Using virtual reality to target positive autobiographical memory in individuals with moderate-to-moderately severe depressive symptoms: A single case experimental design

So far, several aspects of autobiographical memory (AM) have been found to be impaired in depression. Among others, depressed patients show the tendency to recall more negative than positive events (i.e., negative bias) and usually retrieve memories that lack of specificity and details (i.e., overgeneral memories). Based on this, we designed an AM task enhanced by the use of virtual reality (VR) to specifically train the recall of positive memories. Using a single-case, multiple baseline experimental design, we explored the effects of a brief intervention consisting of two sessions of this training in a sample of 18 individuals with moderate-to-moderately severe depressive symptoms. According to the results, changes occurred at the short term only. In particular, almost all participants reported a significant improvement in at least one outcome measure 0-3 days after the intervention. However, these clinical gains were not maintained in the mid-term (from day 4 to 10). The present findings do not support the efficacy of our VR-based AM recall treatment as a standalone intervention. Nevertheless, it might represent a suitable procedure to obtain immediate and/or short-term improvements. It might also serve as a valid component to be integrated in broader protocols for patients with moderate-to-moderately severe depressive symptoms.

The Potential Role of Awe for Depression: Reassembling the Puzzle

Recently, interest in the unique pathways linking discrete positive emotions to specific health outcomes has gained increasing attention, but the role of awe is yet to be elucidated. Awe is a complex and transformative emotion that can restructure individuals' mental frames so deeply that it could be considered a therapeutic asset for major mental health major issues, including depression. Despite sparse evidence showing a potential connection between depression and awe, this link has not been combined into a proposal resulting in specific intervention guidelines. The aim of this perspective was three-fold: (i) to provide a new unifying model of awe's functioning-the Matryoshka model; (ii) to show systematic and explicit connections between this emotion and depression; and (iii) to suggest specific guidelines of intervention utilizing the potential therapeutic role of awe for mental health, specifically for depression. This theoretical endeavor in its entirety has been framed within the health domain.

Positive emotion dispositions and emotion regulation in the Italian population

The goal of this large-scale study was to test the relationship between positive emotion dispositions (i.e., Joy, Contentment, Pride, Love, Compassion, Amusement, and Awe) and two strategies of emotion regulation (i.e., reappraisal and suppression) in the Italian population. 532 Italian-speaking adults completed the Dispositional Positive Emotion Scales (DPES), the Positive and Negative Affective Schedule (PANAS), the Italian Emotion Regulation Questionnaire (ERQ), and the Big-Five Inventory (BFI). DPES scales showed high reliability. Exploratory Factor Analysis showed that a 6-factor model fits the Italian sample better. Joy and Contentment loaded on the same factor. Items assessing the other five emotions loaded on separate factors. The patterns of relationships between positive emotion dispositions, positive and negative affects traits (PANAS), and personality traits (BFI) indicated concurrent validity of the DPES. Twelve separated multiple regression models with BFI and ERQ factors as predictors and DPES factors as response variables showed that Extraversion significantly positively predicted of all DPES emotions. Agreeableness predicted Happiness, Love, Compassion, and Awe positively. Conscientiousness predicted Amusement and Love negatively and Compassion, Pride, and Happiness positively. Neuroticism predicted all emotions negatively except for Compassion. Positive emotions were significantly and positively predicted by reappraisal, and negatively predicted by suppression.

A Review on Research and Evaluation Methods for Investigating Self-Transcendence

Self-transcendence has been characterized as a decrease in self-saliency (ego disillusionment) and increased connection, and has been growing in research interest in the past decade. Several measures have been developed and published with some degree of psychometric validity and reliability. However, to date, there has been no review systematically describing, contrasting, and evaluating the different methodological approaches toward measuring self-transcendence including questionnaires, neurological and physiological measures, and qualitative methods. To address this gap, we conducted a review to describe existing methods of measuring self-transcendence, evaluate the strengths and weaknesses of these methods, and discuss research avenues to advance assessment of self-transcendence, including recommendations for suitability of methods given research contexts.

