Systematic Review and Meta-Analysis of Virtual Reality in Mental Healthcare: Effects of Full Body Illusions on Body Image Disturbance

Background: Body image (BI) disturbances have been identified in both clinical and non-clinical populations. Virtual reality (VR) has recently been used as a tool for modulating BI disturbances through the use of eliciting a full body illusion (FBI). This meta-analysis is the first to collate evidence on the effectiveness of an FBI to reduce BI disturbances in both clinical and non-clinical populations.Methods: We performed a literature search in MEDLINE (PubMed), EMBASE, PsychINFO, and Web of Science with the keywords and synonyms for “virtual reality” and “body image” to identify published studies until September 2020. We included studies that (1) created an FBI with a modified body shape or size and (2) reported BI disturbance outcomes both before and directly after the FBI. FBI was defined as a head-mounted display (HMD)-based simulation of embodying a virtual body from an egocentric perspective in an immersive 3D computer-generated environment.Results: Of the 398 identified unique studies, 13 were included after reading full-texts. Four of these studies were eligible for a meta-analysis on BI distortion inducing a small virtual body FBI in healthy females. Significant post-intervention results were found for estimations of shoulder width, hip width, and abdomen width, with the largest reductions in size being the estimation of shoulder circumference (SMD = −1.3; 95% CI: −2.2 to −0.4; p = 0.004) and hip circumference (SMD = −1.0; 95% CI: −1.6 to −0.4; p = 0.004). Mixed results were found in non-aggregated studies from large virtual body FBIs in terms of both estimated body size and BI dissatisfaction and in small virtual body FBI in terms of BI dissatisfaction.Conclusions: The findings presented in this paper suggest that the participants' BIs were able to conform to both an increased as well as a reduced virtual body size. However, because of the paucity of research in this field, the extent of the clinical utility of FBIs still remains unclear. In light of these limitations, we provide implications for future research about the clinical utility of FBIs for modulating BI-related outcomes.

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Characterizing Body Image Distortion and Bodily Self-Plasticity in Anorexia Nervosa via Visuo-Tactile Stimulation in Virtual Reality

Journal of Clinical Medicine ◽

10.3390/jcm9010098 ◽

2019 ◽

Vol 9 (1) ◽

pp. 98 ◽

Cited By ~ 3

Author(s):

Luca Provenzano ◽

Giuseppina Porciello ◽

Sofia Ciccarone ◽

Bigna Lenggenhager ◽

Gaetano Tieri ◽

...

Keyword(s):

Body Image ◽

Virtual Reality ◽

Anorexia Nervosa ◽

Body Size ◽

Body Dissatisfaction ◽

Image Distortion ◽

Future Research ◽

Body Image Distortion ◽

Person Perspective ◽

Original Weight

We combined virtual reality and multisensory bodily illusion with the aim to characterize and reduce the perceptual (body overestimation) and the cognitive-emotional (body dissatisfaction) components of body image distortion (BID) in anorexia nervosa (AN). For each participant (20 anorexics, 20 healthy controls) we built personalized avatars that reproduced their own body size, shape, and verisimilar increases and losses of their original weight. Body overestimation and dissatisfaction were measured by asking participants to choose the avatar that best resembled their real and ideal body. Results show higher body dissatisfaction in AN, caused by the desire of a thinner body, and no body-size overestimation. Interpersonal multisensory stimulation (IMS) was then applied on the avatar reproducing participant’s perceived body, and on the two avatars which reproduced increases and losses of 15% of it, all presented with a first-person perspective (1PP). Embodiment was stronger after synchronous IMS in both groups, but did not reduce BID in participants with AN. Interestingly, anorexics reported more negative emotions after embodying the fattest avatar, which scaled with symptoms severity. Overall, our findings suggest that the cognitive-emotional, more than the perceptual component of BID is severely altered in AN and that perspective (1PP vs. 3PP) from which a body is evaluated may play a crucial role. Future research and clinical trials might take advantage of virtual reality to reduce the emotional distress related to body dissatisfaction.

