Virtual reality perspective-taking increases cognitive empathy for specific others

Seeing is Not Thinking: Testing Capabilities of VR to Promote Perspective-Taking

Virtual Reality (VR) technologies offer compelling experiences by allowing users to immerse themselves in simulated environments interacting through avatars. However, despite its ability to evoke emotional responses, and seeing 'through the eyes' of the displayed other, it remains unclear to what extent VR actually fosters perspective-taking (PT) or thinking about others' thoughts and feelings. It might be that the common belief that one can "become someone else" through VR is misleading, and that engaging situations through a different viewpoint does not produce a different cognitive standpoint. To test this, we conducted a 2 (perspective, first-person or third-person) by 2 (perspective-taking task or no task) to examine effects on perspective taking, measured via audio-recordings afforded by the think-aloud protocol. Our data demonstrate that while first-person perspective (1PP) facilitates perceived embodiment, it has no appreciable influence on perspective-taking. Regardless of 1PP or third-person perspective (3PP), perspective-taking was substantially and significantly increased when users were given a specific task prompting them to actively consider a character's perspective. Without such tasks, it seems that participants default to their own viewpoints. These data highlight the need for intentional design in VR experiences to consider content rather than simply viewpoint as key to authentic perspective-taking. To truly harness VR's potential as an "empathy machine," developers must integrate targeted perspective-taking tasks or story prompts, ensuring that cognitive engagement is an active component of the experience.

In their shoes: multimodal training using virtual reality to improve knowledge and confidence in caring for LGBTQ+ older adults

LGBTQ+ older adults experience health disparities disproportionately and face age, sexual identity, and gender identity discrimination, yet education is lacking amongst health care professionals. Virtual reality (VR) is a potential tool to combat prejudice and unrecognized bias in clinicians, which is imperative for improving care for marginalized populations. We implemented a multimodal workshop on the care of LGBTQ+ older adults using case-based learning (Aquifer Geriatrics), VR simulation (Embodied Labs), and a discussion with LGBTQ+ Veteran Care Coordinators. A retrospective pre and post survey was collected to ascertain the workshop's effect on learner confidence and knowledge of caring for this population, along with the effectiveness of VR in medical education. Responses were measured on a Likert scale of 1-10, with improvement measured by comparing the increase in scores before and after training. The post survey included an open-ended prompt regarding intent to use learning. The workshop was held 3 times with 33 survey respondents. Results indicated significantly increased knowledge/confidence in all areas. Free text data analysis identified ways respondents intended to apply the learning in everyday work. These findings suggest this workshop was considered an effective teaching strategy that improved confidence and knowledge, and channeled empathy for this underrepresented population.

The First Step is the Hardest: A Mixed Methods Single-Case Experimental Design Study of a VR-Enhanced Training Program in a Forensic Youth Care Setting

Street Temptations is a virtual reality-enhanced training program developed as an add-on intervention for adolescents with disruptive behavior problems. Using mentalization as a primary treatment mechanism, the program aims to address cognitive distortions and increase motivation for behavior change. This study provides an initial evaluation of Street Temptations in a forensic youth care setting, utilizing both quantitative and qualitative data within an A-B-A' single-case experimental design. Throughout a baseline, intervention, and follow-up phase, adolescents completed daily measurements on cognitive distortions and motivation for behavior change. Secondary outcomes were assessed before baseline, after intervention, and after follow-up, which included mentalization and perspective-taking. Qualitative data were collected after the intervention through separate interviews with adolescents and Street Temptations therapists. A total of 8 adolescents were included in the study, 5 of whom dropped out, leaving 3 who provided sufficient data for visual inspection of the outcomes. The observed patterns suggested an increase in adolescents' awareness of others' perspectives during participation in Street Temptations, potentially indicating a positive effect on cognitive distortions. However, daily assessments did not show an increase in adolescents' motivation for behavior change. Positive effects of Street Temptations and virtual reality, as well as areas for improvement, were highlighted in all interviews. Recommendations for further development and implementation are discussed. Overall, this study provides preliminary support for the use of Street Temptations as an add-on intervention in forensic youth care.

A quantitative assessment of the hand kinematic features estimated by the oculus Quest 2

In the past decade, immersive virtual reality (VR) has garnered significant interest due to its capacity to ability a strong sense of presence and allow users to act in virtual environments. In particular, VR has been increasingly used in clinical settings to present scenarios for motor rehabilitation purposes. Existing research efforts mostly focus on investigating the clinical effectiveness of different routines. However, modern VR systems, in addition to presenting scenarios, also have hand motion tracking capabilities that could be potentially used to gather clinically relevant kinematic data from the patients while they execute the VR tasks. Here, we quantitatively assess the capability of tracking hand movements of a popular VR system, the Oculus Quest 2 by Meta, by comparing its kinematic measures with those provided by a commercial marker-based motion capture system. Our findings suggest that the Quest 2 provides reasonably reliable estimates of hand position and velocity. Estimates of acceleration are noisier and might be sometime unsuitable for kinematic assessments. Notably, the accuracy of the kinematic estimates varies across spatial directions. Estimates along the left/right direction are the most accurate, followed by estimates along the up/down axis. Estimates along the near/far axis appear to be the noisiest. Furthermore, we also found that Quest 2 can provide fine-grained measures of grip aperture, but the precision of these measures might be affected by the subject's head movements while wearing the system. Our results suggest that modern VR devices, in addition to presenting immersive scenarios, could be potentially used in rehabilitation settings also to provide clinically relevant kinematic measures that can potentially inform medical decisions.