Rethinking the Role of Affect in Risk Judgment: What We Have Learned From COVID-19 During the First Week of Quarantine in Italy

Due to COVID-19 spreading in Italy, on March 11 the Prime Minister of Italy declared a lockdown and imposed severe restrictive measures impacting citizens’ freedom at several levels. People were required to stay at home and go out only to satisfy basic needs. Several risk models have postulated a link among online searching behavior, affect, anxiety, and complaints by individuals toward government restrictions (GR), which emerged as also related to an increased perception of knowledge toward risk. However, to date, no study has addressed how these key risk-related aspects (i.e., affect, anxiety, perceived knowledge on risk, and risk dimensions) can act jointly to orient online health information-seeking behavior, and people’s complaints toward GR imposed during the lockdown. This study investigated the mechanisms underlying online health information-seeking behavior and people’s complaints toward the government’s restrictions during a COVID-19 emergency in the Italian population. Drawing from the health belief model (HBM), which postulates a link between sociodemographic variables, risk, and affect dimensions in emergency, we assumed risk factors as predictors of affect and anxiety, which, in turn, were posited as mediators between risk dimensions, online health information-seeking behavior, and complaints toward GR. Participants (1,031) were involved during the first week of the quarantine (March 11–18) and completed an online survey composed of (i) an adapted version of the Italian Risk Perception Questionnaire; (ii) the Italian Positive (PA) and Negative Affect (NA) Schedule (PANAS-10); (iii) the State Anxiety Scale (STAI-Y1); (iv) ad hoc personal knowledge measure about novel coronavirus; (v) ad hoc item measuring information search behavior regarding the novel coronavirus; (vi) ad hoc measure of the complains regarding GR; and (vii) sociodemographic questions. General linear models and structural equation modeling (SEM) were carried out to test the model. Sociodemographic and cognitive factors predicted the participants’ affect and anxiety, which, in turn, motivated and fully mediated both information search behavior and complaint toward GR. This research can offer useful suggestions for policy-makers during the COVID-19 emergency, and it advanced the knowledge on the risk–emotion link in emergency situations.

Digital Biomarkers for the Early Detection of Mild Cognitive Impairment: Artificial Intelligence Meets Virtual Reality

Elderly people affected by Mild Cognitive Impairment (MCI) usually report a perceived decline in cognitive functions that deeply impacts their quality of life. This subtle waning, although it cannot be diagnosable as dementia, is noted by caregivers on the basis of their relative’s behaviors. Crucially, if this condition is also not detected in time by clinicians, it can easily turn into dementia. Thus, early detection of MCI is strongly needed. Classical neuropsychological measures – underlying a categorical model of diagnosis - could be integrated with a dimensional assessment approach involving Virtual Reality (VR) and Artificial Intelligence (AI). VR can be used to create highly ecologically controlled simulations resembling the daily life contexts in which patients’ daily instrumental activities (IADL) usually take place. Clinicians can record patients’ kinematics, particularly gait, while performing IADL (Digital Biomarkers). Then, Artificial Intelligence employs Machine Learning (ML) to analyze them in combination with clinical and neuropsychological data. This integrated computational approach would enable the creation of a predictive model to identify specific patterns of cognitive and motor impairment in MCI. Therefore, this new dimensional cognitive-behavioral assessment would reveal elderly people’s neural alterations and impaired cognitive functions, typical of MCI and dementia, even in early stages for more time-sensitive interventions.

The Effects of an Ecological Diversifying Experience on Creativity: An Experimental Study

