Virtual Reality (VR) Research Studies

Therapy and Support

This study investigated the effectiveness of using extended virtual reality (VR), to enhance behavioral activation (BA) therapy for major depressive disorder (MDD). Results indicated that XR-BA was statistically non-inferior to traditional BA, with both groups showing significant decreases in depression severity. Additionally, the XR-BA group exhibited reduced depression scores even before therapy initiation, suggesting potential benefits.
This study featuring Foretell Reality’s platform focuses on the psychological impacts of using virtual reality for remote outpatient therapist-guided peer support groups. The adolescent and young adult patients with cancer in the study showed a significant increase in emotional resilience, an attendance rate of 72.8% (compared to almost 0 in person), and a retention rate of 86.7%.
Mental health, the second largest category of health disorders linked to long-term disability, poses a global challenge due to limited funding and resources for conditions like stress and anxiety. Virtual mental health treatment in the metaverse appears safe and effective, with a 34% reduction in anxiety and a 32% reduction in stress observed in a cohort of 61 participants. 
Therapeutic VR has emerged as an effective, drug-free tool for pain management. Researchers performed a prospective, randomized, comparative effectiveness trial in hospitalized patients with an average pain score of ≥3 out of 10 points and concluded that VR significantly reduces pain versus an active control condition in hospitalized patients. VR is most effective for severe pain.
To test the long-term efficacy of an enhanced cognitive–behavioral therapy (CBT) for obesity, this study tests the effectiveness of a virtual reality (VR) module aimed at both unlocking the negative memory of the body and modifying its behavioral and emotional correlates. As predicted, the study found that only the VR-enhanced CBT was effective in further improving weight loss at a 1-year follow-up.
This study aims to investigate the VR technologies being used to help support the treatment of depression and anxiety. After a Google Scholar search, 26% of shortlisted articles published between 2017-2021 reported the use of CBT with VR. All 9 studies reported the use of CBT either in vivo or in a virtual environment to be effective in supporting the treatment of anxiety or depression.
Automated delivery of psychological therapy using immersive technologies such as virtual reality (VR) might greatly increase the availability of effective help for patients. This study aimed to evaluate the efficacy of an automated VR cognitive therapy to treat avoidance and distress in patients with psychosis, and to analyse how and in whom it might work. Compared with the usual care alone group, the VR therapy group had significant reductions in agoraphobic avoidance.
In a recent study out of the Netherlands, researchers analyzed the psychological benefits of using social virtual reality platforms during the recent COVID-19 pandemic. After interviewing 220 people who actively used social VR platforms during the pandemic, researchers found that 3 different psychological areas reaped the benefits – relatedness, self-expansion, and enjoyment. A sense of spatial and social presence were the main predictors of this; users feel that they are truly immersed in an environment, very similar to the stimulus of meeting with someone in person. Researchers’ findings ultimately suggest that the psychological need for socialization can be met by using social VR platforms.
In one of the first studies of Virtual Reality Group Therapy (VRGT), ten participants and ten therapists viewed videos and then participated in moderated group therapy sessions in VR. The response of both patients and therapists was “largely positive” with both groups citing the anonymity of avatar as minimizing patients’ social anxiety. Patients also cited the ease of attending a session from home, particularly those with physical disabilities and/or social anxiety. 
The purpose of this study was to test the feasibility of Virtual Reality (VR)-based peers support for those seeking substance abuse recovery. “Quantitative data showed that improvement in mood, perceived online social support, and satisfaction with group-therapy alliance were associated with VR meeting attendance. With further research and improvements, this virtual intervention may be an effective tool to teach cognitive-behavioral skills, regulate affect, and provide social support to individuals who are at risk for relapse or in long-term recovery.”
In this study, fifteen patients with generalized SAD attended up to 16 VR-CBT sessions. Questionnaires on clinical and functional outcomes, and diary assessments on social activity, social anxiety and paranoia were completed at baseline, post-treatment and at 6-months follow-up. Though treatment in this case was individual-based cognitive and behavioral therapy, results “suggest that VR-CBT may be effective in reducing anxiety as well as depression, and can increase quality of life.”
This chapter of Reference Module in Neuroscience and Biobehavioral Psychology examines the clinical potential of VR in the assessment and treatment of mental health diseases. The author examines two recent meta-reviews assessing more than 53 systematic reviews and meta-analyses that support VR’s use in anxiety disorders, pain management, and eating and weight disorders, with long-term effects that generalize to the real world.  
This study was comprised of 79 individuals who reported a mental health diagnosis, previous experience with suicidality, or who self-identified with depression. Participants were placed in a physical room with a VR headset and were able to explore a rich audio and visual experience within that space. The study concludes that “future developments within this area should regard virtual and mixed reality as an accessible, non-medical platform for engaging individuals who reported with lived experiences of distress or mental ill health—potentially for a wide range of users from those with slightly lowered mood to acute presentations.”
This study consisted of a two-arm pilot RCT with a sample of 36 individuals recovering from AUD in a therapeutic community; experimental group participants received a therapist-guided, VR-based cognitive training intervention combined with treatment as usual, and control group participants received treatment as usual without cognitive training. When comparing the two groups, researchers found “a positive impact of the VR training on the cognitive rehabilitation, particularly on attention and executive functions, of individuals with AUD.”
This pilot study enlisted six participants with clinically diagnosed Anhedonia, the inability to experience pleasure. By viewing positive scenes in VR, “significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up.”
This study from 2007 coined the term Proteus Effect, the paradigm in which self-representation shapes behavior. Leveraging early VR technology, subjects were assigned either attractive or unattractive avatars. Each subject saw their own avatars, but their counterparts in VR saw them without distinct features. The results indicated that self-perception was more important in providing a feeling of confidence and social comfort than how other percieved of the subject.
In this study, thirty-six chronic persons with aphasia (PWA) were randomly assigned to two groups. The VR group underwent conversational therapy during VR everyday life setting observation, while the control group was trained in a conventional setting without VR support. Results of the six-month study revealed that “language rehabilitation through an ecologically valid VR system can have a large impact in cognitive and psychological functioning.” Additionally, researchers concluded that “given the importance of a positive psychological state in PWA for motivating their participation in the therapy sessions, we believe that the use of VR, in the near future, should be pursued.”
Subjects were shown various scenarios in both 2D and 3D virtual settings. Results of the study “indicated that emotional stimulation was more intense in the 3D environment due to the improved perception of the environment; greater emotional arousal was generated; and higher beta (21–30 Hz) EEG power was identified in 3D than in 2D.”

