Future of mental health in the metaverse

Effects of an Avatar-Based Simulation on Family Nurse Practitioner Students' Self-Evaluated Suicide Prevention Knowledge and Confidence

ABSTRACT

Family nurse practitioners (FNPs) are often gatekeepers and can recognize the warning signs of suicidality yet may lack adequate education or self-confidence in identifying people in crisis. The purpose of this research was to evaluate the effectiveness of an online suicide prevention simulation with 53 FNP students. Pre/post responses were found to be statistically significant across all preparedness and attitudinal items following the Kognito© training ( p < .001). Online, avatar-based suicide prevention training with FNP students may be effective in improving participants' perceived preparedness and self-confidence with patients at risk for suicidality.

How the Metaverse Is Shaping the Future of Healthcare Communication: A Tool for Enhancement or a Barrier to Effective Interaction?

The metaverse is emerging as a transformative force in healthcare communication, integrating virtual reality (VR), augmented reality (AR), artificial intelligence (AI), and extended reality to enhance doctor-patient interactions, interprofessional collaboration, medical education, and surgical planning. By providing immersive, interactive, and data-driven environments, the metaverse could facilitate real-time consultations, remote surgical assistance, and simulation-based training, overcoming traditional geographical and logistical barriers. Despite these advancements, skepticism persists regarding the metaverse's true benefit in fostering meaningful human interaction. Some critics argue that virtual interfaces risk alienating communication, eroding the depth of doctor-patient relationships rather than strengthening them. The concern remains that digital mediation might replace rather than enhance human presence, diminishing the nuances of empathy and trust inherent in face-to-face interactions. Economic constraints, technological disparities, and the potential reduction in direct human interaction can complicate widespread adoption. Some perspectives suggest that, if strategically implemented, the metaverse could foster a more human, authentic, and profound doctor-patient relationship by reducing administrative burdens and allowing physicians to focus more on patient care. While the metaverse holds promise for revolutionizing digital healthcare, its long-term success depends on responsible implementation, equitable access, and strategic integration into existing healthcare frameworks. In this paper, we aim to critically evaluate both sides of this debate, synthesizing existing evidence to clarify the role of the metaverse in future healthcare communication.

Indirect Interventions: Lifestyle Options to Treat Mental Disorders

Mental disorders are highly prevalent worldwide. Unfortunately, most people with these disorders do not receive any treatment. This is due in part to a large set of barriers (e.g., no access to therapists or clinics, lack of insurance, stigma) that impede seeking and obtaining mental health services. Many lifestyle interventions that are not part of traditional mental health services have indirect effects on reducing symptoms of mental disorders. These are interventions that target a direct focus (e.g., physical health, socialization, general well-being) but also have indirect and significant impact on reducing mental disorders. This article discusses indirect interventions as an additional way of reaching people in need of help with mental health problems. Interventions such as physical activity and exercise, diet, addressing sleep problems, yoga, tai chi, qigong, and volunteering have indirect beneficial effects. This article highlights the scope of mental illness as a background, introduces indirect interventions, and details three illustrations with evidence that targeting one focus with indirect effects on improving mental disorders. The interventions point to a category of interventions are not systematically used in the care of mental health problems. Among their many advantages is the prospect of their use at the levels of individuals and populations. Indirect interventions do not replace any of the current advances in treatment but add to ways of reaching people in need.

Metaverse for mental health disorders: Opportunities and challenges

Several articles on the mental health impact of the metaverse and the need to balance its potential benefits with the risks of metaverse use has recently published. The metaverse consists of a combination of immersive technologies and artificial intelligence algorithms. The metaverse differs from the preceding digital psychiatric interventions due to its complex structure and interactions between components. The diverse functions of the metaverse ensure that it may have a substantial impact on mental health. However, the evidence for its efficacy in treating mental health disorders is limited to a few trials. The mental health benefits of immersive technologies are well-documented and suggest that metaverse-based psychiatric treatment may be similarly efficacious. The mental health risks of the metaverse are largely unknown, and it is not clear whether they will be greater than other digital psychiatric interventions. Much more research is needed to determine whether metaverse-based psychiatric treatment will meet the standards of appropriate mental healthcare.

Metaverse Clinic for Pregnant Women With Subclinical Hypothyroidism: Prospective Randomized Study

BACKGROUND

Health care is experiencing new opportunities in the emerging digital landscape. The metaverse, a shared virtual space, integrates technologies such as augmented reality, virtual reality, blockchain, and artificial intelligence. It allows users to interact with immersive digital worlds, connect with others, and explore unknowns. While the metaverse is gaining traction across various medical disciplines, its application in thyroid diseases remains unexplored. Subclinical hypothyroidism (SCH) is the most common thyroid disorder during pregnancy and is frequently associated with adverse pregnancy outcomes.

OBJECTIVE

This study aims to evaluate the safety and effectiveness of a metaverse platform in managing SCH during pregnancy.

METHODS

A randomized controlled trial was conducted at Fujian Provincial Hospital, China, from July 2022 to December 2023. A total of 60 pregnant women diagnosed with SCH were randomly assigned into two groups: the standard group (n=30) and the metaverse group (n=30). Both groups received levothyroxine sodium tablets. Additionally, participants in the metaverse group had access to the metaverse virtual medical consultations and metaverse-based medical games. The primary outcomes were adverse maternal and offspring outcomes, and the secondary outcomes included the neurobehavioral development of offspring and maternal psychological assessments.

