A cognitive model for emotional regulation in virtual reality exposure

Virtual reality exposure (VRE) is an effective form of psychotherapy. However, theoretical frameworks for user experience of virtual reality (VR) have yet to be fully integrated with psychological theory, limiting optimisation of VRE. Presence, a sense of being in a specific place, is the dominant focus of VR/VRE research into emotion regulation. Critically, presence is subject to limitations that make it an impractical concept where precision is needed. More meaningful insights can be obtained by examining specific cognitive constructs. Additionally, presence is a technology-focused consideration. This review argues that in psychotherapy, it is the personal meaning of an environment, rather than the concrete properties of the environment itself, that informs interventions. Because personal meaning is subject to individual differences and most VRE scenarios are generic by nature, situational plausibility must be managed by the therapist. The cognitive person-focused model has been developed to address the limitations of the existing presence–emotion concepts. This model provides a much-needed psychological framework to inform and guide researchers and therapists. The framework also creates a scaffold to support additional variables of interest. As part of the model justification, an examination of presence literature limitations is included. It is hoped that validation and ongoing development of the model will help advance VRE research and therapy.

[1]  Jonathan Freeman,et al.  A Cross-Media Presence Questionnaire: The ITC-Sense of Presence Inventory , 2001, Presence: Teleoperators & Virtual Environments.

[2]  Karen M. Simon,et al.  Clinical Applications of Cognitive Therapy , 2004, Springer US.

[3]  Ruth Rettie,et al.  Using Goffman's Frameworks to Explain Presence and Reality , 2004 .

[4]  P. Pauli,et al.  Causal Interactive Links Between Presence and Fear in Virtual Reality Height Exposure , 2019, Front. Psychol..

[5]  G. VandenBos APA dictionary of psychology, 2nd ed. , 2015 .

[6]  C. Beevers,et al.  Specificity and overlap of attention and memory biases in depression. , 2018, Journal of affective disorders.

[7]  Sergei Nirenburg,et al.  Modeling decision-making biases , 2013, BICA 2013.

[8]  Cathy O Neil DAWN OF THE NEW EVERYTHING Encounters with Reality and Virtual Reality By Jaron Lanier; EXPERIENCE ON DEMAND What Virtual Reality Is, How It Works, and What It Can Do By Jeremy Bailenson , 2018 .

[9]  Frank Biocca,et al.  The Cyborg's Dilemma: Progressive Embodiment in Virtual Environments , 2006, J. Comput. Mediat. Commun..

[10]  Edwin H. Blake,et al.  Cognitive presence as a unified concept of virtual reality effectiveness , 2001, AFRIGRAPH '01.

[11]  A. Mohanty,et al.  Top-down and bottom-up factors in threat-related perception and attention in anxiety , 2016, Biological Psychology.

[12]  Maria V. Sanchez-Vives,et al.  From presence to consciousness through virtual reality , 2005, Nature Reviews Neuroscience.

[13]  M. Zvolensky,et al.  Risk-factor research and prevention programs for anxiety disorders: a translational research framework. , 2006, Behaviour research and therapy.

[14]  E. Saperova,et al.  State Anxiety and Nonlinear Dynamics of Heart Rate Variability in Students , 2016, PloS one.

[15]  Barry Peterson,et al.  Quantitative Measures of Presence in Virtual Environments: The Roles of Attention and Spatial Comprehension , 1999, Cyberpsychology Behav. Soc. Netw..

[16]  Carolina Cruz-Neira,et al.  The Effect of Different Viewing Devices for the Sense of Presence of Immersion in Virtual Environments: A Comparison of Stereoprojections Based on Monitors, HMDs and Screens , 1997, HCI.

[17]  M. Kozak,et al.  Emotional processing of fear: exposure to corrective information. , 1986, Psychological bulletin.

[18]  A. Arntz,et al.  "If I feel anxious, there must be danger": ex-consequentia reasoning in inferring danger in anxiety disorders. , 1995, Behaviour research and therapy.

[19]  G. VandenBos APA dictionary of psychology , 2007 .

[20]  Stéphane Bouchard,et al.  Anxiety Increases the Feeling of Presence in Virtual Reality , 2008, PRESENCE: Teleoperators and Virtual Environments.

[21]  E. Calvete,et al.  Early maladaptive schemas and social anxiety in adolescents: the mediating role of anxious automatic thoughts. , 2013, Journal of anxiety disorders.

