Albert Rizzo

USC Institute for Creative Technologies

Introduction: Cognitive impairment is a debilitating symptom in people with multiple sclerosis (MS). Most of the neuropsychological tasks have little resemblance to everyday life. There is a need for ecologically valid tools for assessing cognition in real-life functional contexts in MS. One potential solution would involve the use of virtual reali...

Addressing the significant mental and physical healthcare needs of Veterans requires innovative strategies to enhance access to evidence-based care. The integration of Virtual Human (VH) agents into Mobile Health (mHealth) applications presents a promising opportunity to overcome barriers associated with suicide prevention and connect with Veterans...

This book uses film/video-based therapy to help build resilience in facing personal, communal, national, and global trauma triggers. Offering a rich and diverse range of perspectives on trauma, this volume advocates positive social change using therapeutic techniques in filmmaking as well as film/video-based therapy, in conjunction with expressive...

Posttraumatic stress disorder (PTSD) is a heritable (h² = 24–71%) psychiatric illness. Copy number variation (CNV) is a form of rare genetic variation that has been implicated in the etiology of psychiatric disorders, but no large-scale investigation of CNV in PTSD has been performed. We present an association study of CNV burden and PTSD symptoms...

Posttraumatic stress disorder (PTSD) is a significant public health issue. Yet, there are limited treatment options and no data to suggest which treatment will work for whom. We tested the efficacy of virtual reality exposure (VRE) or prolonged imaginal exposure (PE), augmented with D-cycloserine (DCS) for combat-related PTSD. As an exploratory aim...

Background Methylphenidate (MPH) is the first-line pharmacological treatment of attention-deficit/hyperactivity disorder (ADHD). MPH binds to the dopamine (DA) transporter (DAT), which has high density in the striatum. Assessments of the striatal dopamine transporter by single positron emission computed tomography (SPECT) in childhood and adolescen...

Objective: Distractions inordinately impair attention in children with Attention-Deficit Hyperactivity Disorder (ADHD) but examining this behavior under real-life conditions poses a challenge for researchers and clinicians. Virtual reality (VR) technologies may mitigate the limitations of traditional laboratory methods by providing a more ecologic...

This editorial introduces the current Special Issue of Translational Issues in Psychological Science which provides novel research findings and perspectives on the use of Virtual Reality (VR) for psychological applications. The variety of topics presented in this themed issue underscore the broad applicability (and potential value) of VR technology...

Since 2020, the worldwide coronavirus 2019 (COVID-19) pandemic has been reported to have increased the frequency of adverse mental health and stress-related conditions, including, depression, anxiety disorders, PTSD, and substance use (Pfefferbaum and North, 2020;Xionget al., 2020;Niles et al., 2021). Changes in lifestyle behaviors, social isolatio...

Research has documented the efficacy of clinical applications that leverage Virtual Reality (VR) for assessment and treatment purposes across a wide range of domains, including pain, phobias, and posttraumatic stress disorder (PTSD). As the field of Clinical VR matures, it is important to review its origins and examine how these initial exploration...

This research report describes the development of a virtual reality (VR) laboratory stressor to study the effects of exposure to stressful events. The aim of the research was to develop a VR simulation that would evoke stressor responses at a level that was tolerable for participants. Veterans with and without warzone-related posttraumatic stress d...

Background: This investigation involved an in‐depth examination of psychophysiological responses during exposure to the trauma memory across 10 sessions among active duty soldiers with combat‐related posttraumatic stress disorder (PTSD) treated by Prolonged Exposure (PE) or Virtual Reality Exposure (VRE). We compared psychophysiological changes, se...

Importance Despite the need for effective and scalable training in motivational interviewing (MI) that includes posttraining coaching and feedback, limited evidence exists regarding the effectiveness of using virtual (computerized) standardized patients (VSPs) in such training. Objective To evaluate the efficacy of training with a VSP on the acqui...

Post-traumatic stress disorder (PTSD) is a mental health condition affecting people who experienced a traumatic event. In addition to the clinical diagnostic criteria for PTSD, behavioral changes in voice, language, facial expression and head movement may occur. In this paper, we demonstrate how a machine learning model trained on a general populat...

