Virtual Reality Environments with Stress Stimuli and Assessment Using Electroencephalography Alpha-Beta Ratio
Abstract and Figures
This study aims to develop the virtual reality environments with stress-stimuli, and assess the results using electroencephalography Alpha/Beta ratio. To do this, we utilised OpenBCI technology to measure brain activity in participants exposed to the stimuli-based VR environment. In order to build the virtual reality environments for this study, we consulted with mental health professionals to carefully design and curate stress-stimulating environments as well as stress-reducing environments. Our results showed that both the stress-stimulating and stress-reducing virtual reality environments were associated with changes in the EEG Alpha/Beta ratio, which is thought to be indicative of stress levels. We also compared the changes in EEG between the four Virtual Reality metaverse spaces and found that the stress-reducing virtual reality environment was more effective at reducing stress, as assessed by the EEG Alpha/Beta ratio, compared to the stress-stimulating virtual reality environment. These findings suggest that the use of a stimuli-based virtual reality environment may have potential as a complementary or alternative treatment for stress management. Further research is needed to confirm these findings and to explore the mechanisms by which the stimuli-based virtual reality environment affects brain activity and stress levels.
![Subject 1 exploring [VR1] Mentally challenged tasks. On the left, it shows the live recorded data of EEG brain signals recorded from the volunteer. On the right, it shows the current view of the volunteer on the VR headset in the metaverse space. [VR1] was developed purposely to be scary with scary sound effects such as but not limited to baby crying, tiger roaring and more. Also, the environment requires the volunteer to walk straight facing different jump-scares such as but not limited to a spider mutant, a zombie with attacking moves, a tiger and more. In the dark environment, there are also mathematical questions at each checkpoint after the moving platforms. If answered wrongly, the volunteer would be thrown into the fire and restart the whole journey in this metaverse space. The volunteer could only proceed if all answers are correct.](https://www.researchgate.net/profile/Chee_Pui_Khei/publication/374002014/figure/fig7/AS:11431281190180754@1695230829664/Subject-1-exploring-VR1-Mentally-challenged-tasks-On-the-left-it-shows-the-live_Q320.jpg)
![Subject 1 exploring [VR2] Mentally challenged film. It requires the volunteer to sit on a chair surrounded by fire in a dark environment. Also, the volunteer is required to watch the horror film being played. [VR2] focuses more on the static motion while [VR1] focused on the dynamic and engaging interactions. In [VR2], the volunteer is being faced with the stress increasing stimuli with little to none movements needed on the controllers.](https://www.researchgate.net/profile/Chee_Pui_Khei/publication/374002014/figure/fig8/AS:11431281190185769@1695231193065/Subject-1-exploring-VR2-Mentally-challenged-film-It-requires-the-volunteer-to-sit-on-a_Q320.jpg)
![Subject 1 exploring [VR3] Top Love (toplove.tech) relaxing tasks. It involves a series of relaxing and stress-reducing stimuli while the volunteer is required to move around freely in the metaverse using the controllers while being seated. The teleportation systems could bring them through different sites in the space, such as but not limited to the avatar-changing site, the dreamy forest site with bridge and musical instruments, another magical forest with rotating trees in a diamond-structured space, and the colourful gummy-ball-shaped meditative chairs. The skybox was aurora while the land is constructed by dynamic ocean, dynamic fog, sand, interactive grass and more elements. The glowing hearts are used to guide the volunteers to interact with different points of interest and complete different tasks to complete the Healing Quest. In the dreamy forest with different trees, there are also hidden interactive points for the volunteers to explore, turn on and off to different sounds, such as but not limited to the binaural beats, a variety of real recorded forest soundtracks, the soothing music played by a kalimba that is seen as a 3D kalimba in the metaverse space and more.](https://www.researchgate.net/profile/Chee_Pui_Khei/publication/374002014/figure/fig9/AS:11431281190169158@1695231738664/Subject-1-exploring-VR3-Top-Love-toplovetech-relaxing-tasks-It-involves-a-series-of_Q320.jpg)