RESULTS

Of the 30 participants in each group, adverse maternal outcomes were observed in 43% (n=13) of the standard group and 37% (n=11) of the metaverse group (P=.60). The incidence of adverse offspring outcomes was 33% (n=10) in the standard group, compared to 7% (n=2) in the metaverse group (P=.01). The Gesell Development Scale did not show significant differences between the two groups. Notably, the metaverse group demonstrated significantly improved scores on the Self-Rating Depression Scale and the Self-Rating Anxiety Scale scores compared to the standard group (P<.001 and P=.001, respectively).

CONCLUSIONS

The use of metaverse technology significantly reduced the incidence of adverse offspring outcomes and positively impacted maternal mental health. Maternal adverse outcomes and offspring neurobehavioral development were comparable between the two groups.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2300076803; https://www.chictr.org.cn/showproj.html?proj=205905.

Problematic social media use in 3D? Relationships between traditional social media use, social virtual reality (VR) use, and mental health

This research expanded on prior work exploring the relationship between social media use, social support, and mental health by including the usage of social virtual reality (VR). In Study 1 (undergraduate students; n = 448) we examined divergent relationships between problematic social media use (e.g., Facebook, TikTok), total use, and users' mental health indicators (e.g., depression, anxiety, social isolation). To determine whether problematic social media use patterns extended to immersive 3-D environments, we sampled active social VR users (e.g., Rec Room) in Study 2 (n = 464). Problematic social VR use was related to decreased real-life social support (β = -.62, 95%CI [-.80, -.44]), but not to VR social support (β = -.06, 95%CI [-.25, .14]). Conversely, the amount of social VR use was only related to increased social VR (β = .06, 95%CI [.04, .15]) but not to real-life social support (β = -.02, 95%CI [-.05, .04]). Study 2 also revealed a finding that may be unique to the 3-D immersive environment: the amount of social VR use facilitated better mental health for VR users, but only through stronger perceived social support on social VR but not in real life. This result highlights the potential of immersive media to promote mental well-being by facilitating engaging and meaningful social interactions.

Cryptocurrency Trading and Associated Mental Health Factors: A Scoping Review

BACKGROUND

Cryptocurrency trading seemingly mirrors the high-risk, high-reward nature of gambling, and may cause significant psychological challenges to traders. As cryptocurrency trading becomes mainstream, this scoping review aims to synthesize evidence from empirical studies to understand the emotional, cognitive, and social influences on cryptocurrency traders, and identify associated mental health traits/attributes influencing their behaviors.

METHODS

This review adhered to PRISMA-ScR guidelines, pooling in 13 studies involving 11,177 participants across multiple countries. A detailed literature search was conducted up to August 4, 2024, and was rerun on October 9, 2024 using databases including PubMed/Medline, Web of Science, Embase, and Scopus. Keywords used included psychiatry, psychology, mental health, cryptocurrency, trading behavior, mental health, substance use, gambling, investment, and/or emotional impact. These terms were refined through iterative searches to retrieve the most relevant studies.

RESULTS

The scoping review found several key psychological factors affecting cryptocurrency trading behaviors. Many traders exhibited addiction-like behaviors, compulsively trading even when it leads to financial losses. Social media was found to have a strong influence, encouraging herd behavior and impulsive decision-making to follow trends. High levels of psychological distress, including anxiety and depression, were found to be linked to the market's volatility and risks. Overconfidence bias was observed to make traders underestimate risks and overestimate their ability to predict the market. Cognitive biases like confirmation bias and the disposition effect caused traders to hold onto losing investments and sell winning ones too early.

CONCLUSION

Due to the shared psychological traits between cryptocurrency trading and gambling, it is imperative to implement targeted early interventions to mitigate the risk of its progression into a pathological condition. Tools like the Problematic Cryptocurrency Trading Scale may help identify and manage risky behaviors. Ongoing research is crucial to identify both positive and negative impact of cryptocurrency trading to develop effective support systems and regulatory policies to address traders' mental well-being.

Multimodal emotion recognition in the metaverse era: New needs and transformation in mental health work

This editorial comments on an article recently published by López del Hoyo et al. The metaverse, hailed as "the successor to the mobile Internet", is undoubtedly one of the most fashionable terms in recent years. Although metaverse development is a complex and multifaceted evolutionary process influenced by many factors, it is almost certain that it will significantly impact our lives, including mental health services. Like any other technological advancements, the metaverse era presents a double-edged sword for mental health work, which must clearly understand the needs and transformations of its target audience. In this editorial, our primary focus is to contemplate potential new needs and transformation in mental health work during the metaverse era from the perspective of multimodal emotion recognition.

Comparing counseling outcome for college students: Metaverse and in-person approaches

ABSTRACTObjective This study compared metaverse counseling with in-person counseling, using in-person counseling as a comparison group. To achieve this, we assessed whether metaverse counseling, a novel treatment approach, is comparable to traditional in-person counseling. Method: A total of 60 participants voluntarily participated in the study. Among the participants, 28 preferred in-person counseling, whereas 32 selected metaverse counseling as their preferred treatment option. Results and Conclusion: The findings indicated no statistically significant differences in the psychological symptom change patterns between the two counseling modalities. Both metaverse and in-person counseling demonstrated a common pattern of reduced symptom levels from pre-to post-session (Metaverse counseling Cohen's d = 1.04, In-person counseling Cohen's d = .62), which remained stable from post-session to follow-up regardless of the chosen counseling modality. Furthermore, the study revealed that the metaverse counseling group exhibited a higher level of working alliances than the in-person counseling group. Additionally, there was a slight tendency toward higher levels of counseling satisfaction in the metaverse counseling group than in the in-person counseling group. The results of this study support the use of synchronous metaverse programs to treat college students. The implications and limitations of this study are discussed. (195 words).