This overview addresses the evidence supporting the efficacy of VR interventions in psychiatric disorders based on 70 reviews. In anxiety/phobias, virtual reality can be used as a supportive therapy, not a replacement for traditional treatments. In pain management, it is emphasized using virtual reality instead of traditional medication therapy.

This study uses the Transformed Social Interaction paradigm to examine different avatar identities and environments over time. In Study 1, entitativity, presence, enjoyment, and realism increased over 8 weeks. Avatars that resembled participants increased synchrony, and similarities in moment-to-moment nonverbal behaviors between participants.

Soft Skills Development

This study aims to discuss the research efforts in developing virtual reality (VR) technology for different training applications. It describes how VR training experiences are typically created and delivered using the current software and hardware. They also discuss the challenges and solutions of applying VR training to different application domains, such as first responder training, medical training, military training, workforce training, and education. Furthermore, they discuss the common assessment tests and evaluation methods used to validate VR training effectiveness. They conclude the article by discussing possible future directions to leverage VR technology advances for developing novel training experiences.

At Edith Cowan University in Australia, researchers studied social interaction in two contexts – one in which participant and researcher engaged in casual conversation and one in which the participant was instructed to disclose both positive and negative personal experiences to their research partner. These contexts were studied within a face-to-face condition as well as a Virtual Reality condition, wherein the researcher was represented as an avatar and controlled in real time through motion capture. While participants had an overall slight preference for face-to-face interaction, 30% of participants preferred the interaction with the avatar over the in-person conversation, specifically on the facets of self-disclosure, comfort, and being able to relax and be oneself. Researchers theorize that the “increased sense of interpersonal distance in VR may be why some of our participants indicated such preferences for VR over face-to-face for negative disclosure”.

In a recent study out of Paris, France, a team of researchers analyzed the effectiveness of learning empathy through virtual reality. They conducted a variety of different experiments, one being a study of high school students in the USA exhibiting more global empathy and interest in learning about other counties succeeding role-playing activities in virtual reality. Researchers found that immersive VR experiences “allow users to literally step into the shoes of others and see the world from their perspective,” which has “shown significant plasticity of empathetic abilities even after the experience by decreasing implicit racial biases and increasing of mimicry of outgroup members.” The team ultimately concluded that immersive VR experiences are a powerful tool in developing empathy, awareness, and altruistic behavior.