Sometimes, life houses rare and unexpected events, such as moving abroad or meeting a special person unexpectedly. Recently, these situations have been indicated as "diversifying experiences" (DEs), defined as unusual and unexpected events that drag people outside their daily routine and accustomed schemas. The core mechanism of DEs would entail the disruption of our mental schema, which can facilitate unexpected connections among even distant ideas, thus enhancing people's cognitive flexibility, that is, a key component of creative thinking. Despite both qualitative and lab-based studies have investigated the features of these experiences, an ecological assessment of their properties also in relation with creativity is still an open issue. The aim of this research is to study the DE-creativity link in a more ecological way, on the basis of a real-life disruptive experience of light deprivation. Specifically, we compared an ecological DE artistic established entertainment format (i.e., "dialogue in the dark," which is seeing people perform several daily life activities but in the absence of light) with an equivalent experience in which the same activities were acted in the sunlight. The absence of light played the role of violating mechanism, framed within the ecological experiential format of the "dialogue in the dark." We compared visitors' emotional profile [Positive and Negative Affect Schedule (PANAS), ad hoc Adjective Checklist], perceived impact of the experience [Centrality of Event Scale (CES)], and creative performance [Torrance Tests of Creative Thinking (TTCT)] in both groups of sighted people (in absence of light vs. in presence of light); and we also controlled for people's openness to experience and need for cognitive closure, as dispositions. Results showed that (vs. control group) "dialogue in the dark" (i) led to worse creative performances, (ii) produced more intense positive affect, and (iii) resulted as a more impacting experience. Intense short-term impact of DE could have been detrimental for participants' creativity. People may need more time to elaborate the DE and accommodate existing schema to generate more creative ideas. This is the first study proposing and succeeding in demonstrating the feasibility to investigate even real complex DEs in a controlled way, thus outlining how their link with creativity can take place in real life.

Gulliver's virtual travels: active embodiment in extreme body sizes for modulating our body representations

It is noted that the perceptual experience of body and space can be modulated by changing the action capabilities or by manipulating the perceived body dimensions through a multisensory stimulation. This study adds to pre-existing literature by investigating the alterations in bodily experience following embodiment to both enlarged and shrunked bodies, while participants actively navigated in a virtual environment. A normal-sized body served as a reference condition. After each embodied navigation, participants estimated the height and width of three different body parts. Results revealed that the embodiment over shrunked body induced a significant reduction in participants' body image, while no changes were reported after the embodiment over the enlarged body. Findings were discussed in terms of previous literature exploring the constraints implicated in the ownership over different bodies.

COVID Feel Good-An Easy Self-Help Virtual Reality Protocol to Overcome the Psychological Burden of Coronavirus

BACKGROUND

Living in the time of the COVID-19 means experiencing not only a global health emergency but also extreme psychological stress with potential emotional side effects such as sadness, grief, irritability, and mood swings. Crucially, lockdown and confinement measures isolate people who become the first and the only ones in charge of their own mental health: people are left alone facing a novel and potentially lethal situation, and, at the same time, they need to develop adaptive strategies to face it, at home. In this view, easy-to-use, inexpensive, and scientifically validated self-help solutions aiming to reduce the psychological burden of coronavirus are extremely necessary.

AIMS

This pragmatic trial aims to provide the evidence that a weekly self-help virtual reality (VR) protocol can help overcome the psychological burden of the Coronavirus by relieving anxiety, improving well-being, and reinforcing social connectedness. The protocol will be based on the "Secret Garden" 360 VR video online (www.covidfeelgood.com) which simulates a natural environment aiming to promote relaxation and self-reflection. Three hundred sixty-degree or spherical videos allow the user to control the viewing direction. In this way, the user can explore the content from any angle like a panorama and experience presence and immersion. The "Secret Garden" video is combined with daily exercises that are designed to be experienced with another person (not necessarily physically together), to facilitate a process of critical examination and eventual revision of core assumptions and beliefs related to personal identity, relationships, and goals.

METHODS

This is a multicentric, pragmatic pilot randomized controlled trial involving individuals who experienced the COVID-19 pandemic and underwent a lockdown and quarantine procedures. The trial is approved by the Ethics Committee of the Istituto Auxologico Italiano. Each research group in all the countries joining the pragmatic trial, aims at enrolling at least 30 individuals in the experimental group experiencing the self-help protocol, and 30 in the control group, over a period of 3 months to verify the feasibility of the intervention.

CONCLUSION

The goal of this protocol is for VR to become the "surgical mask" of mental health treatment. Although surgical masks do not provide the wearer with a reliable level of protection against the coronavirus compared with FFP2 or FFP3 masks, surgical masks are very effective in protecting others from the wearer's respiratory emissions. The goal of the VR protocol is the same: not necessarily to solve complex mental health problems but rather to improve well-being and preserve social connectedness through the beneficial social effects generated by positive emotions.