[22]  Giuseppe Riva,et al.  On feeling (the) present: An evolutionary account of the sense of presence in physical and electronically-mediated environments , 2010 .

[23]  G. Arbanas Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , 2015 .

[24]  Giuseppe Riva,et al.  The Role of Immersion and Narrative in Mediated Presence: The Virtual Hospital Experience , 2011, Cyberpsychology Behav. Soc. Netw..

[25]  Guy M. Wallis,et al.  Contrasting the Effectiveness and Efficiency of Virtual Reality and Real Environments in the Treatment of Acrophobia , 2008, PsychNology J..

[26]  S. Haves,et al.  Experiential Avoidance and Behavioral Disorders: A Functional Dimensional Approach to Diagnosis and Treatment , 2003 .

[27]  Mel Slater,et al.  Place illusion and plausibility can lead to realistic behaviour in immersive virtual environments , 2009, Philosophical Transactions of the Royal Society B: Biological Sciences.

[28]  Julian F. Thayer,et al.  Autonomic characteristics of generalized anxiety disorder and worry , 1996, Biological Psychiatry.

[29]  G. Fink Stress, Definitions, Mechanisms, and Effects Outlined , 2016 .

[30]  Richard C. Anderson Some Reflections on the Acquisition of Knowledge , 1984 .

[31]  J. Altarriba,et al.  Concreteness, context availability, and imageability ratings and word associations for abstract, concrete, and emotion words , 1999, Behavior research methods, instruments, & computers : a journal of the Psychonomic Society, Inc.

[32]  Steven Taylor,et al.  Anxiety sensitivity. , 2020, Clinical handbook of fear and anxiety: Maintenance processes and treatment mechanisms..

[33]  D. Clark A cognitive approach to panic. , 1986, Behaviour research and therapy.

[34]  S. Folkman,et al.  Stress, appraisal, and coping , 1974 .

[35]  Daniel P. Bliss,et al.  Serial Dependence across Perception, Attention, and Memory , 2017, Trends in Cognitive Sciences.

[36]  Caroline Hummels,et al.  Beauty in usability : forget about ease of use! , 2002 .

[37]  Y. Trope,et al.  Construal Levels and Psychological Distance: Effects on Representation, Prediction, Evaluation, and Behavior. , 2007, Journal of consumer psychology : the official journal of the Society for Consumer Psychology.

[38]  A. Beck,et al.  Advances in cognitive theory and therapy: the generic cognitive model. , 2014, Annual review of clinical psychology.

[39]  M. Weishaar,et al.  Schema Therapy: A Practitioner's Guide , 2003 .

[40]  R. Lazarus From psychological stress to the emotions: a history of changing outlooks. , 1993, Annual review of psychology.

[41]  Riddle Dr,et al.  Changes in Cognitive Function in Human Aging -- Brain Aging: Models, Methods, and Mechanisms , 2007 .

[42]  Matthew Lombard,et al.  At the Heart of It All: The Concept of Presence , 2006 .

[43]  K. Pugh,et al.  Jumping to conclusions and paranoid ideation in the general population , 2008, Schizophrenia Research.

[44]  Giuseppe Riva,et al.  The Layers of Presence: A Bio-cultural Approach to Understanding Presence in Natural and Mediated Environments , 2004, Cyberpsychology Behav. Soc. Netw..

[45]  K. Ressler,et al.  Deconstructing the Gestalt: Mechanisms of Fear, Threat, and Trauma Memory Encoding , 2019, Neuron.

[46]  Ratika Sharma,et al.  Virtual Reality Exposure Therapy for the Treatment of Dental Phobia: A Controlled Feasibility Study. , 2017, Behavioural and cognitive psychotherapy.

[47]  C MacLeod,et al.  Anxiety and the selective processing of emotional information: mediating roles of awareness, trait and state variables, and personal relevance of stimulus materials. , 1992, Behaviour research and therapy.

[48]  U. Frith,et al.  The Weak Coherence Account: Detail-focused Cognitive Style in Autism Spectrum Disorders , 2006, Journal of autism and developmental disorders.

[49]  Ralph R. Behnke,et al.  Physical Symptoms of Discomfort Associated with Worry about Giving a Public Speech , 2005 .

[50]  E. Glisky Changes in Cognitive Function in Human Aging , 2007 .

