Testing Augmented Reality for Cue Exposure in Obese Patients: An Exploratory Study

Virtual, augmented, and mixed reality as a versatile tool in food consumer behavior evaluation: Recent advances in aroma, taste, and texture incorporation

The perceptual behavior of consumers on a product displayed in the market has a vital role in analyzing the importance given to that product. Therefore, various strategies have been developed to understand this consumer behavior in the selection of products. Immersive technologies like virtual, augmented, and mixed reality are among them. With the foremost feature of immersion in the virtual world and interaction of users with virtual objects, virtual reality, and augmented reality have unlocked their potential in research and a user-friendly tool for analyzing consumer behavior. In addition to these technologies, mixed reality also has a significant role in investigating consumer behavior. Studies on immersive technologies in food applications are vast, hence this review focuses on the applications of virtual, augmented, and mixed reality in the food selection behavior of consumers. The behavioral studies are elicited to develop new products based on consumer needs, to understand the shopping behavior in supermarkets for real-time usage, and to know the influence of emotions in a selection of products. The findings suggest that virtual, augmented, and mixed reality induce immersion of the users in food selection behavioral studies. Information on the technological advancements in the tools used for bringing immersion and interaction are discussed for its futuristic applications in food. Though immersive technology gives users a realistic virtual environment experience, its application in food systems is in the budding stage. More research on human response studies would contribute to its innovative and inevitable application in the future.

How much is a chef's touch worth? Affective, emotional and behavioural responses to food images: A multimodal study

BACKGROUND

Food aesthetics influences affective dimensions (valence and arousal) and subsequent emotional and behavioural responses in images presented in more traditional form, almost rustic in some cases, to the signature dishes of haute cuisine. However, the visual impact of images of haute cuisine dishes on consumers' affective and emotional responses compared to traditional dishes is still understudied.

METHODS

We recorded electrodermal activity, ocular movements and self-report affect of 35 volunteers while they performed a picture viewing paradigm using images of haute cuisine food, traditional food, and non-food. Additionally, the moderating role of age was examined.

RESULTS

Our results showed that subjects had higher feelings of pleasure and arousal toward images of food (haute cuisine and traditional dishes) compared to non-food images. However, no difference in self-report affect, physiological and behavioural responses was found between haute cuisine and traditional dishes. Interestingly, a moderating effect of age was revealed, reporting that younger participants had greater feelings of pleasure and shorter eye-to-screen distance towards traditional food than haute cuisine.

CONCLUSIONS

As a whole, our findings suggest that food aesthetics could at least partially affect consumers' affective and emotional responses. Interestingly, physiological responses to food pictures seemed to be relatively independent of approach/avoidance motivational states, supporting the assumption that traditional visual restaurant menus with attractive images might be insufficient for eliciting intense positive emotions. This study also contributes to advancing the understanding of the role that age plays in emotional impact when images of haute cuisine dishes are presented to consumers.

A Self-Help Virtual Therapeutic Experience Intervention for Overcoming Psychological Distress Related to the COVID-19 Pandemic: Results From the European Multicentric COVID Feel Good Trial

OBJECTIVE

The general objective of the current study was to investigate the efficacy of a novel self-help virtual therapeutic experience (specifically, the COVID Feel Good intervention) in lowering the psychological burden experienced during the COVID-19 lockdowns in four European countries.

METHODS

We focused on participants recruited from June 2020 to May 2021 in the context of a European multicenter project including four university/academic sites. The total number of participants in the longitudinal studies was 107 (study 1, N = 40; study 2, N = 29; study 3, N = 38). The randomized controlled trial (study 4) included 31 participants in total, 16 in the intervention group and 15 in the control group. Primary outcome measures were depression, anxiety, stress symptoms, perceived stress level, and perceived hopelessness. The secondary outcome was experienced social connectedness.

RESULTS

Using separate linear mixed-effects models, the most consistent result across countries was a reduction in perceived stress after the participation in the COVID Feel Good intervention. By pooling the results of the models using a random-effects meta-analysis, we found that after the COVID Feel Good intervention, participants reported a decrease in perceived general distress (mean standardized effect size for general distress in the treatment groups compared with the control conditions was -0.52 [ p = .008, 95% confidence interval = -0.89 to -0.14]) and an increase in the perceived social connection (mean standardized effect size for social connection using COVID Feel Good compared with the control conditions was 0.50 [ p ≤ .001, 95% confidence interval = 0.25 to 0.76]).