Impact of Spatial Presence on Charitable Behavior in the Metaverse: A Moderated Mediation Model of Norm Message and Involvement with Charity

With the rapid development of virtual technology, the metaverse has become an influential communication tool driving engagement in prosocial behavior. This study examined whether spatial presence in a metaverse affects charitable involvement and prosocial behavior. Additionally, it explored the impact of descriptive norms in the metaverse, validated as effective in the physical world. A laboratory experiment was conducted with 93 participants using a customized ZEPETO map. The results showed that perceived spatial presence significantly increases donation intentions. A moderated mediation model indicated that descriptive norms moderate the indirect effect of spatial presence on donation intentions through charitable involvement. The findings provide a theoretical implication in that descriptive norms in virtual environments may lead to unintended consequences. The study offers practical insights into communication strategies, highlighting the importance of spatial presence for impactful campaigns in the metaverse.

A virtual reality intervention to increase interracial empathy and upstander behaviors in nursing leaders

Efforts to improve diversity, equity, and inclusion (DEI) in healthcare have increased, targeting healthcare worker biases with the goal of increasing inclusion of employees from racial and ethnic minoritized groups and improving care for patients from these groups. Virtual reality (VR) remains an underutilized mechanism for effecting behavior and attitude change. VR educational interventions work through two primary pathways, behavior rehearsal and embodiment. Rehearsal of communication in VR has been shown to improve self-efficacy, including preparedness, comfort, and confidence in speaking up and comforting a patient with anxiety. Embodiment involves users stepping into the point-of-view of an avatar and experiencing a virtual world through the eyes of that avatar. Users can thus experience things through the eyes of someone from a racial/ethnic group different than their own. In this study, we examined the efficacy of a VR intervention with both rehearsal and embodiment components on intergroup attitudes and behaviors in nursing leaders from a large, multi-site health care network with locations in four states of United States. Results showed significant increases, relative to a control group, in empathic feeling and expression, empathic perspective taking, theory of planned behavior-based predictors of increasing upstander behavior, and likelihood of taking action in response to a hypothetical situation where a coworker was treated in a racially biased way. Six to eight months after the intervention, significant increases in each of these measures remained. Empathy and upstander behavioral intention rates were demonstrably improved among nursing leaders towards colleagues facing race-based discrimination. This quantifiable impact reaffirms the program's effectiveness in addressing a critical issue: systemic racism in healthcare settings.

The neurosociological paradigm of the metaverse

Metaverse integrates people into the virtual world, and challenges depend on advances in human, technological, and procedural dimensions. Until now, solutions to these challenges have not involved extensive neurosociological research. The study explores the pioneering neurosociological paradigm in metaverse, emphasizing its potential to revolutionize our understanding of social interactions through advanced methodologies such as hyperscanning and interbrain synchrony. This convergence presents unprecedented opportunities for neurotypical and neurodivergent individuals due to technology personalization. Traditional face-to-face, interbrain coupling, and metaverse interactions are empirically substantiated. Biomarkers of social interaction as feedback between social brain networks and metaverse is presented. The innovative contribution of findings to the broader literature on metaverse and neurosociology is substantiated. This article also discusses the ethical aspects of integrating the neurosociological paradigm into the metaverse.

Harnessing Virtual Reality to Influence Attitudes Toward Beef Consumption: The Role of Empathy in Dietary Interventions

The excessive consumption of red meat, such as beef, is a growing global health concern linked to increased risks of cancer and cardiovascular diseases. The health consequences associated with red meat consumption were estimated to cost USD 285 billion globally in 2020, accounting for approximately 0.3% of total health expenditures that year. Understanding the psychological mechanisms behind food choices is crucial for changing consumption habits, fostering healthy behaviors, and achieving sustainable dietary patterns. To address these challenges, this study utilizes virtual reality (VR) as a persuasive tool to examine how empathy, as a psychological mechanism, influences the intention to reduce beef consumption and its impact on dietary attitudes. Using an experimental design with 142 participants, the study found that in the VR context, individuals with higher empathy scores experienced a stronger sense of presence, significantly influencing their attitudes toward beef consumption, mediated by the change in anti-beef-eating attitude (p = 0.029). This suggests that VR can serve as an effective medium to reduce individuals' willingness to consume beef and consequently prevent health risks associated with excessive meat intake. This study also highlights the importance of considering individual empathy levels when designing VR interventions to maximize their effectiveness and promote healthier dietary habits, ultimately improving public health. However, one limitation of this study is that it only assessed short-term changes in attitudes following the VR intervention, without incorporating long-term follow-ups to determine if these changes are sustained over time.

Virtual Reality-Based Psychoeducation for Dementia Caregivers: The Link between Caregivers' Characteristics and Their Sense of Presence

In neuropsychology and clinical psychology, the efficacy of virtual reality (VR) experiences for knowledge acquisition and the potential for modifying conduct are well documented. Consequently, the scope of VR experiences for educational purposes has expanded in the health field in recent years. In this study, we sought to assess the effectiveness of ViveDe in a psychoeducational caregiver program. ViveDe is a VR application that presents users with possible daily life situations from the perspective of individuals with dementia. These situations can be experienced in immersive mode through 360° video. This research aimed to ascertain the associations between the sense of presence that can be achieved in VR and some users' psychological characteristics, such as distress and empathetic disposition. The study involved 36 informal caregivers of individuals with Alzheimer's disease. These participants were assessed using scales of anxiety and depression, perceived stress, empathy, and emotional regulation. They were asked to participate in a six-session psychoeducation program conducted online on dementia topics, in addition to experiencing the ViveDe application. The immersive VR sessions enabled the caregivers to directly experience the symptoms of dementia (e.g., spatial disorientation, agnosia, difficulty in problem-solving, and anomia) in everyday and social settings. The results indicated that although the experience in ViveDe (evaluated using the XRPS scale and five questions about emotional attunement) showed efficacy in producing a sense of first-person participation in the symptoms of dementia, further research is needed to confirm this. The structural equation model provided evidence that the characteristics of individuals who enjoy the VR experience play a determining role in the perceived sense of presence, which in turn affects the efficacy of the VR experience as a psychoeducational tool. Further research will be conducted to ascertain the potential role of these elements in conveying change in the caregivers of people with dementia. This will help us study the long-term effectiveness of a large-scale psychoeducation program in VR.

