.86]},
keywords = {DTIC, MedVR, Virtual Humans},
pubstate = {published},
tppubtype = {article}
}
Abstract Posttraumatic stress disorder (PTSD) is a significant public health issue. Yet, there are limited treatment options and no data to suggest which treatment will work for whom. We tested the efficacy of virtual reality exposure (VRE) or prolonged imaginal exposure (PE), augmented with D-cycloserine (DCS) for combat-related PTSD. As an exploratory aim, we examined whether brain-derived neurotrophic factor (BDNF) and fatty acid amide hydrolase (FAAH) moderated treatment response. Military personnel with PTSD ( n = 192) were recruited into a multisite double-blind randomized controlled trial to receive nine weeks of VRE or PE, with DCS or placebo. Primary outcome was the improvement in symptom severity. Randomization was stratified by comorbid depression (MDD) and site. Participants in both VRE and PE showed similar meaningful clinical improvement with no difference between the treatment groups. A significant interaction ( p = 0.45) suggested VRE was more effective for depressed participants (CAPS difference M = 3.51 [95% CI 1.17–5.86]
Korand, Sridevi; Fung, Cha Chi; Cohen, Sammy; Talbot, Thomas B.; Fischer, Susan; Luu, Cindy; Sargsyan, Mariam; Ben-Isaac, Eyal; Espinoza, Juan; Chang, Todd P.
In: Simulation & Gaming, vol. 53, no. 4, pp. 335–352, 2022, ISSN: 1046-8781, 1552-826X.
Abstract | Links | BibTeX | Tags: MedVR
@article{korand_association_2022,
title = {The Association Between Multitasking and Multi-Patient Care Skills in a Simulated Patient Care Video Game Among Second Year Medical Students Based on Specialty Choice},
author = {Sridevi Korand and Cha Chi Fung and Sammy Cohen and Thomas B. Talbot and Susan Fischer and Cindy Luu and Mariam Sargsyan and Eyal Ben-Isaac and Juan Espinoza and Todd P. Chang},
url = {http://journals.sagepub.com/doi/10.1177/10468781221103460},
doi = {10.1177/10468781221103460},
issn = {1046-8781, 1552-826X},
year = {2022},
date = {2022-08-01},
urldate = {2022-09-21},
journal = {Simulation & Gaming},
volume = {53},
number = {4},
pages = {335--352},
abstract = {Background and Objective Healthcare providers require multitasking and multi-patient care skills, and training programs do not formally incorporate curricula specifically for multitasking skills to trainees. The medical education community is in equipoise on whether multitasking ability is a fixed trait. Furthermore, it is unclear whether multitasking ability affects those who gravitate toward careers that demand it, particularly among medical students deciding on a specialty. We sought to define the association between specialty choice, multitasking abilities and multi-patient care delivery among pre-clinical medical students. For this study, we examined both efficiency and accuracy metrics within multitasking and whether they were different between students choosing specialties. Methods This was a planned cross-sectional sub-study focused on 2nd year medical students (MS-IIs) within a parent study evaluating multi-patient care skills using a serious game (VitalSigns:ED TM ) depicting a pediatric emergency department. Subjects completed a Multitasking Ability Test (MTAT) and five VitalSigns:ED gameplays. The predictor variable was specialty choice, categorized into multitasking and non-multitasking groups. Outcome variables measuring efficiency and diagnostic accuracy were obtained from the MTAT and the game. The primary analysis was a Mann–Whitney U test, and secondary analyses employed Spearman Rank correlations. Results Twelve students applied to multitasking specialties and 18 applied to others. Those in the multitasking specialties had faster MTAT completions than the other cohort (29.8 vs. 59.7 sec, 95%CI difference -0.9 to -39.8 sec). Differential diagnoses were higher in multitasking specialties in VitalSigns:ED (2.03 vs. 1.06, 95%CI difference +0.05 to +1.54) but efficiency metrics in the game did not differ. Conclusion Multitasking and multi-patient care performance show some association with preferred specialty choices for MS-IIs prior to clinical exposure.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Background and Objective Healthcare providers require multitasking and multi-patient care skills, and training programs do not formally incorporate curricula specifically for multitasking skills to trainees. The medical education community is in equipoise on whether multitasking ability is a fixed trait. Furthermore, it is unclear whether multitasking ability affects those who gravitate toward careers that demand it, particularly among medical students deciding on a specialty. We sought to define the association between specialty choice, multitasking abilities and multi-patient care delivery among pre-clinical medical students. For this study, we examined both efficiency and accuracy metrics within multitasking and whether they were different between students choosing specialties. Methods This was a planned cross-sectional sub-study focused on 2nd year medical students (MS-IIs) within a parent study evaluating multi-patient care skills using a serious game (VitalSigns:ED TM ) depicting a pediatric emergency department. Subjects completed a Multitasking Ability Test (MTAT) and five VitalSigns:ED gameplays. The predictor variable was specialty choice, categorized into multitasking and non-multitasking groups. Outcome variables measuring efficiency and diagnostic accuracy were obtained from the MTAT and the game. The primary analysis was a Mann–Whitney U test, and secondary analyses employed Spearman Rank correlations. Results Twelve students applied to multitasking specialties and 18 applied to others. Those in the multitasking specialties had faster MTAT completions than the other cohort (29.8 vs. 59.7 sec, 95%CI difference -0.9 to -39.8 sec). Differential diagnoses were higher in multitasking specialties in VitalSigns:ED (2.03 vs. 1.06, 95%CI difference +0.05 to +1.54) but efficiency metrics in the game did not differ. Conclusion Multitasking and multi-patient care performance show some association with preferred specialty choices for MS-IIs prior to clinical exposure.
Schweitzer, Julie B.; Rizzo, Albert “Skip”
Virtual Reality and ADHD: Clinical Assessment and Treatment in the Metaverse Journal Article
In: The ADHD Report, vol. 30, no. 3, pp. 1–9, 2022, ISSN: 1065-8025.
Links | BibTeX | Tags: MedVR, VR
@article{schweitzer_virtual_2022,
title = {Virtual Reality and ADHD: Clinical Assessment and Treatment in the Metaverse},
author = {Julie B. Schweitzer and Albert “Skip” Rizzo},
url = {https://guilfordjournals.com/doi/abs/10.1521/adhd.2022.30.3.1},
doi = {10.1521/adhd.2022.30.3.1},
issn = {1065-8025},
year = {2022},
date = {2022-05-01},
urldate = {2022-09-13},
journal = {The ADHD Report},
volume = {30},
number = {3},
pages = {1--9},
keywords = {MedVR, VR},
pubstate = {published},
tppubtype = {article}
}
Talbot, Thomas Brett; Chinara, Chinmay
In: 2022.
Abstract | Links | BibTeX | Tags: DTIC, MedVR, MR, VR
@inproceedings{brett_talbot_open_2022,
title = {Open Medical Gesture: An Open-Source Experiment in Naturalistic Physical Interactions for Mixed and Virtual Reality Simulations},
author = {Thomas Brett Talbot and Chinmay Chinara},
url = {https://openaccess.cms-conferences.org/#/publications/book/978-1-958651-26-1/article/978-1-958651-26-1_0},
doi = {10.54941/ahfe1002054},
year = {2022},
date = {2022-01-01},
urldate = {2022-09-13},
abstract = {Mixed (MR) and Virtual Reality (VR) simulations are hampered by requirements for hand controllers or attempts to perseverate in use of two-dimensional computer interface paradigms from the 1980s. From our efforts to produce more naturalistic interactions for combat medic training for the military, we have developed an open-source toolkit that enables direct hand controlled responsive interactions that is sensor independent and can function with depth sensing cameras, webcams or sensory gloves. From this research and review of current literature, we have discerned several best approaches for hand-based human computer interactions which provide intuitive, responsive, useful, and low frustration experiences for VR users. The center of an effective gesture system is a universal hand model that can map to inputs from several different kinds of sensors rather than depending on a specific commercial product. Parts of the hand are effectors in simulation space with a physics-based model. Therefore, translational and rotational forces from the hands will impact physical objects in VR which varies based on the mass of the virtual objects. We incorporate computer code w/ objects, calling them “Smart Objects”, which allows such objects to have movement properties and collision detection for expected manipulation. Examples of smart objects include scissors, a ball, a turning knob, a moving lever, or a human figure with moving limbs. Articulation points contain collision detectors and code to assist in expected hand actions. We include a library of more than 40 Smart Objects in the toolkit. Thus, is it possible to throw a ball, hit that ball with a bat, cut a bandage, turn on a ventilator or to lift and inspect a human arm.We mediate the interaction of the hands with virtual objects. Hands often violate the rules of a virtual world simply by passing through objects. One must interpret user intent. This can be achieved by introducing stickiness of the hands to objects. If the human’s hands overshoot an object, we place the hand onto that object’s surface unless the hand passes the object by a significant distance. We also make hands and fingers contact an object according to the object’s contours and do not allow fingers to sink into the interior of an object. Haptics, or a sense of physical resistance and tactile sensation from contacting physical objects is a supremely difficult technical challenge and is an expensive pursuit. Our approach ignores true haptics, but we have experimented with an alternative approach, called audio tactile synesthesia where we substitute the sensation of touch for that of sound. The idea is to associate parts of each hand with a tone of a specific frequency upon contacting objects. The attack rate of the sound envelope varies with the velocity of contact and hardness of the object being ‘touched’. Such sounds can feel softer or harder depending on the nature of ‘touch’ being experienced. This substitution technique can provide tactile feedback through indirect, yet still naturalistic means. The artificial intelligence (AI) technique to determine discrete hand gestures and motions within the physical space is a special form of AI called Long Short Term Memory (LSTM). LSTM allows much faster and flexible recognition than other machine learning approaches. LSTM is particularly effective with points in motion. Latency of recognition is very low. In addition to LSTM, we employ other synthetic vision & object recognition AI to the discrimination of real-world objects. This allows for methods to conduct virtual simulations. For example, it is possible to pick up a virtual syringe and inject a medication into a virtual patient through hand motions. We track the hand points to contact with the virtual syringe. We also detect when the hand is compressing the syringe plunger. We could also use virtual medications & instruments on human actors or manikins, not just on virtual objects. With object recognition AI, we can place a syringe on a tray in the physical world. The human user can pick up the syringe and use it on a virtual patient. Thus, we are able to blend physical and virtual simulation together seamlessly in a highly intuitive and naturalistic manner.The techniques and technologies explained here represent a baseline capability whereby interacting in mixed and virtual reality can now be much more natural and intuitive than it has ever been. We have now passed a threshold where we can do away with game controllers and magnetic trackers for VR. This advancement will contribute to greater adoption of VR solutions. To foster this, our team has committed to freely sharing these technologies for all purposes and at no cost as an open-source tool. We encourage the scientific, research, educational and medical communities to adopt these resources and determine their effectiveness and utilize these tools and practices to grow the body of useful VR applications.},
keywords = {DTIC, MedVR, MR, VR},
pubstate = {published},
tppubtype = {inproceedings}
}
Mixed (MR) and Virtual Reality (VR) simulations are hampered by requirements for hand controllers or attempts to perseverate in use of two-dimensional computer interface paradigms from the 1980s. From our efforts to produce more naturalistic interactions for combat medic training for the military, we have developed an open-source toolkit that enables direct hand controlled responsive interactions that is sensor independent and can function with depth sensing cameras, webcams or sensory gloves. From this research and review of current literature, we have discerned several best approaches for hand-based human computer interactions which provide intuitive, responsive, useful, and low frustration experiences for VR users. The center of an effective gesture system is a universal hand model that can map to inputs from several different kinds of sensors rather than depending on a specific commercial product. Parts of the hand are effectors in simulation space with a physics-based model. Therefore, translational and rotational forces from the hands will impact physical objects in VR which varies based on the mass of the virtual objects. We incorporate computer code w/ objects, calling them “Smart Objects”, which allows such objects to have movement properties and collision detection for expected manipulation. Examples of smart objects include scissors, a ball, a turning knob, a moving lever, or a human figure with moving limbs. Articulation points contain collision detectors and code to assist in expected hand actions. We include a library of more than 40 Smart Objects in the toolkit. Thus, is it possible to throw a ball, hit that ball with a bat, cut a bandage, turn on a ventilator or to lift and inspect a human arm.We mediate the interaction of the hands with virtual objects. Hands often violate the rules of a virtual world simply by passing through objects. One must interpret user intent. This can be achieved by introducing stickiness of the hands to objects. If the human’s hands overshoot an object, we place the hand onto that object’s surface unless the hand passes the object by a significant distance. We also make hands and fingers contact an object according to the object’s contours and do not allow fingers to sink into the interior of an object. Haptics, or a sense of physical resistance and tactile sensation from contacting physical objects is a supremely difficult technical challenge and is an expensive pursuit. Our approach ignores true haptics, but we have experimented with an alternative approach, called audio tactile synesthesia where we substitute the sensation of touch for that of sound. The idea is to associate parts of each hand with a tone of a specific frequency upon contacting objects. The attack rate of the sound envelope varies with the velocity of contact and hardness of the object being ‘touched’. Such sounds can feel softer or harder depending on the nature of ‘touch’ being experienced. This substitution technique can provide tactile feedback through indirect, yet still naturalistic means. The artificial intelligence (AI) technique to determine discrete hand gestures and motions within the physical space is a special form of AI called Long Short Term Memory (LSTM). LSTM allows much faster and flexible recognition than other machine learning approaches. LSTM is particularly effective with points in motion. Latency of recognition is very low. In addition to LSTM, we employ other synthetic vision & object recognition AI to the discrimination of real-world objects. This allows for methods to conduct virtual simulations. For example, it is possible to pick up a virtual syringe and inject a medication into a virtual patient through hand motions. We track the hand points to contact with the virtual syringe. We also detect when the hand is compressing the syringe plunger. We could also use virtual medications & instruments on human actors or manikins, not just on virtual objects. With object recognition AI, we can place a syringe on a tray in the physical world. The human user can pick up the syringe and use it on a virtual patient. Thus, we are able to blend physical and virtual simulation together seamlessly in a highly intuitive and naturalistic manner.The techniques and technologies explained here represent a baseline capability whereby interacting in mixed and virtual reality can now be much more natural and intuitive than it has ever been. We have now passed a threshold where we can do away with game controllers and magnetic trackers for VR. This advancement will contribute to greater adoption of VR solutions. To foster this, our team has committed to freely sharing these technologies for all purposes and at no cost as an open-source tool. We encourage the scientific, research, educational and medical communities to adopt these resources and determine their effectiveness and utilize these tools and practices to grow the body of useful VR applications.