CONCLUSIONS

Findings of this study indicate that a virtual self-help intervention is effective in reducing psychological distress. These results contribute to the growing literature supporting the use of digital psychological therapies to relieve psychological distress among the general population during the COVID-19 pandemic.Trial Registration : ISRCTN63887521.

Eating, Smelling, and Seeing: Investigating Multisensory Integration and (In)congruent Stimuli while Eating in VR

Integrating taste in AR/VR applications has various promising use cases - from social eating to the treatment of disorders. Despite many successful AR/VR applications that alter the taste of beverages and food, the relationship between olfaction, gustation, and vision during the process of multisensory integration (MSI) has not been fully explored yet. Thus, we present the results of a study in which participants were confronted with congruent and incongruent visual and olfactory stimuli while eating a tasteless food product in VR. We were interested (1) if participants integrate bi-modal congruent stimuli and (2) if vision guides MSI during congruent/incongruent conditions. Our results contain three main findings: First, and surprisingly, participants were not always able to detect congruent visual-olfactory stimuli when eating a portion of tasteless food. Second, when confronted with tri-modal incongruent cues, a majority of participants did not rely on any of the presented cues when forced to identify what they eat; this includes vision which has previously been shown to dominate MSI. Third, although research has shown that basic taste qualities like sweetness, saltiness, or sourness can be influenced by congruent cues, doing so with more complex flavors (e.g., zucchini or carrot) proved to be harder to achieve. We discuss our results in the context of multimodal integration, and within the domain of multisensory AR/VR. Our results are a necessary building block for future human-food interaction in XR that relies on smell, taste, and vision and are foundational for applied applications such as affective AR/VR.

Virtual self-conversation using motivational interviewing techniques to promote healthy eating and physical activity: A usability study

Introduction

We aim to examine the usability of a Virtual Reality (VR) platform, called ConVRSelf, which has been designed to address the needs of People Living With Obesity (PLWO).

Methods

Fourteen participants with a desire to eat healthier and exercise more (6 normal weight and 8 PLWO; Mean age = 41.86, SD = 13.89) were assigned to the experimental group (EG) or the control group (CG). EG participants, after being trained on motivational interviewing skills, engaged in a virtual self-conversation using embodiment and body swapping techniques, which aimed to normalize and resolve their ambivalence to change lifestyle habits. CG participants, embodied in their virtual bodies, participated in a pre-established discourse with a virtual counselor giving them psychoeducational advice about how to change lifestyle habits. A mixed-methods design was used, involving a semi-structured interview and self-report questionnaires, including readiness to change habits (Readiness Rulers), body ownership (Body Ownership Questionnaire, BOQ), and system usability (System Evaluation Questionnaire, SEQ). Thematic content analysis was carried out for qualitative data while statistical data analysis was carried out using SPSS 20.0.

Results

Participants from both groups showed high readiness to change lifestyle (Readiness Rulers) before engaging with the virtual experiences, which was maintained at the same level after the interventions and their scores on the SEQ and BOQ were satisfactory. Regarding qualitative information obtained from the interviews, almost all participants found the VR experience to be novel, interesting, and enjoyable. A higher acceptability was observed among PLWO from the EG than normal weight participants from the same group, a promising finding for the ConVRSelf platform, which had been specifically designed to address the needs of PLWO.

Conclusion

The ConVRSelf system is well-accepted by participants and is ready to be tested with PLWO in a clinical setting.

A data-centric artificial intelligent and extended reality technology in smart healthcare systems

Extended reality (XR) solutions are quietly maturing, and their novel use cases are already being investigated, particularly in the healthcare industry. By 2022, the extended reality market is anticipated to be worth $209 billion. Certain diseases, such as Alzheimer's, Schizophrenia, Stroke rehabilitation stimulating specific areas of the patient's brain, healing brain injuries, surgeon training, realistic 3D visualization, touch-free interfaces, and teaching social skills to children with autism, have shown promising results with XR-assisted treatments. Similar effects have been used in video game therapies like Akili Interactive's EndeavorRx, which has previously been approved by the Food and Drug Administration (FDA) as a treatment regimen for children with attention deficit hyperactivity disorder (ADHD). However, while these improvements have received positive feedback, the field of XR-assisted patient treatment is in its infancy. The growth of XR in the healthcare sphere has the potential to transform the delivery of medical services. Imagine an elderly patient in a remote setting having a consultation with a world-renowned expert without ever having to leave their house. Rather than operating on cadavers in a medical facility, a surgical resident does surgery in a virtual setting at home. On the first try, a nurse uses a vein finder to implant an IV. Through cognitive treatment in a virtual world, a war veteran recovers from post-traumatic stress disorder (PTSD). The paper discusses the potential impact of XR in transforming the healthcare industry, as well as its use cases, challenges, XR tools and techniques for intelligent health care, recent developments of XR in intelligent healthcare services, and the potential benefits and future aspects of XR techniques in the medical domain.