A theoretical review of the Proteus effect: understanding the underlying processes

Humans' inherent fascination for stories can be observed throughout most of our documented history. If, for a long time, narratives were told through paintings, songs, or literature, recent technological advances such as immersive virtual reality have made it possible for us to interact with storylines and characters in a completely new manner. With these new technologies came the need to study how people interact with them and how they affect their users. Notably, research in this area has revealed that users of virtual environments tend to display behaviors/attitudes that are congruent with the appearance of the avatars they embody; a phenomenon termed the Proteus effect. Since its introduction in the literature, many studies have demonstrated the Proteus effect in various contexts, attesting to the robustness of the effect. However, beyond the first articles on the subject, very few studies have sought to investigate the social, affective, and cognitive mechanisms underlying the effect. Furthermore, the current literature appears somewhat disjointed with different schools of thought, using different methodologies, contributing to this research topic. Therefore, this work aims to give an overview of the current state of the literature and its shortcomings. It also presents a critical analysis of multiple theoretical frameworks that may help explain the Proteus effect. Notably, this work challenges the use of self-perception theory to explain the Proteus effect and considers other approaches from social psychology. Finally, we present new perspectives for upcoming research that seeks to investigate the effect of avatars on user behavior. All in all, this work aims to bring more clarity to an increasingly popular research subject and, more generally, to contribute to a better understanding of the interactions between humans and virtual environments.

Expanding the empirical study of virtual reality beyond empathy to compassion, moral reasoning, and moral foundations

This study utilizes a controlled experimental design to investigate the influence of a virtual reality experience on empathy, compassion, moral reasoning, and moral foundations. With continued debate and mixed results from previous studies attempting to show relationships between virtual reality and empathy, this study takes advantage of the technology for its ability to provide a consistent, repeatable experience, broadening the scope of analysis beyond empathy. A systematic literature review identified the most widely used and validated moral psychology assessments for the constructs, and these assessments were administered before and after the virtual reality experience. The study is comprised of two pre-post experiments with student participants from a university in the United States. The first experiment investigated change in empathy and moral foundations among 44 participants, and the second investigated change in compassion and moral reasoning among 69 participants. The results showed no significant change in empathy nor compassion, but significant change in moral reasoning from personal interest to post-conventional stages, and significant increase in the Care/harm factor of moral foundations. By testing four of the primary constructs of moral psychology with the most widely used and validated assessments in controlled experiments, this study attempts to advance our understanding of virtual reality and its potential to influence human morality. It also raises questions about our self-reported assessment tools and provides possible new insights for the constructs examined.

Exploring empathic engagement in immersive media: An EEG study on mu rhythm suppression in VR

This study investigates the influence of immersive media, particularly Virtual Reality (VR), on empathic responses, in comparison to traditional television (TV), using electroencephalography (EEG). We employed mu rhythm suppression as a measurable neural marker to gauge empathic engagement, as its increase generally signifies heightened empathic responses. Our findings exhibit a greater mu rhythm suppression in VR conditions compared to TV conditions, suggesting a potential enhancement in empathic responses with VR. Furthermore, our results revealed that the strength of empathic responses was not confined to specific actions depicted in the video clips, underscoring the possibility of broader implications. This research contributes to the ongoing discourse on the effects of different media environments on empathic engagement, particularly emphasizing the unique role of immersive technologies such as VR. It invites further investigation into how such technologies can shape and potentially enhance the empathic experience.

Assessing the effectiveness of virtual reality to promote empathy for patients through a mixed-methods study

OBJECTIVE

To describe the implementation and outcomes of EmpathyVR, an immersive experience using virtual reality (VR) to promote empathy for patients with physical limitations due to chronic diseases.

METHODS

First-year student pharmacists participated in a learning experience that incorporated VR and stiff gloves to simulate physical limitations associated with color-blindness and arthritis, respectively. Students completed pre- and post-intervention surveys that included the Kiersma-Chen Empathy Scale and measures of immersion, user enjoyment, perceived usefulness for learning, and adverse effects of the experience. A focus group was also conducted with 6 students to obtain additional feedback on the learning experience.

RESULTS

Of the 132 students who were enrolled in the program, 131 completed the assigned tasks; 117 of these agreed to participate in the study, and their data were included in the analyses. There was a significant improvement in empathy scores in the cognitive domain from pre- to post-intervention. Post-intervention survey results also demonstrated a high degree of immersion in the experience, high levels of self-reported enjoyment, and high levels of perceived usefulness of the activity to support learning. There was a low to moderate incidence of minor self-reported adverse effects from the activity. Focus group feedback was also positive. One student stated, "… it really allowed you to think and put yourself in their shoes."

CONCLUSION

Implementation of a VR-based learning activity into the first semester of the PharmD curriculum was successful and resulted in improved student empathy scores and a positive learning experience.

Exploring the impact of immersive virtual reality on depression knowledge and stigma reduction: a cross-over RCT fMRI study

The stigma of mental illness is a form of negative judgmental knowledge and is a barrier to individual seeking treatment. Contact-based educational interventions with first-person perspective (1PP) combined with immersive virtual reality (IVR) is promising as an anti-stigma intervention. This study aims to investigate the effectiveness of 1PP anti-stigma IVR intervention compared to video in enhancing depression knowledge and reducing stigma, as well as to examine the corresponding depression knowledge brain activity change using functional magnetic resonance imaging (fMRI). Participants engaged in a 1PP anti-stigma intervention using both IVR and conventional video, focusing on the daily life and recovery of a patient with mild depression. The change in depression knowledge, stigma-related behavioral, and brain activity using fMRI were measured at pre- and post-interventions. Depression knowledge improved for both interventions; however, only the IVR intervention reduced stigma. In the IVR intervention, depression knowledge score was positively associated with neural response in the right superior frontal gyrus activation, indicative of empathic concern. Conversely, the video intervention correlated with increased activity in the right anterior insula, suggesting a distress-related response. The findings demonstrate that the immersive nature of IVR can reduce stigma more effectively than video intervention. This effectiveness is underpinned by the change in depression knowledge on neural activity, with IVR fostering empathy-related behavioral responses. The results highlight the potential of IVR in enhancing empathic understanding and reducing stigma towards mental illness, emphasizing the need for further exploration into immersive technologies for mental health education.