Stokes, Jared D.; Rizzo, Albert; Geng, Joy J.; Schweitzer, Julie B.
Measuring Attentional Distraction in Children With ADHD Using Virtual Reality Technology With Eye-Tracking Journal Article
In: Frontiers in Virtual Reality, vol. 3, 2022, ISSN: 2673-4192.
Abstract | Links | BibTeX | Tags: MedVR, VR
@article{stokes_measuring_2022,
title = {Measuring Attentional Distraction in Children With ADHD Using Virtual Reality Technology With Eye-Tracking},
author = {Jared D. Stokes and Albert Rizzo and Joy J. Geng and Julie B. Schweitzer},
url = {https://www.frontiersin.org/articles/10.3389/frvir.2022.855895},
issn = {2673-4192},
year = {2022},
date = {2022-01-01},
urldate = {2022-09-13},
journal = {Frontiers in Virtual Reality},
volume = {3},
abstract = {Objective: Distractions inordinately impair attention in children with Attention-Deficit Hyperactivity Disorder (ADHD) but examining this behavior under real-life conditions poses a challenge for researchers and clinicians. Virtual reality (VR) technologies may mitigate the limitations of traditional laboratory methods by providing a more ecologically relevant experience. The use of eye-tracking measures to assess attentional functioning in a VR context in ADHD is novel. In this proof of principle project, we evaluate the temporal dynamics of distraction via eye-tracking measures in a VR classroom setting with 20 children diagnosed with ADHD between 8 and 12 years of age.Method: We recorded continuous eye movements while participants performed math, Stroop, and continuous performance test (CPT) tasks with a series of “real-world” classroom distractors presented. We analyzed the impact of the distractors on rates of on-task performance and on-task, eye-gaze (i.e., looking at a classroom whiteboard) versus off-task eye-gaze (i.e., looking away from the whiteboard).Results: We found that while children did not always look at distractors themselves for long periods of time, the presence of a distractor disrupted on-task gaze at task-relevant whiteboard stimuli and lowered rates of task performance. This suggests that children with attention deficits may have a hard time returning to tasks once those tasks are interrupted, even if the distractor itself does not hold attention. Eye-tracking measures within the VR context can reveal rich information about attentional disruption.Conclusions: Leveraging virtual reality technology in combination with eye-tracking measures is well-suited to advance the understanding of mechanisms underlying attentional impairment in naturalistic settings. Assessment within these immersive and well-controlled simulated environments provides new options for increasing our understanding of distractibility and its potential impact on the development of interventions for children with ADHD.},
keywords = {MedVR, VR},
pubstate = {published},
tppubtype = {article}
}
Objective: Distractions inordinately impair attention in children with Attention-Deficit Hyperactivity Disorder (ADHD) but examining this behavior under real-life conditions poses a challenge for researchers and clinicians. Virtual reality (VR) technologies may mitigate the limitations of traditional laboratory methods by providing a more ecologically relevant experience. The use of eye-tracking measures to assess attentional functioning in a VR context in ADHD is novel. In this proof of principle project, we evaluate the temporal dynamics of distraction via eye-tracking measures in a VR classroom setting with 20 children diagnosed with ADHD between 8 and 12 years of age.Method: We recorded continuous eye movements while participants performed math, Stroop, and continuous performance test (CPT) tasks with a series of “real-world” classroom distractors presented. We analyzed the impact of the distractors on rates of on-task performance and on-task, eye-gaze (i.e., looking at a classroom whiteboard) versus off-task eye-gaze (i.e., looking away from the whiteboard).Results: We found that while children did not always look at distractors themselves for long periods of time, the presence of a distractor disrupted on-task gaze at task-relevant whiteboard stimuli and lowered rates of task performance. This suggests that children with attention deficits may have a hard time returning to tasks once those tasks are interrupted, even if the distractor itself does not hold attention. Eye-tracking measures within the VR context can reveal rich information about attentional disruption.Conclusions: Leveraging virtual reality technology in combination with eye-tracking measures is well-suited to advance the understanding of mechanisms underlying attentional impairment in naturalistic settings. Assessment within these immersive and well-controlled simulated environments provides new options for increasing our understanding of distractibility and its potential impact on the development of interventions for children with ADHD.
Aster, Hans-Christoph; Romanos, Marcel; Walitza, Susanne; Gerlach, Manfred; Mühlberger, Andreas; Rizzo, Albert; Andreatta, Marta; Hasenauer, Natalie; Hartrampf, Philipp E.; Nerlich, Kai; Reiners, Christoph; Lorenz, Reinhard; Buck, Andreas K.; Deserno, Lorenz
In: Frontiers in Psychiatry, vol. 13, 2022, ISSN: 1664-0640.
Abstract | Links | BibTeX | Tags: MedVR
@article{aster_responsivity_2022,
title = {Responsivity of the Striatal Dopamine System to Methylphenidate—A Within-Subject I-123-β-CIT-SPECT Study in Male Children and Adolescents With Attention-Deficit/Hyperactivity Disorder},
author = {Hans-Christoph Aster and Marcel Romanos and Susanne Walitza and Manfred Gerlach and Andreas Mühlberger and Albert Rizzo and Marta Andreatta and Natalie Hasenauer and Philipp E. Hartrampf and Kai Nerlich and Christoph Reiners and Reinhard Lorenz and Andreas K. Buck and Lorenz Deserno},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2022.804730},
issn = {1664-0640},
year = {2022},
date = {2022-01-01},
urldate = {2022-09-13},
journal = {Frontiers in Psychiatry},
volume = {13},
abstract = {Background:Methylphenidate (MPH) is the first-line pharmacological treatment of attention-deficit/hyperactivity disorder (ADHD). MPH binds to the dopamine (DA) transporter (DAT), which has high density in the striatum. Assessments of the striatal dopamine transporter by single positron emission computed tomography (SPECT) in childhood and adolescent patients are rare but can provide insight on how the effects of MPH affect DAT availability. The aim of our within-subject study was to investigate the effect of MPH on DAT availability and how responsivity to MPH in DAT availability is linked to clinical symptoms and cognitive functioning.MethodsThirteen adolescent male patients (9–16 years) with a diagnosis of ADHD according to the DSM-IV and long-term stimulant medication (for at least 6 months) with MPH were assessed twice within 7 days using SPECT after application of I-123-β-CIT to examine DAT binding potential (DAT BP). SPECT measures took place in an on- and off-MPH status balanced for order across participants. A virtual reality continuous performance test was performed at each time point. Further clinical symptoms were assessed for baseline off-MPH.ResultsOn-MPH status was associated with a highly significant change (−29.9%) of striatal DAT BP as compared to off-MPH (t = −4.12},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Background:Methylphenidate (MPH) is the first-line pharmacological treatment of attention-deficit/hyperactivity disorder (ADHD). MPH binds to the dopamine (DA) transporter (DAT), which has high density in the striatum. Assessments of the striatal dopamine transporter by single positron emission computed tomography (SPECT) in childhood and adolescent patients are rare but can provide insight on how the effects of MPH affect DAT availability. The aim of our within-subject study was to investigate the effect of MPH on DAT availability and how responsivity to MPH in DAT availability is linked to clinical symptoms and cognitive functioning.MethodsThirteen adolescent male patients (9–16 years) with a diagnosis of ADHD according to the DSM-IV and long-term stimulant medication (for at least 6 months) with MPH were assessed twice within 7 days using SPECT after application of I-123-β-CIT to examine DAT binding potential (DAT BP). SPECT measures took place in an on- and off-MPH status balanced for order across participants. A virtual reality continuous performance test was performed at each time point. Further clinical symptoms were assessed for baseline off-MPH.ResultsOn-MPH status was associated with a highly significant change (−29.9%) of striatal DAT BP as compared to off-MPH (t = −4.12
2021
Ionescu, Alina; Daele, Tom Van; Rizzo, Albert; Blair, Carolyn; Best, Paul
360° Videos for Immersive Mental Health Interventions: a Systematic Review Journal Article
In: J. technol. behav. sci., vol. 6, no. 4, pp. 631–651, 2021, ISSN: 2366-5963.