Evaluating the efficacy of support groups in the metaverse for Ukrainian refugees: a protocol for a randomized clinical trial

BACKGROUND

The Ukrainian crisis, sparked by the Russian invasion, has generated one of the most extensive refugee crises in modern history. Addressing the mental health challenges of Ukrainian refugees is critical to promoting their resilience and successful integration into host communities. Traditional support group interventions might be challenging to implement for geographically dispersed populations, making the metaverse an innovative and inclusive platform for providing much-needed support to such populations.

METHODS/DESIGN

Displaced Ukrainian refugee adults (18 years or older) without current psychiatric diagnoses or current involvement in therapeutic interventions are included in the study. Participants are randomized to one of three conditions: (1) Metaverse Support Groups, (2) In-Person Support Groups, or (3) Waitlist. Both intervention groups (Metaverse and In-Person) undergo 5 support group sessions, and data are collected at baseline, mid-intervention, post-intervention, and 3-month follow-up. Primary outcomes are depressive symptomatology and anxiety. Secondary outcomes are perceived social support, well-being, and gender-based violence awareness.

DISCUSSION

To our knowledge, this is the first attempt to test the efficacy of support groups in the Metaverse for the Ukrainian refugee population. This study can thus add substantially to the body of knowledge on effective interventions and policies for refugees.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT06142032 ( https://clinicaltrials.gov/study/NCT06142032 ). Registered on November 8, 2023.

Salutogenic Environmental Health Model-proposing an integrative and interdisciplinary lens on the genesis of health

Introduction

The maintenance of health is a central objective of public health initiatives. Within the salutogenic paradigm, health promotion is focused on understanding the mechanisms of health development. Models serve as indispensable tools. One of the leading paradigms in the health sciences is the Salutogenic Model developed by Aaron Antonovsky. However, it lacks sufficient specification to reflect the complexity of the environmental dimensions that have emerged from research in environmental health science. The interactions and impact pathways between these dimensions on health status are not adequately distinguished. The objective of this study is to address this gap by extending Antonovsky's model to encompass environmental dimensions, that is, the interactions between humans and their environment. Furthermore, the study will integrate examples of models and theories from various disciplines to illustrate how a more comprehensive and holistic explanation of health development can be provided from an interdisciplinary environmental public health perspective.

Methodology

As part of a three-step approach, a Basic Model was first developed that integrates the five environmental dimensions-Natural, Built-Material, Socio-Cultural, Psycho-Social, and Individual-into the Salutogenic Model. Subsequently, narrative non-exhaustive literature research was used to identify interdisciplinary example models. The models were used to identify gaps in the Basic Model through a critical lens and to synthesize them into a more holistic model.

Results

The synthesis of fifteen interdisciplinary models resulted in the development of an integrative Salutogenic Environmental Health Model (SEHM), which comprises twelve principal components of health development and their interactions and pathways. Links to the original models permit the user to refer back to them.

Discussion

This integrative approach offers a comprehensive understanding of the development of health by synthesizing disparate explanatory models and theories from various disciplines through theoretical analysis. The various environmental dimensions and the determinants of health contained therein, as well as their mental and physical processing and the associated components of health development and their interactions, are summarized in this new model. The SEHM thus enables a differentiated analysis of health determinants and serves as an operational framework for health promotion and pathways to well-being in contemporary research contexts.

Virtual worlds, real opportunities: A review of marketing in the metaverse

Metaverse, as an emerging phenomenon, presents businesses with new opportunities to create user-centered, interactive, and fully immersive products and services that transcend the boundaries of physical and digital reality. However, there is a lack of understanding among academics and business leaders regarding what the metaverse is and how it can transform the marketing landscape. By conducting a systematic literature review of 39 articles using 5W1H framework, the study enhances the comprehension of marketing in metaverse from both conceptual and managerial perspectives. The study delves into the intricacies of the metaverse, examining its components, such as 3D virtual world, avatars, interoperability, and persistency, while exploring its opportunities and challenges. Specifically, it highlights the evolution of the 4P's of marketing and their applications across diverse industries, ranging from tourism and education to retailing and beyond. The review provides a comprehensive understanding of the state-of-the-art literature. The findings of this study can guide future research on the potential of metaverse and aid managers in developing effective marketing strategies related to marketing in metaverse.

Healthcare Interventions for Children Using Nonimmersive Virtual Reality: A Mixed Methods Systematic Review

INTRODUCTION

Nonimmersive virtual reality (NIVR), a computer-generated virtual reality experience wherein users are not fully immersed, has been increasingly used in pediatric healthcare. This study aimed to identify the effects of NIVR-based interventions for children.

METHOD

A mixed methods systematic review of relevant studies published until December 2023 was conducted. We included samples of healthy children and those with chronic conditions or disabilities, findings related to self-management or social skills, and the NIVR interventions applied. A convergent-integrated design was used for the synthesis.

RESULTS

This review included 22 studies, of which 15 examined children having autism spectrum disorders. Utilizing NIVR was found to be effective in enhancing social skills. Participating in virtual communities with peers having similar conditions was determined to facilitate social support and identity exploration.

DISCUSSION

Healthcare interventions using NIVR need to be explored further to improve self-management and social skills in children with various conditions.