The virtual interactive consulting agent system is an online virtual career center that supports freshman students in transition to higher education. This virtual counseling system, based on accumulative empirical knowledge for working students and knowledge about effective career intervention, aims to guide first-year university students in combin...

The overall goal of VRN is to develop a novel technology solution at Children’s Hospital Los Angeles (CHLA) to overcome barriers that prevent the recruitment of diverse patient populations to clinical trials by providing both caregivers and children with an interactive educational experience. This system consists of 1) an intelligent agent called Z...

Attention-deficit/Hyperactivity disorder (ADHD) is a common neurodevelopmental disorder among children. Traditional assessment methods generally rely on behavioral rating scales (BRS) performed by clinicians, and sometimes parents or teachers. However, BRS assessment is time consuming, and the subjective ratings may lead to bias for the evaluation....

This scoping review article explores the application of telepresence (TPr), virtual reality (VR), and augmented reality (AR) to clinical care. A literature search of key words was conducted from January 1990 through May 2019 of the following databases: PubMed/Medline, American Psychological Association PsycNET, Pubmed/Medline, Cochrane, Embase, Psy...

This study investigated predictors of involuntary and voluntary memories of stressful virtual reality scenarios. Thirty-two veterans of the two Persian Gulf Wars completed verbal memory tests and diagnostic assessments. They were randomly assigned to a Recounting (16) or a Suppression (16) condition. After immersion in the VR scenarios, the Recount...

This case study describes the expansion of the BRAVE-MIND virtual reality exposure therapy (VRET) system from the domain of combat-related posttraumatic stress disorder (PTSD) to the domain of PTSD due to Military Sexual Trauma (MST). As VRET continues to demonstrate efficacy in treating PTSD across multiple trauma types and anxiety disorders, adap...

Objective: A key symptom of posttraumatic stress disorder (PTSD) is hyperreactivity to trauma-relevant stimuli. Though physiological arousal is reliably elevated in PTSD, the question remains whether this arousal responds to treatment. Virtual reality (VR) has been posited to increase emotional engagement during prolonged exposure therapy (PE) for...

The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate,...

The advent of virtual reality technology has provided a new approach for assessing and training cognitive processing ability, with the design of simulations used to replicate real events in everyday lives. To better understand how head mounted displays/flat screen displays (HMDs/FSDs) and differences in the individuals who use them affect cognitive...

The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate,...

Introduction: Resilience is the ability to maintain or quickly return to a stable physical and psychological equilibrium despite experiencing stressful events. Flexibility of the autonomic nervous system is particularly important for adaptive stress responses and may contribute to individual differences in resilience. Power spectrum analysis of he...

Systematic Representative Design and Clinical Virtual Reality Sharon Mozgai, Arno Hartholt & Albert “Skip” Rizzo* University of Southern California Institute for Creative Technologies Los Angeles, California *contact author The authors of the paper, “Causal Inference in Generalizable Environments: Systematic Representative Design”, boldly announce...

Background: PTSD, which has been identified in up to 23% of post-9-11 veterans, often results in a chronic, pernicious course. Thus, effective treatments are imperative. The Institute of Medicine (IOM) concluded that the only intervention for PTSD with sufficient evidence to conclude efficacy is exposure therapy. This Phase III trial compares the...

We present one of the first applications of virtual humans in Augmented Reality (AR), which allows young adults with Autism Spectrum Disorder (ASD) the opportunity to practice job interviews. It uses the Magic Leap's AR hardware sensors to provide users with immediate feedback on six different metrics, including eye gaze, blink rate and head orient...

Differential diagnosis and treatment of neuropsychological disorders require assessments that can differentiate overlapping symptoms. Previous research has most often relied on paper-and-pencil as well as computerized psychometric tests of cognitive functions. Although these approaches provide highly systematic control and delivery of performance c...

Simulation technology has a long history of adding value in aviation, military training, automotive/aircraft design, and surgical planning. In clinical psychology, Norcross et al. (2013) surveyed 70 therapy experts regarding interventions they predicted to increase in the next decade and virtual reality (VR) was ranked 4th out of 45 options, with o...

Since Dr. Howard Barrows (1964) introduced the human standardized patient in 1963, there have been attempts to game a computer-based simulacrum of a patient encounter; the first being a heart attack simulation using the online PLATO system (Bitzer M, Nursing Research 15:144–150, 1966). With the now ubiquitous use of computers in medicine, interest...