Abstract | Links | BibTeX | Tags: MedVR, VR
@article{ionescu_360_2021,
title = {360° Videos for Immersive Mental Health Interventions: a Systematic Review},
author = {Alina Ionescu and Tom Van Daele and Albert Rizzo and Carolyn Blair and Paul Best},
url = {https://doi.org/10.1007/s41347-021-00221-7},
doi = {10.1007/s41347-021-00221-7},
issn = {2366-5963},
year = {2021},
date = {2021-12-01},
urldate = {2022-09-13},
journal = {J. technol. behav. sci.},
volume = {6},
number = {4},
pages = {631--651},
abstract = {Virtual reality is increasingly recognized as a powerful method for clinical interventions in the mental health field, but has yet to achieve mainstream adoption in routine mental healthcare settings. A similar, yet slightly different technology, immersive 360° videos might have the potential to cover this gap, by requiring both lower costs and less technical skills to construct and operate such virtual environments. This systematic review therefore aims to identify, evaluate, and summarize mental health interventions using immersive 360° videos to support an understanding of their implementation in daily clinical practice. The quality of the 14 selected studies was evaluated using a critical appraisal tool, addressing populations with clinical levels of psychopathological symptoms, somatic conditions associated with psychological implications, and other at-risk groups. Immersive 360° videos successfully increased users’ feelings of presence, given their realistic features, and therefore yielded positive outcomes in clinical interventions where presence is considered as an essential precondition. Because the technical skills required to create immersive 360° video footage are fairly limited, most of the interventions using this approach have been created by mental health researchers or clinicians themselves. Immersive 360° videos are still in an early phase of implementation as a tool for clinical interventions for mental health, resulting in high heterogeneity in focus, procedures, and research designs. An important next step for making use of this technology may therefore involve the creation of standardized procedures, as a means to increase the quality of research and evidence-based interventions.},
keywords = {MedVR, VR},
pubstate = {published},
tppubtype = {article}
}
Virtual reality is increasingly recognized as a powerful method for clinical interventions in the mental health field, but has yet to achieve mainstream adoption in routine mental healthcare settings. A similar, yet slightly different technology, immersive 360° videos might have the potential to cover this gap, by requiring both lower costs and less technical skills to construct and operate such virtual environments. This systematic review therefore aims to identify, evaluate, and summarize mental health interventions using immersive 360° videos to support an understanding of their implementation in daily clinical practice. The quality of the 14 selected studies was evaluated using a critical appraisal tool, addressing populations with clinical levels of psychopathological symptoms, somatic conditions associated with psychological implications, and other at-risk groups. Immersive 360° videos successfully increased users’ feelings of presence, given their realistic features, and therefore yielded positive outcomes in clinical interventions where presence is considered as an essential precondition. Because the technical skills required to create immersive 360° video footage are fairly limited, most of the interventions using this approach have been created by mental health researchers or clinicians themselves. Immersive 360° videos are still in an early phase of implementation as a tool for clinical interventions for mental health, resulting in high heterogeneity in focus, procedures, and research designs. An important next step for making use of this technology may therefore involve the creation of standardized procedures, as a means to increase the quality of research and evidence-based interventions.
Mozgai, Sharon; Leeds, Andrew; Kwok, David; Fast, Ed; Rizzo, Albert Skip; Hartholt, Arno
Building BRAVEMIND Vietnam: User-Centered Design for Virtual Reality Exposure Therapy Inproceedings
In: 2021 IEEE International Conference on Artificial Intelligence and Virtual Reality (AIVR), pp. 247–250, 2021.
Abstract | Links | BibTeX | Tags: DTIC, MedVR, VR
@inproceedings{mozgai_building_2021,
title = {Building BRAVEMIND Vietnam: User-Centered Design for Virtual Reality Exposure Therapy},
author = {Sharon Mozgai and Andrew Leeds and David Kwok and Ed Fast and Albert Skip Rizzo and Arno Hartholt},
doi = {10.1109/AIVR52153.2021.00056},
year = {2021},
date = {2021-11-01},
booktitle = {2021 IEEE International Conference on Artificial Intelligence and Virtual Reality (AIVR)},
pages = {247--250},
abstract = {There has been a recent resurgence of Vietnam-era Veterans seeking Veteran Affairs (VA) services for post-traumatic stress disorder (PTSD). Multiple studies have reported positive outcomes using Virtual Reality Exposure Therapy (VRET) with Iraq/Afghanistan Veteran PTSD patients, but there have been fewer investigations into the acceptability and feasibility of VRET with older Veterans. We have extended an established VRET system, BRAVEMIND, to include Vietnam relevant content following a user-centered iterative design methodology. This paper will present the BRAVEMIND Vietnam VRET system, including setup, content, and technical architecture along with the findings of an initial focus group with Vietnam Veterans. These Veterans rated this system to be acceptable as a treatment tool for combat-related PTSD and provided valuable first-person accounts of their time in Vietnam to help guide the evolution of the VR content.},
keywords = {DTIC, MedVR, VR},
pubstate = {published},
tppubtype = {inproceedings}
}
There has been a recent resurgence of Vietnam-era Veterans seeking Veteran Affairs (VA) services for post-traumatic stress disorder (PTSD). Multiple studies have reported positive outcomes using Virtual Reality Exposure Therapy (VRET) with Iraq/Afghanistan Veteran PTSD patients, but there have been fewer investigations into the acceptability and feasibility of VRET with older Veterans. We have extended an established VRET system, BRAVEMIND, to include Vietnam relevant content following a user-centered iterative design methodology. This paper will present the BRAVEMIND Vietnam VRET system, including setup, content, and technical architecture along with the findings of an initial focus group with Vietnam Veterans. These Veterans rated this system to be acceptable as a treatment tool for combat-related PTSD and provided valuable first-person accounts of their time in Vietnam to help guide the evolution of the VR content.
et al A Rizzo,
Normative Data for a Next Generation Virtual Classroom for Attention Assessment in Children with ADHD and Beyond! Inproceedings
In: Proceedings of the 13th International Conference on Disability, Virtual Reality and Associated Technologies (ICDVRAT 2021), Serpa, Portugal, 2021.
Links | BibTeX | Tags: MedVR, Virtual Humans, VR
@inproceedings{a_rizzo_et_al_normative_2021,
title = {Normative Data for a Next Generation Virtual Classroom for Attention Assessment in Children with ADHD and Beyond!},
author = {et al A Rizzo},
url = {http://studio.hei-lab.ulusofona.pt/archive/},
year = {2021},
date = {2021-09-01},
booktitle = {Proceedings of the 13th International Conference on Disability, Virtual Reality and Associated Technologies (ICDVRAT 2021)},
address = {Serpa, Portugal},
keywords = {MedVR, Virtual Humans, VR},
pubstate = {published},
tppubtype = {inproceedings}
}
Rizzo, Albert “Skip”; Goodwin, Grace J.; Vito, Alyssa N. De; Bell, Joshua D.
Recent advances in virtual reality and psychology: Introduction to the special issue. Journal Article
In: Translational Issues in Psychological Science, vol. 7, no. 3, pp. 213–217, 2021, ISSN: 2332-2179, 2332-2136.
Links | BibTeX | Tags: DTIC, MedVR, VR
@article{rizzo_recent_2021,
title = {Recent advances in virtual reality and psychology: Introduction to the special issue.},
author = {Albert “Skip” Rizzo and Grace J. Goodwin and Alyssa N. De Vito and Joshua D. Bell},
url = {http://doi.apa.org/getdoi.cfm?doi=10.1037/tps0000316},
doi = {10.1037/tps0000316},
issn = {2332-2179, 2332-2136},
year = {2021},
date = {2021-09-01},
urldate = {2022-09-13},
journal = {Translational Issues in Psychological Science},
volume = {7},
number = {3},
pages = {213--217},
keywords = {DTIC, MedVR, VR},
pubstate = {published},
tppubtype = {article}
}
Gramlich, Michael A.; Smolenski, Derek J.; Norr, Aaron M.; Rothbaum, Barbara O.; Rizzo, Albert A.; Andrasik, Frank; Fantelli, Emily; Reger, Greg M.
In: Depression and Anxiety, pp. da.23141, 2021, ISSN: 1091-4269, 1520-6394.
Abstract | Links | BibTeX | Tags: MedVR
@article{gramlich_psychophysiology_2021,
title = {Psychophysiology during exposure to trauma memories: Comparative effects of virtual reality and imaginal exposure for posttraumatic stress disorder},
author = {Michael A. Gramlich and Derek J. Smolenski and Aaron M. Norr and Barbara O. Rothbaum and Albert A. Rizzo and Frank Andrasik and Emily Fantelli and Greg M. Reger},
url = {https://onlinelibrary.wiley.com/doi/10.1002/da.23141},
doi = {10.1002/da.23141},
issn = {1091-4269, 1520-6394},
year = {2021},
date = {2021-03-01},
urldate = {2021-04-14},
journal = {Depression and Anxiety},
pages = {da.23141},
abstract = {Background: This investigation involved an in‐depth examination of psychophysiological responses during exposure to the trauma memory across 10 sessions among active duty soldiers with combat‐related posttraumatic stress disorder (PTSD) treated by Prolonged Exposure (PE) or Virtual Reality Exposure (VRE). We compared psychophysiological changes, session‐by‐session, between VRE and traditional imaginal exposure. Methods: Heart rate (HR), galvanic skin response (GSR), and peripheral skin temperature were collected every 5 min during exposure sessions with 61 combat veterans of Iraq/Afghanistan and compared to the PTSD Checklist (PCL‐C) and Clinician‐Administered PTSD Scale (CAPS) outcomes using multilevel modeling. Results: Over the course of treatment, participants in the PE group had higher HR arousal compared to participants in the VRE group. With reference to GSR, in earlier sessions, participants demonstrated a within‐session increase, whereas, in later sessions, participants showed a within‐session habituation response. A significant interaction was found for GSR and treatment assignment for within‐session change, withinperson effect, predicting CAPS (d = 0.70) and PCL‐C (d = 0.66) outcomes. Conclusion: Overall, these findings suggest that exposure to traumatic memories activates arousal across sessions, with GSR being most associated with reductions in PTSD symptoms for participants in the PE group.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Background: This investigation involved an in‐depth examination of psychophysiological responses during exposure to the trauma memory across 10 sessions among active duty soldiers with combat‐related posttraumatic stress disorder (PTSD) treated by Prolonged Exposure (PE) or Virtual Reality Exposure (VRE). We compared psychophysiological changes, session‐by‐session, between VRE and traditional imaginal exposure. Methods: Heart rate (HR), galvanic skin response (GSR), and peripheral skin temperature were collected every 5 min during exposure sessions with 61 combat veterans of Iraq/Afghanistan and compared to the PTSD Checklist (PCL‐C) and Clinician‐Administered PTSD Scale (CAPS) outcomes using multilevel modeling. Results: Over the course of treatment, participants in the PE group had higher HR arousal compared to participants in the VRE group. With reference to GSR, in earlier sessions, participants demonstrated a within‐session increase, whereas, in later sessions, participants showed a within‐session habituation response. A significant interaction was found for GSR and treatment assignment for within‐session change, withinperson effect, predicting CAPS (d = 0.70) and PCL‐C (d = 0.66) outcomes. Conclusion: Overall, these findings suggest that exposure to traumatic memories activates arousal across sessions, with GSR being most associated with reductions in PTSD symptoms for participants in the PE group.
Mozgai, Sharon; Femminella, Brian; Hartholt, Arno; Rizzo, Skip
User-Centered Design Model for Mobile Health (mHealth) Applications: A Military Case Study in Rapid Assessment Process (RAP) Journal Article
In: pp. 10, 2021.
Abstract | Links | BibTeX | Tags: ARL, MedVR
@article{mozgai_user-centered_2021,
title = {User-Centered Design Model for Mobile Health (mHealth) Applications: A Military Case Study in Rapid Assessment Process (RAP)},
author = {Sharon Mozgai and Brian Femminella and Arno Hartholt and Skip Rizzo},
url = {https://uploads-ssl.webflow.com/5f11f7e80d5a3b6dfdeeb614/5f9b3284d3d73e1da6a8f848_CHI_2021_Battle%20Buddy.pdf},
year = {2021},
date = {2021-01-01},
pages = {10},
abstract = {CCS Concepts: • Human-centered computing → Ubiquitous and mobile computing design and evaluation methods; HCI design and evaluation methods; User centered design; • Applied computing → Military; • Computing methodologies → Intelligent agents.},
keywords = {ARL, MedVR},
pubstate = {published},
tppubtype = {article}
}
CCS Concepts: • Human-centered computing → Ubiquitous and mobile computing design and evaluation methods; HCI design and evaluation methods; User centered design; • Applied computing → Military; • Computing methodologies → Intelligent agents.
2020
Reger, Greg M.; Norr, Aaron M.; Rizzo, Albert “Skip”; Sylvers, Patrick; Peltan, Jessica; Fischer, Daniel; Trimmer, Matthew; Porter, Shelan; Gant, Pamela; Baer, John S.
In: JAMA Network Open, vol. 3, no. 10, 2020, ISSN: 2574-3805.