![Subject 1 exploring [VR4] Relaxing BELIGHT meditation. During our subject selection, we have confirmed with our volunteers to have no epilepsy and sensitivity to flashing lights so that this session could be done. The meditation track is provided by BELIGHT, the light and sound therapists who used flashing lights and sounds of different frequency to alter brain signals into the state to be in a desired state. In this metaverse space, it was a dreamy environment with sun shining on the dynamic ocean. The volunteer would sit on the green meditative site on the island and listen to the instructions to perform the relaxation session.](https://www.researchgate.net/profile/Chee_Pui_Khei/publication/374002014/figure/fig10/AS:11431281190181136@1695231947980/Subject-1-exploring-VR4-Relaxing-BELIGHT-meditation-During-our-subject-selection-we_Q320.jpg)
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Background
Employees in high-risk occupations are exposed to tremendous work stress that hinders organizational effectiveness and personal mental health. Based on positive psychology, courage can be considered a protective factor that buffers the adverse effect of high-risk surroundings on employees. However, little is known about the way courage is simulated or evaluated in response to safety concerns. Virtual reality (VR) is an accessible tool for courage simulation due to its immersive qualities, presence and interactive features and may provide a promising pathway to achieve a scientific, accurate and ecologically valid evaluation of high-risk employees.
Methods
The sample consisted of 51 high-risk employees who were recruited voluntarily. Before and after experiencing the VR courage scenarios, the participants completed the VR features questionnaire, the Physical Courage at Work Scale (PCWS), the Courage Measure (CM), and the Positive and Negative Affect Scale (PANAS). During the process of watching the VR courage scenarios, the participants’ heart rate and skin conductance at resting-state baseline and during virtual courage scenarios were recorded through HTC VIVE Pro Eye and BioGraph Infiniti 8.
Results
The results support the hypothesis and reveal that the interaction, immersion and presence scores of the scenarios were all significantly higher than the median 4 points. The score for the CM in the posttest was significantly higher than that in the pretest. The scared and afraid scores for the posttest were significantly higher than those for the pretest. The heart rate and skin conductance of each scenario showed an increase compared with the baseline. The Pearson’s correlation between physiological indicators and the score of the PCWS was 0.28~0.54.
Conclusion
This study developed virtual courage for high-risk occupations based on well-established theory and VR technology. Experimental data revealed that the paradigm conformed to the requirements of VR features and was able to activate fear and evoke the quality of courage. Thus, the virtual courage paradigms have good validity in simulating scenarios for high-risk employees, which might accelerate organizational effectiveness while buffering working stress.
This paper investigates the use of an electroencephalogram (EEG) signal to classify a subject’s stress level while using virtual reality (VR). For this purpose, we designed an acquisition protocol based on alternating relaxing and stressful scenes in the form of a VR interactive simulation, accompanied by an EEG headset to monitor the subject’s psycho-physical condition. Relaxation scenes were developed based on scenarios created for psychotherapy treatment utilizing bilateral stimulation, while the Stroop test worked as a stressor. The experiment was conducted on a group of 28 healthy adult volunteers (office workers), participating in a VR session. Subjects’ EEG signal was continuously monitored using the EMOTIV EPOC Flex wireless EEG head cap system. After the session, volunteers were asked to re-fill questionnaires regarding the current stress level and mood. Then, we classified the stress level using a convolutional neural network (CNN) and compared the classification performance with conventional machine learning algorithms. The best results were obtained considering all brain waves (96.42%) with a multilayer perceptron (MLP) and Support Vector Machine (SVM) classifiers.