Computerized cognitive interventions to improve working memory also purport to improve ADHD-related inattention and off task behavior. Such interventions have been shown to improve working memory, executive functioning, and fluid reasoning on standardized neuropsychological measures. However, debate continues as to whether such programs lead to imp...

We present a versatile system for training job interviewing skills that focuses specifically on segments of the population facing increased challenges during the job application process. In particular, we target those with Autism Spectrum Disorder (ADS), veterans transitioning to civilian life, and former convicts integrating back into society. The...

Virtual Reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible to deliver using traditional methods are now being developed that take advantage of the assets tha...

Summary, examples and directions of Virtual Reality Technology in Rehabilitation Psychology. TOC: https://www.apa.org/pubs/books/Handbook-of-Rehabilitation-Psychology3e-Intro-Sample.pdf

Background Digital health interventions can fill gaps in mental healthcare provision. However, autonomous e-mental health (AEMH) systems also present challenges for effective risk management. To balance autonomy and safety, AEMH systems need to detect risk situations and act on these appropriately. One option is sending automatic alerts to carers,...

There is substantial interest in the possibility that cognitive skills can be improved by dedicated behavioral training. Yet despite the large amount of work being conducted in this domain, there is not an explicit and widely agreed upon consensus around the best methodological practices. This document seeks to fill this gap. We start from the pers...

Slow-wave sleep (SWS) is known to contribute to memory consolidation, likely through the reactivation of previously encoded waking experiences. Contemporary studies demonstrate that when auditory or olfactory stimulation is administered during memory encoding and then reapplied during SWS, memory consolidation can be enhanced, an effect that is bel...

This exciting collection tours virtual reality in both its current therapeutic forms and its potential to transform a wide range of medical and mental health-related fields. Extensive findings track the contributions of VR devices, systems, and methods to accurate assessment, evidence-based and client-centered treatment methods, and—as described in...

There is substantial interest in the possibility that cognitive skills can be improved by dedicated behavioral training. Yet despite the large amount of work being conducted in this domain, there is not an explicit and widely agreed upon consensus around the best methodological practices. This document seeks to fill this gap. We start from the pers...

The USC Standard Patient is a virtual human-based conversational agent serving in the role of a simulated medical patient, also known as a virtual standardized patient (VSP). This research identified deficiencies of extant VSP systems, defined a robust set of requirements, and successfully achieved nearly all of them. Markedly impressive advancemen...

Purpose: Measurement of simulator-related side effects (SSEs) is an integral component of competent and ethical use of virtual reality exposure (VRE), but common SSEs may overlap with symptoms of anxiety. Limited research exists about the frequency of SSEs during VRE treatment for post-traumatic stress disorder (PTSD) and no research compares self...

Posttraumatic stress disorder (PTSD) is characterized by exaggerated expression of fear responses to danger and safety cues. Translational research suggests that dexamethasone facilitates fear extinction in animal and human fear conditioning models. For this randomized, placebo-controlled trial (N = 27), we aimed to translate these findings to the...

BACKGROUND Therapeutic virtual reality (VR) has emerged as an efficacious treatment modality for a wide range of health conditions. However, in spite of encouraging outcomes from early stage research, a consensus is needed for how best to develop and evaluate VR treatments within a scientific framework. OBJECTIVE We sought to develop a methodologi...

Background: Therapeutic virtual reality (VR) has emerged as an efficacious treatment modality for a wide range of health conditions. However, in spite of encouraging outcomes from early stage research, a consensus is needed for how best to develop and evaluate VR treatments within a scientific framework. Objective: We sought to develop a methodolo...

Virtual reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible, to deliver with traditional methods are now being developed that take advantage of the assets tha...

This initial feasibility study examined the use of virtual reality exposure therapy (VRE) in the treatment of MST-related PTSD, with newly developed content tailored to MST. Participants included 15 veterans (26% male) with MST-related PTSD. Assessment of PTSD, depression, and psychophysiological indicators of distress occurred at pre-treatment, po...