Abstract | Links | BibTeX | Tags: MedVR
@article{reger_virtual_2020,
title = {Virtual Standardized Patients vs Academic Training for Learning Motivational Interviewing Skills in the US Department of Veterans Affairs and the US Military: A Randomized Trial},
author = {Greg M. Reger and Aaron M. Norr and Albert “Skip” Rizzo and Patrick Sylvers and Jessica Peltan and Daniel Fischer and Matthew Trimmer and Shelan Porter and Pamela Gant and John S. Baer},
url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2771733},
doi = {10.1001/jamanetworkopen.2020.17348},
issn = {2574-3805},
year = {2020},
date = {2020-10-01},
journal = {JAMA Network Open},
volume = {3},
number = {10},
abstract = {OBJECTIVE To evaluate the efficacy of training with a VSP on the acquisition and maintenance of MI skills compared with traditional academic study. DESIGN, SETTING, AND PARTICIPANTS This study was a 2-group, parallel-training randomized trial of 120 volunteer health care professionals recruited from a Department of Veterans Affairs and Department of Defense medical facility. Motivational interviewing skill was coded by external experts blinded to training group and skill assessment time points. Data were collected from October 17, 2016, to August 12, 2019. INTERVENTIONS After a computer course on MI, participants trained during two 45-minute sessions separated by 3 months. The 2 randomized training conditions included a branching storyline VSP, which provided MI skill rehearsal with immediate and summative feedback, and a control condition, which included academic study of content from the computerized MI course. MAIN OUTCOMES AND MEASURES Measurement of MI skill was based on recorded conversations with human standardized patients, assessed using the Motivational Interviewing Treatment Integrity 4.2.1 coding system, measured at baseline, after training, and after additional training in the randomized condition 3 months later. RESULTS A total of 120 volunteers (83 [69%] women), with a mean (SD) of 13.6 (10.3) years of health care experience, participated in the study; 61 were randomized to receive the intervention, and 59 were randomized to the control group. Those assigned to VSP training had significantly greater posttraining improvement in technical global scores (0.23; 95% CI, 0.03-0.44; P = .02), relational global scores (0.57; 95% CI, 0.33-0.81; P = .001), and the reflection-to-question ratio (0.23; 95% CI, 0.15-0.31; P = .001). Differences were maintained after the 3-month additional training session, with more improvements achieved after the 3-month training for the VSP trainees on the reflection-to- question ratio (0.15; 95% CI, 0.07-0.24; P = .001). CONCLUSIONS AND RELEVANCE This randomized trial demonstrated a successful transfer of training from a VSP to human standardized patients. The VSP MI skill outcomes were better than those achieved with academic study and were maintained over time. Virtual standardized patients},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE To evaluate the efficacy of training with a VSP on the acquisition and maintenance of MI skills compared with traditional academic study. DESIGN, SETTING, AND PARTICIPANTS This study was a 2-group, parallel-training randomized trial of 120 volunteer health care professionals recruited from a Department of Veterans Affairs and Department of Defense medical facility. Motivational interviewing skill was coded by external experts blinded to training group and skill assessment time points. Data were collected from October 17, 2016, to August 12, 2019. INTERVENTIONS After a computer course on MI, participants trained during two 45-minute sessions separated by 3 months. The 2 randomized training conditions included a branching storyline VSP, which provided MI skill rehearsal with immediate and summative feedback, and a control condition, which included academic study of content from the computerized MI course. MAIN OUTCOMES AND MEASURES Measurement of MI skill was based on recorded conversations with human standardized patients, assessed using the Motivational Interviewing Treatment Integrity 4.2.1 coding system, measured at baseline, after training, and after additional training in the randomized condition 3 months later. RESULTS A total of 120 volunteers (83 [69%] women), with a mean (SD) of 13.6 (10.3) years of health care experience, participated in the study; 61 were randomized to receive the intervention, and 59 were randomized to the control group. Those assigned to VSP training had significantly greater posttraining improvement in technical global scores (0.23; 95% CI, 0.03-0.44; P = .02), relational global scores (0.57; 95% CI, 0.33-0.81; P = .001), and the reflection-to-question ratio (0.23; 95% CI, 0.15-0.31; P = .001). Differences were maintained after the 3-month additional training session, with more improvements achieved after the 3-month training for the VSP trainees on the reflection-to- question ratio (0.15; 95% CI, 0.07-0.24; P = .001). CONCLUSIONS AND RELEVANCE This randomized trial demonstrated a successful transfer of training from a VSP to human standardized patients. The VSP MI skill outcomes were better than those achieved with academic study and were maintained over time. Virtual standardized patients
Yeh, Shih-Ching; Lin, Sheng-Yang; Wu, Eric Hsiao-Kuang; Zhang, Kai-Feng; Xiu, Xu; Rizzo, Albert; Chung, Chia-Ru
A Virtual-Reality System Integrated With Neuro-Behavior Sensing for Attention-Deficit/Hyperactivity Disorder Intelligent Assessment Journal Article
In: IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 28, no. 9, pp. 1899–1907, 2020, ISSN: 1534-4320, 1558-0210.
Abstract | Links | BibTeX | Tags: MedVR
@article{yeh_virtual-reality_2020,
title = {A Virtual-Reality System Integrated With Neuro-Behavior Sensing for Attention-Deficit/Hyperactivity Disorder Intelligent Assessment},
author = {Shih-Ching Yeh and Sheng-Yang Lin and Eric Hsiao-Kuang Wu and Kai-Feng Zhang and Xu Xiu and Albert Rizzo and Chia-Ru Chung},
url = {https://ieeexplore.ieee.org/document/9123917/},
doi = {10.1109/TNSRE.2020.3004545},
issn = {1534-4320, 1558-0210},
year = {2020},
date = {2020-09-01},
journal = {IEEE Transactions on Neural Systems and Rehabilitation Engineering},
volume = {28},
number = {9},
pages = {1899--1907},
abstract = {Attention-deficit/Hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children. Traditional assessment methods generally rely on behavioral rating scales (BRS) performed by clinicians, and sometimes parents or teachers. However, BRS assessment is time consuming, and the subjective ratings may lead to bias for the evaluation. Therefore, the major purpose of this study was to develop a Virtual Reality (VR) classroom associated with an intelligent assessment model to assist clinicians for the diagnosis of ADHD. In this study, an immersive VR classroom embedded with sustained and selective attention tasks was developed in which visual, audio, and visual-audio hybrid distractions, were triggered while attention tasks were conducted. A clinical experiment with 37 ADHD and 31 healthy subjects was performed. Data from BRS was compared with VR task performance and analyzed by rank-sum tests and Pearson Correlation. Results showed that 23 features out of total 28 were related to distinguish the ADHD and non-ADHD children. Several features of task performance and neuro-behavioral measurements were also correlated with features of the BRSs. Additionally, the machine learning models incorporating task performance and neuro-behavior were used to classify ADHD and non-ADHD children. The mean accuracy for the repeated cross-validation reached to 83.2%, which demonstrated a great potential for our system to provide more help for clinicians on assessment of ADHD.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Attention-deficit/Hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children. Traditional assessment methods generally rely on behavioral rating scales (BRS) performed by clinicians, and sometimes parents or teachers. However, BRS assessment is time consuming, and the subjective ratings may lead to bias for the evaluation. Therefore, the major purpose of this study was to develop a Virtual Reality (VR) classroom associated with an intelligent assessment model to assist clinicians for the diagnosis of ADHD. In this study, an immersive VR classroom embedded with sustained and selective attention tasks was developed in which visual, audio, and visual-audio hybrid distractions, were triggered while attention tasks were conducted. A clinical experiment with 37 ADHD and 31 healthy subjects was performed. Data from BRS was compared with VR task performance and analyzed by rank-sum tests and Pearson Correlation. Results showed that 23 features out of total 28 were related to distinguish the ADHD and non-ADHD children. Several features of task performance and neuro-behavioral measurements were also correlated with features of the BRSs. Additionally, the machine learning models incorporating task performance and neuro-behavior were used to classify ADHD and non-ADHD children. The mean accuracy for the repeated cross-validation reached to 83.2%, which demonstrated a great potential for our system to provide more help for clinicians on assessment of ADHD.
Luu, Cindy; Talbot, Thomas B.; Fung, Cha Chi; Ben-Isaac, Eyal; Espinoza, Juan; Fischer, Susan; Cho, Christine S.; Sargsyan, Mariam; Korand, Sridevi; Chang, Todd P.
In: Simulation & Gaming, vol. 51, no. 4, pp. 550–570, 2020, ISSN: 1046-8781, 1552-826X.
Abstract | Links | BibTeX | Tags: MedVR
@article{luu_development_2020,
title = {Development and Performance Assessment of a Digital Serious Game to Assess Multi-Patient Care Skills in a Simulated Pediatric Emergency Department},
author = {Cindy Luu and Thomas B. Talbot and Cha Chi Fung and Eyal Ben-Isaac and Juan Espinoza and Susan Fischer and Christine S. Cho and Mariam Sargsyan and Sridevi Korand and Todd P. Chang},
url = {http://journals.sagepub.com/doi/10.1177/1046878120904984},
doi = {10.1177/1046878120904984},
issn = {1046-8781, 1552-826X},
year = {2020},
date = {2020-08-01},
journal = {Simulation & Gaming},
volume = {51},
number = {4},
pages = {550--570},
abstract = {Objective. Multi-patient care is important among medical trainees in an emergency department (ED). While resident efficiency is a typically measured metric, multi-patient care involves both efficiency and diagnostic / treatment accuracy. Multi-patient care ability is difficult to assess, though simulation is a potential alternative. Our objective was to generate validity evidence for a serious game in assessing multi-patient care skills among a variety of learners.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Objective. Multi-patient care is important among medical trainees in an emergency department (ED). While resident efficiency is a typically measured metric, multi-patient care involves both efficiency and diagnostic / treatment accuracy. Multi-patient care ability is difficult to assess, though simulation is a potential alternative. Our objective was to generate validity evidence for a serious game in assessing multi-patient care skills among a variety of learners.
Rakofsky, Jeffrey J.; Talbot, Thomas B.; Dunlop, Boadie W.
A Virtual Standardized Patient–Based Assessment Tool to Evaluate Psychiatric Residents’ Psychopharmacology Proficiency Journal Article
In: Academic Psychiatry, 2020, ISSN: 1042-9670, 1545-7230.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@article{rakofsky_virtual_2020,
title = {A Virtual Standardized Patient–Based Assessment Tool to Evaluate Psychiatric Residents’ Psychopharmacology Proficiency},
author = {Jeffrey J. Rakofsky and Thomas B. Talbot and Boadie W. Dunlop},
url = {http://link.springer.com/10.1007/s40596-020-01286-x},
doi = {10.1007/s40596-020-01286-x},
issn = {1042-9670, 1545-7230},
year = {2020},
date = {2020-07-01},
journal = {Academic Psychiatry},
abstract = {Objectives A virtual standardized patient-based assessment simulator was developed to address biases and practical limitations in existing methods for evaluating residents’ proficiency in psychopharmacological knowledge and practice. Methods The simulator was designed to replicate an outpatient psychiatric clinic experience. The virtual patient reported symptoms of a treatment-resistant form of major depressive disorder (MDD), requiring the learner to use various antidepressants in order for the patient to fully remit. Test scores were based on the proportion of correct responses to questions asked by the virtual patient about possible side effects, dosing, and titration decisions, which depended upon the patient’s tolerability and response to the learner’s selected medications. The validation paradigm included a novice-expert performance comparison across 4th year medical students, psychiatric residents from all four post-graduate year classes, and psychiatry department faculty, and a correlational analysis of simulator performance with the PRITE Somatic Treatments subscale score. Post-test surveys evaluated the test takers’ subjective impressions of the simulator. Results Forty-three subjects completed the online exam and survey. Total mean scores on the exam differed significantly across all the learner groups in a step-wise manner from students to faculty (F = 6.10},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {article}
}
Objectives A virtual standardized patient-based assessment simulator was developed to address biases and practical limitations in existing methods for evaluating residents’ proficiency in psychopharmacological knowledge and practice. Methods The simulator was designed to replicate an outpatient psychiatric clinic experience. The virtual patient reported symptoms of a treatment-resistant form of major depressive disorder (MDD), requiring the learner to use various antidepressants in order for the patient to fully remit. Test scores were based on the proportion of correct responses to questions asked by the virtual patient about possible side effects, dosing, and titration decisions, which depended upon the patient’s tolerability and response to the learner’s selected medications. The validation paradigm included a novice-expert performance comparison across 4th year medical students, psychiatric residents from all four post-graduate year classes, and psychiatry department faculty, and a correlational analysis of simulator performance with the PRITE Somatic Treatments subscale score. Post-test surveys evaluated the test takers’ subjective impressions of the simulator. Results Forty-three subjects completed the online exam and survey. Total mean scores on the exam differed significantly across all the learner groups in a step-wise manner from students to faculty (F = 6.10
Malta, Loretta S.; Giosan, Cezar; Szkodny, Lauren E.; Altemus, Margaret M.; Rizzo, Albert A.; Silbersweig, David A.; Difede, JoAnn
Development of a virtual reality laboratory stressor Journal Article
In: Virtual Reality, 2020, ISSN: 1359-4338, 1434-9957.