[51]  A. Beck,et al.  Anxiety disorders and phobias : a cognitive perspective , 2005 .

[52]  R. Lazarus,et al.  SHORT-CIRCUITING OF THREAT BY EXPERIMENTALLY ALTERING COGNITIVE APPRAISAL. , 1964, Journal of abnormal psychology.

[53]  Caroline Hummels,et al.  Let's Make Things Engaging , 2005, Funology.

[54]  Gilles Rautureau,et al.  Fear of falling: efficacy of virtual reality associated with serious games in elderly people , 2016, Neuropsychiatric disease and treatment.

[55]  Luciano Gamberini,et al.  An Action-Based Approach to Presence: Foundations and Methods , 2015, Immersed in Media, Telepresence Theory, Measurement & Technology.

[56]  E. Peacock,et al.  Relations Between Appraisals and Coping Schemas: Support for the Congruence Model , 1993 .

[57]  I. Deary,et al.  The neuroscience of human intelligence differences , 2010, Nature Reviews Neuroscience.

[58]  Holger Regenbrecht,et al.  The Experience of Presence: Factor Analytic Insights , 2001, Presence: Teleoperators & Virtual Environments.

[59]  Jack L. Nasar,et al.  Landscapes of Fear and Stress , 1997 .

[60]  Positive emotion enhances association-memory. , 2019, Emotion.

[61]  J. Jackson,et al.  Construal Level Theory and Fear of Crime , 2015 .

[62]  Bram Vervliet,et al.  Gradients of fear: How perception influences fear generalization. , 2017, Behaviour research and therapy.

[63]  Michael J. Singer,et al.  Measuring Presence in Virtual Environments: A Presence Questionnaire , 1998, Presence.

[64]  Guido Makransky,et al.  Development and validation of the Multimodal Presence Scale for virtual reality environments: A confirmatory factor analysis and item response theory approach , 2017, Comput. Hum. Behav..

[65]  J W Mason,et al.  A Review of Psychoendocrine Research on the Sympathetic‐Adrenal Medullary System , 1968, Psychosomatic medicine.

[66]  J. Piaget Biology and knowledge;: An essay on the relations between organic regulations and cognitive processes , 1971 .

[67]  Y. Trope,et al.  Interpersonal Similarity as a Social Distance Dimension: Implications for Perception of Others' Actions. , 2008, Journal of experimental social psychology.

[68]  Michael Meehan,et al.  Physiological measures of presence in stressful virtual environments , 2002, SIGGRAPH.

[69]  M. Krijn,et al.  Treatment of acrophobia in virtual reality: the role of immersion and presence. , 2004, Behaviour research and therapy.

[70]  Alex Martin GRAPES—Grounding representations in action, perception, and emotion systems: How object properties and categories are represented in the human brain , 2015, Psychonomic Bulletin & Review.

[71]  D. Clark A cognitive perspective on social phobia. , 2001 .

[72]  Thomas B. Sheridan,et al.  Musings on Telepresence and Virtual Presence , 1992, Presence: Teleoperators & Virtual Environments.

[73]  Dwight J Kravitz,et al.  Visual working memory directly alters perception , 2019, Nature Human Behaviour.

[74]  Chris Barker,et al.  An Experimental Study on Fear of Public Speaking Using a Virtual Environment , 2006, Cyberpsychology Behav. Soc. Netw..

[75]  Nancy Kanwisher,et al.  Functional Organization of Social Perception and Cognition in the Superior Temporal Sulcus , 2015, Cerebral cortex.

[76]  Jari Takatalo,et al.  Presence, Involvement, and Flow in Digital Games , 2010, Evaluating User Experience in Games.

[77]  Daniel Thalmann,et al.  Introduction: Creating Artificial Life in Virtual Reality , 1994 .

[78]  S. Hofmann Cognitive Factors that Maintain Social Anxiety Disorder: a Comprehensive Model and its Treatment Implications , 2007, Cognitive behaviour therapy.

[79]  Kenneth A. Norman,et al.  Representation of Real-World Event Schemas during Narrative Perception , 2018, The Journal of Neuroscience.

[80]  Megha Yadav,et al.  Virtual reality interfaces and population-specific models to mitigate public speaking anxiety , 2019, 2019 8th International Conference on Affective Computing and Intelligent Interaction (ACII).

[81]  Jack M. Loomis,et al.  Distal Attribution and Presence , 1992, Presence: Teleoperators & Virtual Environments.