Treatment Responsivity in Adolescents With Disruptive Behavior Problems: Co-Creation of a Virtual Reality-Based Add-On Intervention

BACKGROUND

We developed Street Temptations (ST) as an add-on intervention to increase the treatment responsivity of adolescents with disruptive behavior problems. ST's primary aim is to improve adolescents' mentalizing abilities in order to help them engage in and benefit from psychotherapy. Additionally, virtual reality (VR) is used to work in a more visual, less verbal, fashion.

OBJECTIVE

By recapping the lessons learned while developing ST so far, we aim to design the following study on ST. Furthermore, we aim to enhance the development and study of new health care interventions in clinical practice, together with adolescents as their end users.

METHODS

We followed an iterative co-creation process to develop a prototype of ST, in collaboration with adolescents and professionals from a secured residential facility in Amsterdam, the Netherlands. The prototype was tested during a pilot phase, involving 2 test runs, in which 4 adolescents and 4 professionals participated. Qualitative data were collected through interviews with the adolescents and by conducting a group interview with the professionals, in order to gain first insights into ST's usability, feasibility, and its added value to clinical practice. In between the first and second test runs, the prototype was enhanced. On the basis of the complete pilot phase, we reflected on the future development and implementation of ST to design a subsequent study.

RESULTS

Over the course of 6 months, ST's first prototype was developed during multiple creative sessions. Included was the development of a short 360° VR video, to serve as a base for the mentalization exercises. The final version of ST consisted of 7 individual therapy sessions, incorporating both the VR video and a VR StreetView app. On the basis of the qualitative data collected during the pilot phase, we found preliminary signs of ST's potential to support adolescents' perspective-taking abilities specifically. Additionally, using VR to focus on real-life situations that adolescents encounter in their daily lives possibly helps to facilitate communication. However, several challenges and requests concerning the VR hardware and software and the implementation of ST emerged, pointing toward further development of ST as an add-on intervention. These challenges currently limit large-scale implementation, resulting in specific requirements regarding a subsequent study.

CONCLUSIONS

In order to gather more extensive information to shape further development and study treatment effects, a small-scale and individually oriented research design seems currently more suitable than a more standard between-subjects design. Using the reflection on the lessons learned described in this report, a research protocol for a forthcoming study on ST has been developed. By presenting our co-creation journey thus far, we hope to be of inspiration for a more co-creative mindset and in that way contribute to the mutual reinforcement of science and clinical practice.

All it takes is empathy: how virtual reality perspective-taking influences intergroup attitudes and stereotypes

Research in the past decade has demonstrated the potential of virtual reality perspective-taking (VRPT) to reduce bias against salient outgroups. In the perspective-taking literature, both affective and cognitive mechanisms have been theorized and identified as plausible pathways to prejudice reduction. Few studies have systematically compared affective and cognitive mediators, especially in relation to virtual reality, a medium posited to produce visceral, affective experiences. The present study seeks to extend current research on VRPT's mechanisms by comparing empathy (affective) and situational attributions (cognitive) as dual mediators influencing intergroup attitudes (affective) and stereotypes (cognitive). In a between-subjects experiment, 84 participants were randomly assigned to embody a VR ingroup or outgroup waiting staff at a local food establishment, interacting with an impolite ingroup customer. Results indicated that participants in the outgroup VRPT condition reported significantly more positive attitudes and stereotypes towards outgroup members than those in the ingroup VRPT condition. For both attitudes and stereotypes, empathy significantly mediated the effect of VRPT, but situational attributions did not. Findings from this research provide support for affect as a key component of virtual experiences and how they shape intergroup perceptions. Implications and directions for further research are discussed.

Inward VR: Toward a Qualitative Method for Investigating Interoceptive Awareness in VR

lmmersive virtual reality (VR) technologies can produce powerful illusions of being in another place or inhabiting another body, and theories of presence and embodiment provide valuable guidance to designers of VR applications that use these illusions to "take us elsewhere." However, an increasingly common design goal for VR experiences is to develop a deeper awareness of the internal landscape of one's own body (i.e., interoceptive awareness); here, design guidelines and evaluative techniques are less clear. To address this, we present a methodology, including a reusable codebook, for adapting the five dimensions of the Multidimensional Assessment of Interoceptive Awareness (MAIA) conceptual framework to explore interoceptive awareness in VR experiences via qualitative interviews. We report results from a first exploratory study (n=21) applying this method to understand the interoceptive experiences of users in a VR environment. The environment includes a guided body scan exercise with a motion-tracked avatar visible in a virtual mirror and an interactive visualization of a biometric signal detected via a heartbeat sensor. The results provide new insights on how this example VR experience might be refined to better support interoceptive awareness and how the methodology might continue to be refined for understanding other "inward-facing" VR experiences.

Virtual reality for the rehabilitation and prevention of intimate partner violence - From brain to behavior: A narrative review

Rehabilitation and prevention strategies to reduce intimate partner violence (IPV) have limited effectiveness in terms of improving key risk factors and reducing occurrence. Accumulated experimental evidence demonstrates that virtual embodiment, which results in the illusion of owning a virtual body, has a large impact on people's emotional, cognitive, and behavioral responses. This narrative review discusses work that has investigated how embodied perspective - taking in virtual reality has been used as a tool to reduce bias, to enhance recognition of the emotional state of another, and to reduce violent behaviors, in particular in the realm of IPV. Some of the potential neurological mechanisms behind these affective and behavioral changes are also discussed. The process of rehabilitation and prevention is complex and not always effective, but the integration of neuroscience-inspired and validated state-of-the-art technology into the rehabilitation process can make a positive contribution.