Abstract | Links | BibTeX | Tags: MedVR
@article{malta_development_2020,
title = {Development of a virtual reality laboratory stressor},
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 = {http://link.springer.com/10.1007/s10055-020-00455-5},
doi = {10.1007/s10055-020-00455-5},
issn = {1359-4338, 1434-9957},
year = {2020},
date = {2020-07-01},
journal = {Virtual Reality},
abstract = {This research report describes the development of a virtual reality (VR) laboratory stressor to study the effects of exposure to stressful events. The aim of the research was to develop a VR simulation that would evoke stressor responses at a level that was tolerable for participants. Veterans with and without warzone-related posttraumatic stress disorder (PTSD) were presented with VR simulations of combat stressors. There was one complaint of feeling hot during simulations but no incidents of simulator sickness. Participants denied experiencing the simulations as overly distressing, and there were no reports of any distress or problems related to study participation when they were contacted two weeks after the VR challenge. Simulations elicited moderate levels of anxiety and mild levels of dissociation that were significantly greater in Veterans with PTSD. Simulations were less successful in eliciting differential heart rate reactivity and stress hormone secretion, though history of civilian trauma exposure was associated with elevated heart rates during the second simulation. The study demonstrated that the VR paradigm was feasible and tolerable and that it holds promise as a new method with which to conduct controlled laboratory research on the effects of exposure to stressful events.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
This research report describes the development of a virtual reality (VR) laboratory stressor to study the effects of exposure to stressful events. The aim of the research was to develop a VR simulation that would evoke stressor responses at a level that was tolerable for participants. Veterans with and without warzone-related posttraumatic stress disorder (PTSD) were presented with VR simulations of combat stressors. There was one complaint of feeling hot during simulations but no incidents of simulator sickness. Participants denied experiencing the simulations as overly distressing, and there were no reports of any distress or problems related to study participation when they were contacted two weeks after the VR challenge. Simulations elicited moderate levels of anxiety and mild levels of dissociation that were significantly greater in Veterans with PTSD. Simulations were less successful in eliciting differential heart rate reactivity and stress hormone secretion, though history of civilian trauma exposure was associated with elevated heart rates during the second simulation. The study demonstrated that the VR paradigm was feasible and tolerable and that it holds promise as a new method with which to conduct controlled laboratory research on the effects of exposure to stressful events.
Talbot, Thomas Brett; Thiry, Katherine Elizabeth; Jenkins, Michael
In: Advances in Usability, User Experience, Wearable and Assistive Technology, vol. 1217, pp. 129–135, Springer International Publishing, Cham, Switzerland, 2020, ISBN: 978-3-030-51827-1 978-3-030-51828-8.
Abstract | Links | BibTeX | Tags: MedVR
@incollection{talbot_storyboarding_2020,
title = {Storyboarding the Virtuality: Methods and Best Practices to Depict Scenes and Interactive Stories in Virtual and Mixed Reality},
author = {Thomas Brett Talbot and Katherine Elizabeth Thiry and Michael Jenkins},
url = {http://link.springer.com/10.1007/978-3-030-51828-8_17},
doi = {10.1007/978-3-030-51828-8_17},
isbn = {978-3-030-51827-1 978-3-030-51828-8},
year = {2020},
date = {2020-07-01},
booktitle = {Advances in Usability, User Experience, Wearable and Assistive Technology},
volume = {1217},
pages = {129--135},
publisher = {Springer International Publishing},
address = {Cham, Switzerland},
abstract = {Storyboarding is a cinematic prototyping technique to visualize settings, event sequences, dialogues & character depictions. Interactive VR/MR experiences benefit from storyboarding as part of the creation process, yet free movement & immersive 3D introduce challenges. Techniques to visualize 3D settings are explored with methods to conduct traditional storyboarding while requiring multiple viewpoints within a single timestep are elaborated. This is possible w/ perspective scene views. Even with 3D prototyping tools, it is important to maintain practices which optimize VR storyboarding and maintain spatial efficiency, allow storyboards to be hand drawn and be intuitive to read. A powerful solution is to bind several perspectives together to represent a specific time while reverting to a traditional single viewpoint when not necessary, therefore balancing three dimensionality, spatial efficiency & ease of creation.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {incollection}
}
Storyboarding is a cinematic prototyping technique to visualize settings, event sequences, dialogues & character depictions. Interactive VR/MR experiences benefit from storyboarding as part of the creation process, yet free movement & immersive 3D introduce challenges. Techniques to visualize 3D settings are explored with methods to conduct traditional storyboarding while requiring multiple viewpoints within a single timestep are elaborated. This is possible w/ perspective scene views. Even with 3D prototyping tools, it is important to maintain practices which optimize VR storyboarding and maintain spatial efficiency, allow storyboards to be hand drawn and be intuitive to read. A powerful solution is to bind several perspectives together to represent a specific time while reverting to a traditional single viewpoint when not necessary, therefore balancing three dimensionality, spatial efficiency & ease of creation.
Mozgai, Sharon; Hartholt, Arno; Akinyemi, Dayo; Kubicek, Katarina; Rizzo, Albert (Skip); Kipke, Michele
In: HCI International 2020 - Posters, vol. 1225, pp. 304–307, Springer International Publishing, Cham, Switzerland, 2020, ISBN: 978-3-030-50728-2 978-3-030-50729-9.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@incollection{mozgai_development_2020,
title = {Development and Initial Feasibility Testing of the Virtual Research Navigator (VRN): A Public-Facing Agent-Based Educational System for Clinical Research Participation},
author = {Sharon Mozgai and Arno Hartholt and Dayo Akinyemi and Katarina Kubicek and Albert (Skip) Rizzo and Michele Kipke},
url = {http://link.springer.com/10.1007/978-3-030-50729-9_43},
doi = {10.1007/978-3-030-50729-9_43},
isbn = {978-3-030-50728-2 978-3-030-50729-9},
year = {2020},
date = {2020-07-01},
booktitle = {HCI International 2020 - Posters},
volume = {1225},
pages = {304--307},
publisher = {Springer International Publishing},
address = {Cham, Switzerland},
abstract = {The overall goal of VRN is to develop a novel technology solution at Children’s Hospital Los Angeles (CHLA) to overcome barriers that prevent the recruitment of diverse patient populations to clinical trials by providing both caregivers and children with an interactive educational experience. This system consists of 1) an intelligent agent called Zippy that users interact with by keyboard or voice input, 2) a series of videos covering topics including Privacy, Consent and Benefits, and 3) a UI that guides users through all available content. Pre- and post-questionnaires assessed willingness to participate in clinical research and found participants either increased or maintained their level of willingness to participate in research studies. Additionally, qualitative analysis of interview data revealed participants rated the overall interaction favorably and believed Zippy to be more fun, less judgmental and less threatening than interacting with a human. Future iterations are in-progress based on the user-feedback},
keywords = {MedVR, Virtual Humans},
pubstate = {published},
tppubtype = {incollection}
}
The overall goal of VRN is to develop a novel technology solution at Children’s Hospital Los Angeles (CHLA) to overcome barriers that prevent the recruitment of diverse patient populations to clinical trials by providing both caregivers and children with an interactive educational experience. This system consists of 1) an intelligent agent called Zippy that users interact with by keyboard or voice input, 2) a series of videos covering topics including Privacy, Consent and Benefits, and 3) a UI that guides users through all available content. Pre- and post-questionnaires assessed willingness to participate in clinical research and found participants either increased or maintained their level of willingness to participate in research studies. Additionally, qualitative analysis of interview data revealed participants rated the overall interaction favorably and believed Zippy to be more fun, less judgmental and less threatening than interacting with a human. Future iterations are in-progress based on the user-feedback
Hilty, Donald M.; Randhawa, Karan; Maheu, Marlene M.; McKean, Alastair J. S.; Pantera, Richard; Mishkind, Matthew C.; Rizzo, Albert “Skip”
A Review of Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care Journal Article
In: Journal of Technology in Behavioral Science, vol. 5, no. 2, pp. 178–205, 2020, ISSN: 2366-5963.
Abstract | Links | BibTeX | Tags: MedVR
@article{hilty_review_2020,
title = {A Review of Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care},
author = {Donald M. Hilty and Karan Randhawa and Marlene M. Maheu and Alastair J. S. McKean and Richard Pantera and Matthew C. Mishkind and Albert “Skip” Rizzo},
url = {http://link.springer.com/10.1007/s41347-020-00126-x},
doi = {10.1007/s41347-020-00126-x},
issn = {2366-5963},
year = {2020},
date = {2020-06-01},
journal = {Journal of Technology in Behavioral Science},
volume = {5},
number = {2},
pages = {178--205},
abstract = {This scoping review article explores the application of telepresence (TPr), virtual reality (VR), and augmented reality (AR) to clinical care. A literature search of key words was conducted from January 1990 through May 2019 of the following databases: PubMed/ Medline, American Psychological Association PsycNET, Pubmed/Medline, Cochrane, Embase, PsycINFO, Web of Science, Scopus, OTSeeker, ABI/INFORM, computer-mediated communication (CMC), technology-mediated communications, Arts & Humanities Citation Index, Project Muse, ProQuest Research Library Plus, Sociological abstracts, Computers and Applied Sciences Complete and IT Source. It focused on concept areas: (1) TPr related to technologies; (2) virtual, augmented, reality, environment; (3) technology or computer-mediated communication; (4) clinical therapeutic relationship (boundaries, care, communication, connect, engagement, empathy, intimacy, trust); (5) telebehavioral health; (6) psychotherapy via technology; and (7) medicine/health care. Inclusion criteria were concept area 1 in combination with 2–7 and 2 or 3 in combination with any of 4–7. From a total of 5214 potential references, the authors found 512 eligible for full-text review and found 85 papers directly relevant to the concepts. From papers’ references and a review of books and popular literature about TPr, virtual reality (VR), and augmented reality (AR), 13 other sources of information were found. The historical evolution of TPr, VR, and AR shows that definitions, foci of studies (e.g., social neuroscience to business), and applications vary; assessments of TPr also vary widely. Studies discuss VR, AR, and TPr in medicine (e.g., rehabilitation, robotics), experimental psychology (laboratory, field, mixed), and behavioral health. Virtual environment (VE) designs aid the study of interpersonal communication and behavior, using standardized social interaction partners, virtual standardized patients, and/or virtual humans—all contingent on the participants’ experience of presence and the ability to engage. Additional research is needed to standardize experimental and clinical interventions, while maintaining ecological validity. Technology can significantly improve quality of care, access to new treatments and training, if ethical and reimbursement issues are better explored.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
This scoping review article explores the application of telepresence (TPr), virtual reality (VR), and augmented reality (AR) to clinical care. A literature search of key words was conducted from January 1990 through May 2019 of the following databases: PubMed/ Medline, American Psychological Association PsycNET, Pubmed/Medline, Cochrane, Embase, PsycINFO, Web of Science, Scopus, OTSeeker, ABI/INFORM, computer-mediated communication (CMC), technology-mediated communications, Arts & Humanities Citation Index, Project Muse, ProQuest Research Library Plus, Sociological abstracts, Computers and Applied Sciences Complete and IT Source. It focused on concept areas: (1) TPr related to technologies; (2) virtual, augmented, reality, environment; (3) technology or computer-mediated communication; (4) clinical therapeutic relationship (boundaries, care, communication, connect, engagement, empathy, intimacy, trust); (5) telebehavioral health; (6) psychotherapy via technology; and (7) medicine/health care. Inclusion criteria were concept area 1 in combination with 2–7 and 2 or 3 in combination with any of 4–7. From a total of 5214 potential references, the authors found 512 eligible for full-text review and found 85 papers directly relevant to the concepts. From papers’ references and a review of books and popular literature about TPr, virtual reality (VR), and augmented reality (AR), 13 other sources of information were found. The historical evolution of TPr, VR, and AR shows that definitions, foci of studies (e.g., social neuroscience to business), and applications vary; assessments of TPr also vary widely. Studies discuss VR, AR, and TPr in medicine (e.g., rehabilitation, robotics), experimental psychology (laboratory, field, mixed), and behavioral health. Virtual environment (VE) designs aid the study of interpersonal communication and behavior, using standardized social interaction partners, virtual standardized patients, and/or virtual humans—all contingent on the participants’ experience of presence and the ability to engage. Additional research is needed to standardize experimental and clinical interventions, while maintaining ecological validity. Technology can significantly improve quality of care, access to new treatments and training, if ethical and reimbursement issues are better explored.