In a recent study at the University of Nebraska-Lincoln, researcher Elizabeth Enkin asked twenty-one university students who were studying Spanish as a second language to compare the experience of practicing face-to-face with the experience of practicing in Virtual Reality (VR).Students carried out three sets of two dialogues each, one dialogue in VR using a head-mounted display and one with a fellow student in a physical space. At the end of the experience, students were asked to fill out a survey about their experience. Results from the survey “showed overall positive experiences with social VR” and indicated that “VR can be a more fun way to practice speaking that can also reduce feelings of self-consciousness.”

A recent MIT study enlisted 38 police officers to take part in an VR scenario in which they are alongside another officer who is racially abusive towards an African American suspect. Officers were then divided into two different groups in order to witness the same interrogation again. One group witnessed the interaction as an observer while the other embodied the perspective of the suspect. Three weeks later, all officers were again placed in a hostile interrogation of an African American suspect in a different setting. “The results show that the actions of those who had been in the Victim condition were coded as being more helpful towards the victim than those in the Observer condition.”

The study, which intentionally leveraged affordable hardware and psychologists only minimally trained in VR, concluded that “VR exposure therapy can be effective under routine care conditions and is an attractive approach for future, large-scale implementation and effectiveness trials.” Among the studies finding were that patients’ self-reported a “robust” decrease in PSA following VR-assisted therapy and that the “exposure therapy exerted these benefits by reducing patients’ fear of negative evaluation and catastrophic beliefs.” The study also found that “patients rated the quality of their speech performances higher after watching the avatar perform a playback of their speech.”

This study set out to compare the effectiveness of group collaboration through multi-user immersive virtual reality (IVR), face-to-face (FTF) meetings, and video conferencing (VR). The study concluded that “Multi-user IVR can help bridge the gap between the main advantages of IVR (simulation and manipulation of immersive three-dimensional objects) and the growing demand for effective collaboration of spatially distributed teams. This creates new opportunities for remote work that rely on spatial interactivity within a virtual environment.”

Learning and Collaboration

This study explores whether using virtual memory palaces in a head-mounted display with head-tracking would allow a user to better recall information than when using a traditional desktop display with a mouse-based interaction (desktop condition). The study found that virtual memory palaces in VR provide a superior memory recall ability compared to the desktop condition. 

This study explores the magnitude of learning outcome improvement shown by students with the incorporation of VR lesson.In boththe pre/post testing and control trial, an average of afull letter gradeimprovement was observed.Thismagnitude of learning outcome improvement is significant in that the improvement of a letter grade inSTEM classes is correlated with increased probability of students completing a STEMdegree

This systematic review examines experimental studies published since 2013, where quantitative learning outcomes using VR were compared with less immersive pedagogical methods such as desktop computers and slideshows. 

In an attempt to better understand how virtual worlds positively affect student learning, this study used an VR English language learning platform and conducted an experiment to evaluate the student learning effectiveness. Results of the study showed that students improved their phonological, morphological, grammar and syntax knowledge, and virtual world learning assisted in the development of a more complex and higher level of thinking. 

This study on electronics engineering laboratory experiences shows that VR has a significant positive impact on student knowledge, learning motivation, and cognition. By interacting with the three-dimensional virtual models of the laboratory instruments, students who participated in the study were able to demonstrate an improved understanding of the laboratory hardware. 

This study on vocabulary learning in VR showed how participants who learned each language in its own unique context showed reduced interference and improved one-week retention (92%), relative to those who learned the languages in the same context (76%). A follow-up fMRI experiment confirmed that reinstatement of brain activity patterns associated with the original encoding context during word retrieval was associated with improved recall performance. 

This work discusses the working principle of Virtual Reality (VR) and builds an Interactive Learning Model (ILM) using VR. Then, the VR-ILM is used to design the Smart Space services. The proposed VR-ILM-based Smart Space has dramatically improved the practical teaching of CEE. The results show that the proposed VR-ILM-based Smart Space has increased the entrepreneurship teaching courses, entrepreneurship coaching activities, and entrepreneurship practice activities by 4, 6, and 24%, respectively.

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