Comparing immersiveness and perceptibility of spherical and curved displays

Curved displays are believed to create a feeling of immersiveness similar to virtual reality. However systematic studies are needed to demonstrate that this is, in fact, true and under what conditions. In an experimental study 24 participants compared five different displays (concave, convex, hemisphere, sphere and a flat display) in terms of their immersiveness and perceptibility, and they also rated their overall preferences. Both immersiveness and perceptibility affected overall preference ratings. Participants gave higher preference ratings to the convex and concave displays, which were rated high in immersiveness and perceptibility, but gave lower preference ratings to the hemisphere/spherical display which had high ratings on immersiveness but low ratings on perceptibility. The study results imply that curved displays do indeed create a feeling of immersiveness. Concave and convex displays were rated highly favorably and should receive more attention for applications where visual experience and a feeling of immersiveness is particularly important.

The clinical potential of augmented reality

Augmented reality (AR) is a rapidly emerging technology that superimposes digital objects onto real-world scenes as viewed in real time through a smartphone, tablet, or headset. Whereas AR has been adopted for retail, entertainment, and professional training, it also has potential as a novel, mobile, and efficacious treatment modality for psychological disorders. In particular, extinction-based therapies (e.g., anxiety, substance use disorders) could utilize AR to present stimuli in natural environments, enhancing generalizability beyond the clinic. The limited psychological literature on AR has focused on the treatment of simple phobias. Here, with the goal of bringing this technology to the attention of clinicians and researchers, we describe AR, contrast it with virtual reality, review the theoretical foundation for extinction-based therapies, provide examples for the treatment of substance use disorders, and identify theoretical, practical, and implementation-based research questions.

Common themes and emerging trends for the use of technology to support mental health and psychosocial well-being in limited resource settings: A review of the literature

There are significant disparities in access to mental health care. With the burgeoning of technologies for health, digital tools have been leveraged within mental health and psychosocial support programming (eMental health). A review of the literature was conducted to understand and identify how eMental health has been used in resource-limited settings in general. PubMed, Ovid Medline and Web of Science were searched. Six-hundred and thirty full-text articles were identified and assessed for eligibility; of those, 67 articles met the inclusion criteria and were analyzed. The most common mental health use cases were for depression (n = 25) and general mental health and well-being (n = 21). Roughly one-third used a website or Internet-enabled intervention (n = 23) and nearly one-third used an SMS intervention (n = 22). Technology was applied to enhance service delivery (n = 32), behavior change communication (n = 26) and data collection (n = 8), and specifically dealt with adherence (n = 7), ecological momentary assessments (n = 7), well-being promotion (n = 5), education (n = 8), telemedicine (n = 28), machine learning (n = 5) and games (n = 2). Emerging trends identified wearables, predictive analytics, robots and virtual reality as promising areas. eMental health interventions that leverage low-tech tools can introduce, strengthen and expand mental health and psychosocial support services and can be a starting point for future, advanced tools.

Adapting Evidence-Based Treatments for Digital Technologies: a Critical Review of Functions, Tools, and the Use of Branded Solutions

PURPOSE OF REVIEW

We provide a critical review of digital technologies in evidence-based treatments (EBTs) for mental health with a focus on the functions technologies are intended to serve. The review highlights issues related to clarity of purpose, usability, and assumptions related to EBT technology integration, branding, and packaging.

RECENT FINDINGS

Developers continue to use technology in creative ways, often combining multiple functions to convey existing EBTs or to create new technology-enabled EBTs. Developers have a strong preference for creating and investigating whole-source, branded solutions related to specific EBTs, in comparison to developing or investigating technology tools related to specific components of behavior change, or developing specific clinical protocols that can be delivered via existing technologies. Default assumptions that new applications are required for each individual EBT, that EBTs are best served by the use of only one technology solution rather than multiple tools, and that an EBT-specific technology product should include or convey all portions of an EBT slow scientific progress and increase risk of usability issues that negatively impact uptake. We contend that a purposeful, functions-based approach should guide the selection, development, and application of technology in support of EBT delivery.