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.
Abstract | Links | BibTeX | Tags: MedVR
@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 = {MedVR},
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.
Chang, Chen-Wei; Li, Mengtong; Yeh, Shih-Ching; Chen, Yijing; Rizzo, Albert
In: IEEE Access, vol. 8, pp. 69566–69578, 2020, ISSN: 2169-3536.
Abstract | Links | BibTeX | Tags: MedVR
@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 = {MedVR},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@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 = {MedVR, UARC},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@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 = {MedVR, Virtual Humans},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR, UARC, Virtual Humans
@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 = {MedVR, UARC, Virtual Humans},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR
@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 = {MedVR},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR, UARC, Virtual Humans
@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 = {MedVR, UARC, Virtual Humans},
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.
2019
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.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@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 = {MedVR, UARC},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR
@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 = {MedVR},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR, UARC, Virtual Humans
@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 = {MedVR, UARC, Virtual Humans},
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
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.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@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 = {MedVR, Virtual Humans},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR, Social Simulation, UARC
@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 = {MedVR, Social Simulation, UARC},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR, UARC, Virtual Humans
@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 = {MedVR, UARC, Virtual Humans},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR
@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 = {MedVR},
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
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.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@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 = {MedVR, UARC},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR
@article{lahav_virtual_2019,
title = {Virtual interactive consulting agent to support freshman students in transition to higher education},
author = {Orly Lahav and Vadim Talis and Rachel Gali Cinamon and Albert Rizzo},
url = {http://link.springer.com/10.1007/s12528-019-09237-8},
doi = {10.1007/s12528-019-09237-8},
issn = {1042-1726, 1867-1233},
year = {2019},
date = {2019-08-01},
journal = {Journal of Computing in Higher Education},
pages = {1--35},
abstract = {The virtual interactive consulting agent system is an online virtual career center that supports freshman students in transition to higher education. This virtual counseling system, based on accumulative empirical knowledge for working students and knowledge about effective career intervention, aims to guide first-year university students in combining study and work effectively. Three main aspects of career interventions are supplied by this virtual interactive consulting agent system: personal assessment, information, and personal encouragement and relatedness. The virtual interactive consulting agent is based on the SimCoach system. The current research includes two studies that examine acceptability and satisfaction from two perspectives: that of the counselors (the experts) and of the consultees (the target consumers). Both studies included 87 participants divided into two research groups: 45 counselors and 42 counseled freshman students. The data were collected through four data collection tools: acceptability and satisfaction questionnaire, an openended question, Google Docs, and screen recording applications. The participants’ answers were analyzed using quantitative software. The results show that the majority of the counselors were satisfied with the usability of the system but not with the process of counseling through the virtual agent, with some expressing concern about the impact on the profession. In contrast, most of the consultees were satisfied with the counseling process and some stated that the virtual agent helped them to determine how to integrate work and study more effectively.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
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.
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.
Abstract | Links | BibTeX | Tags: MedVR
@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 = {MedVR},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR
@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 = {MedVR},
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.
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.
Abstract | Links | BibTeX | Tags: MedVR
@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 = {MedVR},
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.
Coleman, Benjamin; Marion, Sarah; Rizzo, Albert; Turnbull, Janiece; Nolty, Anne
In: Frontiers in Psychology, vol. 10, 2019, ISSN: 1664-1078.
Abstract | Links | BibTeX | Tags: MedVR
@article{coleman_virtual_2019,
title = {Virtual Reality Assessment of Classroom – Related Attention: An Ecologically Relevant Approach to Evaluating the Effectiveness of Working Memory Training},
author = {Benjamin Coleman and Sarah Marion and Albert Rizzo and Janiece Turnbull and Anne Nolty},
url = {https://www.frontiersin.org/article/10.3389/fpsyg.2019.01851/full},
doi = {10.3389/fpsyg.2019.01851},
issn = {1664-1078},
year = {2019},
date = {2019-08-01},
journal = {Frontiers in Psychology},
volume = {10},
abstract = {Computerized cognitive interventions to improve working memory also purport to improve ADHD-related inattention and off task behavior. Such interventions have been shown to improve working memory, executive functioning, and fluid reasoning on standardized neuropsychological measures. However, debate continues as to whether such programs lead to improvement on ecologically relevant outcomes, such as classroom behavior. This study sought to propose a novel, ecologically relevant approach to evaluate the effectiveness of working memory training on real-world attention performance. Participants included 15 children, aged 6–15, identified as having attention problems were assessed via the virtual classroom continuous performance task (VCCPT) before and after completing 5 weeks of Cogmed working memory training. The VCCPT is a validated measure of sustained and selective attention set within a virtual reality (VR) environment. Several key areas of attention performance were observed to improve, including omission errors, reaction time, reaction time variability, and hit variability. Results suggest that working memory training led to substantial improvements in sustained attention in a real-life scenario of classroom learning. Moreover, the use of psychometrically validated VR measurement provides incremental validity beyond that of teacher or parent report of behavior. Observing such improvements on ecologically relevant measures of attention adds to the discussion around how to evaluate the effectiveness of working memory training as it pertains to real-life improvements and serves to inform consumer awareness of such products and their claims.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
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.
Hartholt, Arno; Mozgai, Sharon; Rizzo, Albert "Skip"
Virtual Job Interviewing Practice for High-Anxiety Populations Inproceedings
In: Proceedings of the 19th ACM International Conference on Intelligent Virtual Agents - IVA '19, pp. 238–240, ACM Press, Paris, France, 2019, ISBN: 978-1-4503-6672-4.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@inproceedings{hartholt_virtual_2019,
title = {Virtual Job Interviewing Practice for High-Anxiety Populations},
author = {Arno Hartholt and Sharon Mozgai and Albert "Skip" Rizzo},
url = {http://dl.acm.org/citation.cfm?doid=3308532.3329417},
doi = {10.1145/3308532.3329417},
isbn = {978-1-4503-6672-4},
year = {2019},
date = {2019-07-01},
booktitle = {Proceedings of the 19th ACM International Conference on Intelligent Virtual Agents - IVA '19},
pages = {238--240},
publisher = {ACM Press},
address = {Paris, France},
abstract = {We present a versatile system for training job interviewing skills that focuses specifically on segments of the population facing increased challenges during the job application process. In particular, we target those with Autism Spectrum Disorder (ADS), veterans transitioning to civilian life, and former convicts integrating back into society. The system itself follows the SAIBA framework and contains several interviewer characters, who each represent a different type of vocational field, (e.g. service industry, retail, office, etc.) Each interviewer can be set to one of three conversational modes, which not only affects what they say and how they say it, but also their supporting body language. This approach offers varying difficulties, allowing users to start practicing with interviewers who are more encouraging and accommodating before moving on to personalities that are more direct and indifferent. Finally, the user can place the interviewers in different environmental settings (e.g. conference room, restaurant, executive office, etc.), allowing for many different combinations in which to practice.},
keywords = {MedVR, Virtual Humans},
pubstate = {published},
tppubtype = {inproceedings}
}
We present a versatile system for training job interviewing skills that focuses specifically on segments of the population facing increased challenges during the job application process. In particular, we target those with Autism Spectrum Disorder (ADS), veterans transitioning to civilian life, and former convicts integrating back into society. The system itself follows the SAIBA framework and contains several interviewer characters, who each represent a different type of vocational field, (e.g. service industry, retail, office, etc.) Each interviewer can be set to one of three conversational modes, which not only affects what they say and how they say it, but also their supporting body language. This approach offers varying difficulties, allowing users to start practicing with interviewers who are more encouraging and accommodating before moving on to personalities that are more direct and indifferent. Finally, the user can place the interviewers in different environmental settings (e.g. conference room, restaurant, executive office, etc.), allowing for many different combinations in which to practice.
Rizzo, Albert S.
Clinical virtual reality in mental health and rehabilitation: a brief review of the future! Inproceedings
In: Fulop, Gabor F.; Hanson, Charles M.; Andresen, Bjørn F. (Ed.): Infrared Technology and Applications XLV, pp. 51–74, SPIE, Baltimore, United States, 2019, ISBN: 978-1-5106-2669-0 978-1-5106-2670-6.
Abstract | Links | BibTeX | Tags: MedVR
@inproceedings{rizzo_clinical_2019,
title = {Clinical virtual reality in mental health and rehabilitation: a brief review of the future!},
author = {Albert S. Rizzo},
editor = {Gabor F. Fulop and Charles M. Hanson and Bjørn F. Andresen},
url = {https://www.spiedigitallibrary.org/conference-proceedings-of-spie/11002/2524302/Clinical-virtual-reality-in-mental-health-and-rehabilitation–a/10.1117/12.2524302.full},
doi = {10.1117/12.2524302},
isbn = {978-1-5106-2669-0 978-1-5106-2670-6},
year = {2019},
date = {2019-05-01},
booktitle = {Infrared Technology and Applications XLV},
volume = {37},
number = {1},
pages = {51--74},
publisher = {SPIE},
address = {Baltimore, United States},
abstract = {The paper details some of the history of Clinical Virtual Reality (VR) as it has evolved over the last 25 years and provides a brief overview of the key scientific findings for making a judgment regarding its value in the areas of mental health and rehabilitation. This write-up is designed be a companion piece to my SPIE keynote on the topic of, “Is Clinical Virtual Reality Ready for Primetime?” As such, the paper is packed with citations to key scientific research in this area that should provide readers who are interested in this topic with a roadmap for further exploration of the literature. After presenting a brief history of the area, a discussion follows as to the theory, research, and pragmatic issues that support the view that this VR use case is theoretically informed, has a large and convincing scientific literature to support its clinical application, and that recent technology advances and concomitant cost reductions have made clinical implementation feasible and pragmatically supported. The paper concludes with the perspective that Clinical VR applications will soon become indispensable tools in the toolbox of psychological researchers and practitioners and will only grow in relevance and popularity in the future.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {inproceedings}
}
The paper details some of the history of Clinical Virtual Reality (VR) as it has evolved over the last 25 years and provides a brief overview of the key scientific findings for making a judgment regarding its value in the areas of mental health and rehabilitation. This write-up is designed be a companion piece to my SPIE keynote on the topic of, “Is Clinical Virtual Reality Ready for Primetime?” As such, the paper is packed with citations to key scientific research in this area that should provide readers who are interested in this topic with a roadmap for further exploration of the literature. After presenting a brief history of the area, a discussion follows as to the theory, research, and pragmatic issues that support the view that this VR use case is theoretically informed, has a large and convincing scientific literature to support its clinical application, and that recent technology advances and concomitant cost reductions have made clinical implementation feasible and pragmatically supported. The paper concludes with the perspective that Clinical VR applications will soon become indispensable tools in the toolbox of psychological researchers and practitioners and will only grow in relevance and popularity in the future.