[82]  M. Tsakiris,et al.  Enhanced interoceptive awareness during anticipation of public speaking is associated with fear of negative evaluation , 2014, Cognition & emotion.

[83]  C. Youngblut Experience of Presence in Virtual Environments , 2003 .

[84]  Giuseppe Riva,et al.  Presence: Form, Content and Consciousness , 2015, Immersed in Media, Telepresence Theory, Measurement & Technology.

[85]  S. Hayes,et al.  Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. , 1996 .

[86]  Y. Trope,et al.  The role of feasibility and desirability considerations in near and distant future decisions: A test of temporal construal theory. , 1998 .

[87]  Yaacov Trope,et al.  You focus on the forest when you're in charge of the trees: power priming and abstract information processing. , 2006, Journal of personality and social psychology.

[88]  Jonathan Steuer,et al.  Defining virtual reality: dimensions determining telepresence , 1992 .

[89]  G. Chrousos,et al.  Differential hypothalamic-pituitary-adrenal axis reactivity to psychological and physical stress. , 1999, The Journal of clinical endocrinology and metabolism.

[90]  Helmut Hlavacs,et al.  Afraid to Be There? Evaluating the Relation Between Presence, Self-Reported Anxiety, and Heart Rate in a Virtual Public Speaking Task , 2014, Cyberpsychology Behav. Soc. Netw..

[91]  Paul M. Salkovskis,et al.  Cognitive behaviour therapy for psychiatric problems : a practical guide , 1989 .

[92]  Mar Rus-Calafell,et al.  Factors Affecting Sense of Presence in a Virtual Reality Social Environment: A Qualitative Study , 2019, Cyberpsychology Behav. Soc. Netw..

[93]  Nathaniel I. Durlach,et al.  Virtual Reality: Scientific and Technological Challenges , 1994 .

[94]  K. J. Blom,et al.  Public speaking anxiety decreases within repeated virtual reality training sessions , 2019, PloS one.

[95]  R. Aylett,et al.  Towards a narrative theory of virtual reality , 2003, Virtual Reality.

[96]  Peter D. MacIntyre,et al.  Heart Rate Variability as a Predictor of Speaking Anxiety , 2010 .

[97]  J. Gross The Emerging Field of Emotion Regulation: An Integrative Review , 1998 .

[98]  Marc Busch,et al.  I'm There! The influence of virtual reality and mixed reality environments combined with two different navigation methods on presence , 2015, 2015 IEEE Virtual Reality (VR).

[99]  Doug A. Bowman,et al.  Virtual Reality: How Much Immersion Is Enough? , 2007, Computer.

[100]  Craig A. Smith,et al.  Patterns of cognitive appraisal in emotion. , 1985, Journal of personality and social psychology.

[101]  Mel Slater,et al.  Presence in response to dynamic visual realism: a preliminary report of an experiment study , 2006, VRST '06.

[102]  Anja S. Göritz,et al.  Virtual reality in the application of heart rate variability biofeedback , 2019, Int. J. Hum. Comput. Stud..

[103]  J. García-Campayo,et al.  Evaluation of a Mindfulness-Based Intervention With and Without Virtual Reality Dialectical Behavior Therapy® Mindfulness Skills Training for the Treatment of Generalized Anxiety Disorder in Primary Care: A Pilot Study , 2019, Front. Psychol..

[104]  Yun Ling,et al.  Effects of Stereoscopic Viewing on Presence, Anxiety, and Cybersickness in a Virtual Reality Environment for Public Speaking , 2012, PRESENCE: Teleoperators and Virtual Environments.

[105]  Y. Trope,et al.  Construal-level theory of psychological distance. , 2010, Psychological review.

[106]  John R. Wilson,et al.  Measurement of presence and its consequences in virtual environments , 2000, Int. J. Hum. Comput. Stud..

[107]  P. Philippot,et al.  The perception of bodily sensations during emotion: A cross-cultural perspective. , 1997 .

[108]  Wa Wijnand IJsselsteijn,et al.  History of telepresence , 2005 .

[109]  T. Chartrand,et al.  The mind in the middle: A practical guide to priming and automaticity research. , 2000 .

[110]  Rory V. O'Connor,et al.  Overcoming Public Speaking Anxiety of Software Engineers Using Virtual Reality Exposure Therapy , 2017, EuroSPI.