Domestic Violence From a Child Perspective: Impact of an Immersive Virtual Reality Experience on Men With a History of Intimate Partner Violent Behavior

Domestic violence has long-term negative consequences on children. In this study, men with a history of partner aggression and a control group of non-offenders were embodied in a child's body from a first-person perspective in virtual reality (VR). From this perspective, participants witnessed a scene of domestic violence where a male avatar assaulted a female avatar. We evaluated the impact of the experience on emotion recognition skills and heart rate deceleration responses. We found that the experience mainly impacted the recognition of angry facial expressions. The results also indicate that males with a history of partner aggression had larger physiological responses during an explicit violent event (when the virtual abuser threw a telephone) compared with controls, while their physiological reactions were less pronounced when the virtual abuser invaded the victim's personal space. We show that embodiment from a child's perspective during a conflict situation in VR impacts emotion recognition, physiological reactions, and attitudes towards violence. We provide initial evidence of the potential of VR in the rehabilitation and neuropsychological assessment of males with a history of domestic violence, especially in relation to children.

Disrupting the "empathy machine": The power and perils of virtual reality in addressing social issues

This article looks through a critical media lens at mediated effects and ethical concerns of virtual reality (VR) applications that explore personal and social issues through embodiment and storytelling. In recent years, the press, immersive media practitioners and researchers have promoted the potential of virtual reality storytelling to foster empathy. This research offers an interdisciplinary narrative review, with an evidence-based approach to challenge the assumptions that VR films elicit empathy in the participant-what I refer to as the VR-empathy model. A review of literature from the fields of psychology, computer science, embodiment, medicine, and virtual reality was carried out to question and counter these claims through case studies of both fiction and non-fiction VR experiences. The results reveal that there is little empirical evidence of a correlation between VR exposure and an increase in empathy that motivates pro-social behavior, and a lack of research covering VR films exposure eliciting empathy. Furthermore, the results show an alarming lack of research into the long-term effects of VR films and other VR immersive experiences. This contribution aims to understand and demystify the current "empathy machine" rhetoric and calls for more rigorous, scientific research that can authenticate future claims and systemize ethical best practices.

Interview with an avatar: Comparing online and virtual reality perspective taking for gender bias in STEM hiring decisions

Virtual perspective taking can reduce unconscious bias and increase empathy and prosocial behavior toward individuals who are marginalized based on group stereotypes such as age, race, or socioeconomic status. However, the question remains whether this approach might reduce implicit gender bias, and the degree to which virtual immersion contributes to behavioral modulation following perspective taking tasks is unknown. Accordingly, we investigate the role of virtual perspective taking for binary gender using an online platform (Study 1) and immersive virtual reality (Study 2). Female and male undergraduates performed a simulated interview while virtually represented by an avatar that was either congruent or incongruent with their own gender. All participants rated a male and a female candidate on competence, hireability, likeability, empathy, and interpersonal closeness and then chose one of these two equivalently qualified candidates to hire for a laboratory assistant position in the male dominated industry of information technology. Online perspective taking did not reveal a significant influence of avatar gender on candidate ratings or candidate choice, whereas virtual reality perspective taking resulted in significant changes to participant behavior following exposure to a gender-incongruent avatar (e.g., male embodied as female), such that men showed preference for the female candidate and women showed preference for the male candidate. Although between-group differences in candidate ratings were subtle, rating trends were consistent with substantial differences in candidate choice, and this effect was greater for men. Compared to an online approach, virtual reality perspective taking appears to exert greater influence on acute behavioral modulation for gender bias due to its ability to fully immerse participants in the experience of (temporarily) becoming someone else, with empathy as a potential mechanism underlying this phenomenon.

Impact of a Virtual Reality-Based Simulation on Empathy and Attitudes Toward Schizophrenia

Virtual Reality (VR) has been identified as one of the most promising resources for developing empathy towards stigmatized groups as it allows individuals to experience a situation close to reality from another person’s perspective. This quasi-experimental study aimed to examine the impact on empathy, knowledge, and attitudes towards people with schizophrenia of a VR simulation that reproduces the experience of psychotic symptoms while performing a cognitive task compared with watching a 2D video and, thus, how these experiences could reduce stigma towards people diagnosed with schizophrenia. The sample comprised of 102 higher education health students, distributed by the experimental and control groups. The impact of the program was measured by completing multiple questionnaires on levels of empathy, attitudes, and mental health knowledge. Both methods (VR and 2D video) were, to a certain extent, effective. However, VR was more effective at eliciting attitudes and knowledge change compared to the control group. These findings suggest that not only VR but also 2D videos could be interesting strategies to enhance empathy and improve attitudes towards people with schizophrenia in higher education health students.

Virtual Reality-Integrated Immersion-Based Teaching to English Language Learning Outcome

Globalization and informatization are reshaping human life and social behaviors. The purpose is to explore the worldwide strategies to cultivate international talents with a global vision. As a global language with the largest population, English, and especially its learning effect, have always been the major concerns of scholars and educators. This work innovatively studies the combination of immersion-based English teaching with virtual reality (VR) technology. Then, based on the experimental design mode, 106 students from a Chinese school were selected for a quasi-experimental study for 16 weeks (3 h a week, and 48 h in total). The collected data were analyzed by computer statistical software, and hypotheses are verified. The results showed that there is a significantly positive correlation between VR and immersion-based language teaching (0.851, p < 0.01). There is a significantly positive correlation between immersion-based language teaching and academic achievement (0.824, p < 0.01), and VR is positively correlated with learning outcome (LO) (0.836, p < 0.01). Compared with other state-of-art research methods, this work modifies the students' oral test through the analysis and comparison with the system database, and the students' learning effect is greatly improved. Finally, some suggestions are put forward according to the research results to provide an experimental reference for English teachers and future linguistics teaching.