Virtual Reality Rehabilitation and Artificial Intelligence in Healthcare Technology

The benefit of virtual rehabilitation is that it helps the patient increase their engagement and motivation. Another advantage is that it allows patient specific. A third utility is that the therapist can make the sessions more efficient and productive. A feature of virtual reality (VR) rehabilitation is that it is possible to create virtual environments which are more realistic than those in a video game and in which the patients can perform exercises. As a result, the patients are more immersed and motivated to avoid the boredom from which patients in standard therapy usually suffer. The features of artificial intelligence (AI) in biomedicine are the optimisation of diagnostics, treatment, and patient monitoring. AI allows for the analysis to have the potential to detect subtle deviations. In this chapter, the application of virtual reality and artificial intelligence in healthcare was discussed.

MetaHealth: unlocking metaverse technologies in digital healthcare

INTRODUCTION

The metaverse is a new digital world powered by cutting-edge technologies that offers tremendous potential for healthcare. The metaverse is anticipated to experience enormous growth and adoption with a rising need for digital healthcare over the next decade. This article offers a comprehensive analysis of the integration of metaverse technologies into healthcare.

AREAS COVERED

This article delves into the multifaceted realm of metaverse technologies within healthcare, offering insights into its diverse contexts. Central to its exploration are the significant contributions, such as examining the current landscape of metaverse technologies in healthcare, offering a nuanced understanding of their applications. The article meticulously explores the array of tools and platforms available for surgical procedures, highlighting their efficacy and it also delves into how these technologies illuminate the evolving landscape of healthcare delivery. Through thorough analysis, this article elucidates the transformative potential of metaverse technologies in revolutionizing healthcare practices.

EXPERT OPINION

The integration of metaverse technologies in healthcare signifies a transformative shift in service delivery. The metaverse, driven by advanced technology, promises substantial changes, enhances medical education, patient care, and research through immersive experiences. This article aims to explore its various contexts heralding a new era in healthcare.

Phubbing and its impact on the individual's psychological well-being

Increasingly, smartphones have become a part of people's everyday lives, and are now considered by many to be an indispensable social accessory. Since attachment to a smartphone could have negative psychological consequences, a burgeoning new area of research has emerged which examines the effects of smartphones on individuals' well-being. Hence, this study focuses on phubbing - one's engagement with the smartphone during a face-to-face conversation with another person or group of people - and its association with psychological well-being. For this investigation, a quantitative descriptive approach has been adopted involving a sample of 370 women and men from Spain between 25 and 60 years old. The survey was distributed during late 2019 and the first quarter of 2020. The Phubbing Behaviors Survey was conducted, comprising five dimensions (cultural, technological, social, communicational, and psychological), and a total of 33 items requiring responses on a 5-point Likert scale. This survey was used in conjunction with the General Health Questionnaire (GHQ-28), consisting of four categories (somatic symptoms, social dysfunction, anxiety and insomnia, and severe depression), and 7 items per category. The findings reveal a positive correlation between phubbing and severe depression and, young women under 25 years old show higher levels of somatic symptoms than men in the same age group. This study demonstrates the need to raise awareness via health education and to promote healthy use of the Internet to prevent psychological distress resulting from phubbing.

Role of augmented reality and virtual reality from the Indian healthcare education perspective - A systematic review

Augmented reality (AR) and virtual reality (VR), are upcoming technologies with considerable potential to revolutionizing healthcare education, enhancing patient safety, and improving healthcare quality particularly in the Indian context. This review is conducted to view the current scenario of Indian context considering the impact of COVID-19. The current systematic review study was done following PRISMA 2020 guidelines using the key terms "Augmented Reality," "Virtual Reality," "Healthcare," and "India." Only the PubMed database was selected based on its reputation and authenticity, which is the only limitation of this study and strength. Both qualitative and quantitative methods are used for synthesis of results. In Indian context, 12 (1.7%) and 36 (2.2%) articles related to AR and VR were found, respectively. Six abstracts could not be retrieved, and after screening abstracts, three were found not suitable in VR and eight were found duplicate. A total of 30 articles were considered for this review. 18 (50%) were original, 12 (33.3%) were review, and 6 (16.7%) were other articles. 03 (8.3%), 21 (58.3%), and 12 (33.3%) articles were related to AR, VR, and both AR and VR, respectively. Considering the single database search and six unretrievable abstract, AR, VR, mixed reality (MR), soft e-skin, and extended reality (XR) technologies have the potential to revolutionize healthcare education and training, reducing real-life errors and improving patient safety. Although the Indian healthcare sector only contributes 1.7-2.2% to PubMed publications related to AR and VR.. The review was not registered.

SAFEvR MentalVeRse.app: Development of a Free Immersive Virtual Reality Exposure Therapy for Acrophobia and Claustrophobia

Background: Specific phobias impact over 400 million people worldwide. Digitalizing mental health could alleviate the burden. Still, although the corporate-driven Metaverse is expanding rapidly, there needs to be more momentum in harnessing virtual reality exposure therapy uptake. Objective: This study aims to conceptualize, develop, and deploy a free Virtual Reality Exposure Therapy (VRET) application specifically designed for treating acrophobia and claustrophobia. This pilot study, which holds the promise of a future where mental health is more accessible and effective, explores the feasibility of leveraging transdisciplinary collaboration among specialists to create a safe, accessible, and effective VRET solution. Methods: We conducted a Delphi heuristic approach involving bioethicists, neuroscientists, and tech developers. Second, we reviewed the existing psychological theories and therapeutic strategies for addressing phobias in VR. Third, we conceptualized a thematic analysis-derived framework for a safe, adaptive-gamified free exposure to virtual reality acrophobia and claustrophobia (SAFEvR ACT). Finally, we provide an overview of the iterative improvements made during 12 workshops and 76 weekly briefings on developmental implementations. Results: We developed the SAFEvR ACT into a proof-of-concept application freely deployed on the MentalVerse app platform. Our safety-focused approach can benefit from prevalidation perspectives within future randomized control trials. Conclusions: The resulting application derived from the SAFEvR ACT framework represents a blueprint to counter the current lack of iVR mental health uptake by offering a free VRET alternative. Future research should aim towards developing similar free platforms to lessen mental health burdens and gather quantitative data. We conclude with a call to action to researchers to fine-tune our current approach and take a stand for free digital mental health within MentalVeRse.app.

