Look at the Audience? A Randomized Controlled Study of Shifting Attention From Self-Focus to Nonsocial vs. Social External Stimuli During Virtual Reality Exposure to Public Speaking in Social Anxiety

An Approach of Query Audience's Attention in Virtual Speech

Virtual speeches are a very popular way for remote multi-user communication, but it has the disadvantage of the lack of eye contact. This paper proposes the evaluation of an online audience attention based on gaze tracking. Our research only uses webcams to capture the audience's head posture, gaze time, and other features, providing a low-cost method for attention monitoring with reference values across multiple domains. Meantime, we also propose a set of indexes which can be used to evaluate the audience's degree of attention, making up for the fact that the speaker cannot gauge the audience's concentration through eye contact during online speeches. We selected 96 students for a 20 min group simulation session and used Spearman's correlation coefficient to analyze the correlation between our evaluation indicators and concentration. The result showed that each evaluation index has a significant correlation with the degree of attention (p = 0.01), and all the students in the focused group met the thresholds set by each of our evaluation indicators, while the students in the non-focused group failed to reach the standard. During the simulation, eye movement data and EEG signals were measured synchronously for the second group of students. The EEG results of the students were consistent with the systematic evaluation. The performance of the measured EEG signals confirmed the accuracy of the systematic evaluation.

The perception and passage of time during public speaking

Several studies have shown that anxious individuals experience a slower passage of time under threat conditioning. Anxiety-evoking situations have also been proposed to elevate arousal levels, which, in turn, alter one's time percept. However, the effect of social stressors on time perception remains significantly neglected. The current research aimed to investigate the impact of anxiety levels on time estimation and passage of time judgments during public speaking in healthy adults. Participants were recruited from a pool of students that had to give a presentation as part of a university course or their teaching duties. Following the presentation, they were asked to make retrospective time estimations on the duration of the latter, as well as to provide passage of time judgments. Self-reported questionnaires related to affective states, public speaking anxiety, and performance were also administered. Analysis showed that higher levels of public speaking anxiety predicted temporal overestimation and slower "feel" duration and passage of time. Moreover, the relationship between public speaking anxiety and passage of time was mediated by participants' mood states, which remained significant after -indirectly- controlling for fear of evaluation. Overall, our observations suggest that anxiety levels during public presentation significantly predict altered perception and experience of time. The latter can be explained by the speaker's mood status. Identifying the mechanisms that modulate timing under psychological stressors could complement our understanding regarding their impact on educational and social settings, as well as set the ground towards the development of early intervention and prevention strategies for those who suffer from stress-related disorders.

Efficacy of virtual reality for pain relief in medical procedures: a systematic review and meta-analysis

BACKGROUND

Effective pain control is crucial to optimise the success of medical procedures. Immersive virtual reality (VR) technology could offer an effective non-invasive, non-pharmacological option to distract patients and reduce their experience of pain. We aimed to evaluate the efficacy of Immersive virtual reality (VR) technology in reducing patient's pain perception during various medical procedures by conducting a systematic review and meta-analysis.

METHODS

We searched MEDLINE, EMBASE, CENTRAL, CINAHL, and SIGLE until December 2022 for all randomised clinical trials (RCT) evaluating any type of VR in patients undergoing any medical procedure. We conducted a random effect meta-analysis summarising standardised mean differences (SMD) with 95% confidence intervals (CI). We evaluated heterogeneity using I 2 and explored it using subgroup and meta-regression analyses.

RESULTS

In total, we included 92 RCTs (n = 7133 participants). There was a significant reduction in pain scores with VR across all medical procedures (n = 83, SMD - 0.78, 95% CI - 1.00 to - 0.57, I 2 = 93%, p = < 0.01). Subgroup analysis showed varied reduction in pain scores across trial designs [crossover (n = 13, SMD - 0.86, 95% CI - 1.23 to - 0.49, I 2 = 72%, p = < 0.01) vs parallel RCTs (n = 70, SMD - 0.77, 95% CI - 1.01 to - 0.52, I 2 = 90%, p = < 0.01)]; participant age groups [paediatric (n = 43, SMD - 0.91, 95% CI - 1.26 to - 0.56, I 2 = 87%, p = < 0.01) vs adults (n = 40, SMD - 0.66, 95% CI - 0.94 to - 0.39, I 2 = 89%, p = < 0.01)] or procedures [venepuncture (n = 32, SMD - 0.99, 95% CI - 1.52 to - 0.46, I 2 = 90%, p = < 0.01) vs childbirth (n = 7, SMD - 0.99, 95% CI - 1.59 to - 0.38, I 2 = 88%, p = < 0.01) vs minimally invasive medical procedures (n = 25, SMD - 0.51, 95% CI - 0.79 to - 0.23, I 2 = 85%, p = < 0.01) vs dressing changes in burn patients (n = 19, SMD - 0.8, 95% CI - 1.16 to - 0.45, I 2 = 87%, p = < 0.01)]. We explored heterogeneity using meta-regression which showed no significant impact of different covariates including crossover trials (p = 0.53), minimally invasive procedures (p = 0.37), and among paediatric participants (p = 0.27). Cumulative meta-analysis showed no change in overall effect estimates with the additional RCTs since 2018.

CONCLUSIONS

Immersive VR technology offers effective pain control across various medical procedures, albeit statistical heterogeneity. Further research is needed to inform the safe adoption of this technology across different medical disciplines.

Using expectation violation models to improve the outcome of psychological treatments

Expectations are a central maintaining mechanism in mental disorders and most psychological treatments aim to directly or indirectly modify clinically relevant expectations. Therefore, it is crucial to examine why patients with mental disorders maintain dysfunctional expectations, even in light of disconfirming evidence, and how expectation-violating situations should be created in treatment settings to optimize treatment outcome and reduce the risk of treatment failures. The different psychological subdisciplines offer various approaches for understanding the underlying mechanisms of expectation development, persistence, and change. Here, we convey recommendations on how to improve psychological treatments by considering these different perspectives. Based on our expectation violation model, we argue that the outcome of expectation violation depends on several characteristics: features of the expectation-violating situation; the dynamics between the magnitude of expectation violation and cognitive immunization processes; dealing with uncertainties during and after expectation change; controlled and automatic attention processes; and the costs of expectation changes. Personality factors further add to predict outcomes and may offer a basis for personalized treatment planning. We conclude with a list of recommendations derived from basic psychology that could contribute to improved treatment outcome and to reduced risks of treatment failures.