Nursing students' views of using virtual reality in healthcare: A qualitative study

AIMS AND OBJECTIVES

This study explored nursing students' views of using virtual reality in healthcare.

BACKGROUND

The popularity and use of virtual reality in healthcare delivery and education is on the rise. Yet, the views of future nurses regarding this technology remain underexplored.

DESIGN

This is a qualitative descriptive study guided by a naturalistic inquiry and reported using the Standards for Reporting Qualitative Research checklist.

METHODS

Nursing students (n = 26) were recruited using convenience and snowball sampling. They were first exposed to a virtual reality intervention aimed to enhance men's awareness of testicular diseases. This was attempted to familiarise participants with the technology and initiate conversations around its use in healthcare. Participants were then interviewed face-to-face, either individually or within focus groups. Data were analysed using thematic analysis.

RESULTS

Four themes were identified: (i) positive experiences of virtual reality; (ii) challenges to using virtual reality; (iii) settings where virtual reality can be implemented; and (iv) blue-sky and future applications of virtual reality. Participants described this technology as novel, enjoyable, immersive, memorable and inclusive. They questioned, however, the suitability of virtual reality for older adults, reported minor technical difficulties and stressed the importance of prior preparation in the use of the technology. Virtual reality was recommended for use in outpatient healthcare settings, schools and the community. Participants suggested using virtual reality in health promotion, disease prevention and management, and to promote nurses' empathy towards patients.

CONCLUSIONS

Findings highlight the potential role of virtual reality in assisting nurses in promoting health and managing disease. Future research is needed to establish the long-term effect of virtual reality interventions among more diverse participants.

RELEVANCE TO CLINICAL PRACTICE

Virtual reality can be implemented in outpatient, educational and community settings in order to promote health, prevent disease, enhance disease and self-management, and increase nurses' empathy towards patients.

Why a Virtual Assistant for Moral Enhancement When We Could have a Socrates?

Can Artificial Intelligence (AI) be more effective than human instruction for the moral enhancement of people? The author argues that it only would be if the use of this technology were aimed at increasing the individual's capacity to reflectively decide for themselves, rather than at directly influencing behaviour. To support this, it is shown how a disregard for personal autonomy, in particular, invalidates the main proposals for applying new technologies, both biomedical and AI-based, to moral enhancement. As an alternative to these proposals, this article proposes a virtual assistant that, through dialogue, neutrality and virtual reality technologies, can teach users to make better moral decisions on their own. The author concludes that, as long as certain precautions are taken in its design, such an assistant could do this better than a human instructor adopting the same educational methodology.

Virtual reality for the enhancement of emotion regulation

In recent decades, a growing body of literature has focused on emotion regulation (ER), which refers to the ability to implement strategies in order to modulate emotional responses and reach desirable goals. To date, impaired ER (i.e., emotion dysregulation) has been identified as a transdiagnostic factor across a wide range of psychopathological conditions, which shows the importance of improving patients' ability to regulate negative and positive emotions in clinical practice. In addition to the increasing evidence showing its efficacy in the treatment of several clinical conditions, virtual reality (VR) has recently emerged as a potentially powerful tool for enhancing ER, thus breaking new ground in the development of cutting-edge transdiagnostic interventions. In the present narrative review, we will provide an overview of the existing evidence about VR-based interventions in the field of ER, emphasizing the promising findings and the barriers that still have to be addressed. To this aim, the available VR-based literature will be analysed in relation to four categories of ER strategies: situational strategies, attentional strategies, cognitive strategies, and response modulation strategies. Furthermore, new emerging fields of research targeting innovative aspects of ER will be highlighted, including the use of VR to promote positive emotions and interpersonal ER skills. Besides, its cost-effectiveness will be discussed, taking into account the costs for both developers (e.g., clinicians and researchers) and end-users. Finally, future directions in this promising field of research will be outlined.

Can't simply roll it out: Evaluating a real-world virtual reality intervention to reduce driving under the influence

Driving under the influence (DUI) increases the risk of crashes. Emerging technologies, such as virtual reality (VR), represent potentially powerful and attractive tools for the prevention of risky behaviours, such as DUI. Therefore, they are embraced in prevention efforts with VR interventions primed to grow in popularity in near future. However, little is known about the actual effectiveness of such DUI-targeting VR interventions. To help fill the knowledge gap, this study explored the effects of one VR intervention as delivered in the real world. Using pre and post test design, including an intervention group (n = 98) and a control group (n = 39), the intervention evaluation examined young drivers’ (aged 18 to 25, no known history of DUI) intention and self-reported behaviour three months after the intervention as compared to the baseline. The results did not provide evidence for statistically significant effects of the VR intervention on self-reported DUI behaviour during the three months post intervention and DUI intention at three months post intervention. Such results might be due to the fact that the recruited participants generally self-reported little DUI behaviour, i.e. positively changing behaviour that is already positive is inherently challenging. Nevertheless, the results question the utility of funding the roll-out of arguably attractive technologies without a thorough understanding of their effectiveness in particular settings. To improve the potential for future positive outcomes of such interventions, we provide suggestions on how VR software might be further developed and, subsequently, leveraged in future research to improve the likelihood for behavioural change, e.g. by collecting, analysing and presenting objective driving performance data. Alternatively, future endeavours might focus on participants with known DUI history and examine the effects of the VR intervention for this particular higher-risk group.

