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

The visuomotor synchronization immersive virtual reality of a depression avatar in a stigma context experience mobilizes the fronto-parietal cortex and anterior insula

Introduction

The gradual synchronization of the movement of one's real hand with a virtual one can effectively induce a sense of embodiment (SoE) with an avatar with depression. Although neuroimaging studies have explored the neural correlates of some SoE subcomponents of visuomotor synchronization, the neural correlates of individual differences in SoE and how humans acquire virtual body representations through SoE subcomponents remain to be investigated.

Methods

Here, we used the right hand of a virtual patient with depression in immersive virtual reality (IVR) to induce SoE in participants and measured whole brain activity using functional magnetic resonance imaging (fMRI). Participants were instructed to listen to the audio recording of the IVR experience and visualize movements during the fMRI scan. fMRI data were acquired before and immediately after the visuomotor synchronization IVR experience (target condition) or an asynchronized video experience (control condition), followed by embodiment measures related to the two types of experiences.

Results

All five subcomponents of SoE (sense of ownership, sense of agency, sense of localization, appearance, and response to stimuli) were significantly increased during the visuomotor synchronization IVR experience compared with the asynchronized video experience. A significant negative effect of the SoE score was identified in the frontoparietal and anterior insula only for the visuomotor synchronization IVR experience of guiding the virtual right hand of the avatar with depression, implicating interoceptive and multisensory integration.

Discussion

We demonstrated that all five subcomponents of the SoE were present, and that decreased activity in the frontoparietal and anterior insula were crucial brain regions for the virtual human body to be perceived as one's own body and promote conscious feelings of embodiment.

Treatment of aggression regulation problems with virtual reality: study protocol for a randomized controlled trial

Background

Aggressive conduct among delinquents presents a pervasive issue, bearing substantial implications for not only society at large but also for the victims and the individuals displaying the aggression. Traditional approaches to treating aggression regulation deficiencies generally employ Cognitive Behavioral Therapy (CBT) in conjunction with analog role-playing exercises. A body of research supports the efficacy of various therapeutic models for aggression regulation, including Responsive Aggression Regulation Therapy (Re-ART). Role-playing within a therapeutic context has been shown to contribute significantly to reductions in violent reoffending. However, the practical application of these skills in real-world settings remains challenging due to the inherent risk of aggressive outbreaks. Additionally, the conventional role-playing scenarios, often conducted in a therapy room, lack contextual realism and may induce role confusion between the patient and the therapist. Virtual Reality (VR) technology could offer a viable solution to these limitations by allowing for skill training in both behavioral and cognitive domains within a realistic yet safe and controlled setting. The technology also facilitates real-time awareness of emotional states and tension levels in the patient. This paper describes the study protocol of a randomized controlled trial in which Re-ART offered in a virtual environment (Re-ART VR) is compared to Re-ART offered as treatment as usual.

Methods and analysis

Adult forensic outpatients with aggression regulation problems are randomly assigned to either Re-ART VR or Re-ART. The Controlling Skills, Influence of Thinking and Handling Conflicts modules will be offered to both groups during 3-6 months. Pre- and post-intervention measurements are performed. The primary outcome measurement is the degree of aggression regulation, while secondary outcome measurements include impulsivity and cognitive biases. Additionally, patient motivation and therapist motivation are expected to act as moderating factors.

Discussion

To date, scarcely previous research has been done on the effectiveness of VR in treatment of aggression regulation problems in forensic outpatients. Forensic outpatients who do not benefit sufficiently from mainly CBT-based interventions may benefit more from experiential learning. The unique capabilities of VR in this regard have the potential to enhance the treatment effect.Clinical trial registration: [https://clinicaltrials.gov/], identifier [NL78265.018.21].