From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions

In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably. In this paper, we sought to draw upon the latest data from large-scale epidemiological studies and systematic reviews, along with randomized controlled trials and qualitative research recently emerging on this topic, in order to now provide a multi-dimensional overview of the impacts of Internet usage across psychological, cognitive and societal outcomes. Within this, we detail the empirical evidence on how effects differ according to various factors such as age, gender, and usage types. We also draw from new research examining more experiential aspects of individuals' online lives, to understand how the specifics of their interactions with the Internet, and the impact on their lifestyle, determine the benefits or drawbacks of online time. Additionally, we explore how the nascent but intriguing areas of culturomics, artificial intelligence, virtual reality, and augmented reality are changing our understanding of how the Internet can interact with brain and behavior. Overall, the importance of taking an individualized and multi-dimensional approach to how the Internet affects mental health, cognition and social functioning is clear. Furthermore, we emphasize the need for guidelines, policies and initiatives around Internet usage to make full use of the evidence available from neuroscientific, behavioral and societal levels of research presented herein.

Understanding the knowledge structure and the value creation process of the metaverse

The metaverse is a digital space that empowers users to interact socially, using new and specific technologies, to generate value and co-create experiences. This paper provides a framework for organising the themes discussed in pioneering literature. An adaptation of the PRISMA process was used to explain the methodology applied. The results showed that more than 84 % of studies on the metaverse have been published since 2020. Technologies such as augmented reality and artificial intelligence are positioned as the basic themes, and decision-making and human-machine interface are emerging themes. This paper constitutes an original contribution as it also presents the highlights and structure of the main themes on metaverse. Additionally, it develops an analytical framework for understanding the metaverse value creation. Therefore, this paper represents a starting point for a reflection on the applications of the metaverse that can contribute to the achievement of productive and valuable progress in various fields of research.

XR and mental wellbeing: state of the art and future research directions for the Metaverse

Introduction

The purpose of this study is to provide an overview of extant research regarding XR technology and its effect on consumer wellbeing. With the hopes of informing marketing practitioners on XR consumer psychology, in preparation for the Metaverse.

Methods

To achieve the above aim, two types of analysis took place. Firstly, a bibliometric analysis was conducted which was then followed by a framework-based structured literature review. The latter entailed an analysis of 81 articles evaluated from a positive psychological approach.

Findings

Following the TCCM framework, the analysis revealed the most common psychological theories demonstrating potential avenues for XR to impact consumer wellbeing. Moreover, researchers found preliminary links between, theory, characteristics, and contexts. Giving a preliminary description of how theory manifests into reality. Finally, the overview of extant literature was used to propose new avenues for future research pertaining to marketing, the Metaverse, and consumer effects.

Conclusion

In conclusion, the paper provides stakeholder insights which can ensure minimal consumer risk and sustainable use of the XR technology and Metaverse. While addressing the need for more research that uncovers the psychological effects of emerging technologies, so to prepare for the Metaverse. This is especially important when considering the current upsurge of these technologies and the uncertainties associated with their novelty and the idea of an 'always on' consumer.

Effectiveness of Metaverse Space-Based Exercise Video Distribution in Young Adults: Randomized Controlled Trial

BACKGROUND

In response to the serious lack of physical activity among young adults, recent attempts have been made to encourage young people to exercise through exercise video distribution. However, merely distributing videos does not lead to improved physical activity levels. Metaverse space, which enables web-based interaction through avatars, allows users to watch exercise videos in the same space as other avatars.

OBJECTIVE

This study explored whether exercise video distribution using metaverse space is effective in improving physical activity levels, along with mental health and locomotive function, among young people.

METHODS

In this parallel-group randomized controlled trial participants were recruited using printed poster displays. A total of 48 young adults aged between 18 and 30 years were assigned to 3 groups of 16 each: the metaverse, YouTube, and control group. To encourage exercise, the metaverse group was given an exercise video each week with a load of around 4-8 metabolic equivalents of tasks (METs) for 8 videos delivered in the metaverse space. The YouTube group was sent a URL on YouTube every week to view exercise videos with the same content as the metaverse group. The control group was given no special instructions. The intervention period was 8 weeks. Pre- and postintervention physical activity, well-being, locomotive syndrome risk tests, and social capital were measured. Although this study was not blinded to the participants, the measurers did not know to which group the participants belonged. Mixed model repeated-measures analyses and a post hoc Wilcoxon signed rank sum test were performed to detect the effects of the intervention in all groups.

RESULTS

The results of the mixed model repeated-measures analyses showed a significant interaction between groups and before and after the intervention for total physical activity (metaverse group: pre 737.1, SD 609.5 METs/week, post 1575.4, SD 1071.8 METs/week; YouTube group: pre 661.7, SD 710.7 METs/week, post 911.9, SD 1103.3 METs/week; and control group: pre 930.6, SD 665.1 METs/week, post 844.7, SD 701.8 METs/week; P=.04) but none for the indicators of well-being (P=.40), locomotive function scale (P=.17), and social capital (P=.23). A post hoc test showed a significant increase in physical activity in the metaverse group before and after the intervention (P=.006).