When Virtual Feels Real: Comparing Emotional Responses and Presence in Virtual and Natural Environments

Although virtual reality (VR) is increasingly regarded as an effective emotion induction technique, little research has examined whether and how emotions elicited in VR differ from those evoked in real life. To address this question, 50 participants (25 females and 25 males) were exposed to either a real-life contemplative scenario (a panoramic view of a lake) or to an immersive 360° footage of the same landscape. Next, type and valence of emotions, as well as sense of presence reported by participants, were compared across conditions. Findings showed that emotions elicited by virtual and natural conditions were not significantly different. The only exception was anger, which was significantly higher in the natural condition, and amusement, which was significantly higher in the virtual condition. Sense of physical presence and engagement dimensions of presence did not significantly differ between virtual and real conditions. However, different correlation patterns between emotions and key dimensions of presence were found after in vivo and in virtuo exposure. These findings provide initial evidence that emotions and sense of presence elicited by immersive videos are comparable with those evoked by real-life scenarios and warrant further investigations.

Effects of Interpersonal Sensorimotor Synchronization on Dyadic Creativity: Gender Matters

Although it is noted that interpersonal sensorimotor coordination can influence several high-level socio-cognitive processes, its impact on creative collaboration is nearly unexplored. Here, we investigated the effects of a form of sensorimotor coordination, that is, sensorimotor synchronization, on a subsequent creative collaboration task. 60 pairs (n total = 120 participants) formed by previously unacquainted individuals performed a tower-building task either jointly or alone, followed by a dyadic creativity task. Tower building time in the joint condition was recorded through a sensorized platform and creativity performance was evaluated by two independent raters based on the quantity and quality of generated ideas. We controlled for gender composition and for the disposition to cooperate and to adopt a creative, analytical style. Results showed that male-male couples were more creative after the joint-action condition, whereas female-female and mixed-gender couples were more creative after the solo condition. Regression analyses of tower building time on creativity performance revealed that building time was a significant predictor of creativity dimensions in male-male and in mixed-gender couples but did not predict creative performance in female-female couples. Overall, these findings suggest that the manipulation of sensorimotor coordination can influence performance in a subsequent creative collaboration task, with the nature, and magnitude of this effect depending on the gender composition of the dyads. These results have potential implications for the design of sensorimotor-based strategies to enhance dyadic creative performance in several contexts, especially for the organizational settings.

Toward Emotionally Adaptive Virtual Reality for Mental Health Applications

Here, we introduce the design and preliminary validation of a general-purpose architecture for affective-driven procedural content generation in virtual reality (VR) applications in mental health and wellbeing. The architecture supports seven commercial physiological sensing technologies and can be deployed in immersive and non-immersive VR systems. To demonstrate the concept, we developed the "The Emotional Labyrinth," a non-linear scenario in which navigation in a procedurally generated three-dimensional maze is entirely decided by the user, and whose features are dynamically adapted according to a set of emotional states. During navigation, affective states are dynamically represented through pictures, music, and animated visual metaphors chosen to represent and induce affective states. The underlying hypothesis is that exposing users to multimodal representations of their affective states can create a feedback loop that supports emotional self-awareness and fosters more effective emotional regulation strategies. We carried out a first study to, first, assess the effectiveness of the selected metaphors in inducing target emotions, and second, identify relevant psycho-physiological markers of the emotional experience generated by the labyrinth. Results show that the Emotional Labyrinth is overall a pleasant experience in which the proposed procedural content generation can induce distinctive psycho-physiological patterns, generally coherent with the meaning of the metaphors used in the labyrinth design. Furthermore, collected psycho-physiological responses such as electrocardiography, respiration, electrodermal activity, and electromyography are used to generate computational models of users' reported experience. These models enable the future implementation of the closed loop mechanism to adapt the Labyrinth procedurally to the users' affective state.