Yeom, Dongwoo; Choi, Joon-Ho; Kang, Sin-Hwa
In: Building and Environment, vol. 154, pp. 44–54, 2019, ISSN: 03601323.
Abstract | Links | BibTeX | Tags: MedVR
@article{yeom_investigation_2019,
title = {Investigation of the physiological differences in the immersive virtual reality environment and real indoor environment: Focused on skin temperature and thermal sensation},
author = {Dongwoo Yeom and Joon-Ho Choi and Sin-Hwa Kang},
url = {https://linkinghub.elsevier.com/retrieve/pii/S0360132319301672},
doi = {10.1016/j.buildenv.2019.03.013},
issn = {03601323},
year = {2019},
date = {2019-05-01},
journal = {Building and Environment},
volume = {154},
pages = {44--54},
abstract = {The goal of this research is to investigate and determine whether the effect of an IVE condition on an occupant's environmental sensations and physiological responses is different from the effect of a real environmental condition in the indoor environment. The research included a series of human subject experiments, with 16 participants in an environmental chamber. A thermal quality condition was selected as a primary environmental parameter, based on current IEQ-relevant studies. While the ambient thermal condition was gradually changed from 20 °C to 30 °C, the participants were asked to report their overall thermal sensations. Their skin temperatures were also continuously measured to collect physiological signal information in real time. The results of this experimental study revealed that the participants mostly generated higher skin temperature at the selected seven skin areas. Their reported thermal sensations were significantly higher in the IVE condition, than in the real environment, showing a difference of 12%.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
The goal of this research is to investigate and determine whether the effect of an IVE condition on an occupant's environmental sensations and physiological responses is different from the effect of a real environmental condition in the indoor environment. The research included a series of human subject experiments, with 16 participants in an environmental chamber. A thermal quality condition was selected as a primary environmental parameter, based on current IEQ-relevant studies. While the ambient thermal condition was gradually changed from 20 °C to 30 °C, the participants were asked to report their overall thermal sensations. Their skin temperatures were also continuously measured to collect physiological signal information in real time. The results of this experimental study revealed that the participants mostly generated higher skin temperature at the selected seven skin areas. Their reported thermal sensations were significantly higher in the IVE condition, than in the real environment, showing a difference of 12%.
Koenig, Sebastian T.; Krch, Denise; Lange, Belinda S.; Rizzo, Albert
Virtual reality and rehabilitation. Incollection
In: Handbook of rehabilitation psychology (3rd ed.)., pp. 521–539, American Psychological Association, Washington, DC, 2019, ISBN: 978-1-4338-2985-7 978-1-4338-2984-0.
Abstract | Links | BibTeX | Tags: MedVR
@incollection{koenig_virtual_2019,
title = {Virtual reality and rehabilitation.},
author = {Sebastian T. Koenig and Denise Krch and Belinda S. Lange and Albert Rizzo},
url = {http://content.apa.org/books/16122-032},
isbn = {978-1-4338-2985-7 978-1-4338-2984-0},
year = {2019},
date = {2019-04-01},
booktitle = {Handbook of rehabilitation psychology (3rd ed.).},
pages = {521--539},
publisher = {American Psychological Association},
address = {Washington, DC},
abstract = {Virtual reality (VR) technology has seen a recent surge in market adoption for video games, movies, broadcasting of live events, and industries such as real estate and health care. This chapter focuses on evidence and technology released within the past 5 years to avoid discussing outdated or discontinued VR systems. It provides a pragmatic overview of VR technology, including its strengths and limitations, recent research and system development, and future perspectives. The widespread appeal of VR in society, untethered hardware, and integration of VR accessories, tracking devices, and psychophysiological monitoring are among the topics that have pushed VR into the spotlight, even in nontraditional VR markets such as rehabilitation psychology. The chapter provides an updated view of VR as a natural fit for clinical use, highlighting key features that can positively impact rehabilitation outcomes and address social and vocational aspects of cognitive rehabilitation. (PsycInfo Database Record (c) 2020 APA, all rights reserved)},
keywords = {MedVR},
pubstate = {published},
tppubtype = {incollection}
}
Virtual reality (VR) technology has seen a recent surge in market adoption for video games, movies, broadcasting of live events, and industries such as real estate and health care. This chapter focuses on evidence and technology released within the past 5 years to avoid discussing outdated or discontinued VR systems. It provides a pragmatic overview of VR technology, including its strengths and limitations, recent research and system development, and future perspectives. The widespread appeal of VR in society, untethered hardware, and integration of VR accessories, tracking devices, and psychophysiological monitoring are among the topics that have pushed VR into the spotlight, even in nontraditional VR markets such as rehabilitation psychology. The chapter provides an updated view of VR as a natural fit for clinical use, highlighting key features that can positively impact rehabilitation outcomes and address social and vocational aspects of cognitive rehabilitation. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
Trahan, Mark H.; Smith, Kenneth Scott; Talbot, Thomas B.
Past, Present, and Future: Editorial on Virtual Reality Applications to Human Services Journal Article
In: Journal of Technology in Human Services, vol. 37, no. 1, pp. 1–12, 2019, ISSN: 1522-8835, 1522-8991.
Abstract | Links | BibTeX | Tags: MedVR
@article{trahan_past_2019,
title = {Past, Present, and Future: Editorial on Virtual Reality Applications to Human Services},
author = {Mark H. Trahan and Kenneth Scott Smith and Thomas B. Talbot},
url = {https://www.tandfonline.com/doi/full/10.1080/15228835.2019.1587334},
doi = {10.1080/15228835.2019.1587334},
issn = {1522-8835, 1522-8991},
year = {2019},
date = {2019-04-01},
journal = {Journal of Technology in Human Services},
volume = {37},
number = {1},
pages = {1--12},
abstract = {"Virtual Reality” interventions in human services may include 360 video, augmented reality, mixed reality, and fully immersive 3-dimensional virtual reality simulations. A variety of applications have been evaluated in various fields of study, including medicine, social work, psychology, and human performance training. Currently, the state of research of VR interventions in human services has primarily focused on efficacy and effectiveness research, with few studies evaluating “scaling up” or implementation of VR interventions in larger populations. Unfortunately, the state of efficacy and effectiveness studies of VR interventions still remains weak with some applications due to smaller sample sizes, lack of randomized control trials, and a gap in reporting key intervention qualities, dosage, and outcomes. With new developments in combining artificial intelligence with VR, realism and the potential for human interaction with computer generated simulations may boost presence and immersion within these applications. This editorial provides an overview of the state of virtual reality applications in human service provision, potential gaps to be addressed by research in the future, and the development of AI based interactive sequences that may boost use presence.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
"Virtual Reality” interventions in human services may include 360 video, augmented reality, mixed reality, and fully immersive 3-dimensional virtual reality simulations. A variety of applications have been evaluated in various fields of study, including medicine, social work, psychology, and human performance training. Currently, the state of research of VR interventions in human services has primarily focused on efficacy and effectiveness research, with few studies evaluating “scaling up” or implementation of VR interventions in larger populations. Unfortunately, the state of efficacy and effectiveness studies of VR interventions still remains weak with some applications due to smaller sample sizes, lack of randomized control trials, and a gap in reporting key intervention qualities, dosage, and outcomes. With new developments in combining artificial intelligence with VR, realism and the potential for human interaction with computer generated simulations may boost presence and immersion within these applications. This editorial provides an overview of the state of virtual reality applications in human service provision, potential gaps to be addressed by research in the future, and the development of AI based interactive sequences that may boost use presence.
Tielman, Myrthe L.; Neerincx, Mark A.; Pagliari, Claudia; Rizzo, Albert; Brinkman, Willem-Paul
Considering patient safety in autonomous e-mental health systems – detecting risk situations and referring patients back to human care Journal Article
In: BMC Medical Informatics and Decision Making, vol. 19, no. 1, 2019, ISSN: 1472-6947.
Abstract | Links | BibTeX | Tags: MedVR
@article{tielman_considering_2019,
title = {Considering patient safety in autonomous e-mental health systems – detecting risk situations and referring patients back to human care},
author = {Myrthe L. Tielman and Mark A. Neerincx and Claudia Pagliari and Albert Rizzo and Willem-Paul Brinkman},
url = {https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-019-0796-x},
doi = {10.1186/s12911-019-0796-x},
issn = {1472-6947},
year = {2019},
date = {2019-03-01},
journal = {BMC Medical Informatics and Decision Making},
volume = {19},
number = {1},
abstract = {Background: Digital health interventions can fill gaps in mental healthcare provision. However, autonomous emental health (AEMH) systems also present challenges for effective risk management. To balance autonomy and safety, AEMH systems need to detect risk situations and act on these appropriately. One option is sending automatic alerts to carers, but such ‘auto-referral’ could lead to missed cases or false alerts. Requiring users to actively self-refer offers an alternative, but this can also be risky as it relies on their motivation to do so. This study set out with two objectives. Firstly, to develop guidelines for risk detection and auto-referral systems. Secondly, to understand how persuasive techniques, mediated by a virtual agent, can facilitate self-referral. Methods: In a formative phase, interviews with experts, alongside a literature review, were used to develop a risk detection protocol. Two referral protocols were developed – one involving auto-referral, the other motivating users to self-refer. This latter was tested via crowd-sourcing (n = 160). Participants were asked to imagine they had sleeping problems with differing severity and user stance on seeking help. They then chatted with a virtual agent, who either directly facilitated referral, tried to persuade the user, or accepted that they did not want help. After the conversation, participants rated their intention to self-refer, to chat with the agent again, and their feeling of being heard by the agent. Results: Whether the virtual agent facilitated, persuaded or accepted, influenced all of these measures. Users who were initially negative or doubtful about self-referral could be persuaded. For users who were initially positive about seeking human care, this persuasion did not affect their intentions, indicating that a simply facilitating referral without persuasion was sufficient. Conclusion: This paper presents a protocol that elucidates the steps and decisions involved in risk detection, something that is relevant for all types of AEMH systems. In the case of self-referral, our study shows that a virtual agent can increase users’ intention to self-refer. Moreover, the strategy of the agent influenced the intentions of the user afterwards. This highlights the importance of a personalised approach to promote the user’s access to appropriate care.},
keywords = {MedVR},
pubstate = {published},
tppubtype = {article}
}
Background: Digital health interventions can fill gaps in mental healthcare provision. However, autonomous emental health (AEMH) systems also present challenges for effective risk management. To balance autonomy and safety, AEMH systems need to detect risk situations and act on these appropriately. One option is sending automatic alerts to carers, but such ‘auto-referral’ could lead to missed cases or false alerts. Requiring users to actively self-refer offers an alternative, but this can also be risky as it relies on their motivation to do so. This study set out with two objectives. Firstly, to develop guidelines for risk detection and auto-referral systems. Secondly, to understand how persuasive techniques, mediated by a virtual agent, can facilitate self-referral. Methods: In a formative phase, interviews with experts, alongside a literature review, were used to develop a risk detection protocol. Two referral protocols were developed – one involving auto-referral, the other motivating users to self-refer. This latter was tested via crowd-sourcing (n = 160). Participants were asked to imagine they had sleeping problems with differing severity and user stance on seeking help. They then chatted with a virtual agent, who either directly facilitated referral, tried to persuade the user, or accepted that they did not want help. After the conversation, participants rated their intention to self-refer, to chat with the agent again, and their feeling of being heard by the agent. Results: Whether the virtual agent facilitated, persuaded or accepted, influenced all of these measures. Users who were initially negative or doubtful about self-referral could be persuaded. For users who were initially positive about seeking human care, this persuasion did not affect their intentions, indicating that a simply facilitating referral without persuasion was sufficient. Conclusion: This paper presents a protocol that elucidates the steps and decisions involved in risk detection, something that is relevant for all types of AEMH systems. In the case of self-referral, our study shows that a virtual agent can increase users’ intention to self-refer. Moreover, the strategy of the agent influenced the intentions of the user afterwards. This highlights the importance of a personalised approach to promote the user’s access to appropriate care.