Do food cinemagraphs evoke stronger appetitive responses than stills?

Viewing images of food triggers the desire to eat and this effect increases when images represent food in a more vivid way. Cinemagraphs are a new medium that is intermediate between photographs and videos: most of the frame is static, while some details are animated in a seamless loop, resulting in a vivid viewing experience. On social media cinemagraphs are increasingly used for food-related communication. Given their vivid appearance we hypothesized that food cinemagraphs may evoke stronger appetitive responses than their static counterparts (stills). This would make them a promising medium for food advertisements on the Internet or on digital menu boards. In this study we measured the ‘wanting’ (appetitive) and ‘liking’ (affective) responses to both cinemagraph and stills representing a wide range of different food products. Our results show that food cinemagraphs slightly increase ‘wanting’ scores while not affecting ‘liking’ scores, compared to similar stills. Although we found no overall main effect of image dynamics on ‘liking’, we did observe a significant effect for some individual food items. The effects of image dynamics on ‘wanting’ and ‘liking’ appear to be product specific: while dynamic images were scored higher on ‘wanting’ or ‘liking’ for some products, static images were scored higher on these factors for other products. Observer responses to a free association task indicate that image dynamics can affect the appeal of a food product in two ways: by emphasizing its hedonic qualities (lusciousness, freshness) and by enhancing the observers’ awareness of their own core affect (‘liking’) for the product. We conclude that the effective use of cinemagraphs in food advertisements therefore requires a careful consideration of the characteristics (hedonic aspects) of the food product that are to be highlighted through image motion and the inherent preferences (core liking) of the target group.

CROCUFID: A Cross-Cultural Food Image Database for Research on Food Elicited Affective Responses

We present CROCUFID: a CROss-CUltural Food Image Database that currently contains 840 images, including 479 food images with detailed metadata and 165 images of non-food items. The database includes images of sweet, savory, natural, and processed food from Western and Asian cuisines. To create sufficient variability in valence and arousal we included images of food with different degrees of appetitiveness (fresh, unfamiliar, molded or rotten, spoiled, and partly consumed). We used a standardized photographing protocol, resulting in high resolution images depicting all food items on a standard background (a white plate), seen from a fixed viewing (45°) angle. CROCUFID is freely available under the CC-By Attribution 4.0 International license and hosted on the OSF repository. The advantages of the CROCUFID database over other databases are its (1) free availability, (2) full coverage of the valence - arousal space, (3) use of standardized recording methods, (4) inclusion of multiple cuisines and unfamiliar foods, (5) availability of normative and demographic data, (6) high image quality and (7) capability to support future (e.g., virtual and augmented reality) applications. Individuals from the United Kingdom (N = 266), North-America (N = 275), and Japan (N = 264) provided normative ratings of valence, arousal, perceived healthiness, and desire-to-eat using visual analog scales (VAS). In addition, for each image we computed 17 characteristics that are known to influence affective observer responses (e.g., texture, regularity, complexity, and colorfulness). Significant differences between groups and significant correlations between image characteristics and normative ratings were in accordance with previous research, indicating the validity of CROCUFID. We expect that CROCUFID will facilitate comparability across studies and advance experimental research on the determinants of food-elicited emotions. We plan to extend CROCUFID in the future with images of food from a wide range of different cuisines and with non-food images (for applications in for instance neuro-physiological studies). We invite researchers from all parts of the world to contribute to this effort by creating similar image sets that can be linked to this collection, so that CROCUFID will grow into a truly multicultural food database.

Methods for Evaluating Emotions Evoked by Food Experiences: A Literature Review

Besides sensory characteristics of food, food-evoked emotion is a crucial factor in predicting consumer's food preference and therefore in developing new products. Many measures have been developed to assess food-evoked emotions. The aim of this literature review is (i) to give an exhaustive overview of measures used in current research and (ii) to categorize these methods along measurement level (physiological, behavioral, and cognitive) and emotional processing level (unconscious sensory, perceptual/early cognitive, and conscious/decision making) level. This 3 × 3 categorization may help researchers to compile a set of complementary measures (“toolbox”) for their studies. We included 101 peer-reviewed articles that evaluate consumer's emotions and were published between 1997 and 2016, providing us with 59 different measures. More than 60% of these measures are based on self-reported, subjective ratings and questionnaires (cognitive measurement level) and assess the conscious/decision-making level of emotional processing. This multitude of measures and their overrepresentation in a single category hinders the comparison of results across studies and building a complete multi-faceted picture of food-evoked emotions. We recommend (1) to use widely applied, validated measures only, (2) to refrain from using (highly correlated) measures from the same category but use measures from different categories instead, preferably covering all three emotional processing levels, and (3) to acquire and share simultaneously collected physiological, behavioral, and cognitive datasets to improve the predictive power of food choice and other models.