CONCLUSIONS

This study is the first to show that delivering exercise videos through metaverse space can increase physical activity in young adults by providing a gathering space for individuals similarly motivated for exercise practice. This way, the sense of isolation during exercise is reduced compared with merely distributing videos on YouTube. The use of metaverse space in health promotion is likely to spread, and this study provides a useful reference for its exploration.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06019156; https://ichgcp.net/clinical-trials-registry/NCT06019156.

The Metaverse, Religious Practice and Wellbeing: A Narrative Review

The metaverse is touted as the next phase in the evolution of the Internet. This emerging digital ecosystem is widely conceptualized as a persistent matrix of interconnected multiuser, massively scaled online environments optimally experienced through immersive digital technologies such as virtual reality (VR). Much of the prognostication about the social implications of the metaverse center on secular activities. For example, retail, entertainment (gaming/concerts), and social networking. Little attention has been given to how the metaverse might impact religion. This narrative review explores contemporary research into online religious practice and the use of immersive digital technologies for religious purposes. This focus informs a discussion about how the metaverse, an online and immersive technology, might impact religion/religious practices. For billions worldwide, religion is an essential aspect of social identity and a cornerstone of psychological wellbeing. The emergence of the metaverse may represent a new way of connecting with an ancient source of human flourishing.

Application and challenges of a metaverse in medicine

Metaverse has been confirmed as a relatively amorphous concept of innovation, which refers to technological advancement. Metaverse, i.e., a coalition between reality world and virtual world, has created significant significance and convenience in education, communication, economy, etc. The COVID-19 outbreak has stimulated the growth of metaverse applications in medicine. The above-mentioned technology has broad applications while comprising online remote medical treatment, online conferences, medical education, preparation of surgical plans, etc. Moreover, technical, security, and financial challenges should be tackled down by the future widespread use of metaverse. Metaverse is limitlessly promising, and it will exert a certain effect on future scientific and technological advancements in the medical industry. The review article primarily aims to summarize the application of the metaverse in medicine and their challenge in the future of medicine.

Topical Cellular/Tissue and Molecular Aspects Regarding Nonpharmacological Interventions in Alzheimer's Disease-A Systematic Review

One of the most complex and challenging developments at the beginning of the third millennium is the alarming increase in demographic aging, mainly-but not exclusively-affecting developed countries. This reality results in one of the harsh medical, social, and economic consequences: the continuously increasing number of people with dementia, including Alzheimer's disease (AD), which accounts for up to 80% of all such types of pathology. Its large and progressive disabling potential, which eventually leads to death, therefore represents an important public health matter, especially because there is no known cure for this disease. Consequently, periodic reappraisals of different therapeutic possibilities are necessary. For this purpose, we conducted this systematic literature review investigating nonpharmacological interventions for AD, including their currently known cellular and molecular action bases. This endeavor was based on the PRISMA method, by which we selected 116 eligible articles published during the last year. Because of the unfortunate lack of effective treatments for AD, it is necessary to enhance efforts toward identifying and improving various therapeutic and rehabilitative approaches, as well as related prophylactic measures.

Virtual reality (VR) treatments for anxiety disorders are unambiguously successful, so why are so few therapists using it? Barriers to adoption and potential solutions

Anxiety disorders are a significant cause of disability globally, yet only one in ten sufferers receives adequate quality treatment. Exposure-based therapies are effective in reducing symptoms associated with a number of anxiety disorders. However, few therapists use exposure techniques to treat these conditions, even when they are adequately trained in them, often because of concerns about provoking distress, drop out, logistical barriers, and other concerns. Virtual reality exposure therapy (VRET) can address many of these concerns, and a large body of research decisively shows that VRET is as efficacious for treating these conditions as in vivo exposures. Yet, use of VRET remains low. In this article, we discuss several factors we believe are contributing to low VRET adoption among therapists and raise potential solutions to address them. We consider steps that VR experience developers and researchers might take, such as leading studies of VRET's real-world effectiveness and treatment optimization trials and continuing to improve the fit of platforms with clinicians' workflows. We also discuss steps to address therapist reservations using aligned implementation strategies, as well as barriers for clinics, and the roles that professional organizations and payers could have in improving care by encouraging adoption of VRET.

Emergence of the Metaverse and Psychiatric Concerns in Children and Adolescents

Advancements in digital technology have led to increased usage of digital devices among teenagers. The coronavirus disease 2019 pandemic and the subsequent implementation of social distancing policies have further accelerated this change. Consequently, a new concept called the metaverse has emerged. The metaverse is a combination of a virtual reality universe that allows individuals to meet, socialize, work, play, entertain, and create. This review provides an overview of the concept and main features of the metaverse and examples of its utilization in the real world. It also explains the unique developmental characteristics of childhood and adolescence, as well as the possible negative influences of the metaverse on them, including addiction, antisocial behavior, cyberbullying, and identity confusion. This review summarizes several suggestions for future research because the metaverse is a relatively new concept.

Digital intervention in improving the outcomes of mental health among LGBTQ+ youth: a systematic review

LGBTQ+ youth experience mental health disparities and higher rates of mental disorders due to barriers to accessing care, including insufficient services and the anticipated stigma of revealing their identities. This systematic review incorporated 15 empirical studies on digital interventions' impact on LGBTQ+ youth mental health, examining their potential to address these inequities. This study innovatively categorized existing digital interventions into four streams: Structured Formal (telehealth, online programs), Structured Informal (serious games), Unstructured Formal (mobile applications), and Unstructured Informal (social media). We found that S&F and U&F effectively reduced symptoms. U&F showed potential but required enhancement, while U&I fostered resilience but posed risks. Further integration of emerging technologies like virtual reality may strengthen these interventions. This review identifies the characteristics of effective digital health interventions and evaluates the overall potential of digital technologies in improving LGBTQ+ youth mental health, uniquely contributing insights on digital solutions advancing LGBTQ+ youth mental healthcare.