1 Background The majority of studies comparing active psychological treatments for posttraumatic stress disorder (PTSD) do not find significant differences at posttreatment. This was the case in a recent trial examining prolonged exposure (PE) and virtual reality exposure (VRE) among active‐duty soldiers with combat‐related PTSD. Matching individua...

IEEE VR 2018 conference panel.

Objective: Virtual environments have been used to assess children with ADHD but have never been tested as therapeutic tools. We tested a new virtual classroom cognitive remediation program to improve symptoms in children with ADHD. Method: In this randomized clinical trial, 51 children with ADHD (7-11 years) were assigned to a virtual cognitive...

PANEL TITLE: Getting close to domain users: VR and AR in support of application domains OVERVIEW: The last couple of years have been marked by an explosion of solutions in the VR and AR domains: the accepted norm of this market has been to provide users with lightweight VR and AR displays, input controllers that recognize human gestures, superior...

Conversational virtual human (VH) agents are increasingly used to support role-play experiential learning. This project examined whether a Virtual Interactive Training Agent (ViTA) system would improve job interviewing skills in individuals with autism and developmental disabilities (N = 32). A linear mixed model was employed to evaluate adjusted l...

Augmented Reality (AR) is now more and more widespreadin many application fields. Thanks to the new progresses in computerpower, especially on mobile devices such as smart-phones and/or tablets,AR can now be used widely without any expensive additional devices. Inaddition to its interest for entertainment, this technology also has a hugepotential f...

Posttraumatic stress disorder (PTSD) continues to be a significant issue for veterans of the Iraq and Afghanistan combat environments. A growing literature has now evolved that supports the idea that Virtual Reality Exposure Therapy (VRET) may be a useful approach for addressing this healthcare challenge. This chapter will describe the history and...

Background: This paper is based on a panel discussion at the 32nd annual meeting of the International Society for Traumatic Stress Studies in Dallas, Texas, in November 2016. Objective: Paula Schnurr convened a panel of experts in the fields of public health and technology to address the topic: ‘What I have changed my mind about and why.’ Method: T...

Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) military personnel has created a significant behavioural healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-b...

Objective: Since the mid-1990s, a significant scientific literature has evolved regarding the outcomes from the use of what we now refer to as Clinical Virtual Reality (VR). This use of VR simulation technology has produced encouraging results when applied to address cognitive, psychological, motor, and functional impairments across a wide range of...

A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTS...

In recent years we have seen a trend towards the use of virtual reality (VR) technologies for rehabilitation and disability support. This is partly driven by the decreasing cost and improved accessibility to the technology, but also by the growth in expertise of virtual rehabilitation researchers and practitioners. The benefits of virtual reality a...

In recent years, humanity has seen a trend towards the use of virtual reality (VR) technologies for rehabilitation and disability support. This is partly driven not only by the decreasing cost and improved accessibility to technology, but also by the growth in expertise of virtual rehabilitation researchers and practitioners. The benefits of virtua...

This chapter discusses virtual human (VH) conversational agents to support client interaction within a healthcare context. After a brief discussion of the history of VHs in the Clinical Virtual Reality domain, applications where a VH can provide private online healthcare information and support (i.e., SimCoach) and where a VH can serve the role as...

Virtual reality (VR) is a multimedia interactive experience in which users feel immersed within the computer generated, virtual environment. It is a powerful platform to use for therapy involving exposure to cues, particularly for persons with anxiety disorders. VR exposure (VRE) therapy has been found to be a successful tool for treating many phob...

Study design: Cross sectional. Introduction: Measuring wrist range of motion (ROM) is an essential procedure in hand therapy clinics. Purpose of the study: To test the reliability and validity of a dynamic ROM assessment, the Camera Wrist Tracker (CWT). Methods: Wrist flexion and extension ROM of 15 patients with distal radius fractures and...

Objective: Prolonged exposure (PE) is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD) but there is limited research with active-duty military populations. Virtual reality exposure (VRE) has shown promise but randomized trials are needed to evaluate efficacy relative to existing standards of care. This study evaluated the ef...

This study presents preliminary feasibility and acceptability data on the use of virtual patient (VP) simulations to develop brief assessment skills within an interdisciplinary care setting. Results support the acceptability of technology-enhanced simulations and offer preliminary evidence for an association between engagement in VP practice simula...