To achieve an immersive virtual reality (VR) environment, omnidirectional treadmills (ODTs) allow users to perform locomotion in any direction. However, existing ODTs are heavy and complex, and operate at low speeds. This limits fast user motion and prevents natural interactions in real applications such as military training programs and interactive games. In this paper, we introduce a novel locomotion interface device with running capability, which uses an omnidirectional treadmill with a new power transmission mechanism and a locomotion controller that enables the user to make fast movements. As a result of the improved power transmission performance due to the simple and relatively lightweight structure, the proposed two-dimensional treadmill can generate a maximum speed of 3 m/s, with an acceleration of 3 m/s2. Moreover, through a pilot test with the proposed locomotion interface device, we verified that the fast directional changes during walking and running with the designed speed adaptation controller do not exceed the acceleration performance of the proposed system. Due to its wide range of movement speeds and acceleration capabilities, and lack of any motion constraints, the proposed locomotion interface device with a novel ODT can be used as a representative platform in various VR environments to enhance the immersive experience.
The symbiosis of neuronal activities and glucose energy metabolism is reflected in the generation of functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) signals. However, their association with the balance between neuronal excitation and inhibition (E/I-B), which is closely related to the activities of glutamate and γ-aminobutyric acid (GABA) and the receptor availability (RA) of GABAA and mGluR5, remains unexplored. This research investigates these associations during the resting state (RS) condition using simultaneously recorded PET/MR/EEG (trimodal) data. The trimodal data were acquired from three studies using different radio-tracers such as, [11C]ABP688 (ABP) (N = 9), [11C]Flumazenil (FMZ) (N = 10) and 2-[18F]fluoro-2-deoxy-d-glucose (FDG) (N = 10) targeted to study the mGluR5, GABAA receptors and glucose metabolism respectively. Glucose metabolism and neuroreceptor binding availability (non-displaceable binding potential (BPND)) of GABAA and mGluR5 were found to be significantly higher and closely linked within core resting-state networks (RSNs). The neuronal generators of EEG microstates and the fMRI measures were most tightly associated with the BPND of GABAA relative to mGluR5 BPND and the glucose metabolism, emphasising a predominance of inhibitory processes within in the core RSNs at rest. Changes in the neuroreceptors leading to an altered coupling with glucose metabolism may render the RSNs vulnerable to psychiatric conditions. The paradigm employed here will likely help identify the precise neurobiological mechanisms behind these alterations in fMRI functional connectivity and EEG oscillations, potentially benefitting individualised healthcare treatment measures.
Purpose of review:
This review provides an overview of current methods and important aspects to consider when applying virtual worlds in the treatment of social anxiety disorder (SAD).
Recent findings:
Different aspects such as dialogs between avatars and patients have been investigated as well as virtual audiences, emotional facial expression, and verbal interaction with avatars. Results of these studies are promising. Few randomized controlled trials (RCTs) have investigated the efficacy of virtual reality exposure therapy (VRET) in SAD. Unfortunately, most RCTs into the efficacy of VRET in comparison with exposure in vivo in SAD have been conducted with a combination of cognitive interventions and VRET. No differences between these conditions were found, but the pure effect of VRET as a stand-alone treatment has only been investigated in one RCT, wherein VRET was not superior to exposure in vivo. Current research into different facets of SAD and VRET has produced promising results with respect to technological aspects. No differences in efficacy between cognitive behavior therapy and VRET were found, but there is a clear need for studies investigating the efficacy of VRET as a stand-alone treatment and the therapeutic processes involved before this therapy can be disseminated in routine clinical practice.
Background:
Evidence was found for the effectiveness of virtual reality-based cognitive behavioral therapy (VR-CBT) for treating paranoia in psychosis, but health-economic evaluations are lacking.
Objective:
This study aimed to determine the short-term cost-effectiveness of VR-CBT.