Counseling Psychological Understanding and Considerations of the Metaverse: A Theoretical Review

The COVID-19 pandemic has triggered the interest in and demand for online platforms that can replace traditional face-to-face activities. Accordingly, metaverses have been increasingly used across society, especially in the Mental health field. This broad use of metaverses is now recognized as a major trend that will drive various industries across healthcare and society. In response to this societal change, this study provides a theoretical framework for understanding and applying metaverses as therapeutic spaces in mental health fields through a conceptualization and characterization of metaverses for a range of technologies and services. The value of metaverses as a human-centered "field of experience" was identified and proposed based on the essential aspect of the user, the human being, rather than from the technology used. According to existing psychotherapeutic theories, four therapeutic concepts for the metaverse were proposed: metaverse as an "average expectable environment" in the developmental and therapeutic categories of the self, a transitional stage for adaptation to reality, a creative space for memory and communication for the self, and an expanded or "surplus" reality. This work is expected to be a useful basis for expanding new psychotherapeutic strategies and methods as therapeutic spaces for maintaining mental health through the metaverse.

A new door to a different world: opportunities from the metaverse and the raise of meta-medical laboratories

OBJECTIVES

In the digital age, the metaverse has emerged with impressive potential for many segments of society. The metaverse could be presented as a parallel dimension able to enhance the physical world as well as our actions and decisions in it with the objective to use a coalition between the natural and virtual worlds for value creation. Our aim was to elaborate on the impact of the metaverse on laboratory medicine.

METHODS

Based on the available evidence, literature and reports, we analyzed the different perspectives of the metaverse on laboratory medicine and the needs for an efficient transition.

RESULTS

The convergence and integration of technologies in the metaverse will participate to the reimagination of laboratory medicine services with augmented services, users' experiences, efficiency, and personalized care. The revolution around the metaverse offers different opportunities for laboratory medicine but also open multiple related challenges that are presented in this article.

CONCLUSIONS

Scientific societies, multidisciplinary teams and specialists in laboratory medicine must prepare the integration metaverse and meta-medical laboratories, raise the awareness, educate, set guidance to obtain a maximum of value and mitigate potential adverse consequences.

Social circuits and their dysfunction in autism spectrum disorder

Social behaviors, how individuals act cooperatively and competitively with conspecifics, are widely seen across species. Rodents display various social behaviors, and many different behavioral paradigms have been used for investigating their neural circuit bases. Social behavior is highly vulnerable to brain network dysfunction caused by neurological and neuropsychiatric conditions such as autism spectrum disorders (ASDs). Studying mouse models of ASD provides a promising avenue toward elucidating mechanisms of abnormal social behavior and potential therapeutic targets for treatment. In this review, we outline recent progress and key findings on neural circuit mechanisms underlying social behavior, with particular emphasis on rodent studies that monitor and manipulate the activity of specific circuits using modern systems neuroscience approaches. Social behavior is mediated by a distributed brain-wide network among major cortical (e.g., medial prefrontal cortex (mPFC), anterior cingulate cortex, and insular cortex (IC)) and subcortical (e.g., nucleus accumbens, basolateral amygdala (BLA), and ventral tegmental area) structures, influenced by multiple neuromodulatory systems (e.g., oxytocin, dopamine, and serotonin). We particularly draw special attention to IC as a unique cortical area that mediates multisensory integration, encoding of ongoing social interaction, social decision-making, emotion, and empathy. Additionally, a synthesis of studies investigating ASD mouse models demonstrates that dysfunctions in mPFC-BLA circuitry and neuromodulation are prominent. Pharmacological rescues by local or systemic (e.g., oral) administration of various drugs have provided valuable clues for developing new therapeutic agents for ASD. Future efforts and technological advances will push forward the next frontiers in this field, such as the elucidation of brain-wide network activity and inter-brain neural dynamics during real and virtual social interactions, and the establishment of circuit-based therapy for disorders affecting social functions.

Development and Effectiveness Verification of Metaverse Cognitive Therapy Contents for MCI Patients

It is very important to prevent dementia by intervening in advance in the stage of mild cognitive impairment, which is the pre-stage of dementia. Recently, cognitive therapy research using metaverse has been on the rise. We propose a way to utilize metaverse cognitive therapy content as a non-drug treatment method of mild cognitive impairment patients. This paper shows the results of clinical trials using metaverse cognitive therapy contents developed by us. We collected data from MCI patient groups and normal groups through MMSE-KC tests and in-content data collection systems. We conducted paired t-tests and repeat measurement ANOVA based on the collected data. The results of this study show how metaverse cognitive therapy content affects MCI patients, and suggest various factors to be considered when creating functional content.

Metaverse as a new place for online mental health services in the post-COVID-19 era: Is it a challenge or an opportunity?

In this article, the author describes the challenges and opportunities of metaverse's presence in the world for online mental health services. Aside from that, the author provides insight that metaverse can become a new place that is more comfortable and enjoyable for everyone who can relish the online mental health meetings with a new atmosphere and sensation, especially in the post-COVID-19 era.