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Cybersickness in current-generation virtual reality head-mounted displays: systematic review and outlook

Virtual Reality ◽

10.1007/s10055-021-00513-6 ◽

2021 ◽

Author(s):

Polona Caserman ◽

Augusto Garcia-Agundez ◽

Alvar Gámez Zerban ◽

Stefan Göbel

Keyword(s):

Systematic Review ◽

Virtual Reality ◽

Meta Analysis ◽

Subjective Evaluation ◽

Future Research ◽

Current Generation ◽

Research Areas ◽

Head Mounted Displays ◽

Skin Response ◽

Golden Standard

AbstractCybersickness (CS) is a term used to refer to symptoms, such as nausea, headache, and dizziness that users experience during or after virtual reality immersion. Initially discovered in flight simulators, commercial virtual reality (VR) head-mounted displays (HMD) of the current generation also seem to cause CS, albeit in a different manner and severity. The goal of this work is to summarize recent literature on CS with modern HMDs, to determine the specificities and profile of immersive VR-caused CS, and to provide an outlook for future research areas. A systematic review was performed on the databases IEEE Xplore, PubMed, ACM, and Scopus from 2013 to 2019 and 49 publications were selected. A summarized text states how different VR HMDs impact CS, how the nature of movement in VR HMDs contributes to CS, and how we can use biosensors to detect CS. The results of the meta-analysis show that although current-generation VR HMDs cause significantly less CS ($$p<0.001$$ p < 0.001 ), some symptoms remain as intense. Further results show that the nature of movement and, in particular, sensory mismatch as well as perceived motion have been the leading cause of CS. We suggest an outlook on future research, including the use of galvanic skin response to evaluate CS in combination with the golden standard (Simulator Sickness Questionnaire, SSQ) as well as an update on the subjective evaluation scores of the SSQ.

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Physical Attractiveness, Body Image, and Women's Sexual Self-Schema

Psychology of Women Quarterly ◽

10.1111/j.1471-6402.1997.tb00131.x ◽

1997 ◽

Vol 21 (4) ◽

pp. 567-580 ◽

Cited By ~ 34

Author(s):

Michael W. Wiederman ◽

Shannon R. Hurst

Keyword(s):

Body Image ◽

Body Size ◽

Physical Attractiveness ◽

Facial Attractiveness ◽

Self Report ◽

Future Research ◽

Adult Women ◽

Social Avoidance ◽

Personal Appearance ◽

Self Schema

Recently, Andersen and Cyranowski (1994) presented a self-report measure of women's sexual self-schema, or cognitive view of the self regarding sexuality. In the current study, we investigated potential relationships between women's sexual self-schema and physical attractiveness, body size and shape, and body image. Young adult women ( N = 199) completed questionnaires and were weighed, measured, and rated for facial attractiveness. Results revealed that sexual self-schema was unrelated to body size or shape, general body dissatisfaction, history of teasing about weight, and degree of investment in personal appearance. Sexual self-schema scores significantly correlated with experimenter-rated facial attractiveness, self-rated facial and bodily attractiveness, and degree of social avoidance due to concerns over personal appearance, however. In a multiple regression analysis, only self-rated facial attractiveness and social avoidance were unique predictors. Results are discussed with regard to implications for the development of women's sexual self-schema and directions for future research.

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Ocean acidification and bivalve byssus: explaining variable responses using meta-analysis

10.32942/osf.io/6bpqm ◽

2021 ◽

Author(s):

Jeff Clements ◽

Matthew N. George

Keyword(s):