Kang, Sinhwa; Chanenson, Jake; Cowal, Peter; Weaver, Madeleine
Advancing Ethical Decision Making in Virtual Reality Inproceedings
In: Proceedings of the 2019 IEEE Conference on Virtual Reality and 3D User Interfaces (VR), pp. 2, IEEE, Osaka, Japan, 2019.
Abstract | Links | BibTeX | Tags: MedVR, MxR, UARC
@inproceedings{kang_advancing_2019,
title = {Advancing Ethical Decision Making in Virtual Reality},
author = {Sinhwa Kang and Jake Chanenson and Peter Cowal and Madeleine Weaver},
url = {https://ieeexplore.ieee.org/document/8798151},
doi = {10.1109/VR.2019.8798151},
year = {2019},
date = {2019-03-01},
booktitle = {Proceedings of the 2019 IEEE Conference on Virtual Reality and 3D User Interfaces (VR)},
pages = {2},
publisher = {IEEE},
address = {Osaka, Japan},
abstract = {Virtual reality (VR) has been widely utilized for training and education purposes because of pedagogical, safety, and economic benefits. The investigation of moral judgment is a particularly interesting VR application, related to training. For this study, we designed a withinsubject experiment manipulating the role of study participants in a Trolley Dilemma scenario: either victim or driver. We conducted a pilot study with four participants and describe preliminary results and implications in this poster.},
keywords = {MedVR, MxR, UARC},
pubstate = {published},
tppubtype = {inproceedings}
}
Virtual reality (VR) has been widely utilized for training and education purposes because of pedagogical, safety, and economic benefits. The investigation of moral judgment is a particularly interesting VR application, related to training. For this study, we designed a withinsubject experiment manipulating the role of study participants in a Trolley Dilemma scenario: either victim or driver. We conducted a pilot study with four participants and describe preliminary results and implications in this poster.
Artstein, Ron; Gordon, Carla; Sohail, Usman; Merchant, Chirag; Jones, Andrew; Campbell, Julia; Trimmer, Matthew; Bevington, Jeffrey; Engen, COL Christopher; Traum, David
Digital Survivor of Sexual Assault Inproceedings
In: Proceedings of the 24th International Conference on Intelligent User Interfaces, pp. 417–425, ACM, Marina del Rey, California, 2019, ISBN: 978-1-4503-6272-6.
Abstract | Links | BibTeX | Tags: DoD, Graphics, MedVR, UARC, Virtual Humans
@inproceedings{artstein_digital_2019,
title = {Digital Survivor of Sexual Assault},
author = {Ron Artstein and Carla Gordon and Usman Sohail and Chirag Merchant and Andrew Jones and Julia Campbell and Matthew Trimmer and Jeffrey Bevington and COL Christopher Engen and David Traum},
url = {https://doi.org/10.1145/3301275.3302303},
doi = {10.1145/3301275.3302303},
isbn = {978-1-4503-6272-6},
year = {2019},
date = {2019-03-01},
booktitle = {Proceedings of the 24th International Conference on Intelligent User Interfaces},
pages = {417--425},
publisher = {ACM},
address = {Marina del Rey, California},
abstract = {The Digital Survivor of Sexual Assault (DS2A) is an interface that allows a user to have a conversational experience with a survivor of sexual assault, using Artificial Intelligence technology and recorded videos. The application uses a statistical classifier to retrieve contextually appropriate pre-recorded video utterances by the survivor, together with dialogue management policies which enable users to conduct simulated conversations with the survivor about the sexual assault, its aftermath, and other pertinent topics. The content in the application has been specifically elicited to support the needs for the training of U.S. Army professionals in the Sexual Harassment/Assault Response and Prevention (SHARP) Program, and the application comes with an instructional support package. The system has been tested with approximately 200 users, and is presently being used in the SHARP Academy's capstone course.},
keywords = {DoD, Graphics, MedVR, UARC, Virtual Humans},
pubstate = {published},
tppubtype = {inproceedings}
}
The Digital Survivor of Sexual Assault (DS2A) is an interface that allows a user to have a conversational experience with a survivor of sexual assault, using Artificial Intelligence technology and recorded videos. The application uses a statistical classifier to retrieve contextually appropriate pre-recorded video utterances by the survivor, together with dialogue management policies which enable users to conduct simulated conversations with the survivor about the sexual assault, its aftermath, and other pertinent topics. The content in the application has been specifically elicited to support the needs for the training of U.S. Army professionals in the Sexual Harassment/Assault Response and Prevention (SHARP) Program, and the application comes with an instructional support package. The system has been tested with approximately 200 users, and is presently being used in the SHARP Academy's capstone course.
Lerner, Itamar; Ketz, Nicholas A.; Jones, Aaron P.; Bryant, Natalie B.; Robert, Bradley; Skorheim, Steven W.; Hartholt, Arno; Rizzo, Albert S.; Gluck, Mark A.; Clark, Vincent P.; Pilly, Praveen K.
In: Scientific Reports, vol. 9, no. 1, 2019, ISSN: 2045-2322.
Abstract | Links | BibTeX | Tags: MedVR, Virtual Humans
@article{lerner_transcranial_2019,
title = {Transcranial Current Stimulation During Sleep Facilitates Insight into Temporal Rules, but does not Consolidate Memories of Individual Sequential Experiences},
author = {Itamar Lerner and Nicholas A. Ketz and Aaron P. Jones and Natalie B. Bryant and Bradley Robert and Steven W. Skorheim and Arno Hartholt and Albert S. Rizzo and Mark A. Gluck and Vincent P. Clark and Praveen K. Pilly},
url = {http://www.nature.com/articles/s41598-018-36107-7},
doi = {10.1038/s41598-018-36107-7},
issn = {2045-2322},
year = {2019},
date = {2019-02-01},
journal = {Scientific Reports},
volume = {9},
number = {1},
abstract = {Slow-wave sleep (SWS) is known to contribute to memory consolidation, likely through the reactivation of previously encoded waking experiences. Contemporary studies demonstrate that when auditory or olfactory stimulation is administered during memory encoding and then reapplied during SWS, memory consolidation can be enhanced, an effect that is believed to rely on targeted memory reactivation (TMR) induced by the sensory stimulation. Here, we show that transcranial current stimulations (tCS) during sleep can also be used to induce TMR, resulting in the facilitation of high-level cognitive processes. Participants were exposed to repeating sequences in a realistic 3D immersive environment while being stimulated with particular tCS patterns. A subset of these tCS patterns was then reapplied during sleep stages N2 and SWS coupled to slow oscillations in a closed-loop manner. We found that in contrast to our initial hypothesis, performance for the sequences corresponding to the reapplied tCS patterns was no better than for other sequences that received stimulations only during wake or not at all. In contrast, we found that the more stimulations participants received overnight, the more likely they were to detect temporal regularities governing the learned sequences the following morning, with tCS-induced beta power modulations during sleep mediating this effect.},
keywords = {MedVR, Virtual Humans},
pubstate = {published},
tppubtype = {article}
}
Slow-wave sleep (SWS) is known to contribute to memory consolidation, likely through the reactivation of previously encoded waking experiences. Contemporary studies demonstrate that when auditory or olfactory stimulation is administered during memory encoding and then reapplied during SWS, memory consolidation can be enhanced, an effect that is believed to rely on targeted memory reactivation (TMR) induced by the sensory stimulation. Here, we show that transcranial current stimulations (tCS) during sleep can also be used to induce TMR, resulting in the facilitation of high-level cognitive processes. Participants were exposed to repeating sequences in a realistic 3D immersive environment while being stimulated with particular tCS patterns. A subset of these tCS patterns was then reapplied during sleep stages N2 and SWS coupled to slow oscillations in a closed-loop manner. We found that in contrast to our initial hypothesis, performance for the sequences corresponding to the reapplied tCS patterns was no better than for other sequences that received stimulations only during wake or not at all. In contrast, we found that the more stimulations participants received overnight, the more likely they were to detect temporal regularities governing the learned sequences the following morning, with tCS-induced beta power modulations during sleep mediating this effect.
Rizzo, Albert; Koenig, Sebastian Thomas; Talbot, Thomas B.
Clinical Results Using Virtual Reality Journal Article
In: Journal of Technology in Human Services, vol. 37, no. 1, pp. 51–74, 2019, ISSN: 1522-8835, 1522-8991.
Abstract | Links | BibTeX | Tags: MedVR, UARC
@article{rizzo_clinical_2019-1,
title = {Clinical Results Using Virtual Reality},
author = {Albert Rizzo and Sebastian Thomas Koenig and Thomas B. Talbot},
editor = {Gabor F. Fulop and Charles M. Hanson and Bjørn F. Andresen},
url = {https://www.tandfonline.com/doi/full/10.1080/15228835.2019.1604292},
doi = {10.1080/15228835.2019.1604292},
issn = {1522-8835, 1522-8991},
year = {2019},
date = {2019-02-01},
booktitle = {Infrared Technology and Applications XLV},
journal = {Journal of Technology in Human Services},
volume = {37},
number = {1},
pages = {51--74},
publisher = {SPIE},
address = {Baltimore, United States},
abstract = {Virtual Reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible to deliver using traditional methods are now being developed that take advantage of the assets that are available with VR technology. As research evidence continues to indicate clinical efficacy, VR applications are being increasingly regarded as providing innovative options for targeting the cognitive, psychological, motor, and functional impairments that result from various clinical health conditions. VR allows for the precise presentation and control of stimuli within dynamic multisensory 3-D computer generated simulations as well as providing advanced methods for capturing and quantifying behavioral responses. These characteristics support the rationale for the use of VR applications in clinical assessment, intervention, and training. This article begins with a brief review of the history and rationale for the use of VR with clinical populations. We then detail one use-case for the clinical application of VR—the exposure therapy treatment of anxiety disorders and post-traumatic stress disorder. While significant work is cited in other areas of Clinical VR (e.g., pain management, cognitive/physical assessment/rehabilitation, eating disorders, social skills/clinical training, etc.), a full overview of such a broad literature is beyond the scope of this article. Thus, we have opted to provide more in-depth analysis of one specific clinical area that clearly illustrates how VR has been successfully applied and is supported by an encouraging and evolving scientific literature.},
keywords = {MedVR, UARC},
pubstate = {published},
tppubtype = {article}
}
Virtual Reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible to deliver using traditional methods are now being developed that take advantage of the assets that are available with VR technology. As research evidence continues to indicate clinical efficacy, VR applications are being increasingly regarded as providing innovative options for targeting the cognitive, psychological, motor, and functional impairments that result from various clinical health conditions. VR allows for the precise presentation and control of stimuli within dynamic multisensory 3-D computer generated simulations as well as providing advanced methods for capturing and quantifying behavioral responses. These characteristics support the rationale for the use of VR applications in clinical assessment, intervention, and training. This article begins with a brief review of the history and rationale for the use of VR with clinical populations. We then detail one use-case for the clinical application of VR—the exposure therapy treatment of anxiety disorders and post-traumatic stress disorder. While significant work is cited in other areas of Clinical VR (e.g., pain management, cognitive/physical assessment/rehabilitation, eating disorders, social skills/clinical training, etc.), a full overview of such a broad literature is beyond the scope of this article. Thus, we have opted to provide more in-depth analysis of one specific clinical area that clearly illustrates how VR has been successfully applied and is supported by an encouraging and evolving scientific literature.