Exploring the Influence of Haptic and Olfactory Cues of a Virtual Donut on Satiation and Eating Behavior

Olfactory research in immersive virtual environments (IVEs) have often examined the addition of scent as part of the environment or atmosphere that act as experimental stimuli. There appears to be a lack of research on the influence of virtual foods in IVEs on human satiation. Studies based on situational cues or self-perception theory provide support for the hypothesis that touching and smelling a virtual food item may lead to increased consumption as a result of modeling expected behavior. On the other hand, studies grounded in embodied cognition suggest that satiation may take place as a result of mental simulation that resembles actual consumption behavior. In this preliminary study, we sought to explore the effects of haptic and olfactory cues through virtual food on human satiation and eating behavior. In our study, 101 participants took part in a 2 (touch: present vs absent) × 2 (scent: present vs absent) experiment where they interacted with a donut in an IVE. Findings showed that participants in the touch and scent present conditions ate significantly fewer donuts than those who were not exposed to these cues, and reported higher satiation as compared to their counterparts. However, findings were less clear with respect to participants who received both haptic and olfactory cues. As a whole, results provide preliminary support for satiation effects as a result of sensory simulation.

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.

Virtual reality in the assessment, understanding, and treatment of mental health disorders

Mental health problems are inseparable from the environment. With virtual reality (VR), computer-generated interactive environments, individuals can repeatedly experience their problematic situations and be taught, via evidence-based psychological treatments, how to overcome difficulties. VR is moving out of specialist laboratories. Our central aim was to describe the potential of VR in mental health, including a consideration of the first 20 years of applications. A systematic review of empirical studies was conducted. In all, 285 studies were identified, with 86 concerning assessment, 45 theory development, and 154 treatment. The main disorders researched were anxiety (n = 192), schizophrenia (n = 44), substance-related disorders (n = 22) and eating disorders (n = 18). There are pioneering early studies, but the methodological quality of studies was generally low. The gaps in meaningful applications to mental health are extensive. The most established finding is that VR exposure-based treatments can reduce anxiety disorders, but there are numerous research and treatment avenues of promise. VR was found to be a much-misused term, often applied to non-interactive and non-immersive technologies. We conclude that VR has the potential to transform the assessment, understanding and treatment of mental health problems. The treatment possibilities will only be realized if - with the user experience at the heart of design - the best immersive VR technology is combined with targeted translational interventions. The capability of VR to simulate reality could greatly increase access to psychological therapies, while treatment outcomes could be enhanced by the technology's ability to create new realities. VR may merit the level of attention given to neuroimaging.

Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives

Obesity is a chronic condition associated with risk factors for many medical complications and comorbidities such as cardiovascular diseases, some types of cancer, osteoarthritis, hypertension, dyslipidemia, hypercholesterolemia, type-2 diabetes, obstructive sleep apnea syndrome, and different psychosocial issues and psychopathological disorders. Obesity is a highly complex, multifactorial disease: genetic, biological, psychological, behavioral, familial, social, cultural, and environmental factors can influence in different ways. Evidence-based strategies to improve weight loss, maintain a healthy weight, and reduce related comorbidities typically integrate different interventions: dietetic, nutritional, physical, behavioral, psychological, and if necessary, pharmacological and surgical ones. Such treatments are implemented in a multidisciplinary context with a clinical team composed of endocrinologists, nutritionists, dietitians, physiotherapists, psychiatrists, psychologists, and sometimes surgeons. Cognitive behavioral therapy (CBT) is traditionally recognized as the best established treatment for binge eating disorder and the most preferred intervention for obesity, and could be considered as the first-line treatment among psychological approaches, especially in a long-term perspective; however, it does not necessarily produce a successful weight loss. Traditional CBT for weight loss and other protocols, such as enhanced CBT, enhanced focused CBT, behavioral weight loss treatment, therapeutic education, acceptance and commitment therapy, and sequential binge, are discussed in this review. The issue of long-term weight management of obesity, the real challenge in outpatient settings and in lifestyle modification, is discussed taking into account the possible contribution of mHealth and the stepped-care approach in health care.

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.