Innovation for Positive Sustainable Legacy From Mega Sports Events: Virtual Reality as a Tool for Social Inclusion Legacy for Paris 2024 Paralympic Games

There is significant interest in how sports events and their associated legacies could act as a platform to address global challenges and engender social change. The United Nations (UN) has acknowledged the important role that sport plays in supporting the UN 2030 Agenda for Sustainable Development and the Olympic movement could be argued as central to that objective. Yet critical questions and concerns have been raised about the growing expenditure, viability, long term legacy, and impacts of mega sports events such as the Olympic Games. While much evidence has focused on the challenges of creating legacy for Olympic Games, there is considerably less literature on understanding the Paralympic context. The purpose of this paper is to discuss the role of innovation in creating legacy from MSEs and propose a theoretical and methodological plan for such research. Innovation, a key driver in organizational performance, is suggested as essential to defining, planning for and measuring legacy. We specifically examine the potential of virtual reality (VR) as a technological innovation which can help create a social inclusion legacy in the context of Paris 2024 Olympic/Paralympic Games. A conceptual model is developed, which identifies legacy as a "wicked problem", and this paper discusses the importance of innovation with regards to legacy, by suggesting a new application for VR technology in the context of legacy related to social inclusion. Information technology is a valuable facilitator of social inclusion for individuals with a disability. We specifically examine the potential of VR as a technological innovation which can help create legacy through influencing unconscious biases (symbolic ableism) toward diversity such as disability, gender, and race.

A Pilot Study of the Impact of Virtually Embodying a Patient with a Terminal Illness

Compassionate end-of-life care matters deeply for patients and their caregivers, but studies continue to demonstrate ways in which physicians fall short. Despite specific training during medical school, many patients report lack of empathy in their providers with respect to end-of-life conversations. This is likely because empathy is simply hard to teach. Numerous activities have been tried to combat the decline in empathy during medical training with little to moderate success. However, virtual reality, which allows users to viscerally experience anything from another person's point of view, could be a game changer for building empathy within medicine. This type of perspective-taking has previously shown to improve understanding, reduce biases, facilitate empathy, and promote prosocial behaviors. In this pilot study, virtual reality was used to allow students to "become a patient" virtually embodying their daily activities, symptoms, and interactions with caregivers. Using the Embodied Labs modules, first-year medical students were able to experience first-hand having a terminal illness, being told no further treatments are available and witnessing loved ones' reactions. Data generated through surveys and reflections indicated a high level of place illusion, plausibility, and embodiment of users. This high level of immersion generated an increase in comfortability with talking about end-of-life issues, produced a better understanding of what patients and their families experience, and promoted a change in the way students would approach clinical skills. Analysis of reflections indicated a high level of empathy for the patient and his family members. Overall, the activity was highly received by students as a valuable learning activity. As such, we propose that virtual reality could be a useful pedagogical tool to facilitate empathy and clinical skills within medical education.

Being the victim of virtual abuse changes default mode network responses to emotional expressions

Recent behavioural studies have provided evidence that virtual reality (VR) experiences have an impact on socio-affective processes, and a number of findings now underscore the potential of VR for therapeutic interventions. An interesting recent result is that when male offenders experience a violent situation as a female victim of domestic violence in VR, their sensitivity for recognition of fearful facial expressions improves. A timely question now concerns the underlying brain mechanisms of these behavioural effects as these are still largely unknown. The current study used fMRI to measure the impact of a VR intervention in which participants experienced a violent aggression from the specific vantage point of the victim. We compared brain processes related to facial and bodily emotion perception before and after the VR experience. Our results show that the virtual abuse experience led to an enhancement of Default Mode Network (DMN) activity, specifically associated with changes in the processing of ambiguous emotional stimuli. In contrast, DMN activity was decreased when observing fully fearful expressions. Finally, we observed increased variability in brain activity for male versus female facial expressions. Taken together, these results suggest that the first-person perspective of a virtual violent situation impacts emotion recognition through modifications in DMN activity. Our study contributes to a better understanding of the brain mechanisms associated with the behavioural effects of VR interventions in the context of a violent confrontation with the male participant embodied as a female victim. Furthermore, this research also consolidates the use of VR embodied perspective-taking interventions for addressing socio-affective impairments.

Virtual Reality and Empathy Enhancement: Ethical Aspects

The history of humankind is full of examples that indicate a constant desire to make human beings more moral. Nowadays, technological breakthroughs might have a significant impact on our moral character and abilities. This is the case of Virtual Reality (VR) technologies. The aim of this paper is to consider the ethical aspects of the use of VR in enhancing empathy. First, we will offer an introduction to VR, explaining its fundamental features, devices and concepts. Then, we will approach the characterization of VR as an "empathy machine," showing why this medium has aroused so much interest and why, nevertheless, we do not believe it is the ideal way to enhance empathy. As an alternative, we will consider fostering empathy-related abilities through virtual embodiment in avatars. In the conclusion, however, we will examine some of the serious concerns related to the ethical relevance of empathy and will defend the philosophical case for a reason-guided empathy, also suggesting specific guidelines for possible future developments of empathy enhancement projects through VR embodied experiences.

Navigating an Identity Playground: Using sociomateriality to build a theory of identity play

The construct of identity play, which involves the exploration and experimentation with possible future selves, is underexplored in organizational literature. To extend theory on identity play, we take a narrative inquiry approach and examine qualitative interview data in the context of virtual environments. Using a sociomateriality perspective, we contribute to theory on identity play in three ways. First, we reveal how identity play unfolds via the sociomaterial intertwining of not just human agency, but also material agency, situated work practices, and self-representations. Second, we offer a new definition of identity play that goes beyond the exploration of possible selves and uncover identity play narratives on the possible self, the improbable self, and the impossible self. We demonstrate how identity play, particularly with impossible selves, shapes others’ experiences and thus has implications beyond the self. Finally, three identity play affordances emerged: plasticity of appearance, plasticity of behavior, and plasticity of perspective.

Designing a Virtual Reality Game for Promoting Empathy Toward Patients With Chronic Pain: Feasibility and Usability Study

Background

Many researchers have been evaluating how digital media may impact the emotional and perspective taking aspects of empathy in both clinical and nonclinical settings. Despite the growing interest in using virtual reality (VR) and VR games to motivate empathy, few studies have focused on empathy for people who live with chronic pain.