The Role of Age on Multisensory Bodily Experience: An Experimental Study with a Virtual Reality Full-Body Illusion

A growing body of evidence demonstrated that it is feasible to induce ownership over an artificial body to alter bodily experience. However, several uncharted aspects about full-body illusion applications need to be tackled before a complete exploitation of these methods in clinical practice. This work is devoted to explore possible individual age-related differences in shaping changes in body representations induced with a full-body illusion. A total of 40 women were divided into two different age groups according to the median of the variable age. Participants estimated the width of three different body parts (i.e., shoulders, abdomen, and hips) before the entire illusion was induced (baseline), and after the synchronous and the asynchronous conditions. Results revealed that 26-to-55-year-old participants were more resistant to changes induced by the bodily illusion, whereas 19-to-25-year-old participants underestimated their bodies after both conditions. The findings were discussed in terms of the literature exploring age differences in responses to bodily illusion, which could suggest a Bayesian mechanism underlying these individual differences.

Designing Awe in Virtual Reality: An Experimental Study

Awe is a little-studied emotion with a great transformative potential. Therefore, the interest toward the study of awe's underlying mechanisms has been increased. Specifically, researchers have been interested in how to reproduce intense feelings of awe within laboratory conditions. It has been proposed that the use of virtual reality (VR) could be an effective way to induce awe in controlled experimental settings, thanks to its ability of providing participants with a sense of "presence," that is, the subjective feeling of being displaced in another physical or imaginary place. However, the potential of VR as awe-inducing medium has not been fully tested yet. In the present study, we provided an evidence-based design and a validation of four immersive virtual environments (VEs) involving 36 participants in a within-subject design. Of these, three VEs were designed to induce awe, whereas the fourth VE was targeted as an emotionally neutral stimulus. Participants self-reported the extent to which they felt awe, general affect and sense of presence related to each environment. As expected, results showed that awe-VEs could induce significantly higher levels of awe and presence as compared to the neutral VE. Furthermore, these VEs induced significantly more positive than negative affect. These findings supported the potential of immersive VR for inducing awe and provide useful indications for the design of awe-inspiring virtual environments.

Effectiveness of Immersive Videos in Inducing Awe: An Experimental Study

Awe, a complex emotion composed by the appraisal components of vastness and need for accommodation, is a profound and often meaningful experience. Despite its importance, psychologists have only recently begun empirical study of awe. At the experimental level, a main issue concerns how to elicit high intensity awe experiences in the lab. To address this issue, Virtual Reality (VR) has been proposed as a potential solution. Here, we considered the highest realistic form of VR: immersive videos. 42 participants watched at immersive and normal 2D videos displaying an awe or a neutral content. After the experience, they rated their level of awe and sense of presence. Participants' psychophysiological responses (BVP, SC, sEMG) were recorded during the whole video exposure. We hypothesized that the immersive video condition would increase the intensity of awe experienced compared to 2D screen videos. Results indicated that immersive videos significantly enhanced the self-reported intensity of awe as well as the sense of presence. Immersive videos displaying an awe content also led to higher parasympathetic activation. These findings indicate the advantages of using VR in the experimental study of awe, with methodological implications for the study of other emotions.

The Potential of Virtual Reality for the Investigation of Awe

The emotion of awe is characterized by the perception of vastness and a need for accommodation, which can include a positive and/or negative valence. While a number of studies have successfully manipulated this emotion, the issue of how to elicit particularly intense awe experiences in laboratory settings remains. We suggest that virtual reality (VR) is a particularly effective mood induction tool for eliciting awe. VR provides three key assets for improving awe. First, VR provides users with immersive and ecological yet controlled environments that can elicit a sense of “presence,” the subjective experience of “being there” in a simulated reality. Further, VR can be used to generate complex, vast stimuli, which can target specific theoretical facets of awe. Finally, VR allows for convenient tracking of participants’ behavior and physiological responses, allowing for more integrated assessment of emotional experience. We discussed the potential and challenges of the proposed approach with an emphasis on VR’s capacity to raise the signal of reactions to emotions such as awe in laboratory settings.