Exploring the Darkverse: A Multi-Perspective Analysis of the Negative Societal Impacts of the Metaverse

The Metaverse has the potential to form the next pervasive computing archetype that can transform many aspects of work and life at a societal level. Despite the many forecasted benefits from the metaverse, its negative outcomes have remained relatively unexplored with the majority of views grounded on logical thoughts derived from prior data points linked with similar technologies, somewhat lacking academic and expert perspective. This study responds to the dark side perspectives through informed and multifaceted narratives provided by invited leading academics and experts from diverse disciplinary backgrounds. The metaverse dark side perspectives covered include: technological and consumer vulnerability, privacy, and diminished reality, human-computer interface, identity theft, invasive advertising, misinformation, propaganda, phishing, financial crimes, terrorist activities, abuse, pornography, social inclusion, mental health, sexual harassment and metaverse-triggered unintended consequences. The paper concludes with a synthesis of common themes, formulating propositions, and presenting implications for practice and policy.

Mental health services in the metaverse: potential and concerns

No abstract available.

Metaverse for Exercise Rehabilitation: Possibilities and Limitations

OBJECTIVES

This study aimed to obtain a consensus agreement from an expert panel on the metaverse for exercise rehabilitation in stroke patients using the Delphi technique.

METHODS

This study recruited twenty-two experts and conducted three rounds of online surveys between January and February 2023. The Delphi consensus technique was performed online to review and evaluate the framework module. A panel of experts, including scholars, physicians, physical therapists, and physical education specialists in the Republic of Korea, was invited to participate in this study. For each round, the expert consensus was defined as more than 90% of the expert panel agreeing or strongly agreeing with the proposed items.

RESULTS

A total of twenty experts completed the three Delphi rounds. First, virtual reality-assisted (VR) treadmill walking could improve cognitive function, concentration, muscular endurance, stroke prevention, proper weight maintenance, and cardiorespiratory function. Second, related technology, safety, price, place, and securing experts would be obstacles or challenges in VR-assisted treadmill walking for stroke patients. Third, the role of exercise instructors in exercise planning, performance, and assessment for VR-assisted treadmill walking is equally important, and reeducation for them is required. Fourth, VR-assisted treadmill walking for stroke patients requires an exercise intensity of at least five times a week, about one hour each time.

CONCLUSIONS

This study showed that the metaverse for exercise rehabilitation for stroke patients could be successfully developed and would be feasible to be implemented in the future. However, it would have limitations in terms of technology, safety, price, place, and expert factors to be overcome in the future.

Taking modern psychiatry into the metaverse: Integrating augmented, virtual, and mixed reality technologies into psychiatric care

The landscape of psychiatry is ever evolving and has recently begun to be influenced more heavily by new technologies. One novel technology which may have particular application to psychiatry is the metaverse, a three-dimensional digital social platform accessed via augmented, virtual, and mixed reality (AR/VR/MR). The metaverse allows the interaction of users in a virtual world which can be measured and manipulated, posing at once exciting new possibilities and significant potential challenges and risks. While the final form of the nascent metaverse is not yet clear, the immersive simulation and holographic mixed reality-based worlds made possible by the metaverse have the potential to redefine neuropsychiatric care for both patients and their providers. While a number of applications for this technology can be envisioned, this article will focus on leveraging the metaverse in three specific domains: medical education, brain stimulation, and biofeedback. Within medical education, the metaverse could allow for more precise feedback to students performing patient interviews as well as the ability to more easily disseminate highly specialized technical skills, such as those used in advanced neurostimulation paradigms. Examples of potential applications in brain stimulation and biofeedback range from using AR to improve precision targeting of non-invasive neuromodulation modalities to more innovative practices, such as using physiological and behavioral measures derived from interactions in VR environments to directly inform and personalize treatment parameters for patients. Along with promising future applications, we also discuss ethical implications and data security concerns that arise when considering the introduction of the metaverse and related AR/VR technologies to psychiatric research and care.

Application of Metaverse Service to Healthcare Industry: A Strategic Perspective

This study is to explore a state of the art in metaverse service that is an emerging issue in applying it to the healthcare industry. The purpose of this study is to provide applicable strategic scenarios for effective metaverse service planning and implementation in healthcare settings. This study is focused on metaverse service as a business model. Thus, related literatures of metaverse service are reviewed in various aspects in healthcare industry. An exploratory approach is used to analyze current qualitative data characterizing healthcare metaverse service business positions and derive applicable strategies from business trends of current metaverse services. Several cases are examined based on the data obtained from various sources of healthcare and other related industries. This study synthesizes finding results and suggests applicable strategies of metaverse service in the healthcare industry. This study will facilitate strategic decision-making and policy-making processes to pursue a business opportunity development through an application of a metaverse service in healthcare and similar settings.

The Metaverse: A New Challenge for the Healthcare System: A Scoping Review

(1) Background: The metaverse is now a reality, and it interests the scientific community, the educational setting, and medical care. Considering the number of people in front of screens, especially children and adolescents, the metaverse could and should become a place of health promotion. Consequently, the objective of the present study was to review the current literature to detect articles that connected the metaverse with prevention and treatment, education and training, and research setting. (2) Methods: Articles were searched on Pubmed, Web of Science, and Scopus, including English-written papers published until 12 August 2022. They were screened against the eligibility criteria and discussed narratively. (3) Results: The literature published is poor; only 21 articles were included, and 11 of them were added in a second moment. These articles were mainly reviews of the literature or editorials. The aspects related to this virtual world in terms of health prevention and the treatment of clinical conditions, education and training, and research have been narratively discussed. (4) Conclusions: The metaverse could be considered a useful instrument to arrive easily and quickly to the population. Given its importance, today, different studies and investments are required to develop proper health promotion programs that are feasible and valid in the metaverse.