Objective

Chronic pain affects, by conservative estimates, 1 in 5 people in industrialized countries. Despite this prevalence, public awareness of chronic pain was remarkably low until the recent opioid crisis; as a result, stigma remains a problem frequently faced by people who live with this condition. To address this, the VR game AS IF was developed to increase nonpatients’ empathy toward the growing number of people who live with long-term chronic pain. On the basis of our prior work, we overhauled our approach, designed and built a VR prototype and evaluated it, and offered design suggestions for future research.

Methods

We introduced the design features of the VR game AS IF and described the study we devised to evaluate its effectiveness. We adopted a mixed methods approach and compared the empathy-related outcomes in both pre- and posttesting. A total of 19 participants were recruited.

Results

The findings of this study suggest that the VR game was effective in improving implicit and explicit empathy as well as its emotional and perspective taking aspects. More specifically, for the Empathy Scale, the total pretest scores (mean 47.33, SD 4.24) and posttest scores (mean 59.22, SD 4.33) did not reach statistical significance (P=.08). However, we did find differences in the subscales. The kindness subscale showed a statistically significant increase in the posttest score (mean 15.61, SD 2.85) compared with the pretest score (mean 17.06, SD 2.65;P=.001). For the Willingness to Help Scale, a significant increase was observed from a t test analysis (P<.001) of scores before (mean 7.17, SD 2.28) and after (mean 8.33, SD 2.03) the gameplay. The effect size for this analysis was large (d=−1.063).

Conclusions

The contributions of this research are as follows: AS IF provides a promising approach for designing VR games to motivate people’s empathy toward patients with chronic pain, the study evaluates the potential effectiveness of such a VR approach, and the general design suggestions devised from this study could shed light on future VR game systems.

Computational Social Science and Sociology

The integration of social science with computer science and engineering fields has produced a new area of study: computational social science. This field applies computational methods to novel sources of digital data such as social media, administrative records, and historical archives to develop theories of human behavior. We review the evolution of this field within sociology via bibliometric analysis and in-depth analysis of the following subfields where this new work is appearing most rapidly: (a) social network analysis and group formation; (b) collective behavior and political sociology; (c) the sociology of knowledge; (d) cultural sociology, social psychology, and emotions; (e) the production of culture; (f) economic sociology and organizations; and (g) demography and population studies. Our review reveals that sociologists are not only at the center of cutting-edge research that addresses longstanding questions about human behavior but also developing new lines of inquiry about digital spaces as well. We conclude by discussing challenging new obstacles in the field, calling for increased attention to sociological theory, and identifying new areas where computational social science might be further integrated into mainstream sociology.

A Virtual Reality Simulation of Drug Users' Everyday Life: The Effect of Supported Sensorimotor Contingencies on Empathy

Perspective taking techniques have been used to transport people into imaginary situations and the lives of others. Virtual Reality provides an immersive way to virtually experience the lives of stigmatized by society members. Through the support of sensorimotor contingencies, people can use natural movements to view and interact with the virtual world around them. In this study, we compared a perspective-taking immersive Virtual Reality system which supports a number of sensorimotor contingencies (SC group) with a perspective-taking desktop system of the same application but without support of any sensorimotor contingencies (NSC group), to investigate the effect of the supported sensorimotor contingencies in promoting empathy and positive attitudes toward drug users. Results demonstrate a strong correlation between closeness to the drug user and empathy in the SC group. In both groups there were a within group significant change in their reported attitudes before and after their exposure. Finally, participants in the SC condition reported significantly higher levels of Place Illusion (PI), body ownership, agency and plausibility of people. Further research is needed to investigate how sensorimotor contingencies can be exploited to the fullest to be used as an effective method to induce empathy and change attitudes toward stigmatized by society people.

The Use of Virtual Reality in Psychiatry: A Review

With the advancement in modern information technology, virtual reality (VR) is being increasingly used for the diagnosis, assessment, and treatment of mental disorders. Recently, a VR-based cognitive behavioral therapy for social phobia has been recognized as a new medical technology in South Korea. This might lead to an increase in the use of VR in the field of psychiatry. The present review provides an overview of the status of VR therapies in various psychiatric conditions such as anxiety disorder, post-traumatic stress disorder, psychosis, addiction, and eating disorder. Besides, it summarizes the role of VR therapy in the management of disorders associated with child and adolescence psychiatry as well as various other clinical applications. Additionally, we discuss the merits and limitations of VR therapy, which might serve as a useful reference for researchers. In the current environment wherein novel medical models consisting of a combination of digital devices and medicine are being developed; understanding new technologies such as VR could open new doors to mental health treatments.

Evaluation of a virtual reality enhanced bullying prevention curriculum pilot trial

INTRODUCTION

Bullying is a widely prevalent public health and safety issue that can have serious long-term consequences for youth. Given the limited efficacy of traditional bullying prevention programs, a need exists for novel, theoretically informed, prevention programming. Construal Level Theory provides a useful framework.

METHODS

This study evaluated a pseudo-randomized pilot trial of a virtual reality enhanced bullying prevention program among middle school students (N = 118) in the Midwest United States. Two models were proposed. The first predicts reductions in bullying behavior (traditional bullying, cyberbullying, relational aggression) at post-test, mediated by changes in empathy in the virtual reality condition compared to the control condition. The second predicts increases in school belonging and willingness to intervene as an active bystander at post-test, mediated by changes in empathy in the virtual reality condition compared to the control condition.

RESULTS

The virtual reality condition yielded increased empathy from pre-to post-intervention compared to the control condition. Through the mediating role of empathy, changes in the desirable directions were also observed for traditional bullying, sense of school belonging, and willingness to intervene as an active bystander, but not for cyberbullying or relational aggression.

CONCLUSIONS

The scope and practical limitations of the virtual reality trial prevented a larger scale and more rigorous evaluation; however, results justify an expanded examination of virtual reality as a youth violence prevention tool.