Methods:
The health-economic evaluation was embedded in a randomized controlled trial evaluating VR-CBT in 116 patients with a psychotic disorder suffering from paranoid ideation. The control group (n=58) received treatment as usual (TAU) for psychotic disorders in accordance with the clinical guidelines. The experimental group (n=58) received TAU complemented with add-on VR-CBT to reduce paranoid ideation and social avoidance. Data were collected at baseline and at 3 and 6 months postbaseline. Treatment response was defined as a pre-post improvement of symptoms of at least 20% in social participation measures. Change in quality-adjusted life years (QALYs) was estimated by using Sanderson et al's conversion factor to map a change in the standardized mean difference of Green's Paranoid Thoughts Scale score on a corresponding change in utility. The incremental cost-effectiveness ratios were calculated using 5000 bootstraps of seemingly unrelated regression equations of costs and effects. The cost-effectiveness acceptability curves were graphed for the costs per treatment responder gained and per QALY gained.
Results:
The average mean incremental costs for a treatment responder on social participation ranged between €8079 and €19,525, with 90.74%-99.74% showing improvement. The average incremental cost per QALY was €48,868 over the 6 months of follow-up, with 99.98% showing improved QALYs. Sensitivity analyses show costs to be lower when relevant baseline differences were included in the analysis. Average costs per treatment responder now ranged between €6800 and €16,597, while the average cost per QALY gained was €42,030.
Conclusions:
This study demonstrates that offering VR-CBT to patients with paranoid delusions is an economically viable approach toward improving patients' health in a cost-effective manner. Long-term effects need further research.
Trial registration:
International Standard Randomised Controlled Trial Number (ISRCTN) 12929657; http://www.isrctn.com/ISRCTN12929657.
This paper presents an analysis of stress feature using the power ratio of frequency bands including Alpha to Beta and Theta to Beta. In this study, electroencephalography (EEG) acquisition tool was utilized to collect brain signals from 40 subjects and objectively reflected stress features induced by virtual reality (VR) technology. The EEG signals were analyzed using Welch’s fast Fourier transform (FFT) to extract power spectral density (PSD) features which represented the power of a signal distributed over a range of frequencies. Slow wave versus fast wave (SW/FW) of EEG has been studied to discriminate stress from resting baseline. The results showed the Alpha/Beta ratio and Theta/Beta ratio are negatively correlated with stress and indicated that the power ratios can discriminate the data characteristics of brainwaves for stress assessment.
Trials of virtual reality exposure therapy (VRET) for anxiety-related disorders have proliferated in number and diversity since our previous meta-analysis that examined 13 total trials, most of which were for specific phobias (Powers & Emmelkamp, 2008). Since then, new trials have compared VRET to more diverse anxiety and related disorders including social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), and panic disorder (PD) with and without agoraphobia. With the availability of this data, it is imperative to re-examine the efficacy of VRET for anxiety. A literature search for randomized controlled trials of VRET versus control or in vivo exposure yielded 30 studies with 1057 participants. Fourteen studies tested VRET for specific phobias, 8 for SAD or performance anxiety, 5 for PTSD, and 3 for PD. A random effects analysis estimated a large effect size for VRET versus waitlist (g = 0.90) and a medium to large effect size for VRET versus psychological placebo conditions (g = 0.78). A comparison of VRET and in vivo conditions did not show significantly different effect sizes (g = -0.07). These findings were relatively consistent across disorders. A meta-regression analysis revealed that larger sample sizes were associated with lower effect sizes in VRET versus control comparisons (β = -0.007, p < 0.05). These results indicate that VRET is an effective and equal medium for exposure therapy.
Highly Capable and Fluently Conversant AI-Powered NPCs, Characters, and Avatars Launch within the Aftermath Islands Metaverse. AI-enabled virtual brand ambassadors will provide players with round-the-clock service and information
Aftermath Islands Metaverse Limited. (2023). Highly Capable and Fluently
Conversant AI-Powered NPCs, Characters, and Avatars Launch within the
Aftermath Islands Metaverse. AI-enabled virtual brand ambassadors will
provide players with round-the-clock service and information.
Worldwide virtual and augmented reality headset forecast
- Idc
IDC. (2019). Worldwide virtual and augmented reality headset forecast, 2019-2023.
Retrieved from https://www.idc.com/