Body Size ◽

Ocean Acidification ◽

Effect Size ◽

Literature Search ◽

Meta Analysis ◽

Size Variation ◽

Future Research ◽

Systematic Literature Search ◽

Attachment Strength ◽

The Impact

1. Many bivalve molluscs settle and attach to surfaces using adhesive byssal threads – proteinaceous fibers that together form a network known as the byssus. Since these bivalves rely on byssus for survival, strong byssal attachment promotes a myriad of broad ecological services, including water filtration, nutrient extraction, sediment stabilization, and enhancing biodiversity through habitat creation.2. Numerous studies have documented weakened byssal attachment strength under ocean acidification (OA); however, a comparable number report no effect, even within the same species. Consequently, whether elevated CO2 levels expected under near-future OA will affect byssal attachment strength in nature remains hotly contested.3. We used a systematic literature search and meta-analysis to explore factors that could potentially explain observed effect size variation in byssal attachment strength following OA exposure. 4. A systematic literature search uncovered 20 studies experimentally testing the impact of OA on byssal attachment strength (or some proxy thereof). Meta-analysis revealed that body size (mean shell length) was the strongest predictor of effect size variation, with no significant effect of climate, species, year, study temperature, study location, exposure time, food amount, and pH offset. Functionally, a negative linear relationship was observed between body size and effect size.5. Our finding that the byssal strength of larger bivalves is more susceptible to negative OA effects runs counter to prevailing wisdom that larger, older animals of a given species are more robust to OA than earlier life history stages. 6. This highlights that body size and age may be important factors that determine OA sensitivity in adult calcifiers. In addition to body size, a critical review of each study revealed commonly neglected factors that could influence byssal thread attachment strength which we highlight to provide suggestions for future research in this area.

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Exploring the Influence of a Virtual Body on Spatial Awareness

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/154193129604002208 ◽

1996 ◽

Vol 40 (22) ◽

pp. 1146-1150 ◽

Cited By ~ 2

Author(s):

Mark H. Draper ◽

Maxwell J. Wells ◽

Valerie J. Gawron ◽

Tom A. Furness

Keyword(s):

Complex Interaction ◽

Future Research ◽

Spatial Awareness ◽

Target Height ◽

Estimation Task ◽

Perceived Utility ◽

Visual Background ◽

Spatial Tasks ◽

Full Body ◽

Virtual Body

A virtual reality study explored the potential for a virtual body (VB) to enhance a participant's spatial awareness of a virtual environment (VE) by providing an invariant, subtle point of reference for object positioning. The study used the ecological metric of perceived reachability as the manifestation of spatial awareness. Nine subjects entered a VE and performed a maximum virtual reach estimation task in which VB configuration (full-body, hand-only, no-body) and target height (low, medium, high) were manipulated. Estimations of reach were more significantly accurate for low target heights. This seemed most attributable to the influence of the more richly patterned visual background for that condition. A complex interaction between VB configuration and target height indicates that the specific VB used may impact observed performance. Subjective comments also indicate a perceived utility of a full-body virtual body as a reference point for spatial tasks. Results are discussed in regard to potential design implications and future research opportunities.

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Head-Mounted Display Virtual Reality in Disease Treatment: A Systematic Review and Meta-analysis

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641331 ◽

2020 ◽

Vol 64 (1) ◽

pp. 1388-1389

Author(s):

Jiayin Chen ◽

Zhenzhen Xie ◽

Calvin Kalun Or

Keyword(s):

Systematic Review ◽

Virtual Reality ◽

Meta Analysis ◽

Disease Treatment ◽

Head Mounted Display

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User Experience and usability of a new virtual reality set-up to treat eating disorders: a pilot study

10.31234/osf.io/b38ym ◽

2020 ◽

Author(s):

Marta Matamala-Gomez ◽

Eleonora Brivio ◽

Alice CHIRICO ◽

Clelia Malighetti ◽

Olivia Realdon ◽

...

Keyword(s):

Virtual Reality ◽

Body Size ◽

Pilot Study ◽

User Experience ◽

Affective State ◽

The Body ◽

Long Term Memory ◽

Italian Women ◽

State Increase ◽

Virtual Body

Virtual Reality (VR) has progressively emerged as an effective tool for wellbeing and health in clinical populations. VR effectiveness has been tested before in Anorexia Nervosa (AN) with full-body illusion. It consists in the embodiment of patients with AN into a different virtual body to modify their long-term memory of the body as a crucial factor for the onset and maintenance of this disorder. We extended this protocol using the autobiographical recall emotion-induction technique, in which patients recall an emotional episode of their life related to their body. In this pilot study, we aimed to test the usability and User Experience (UX) of this VR-based protocol. Five Italian women with AN were embodied in a virtual body resembling their perceived body size from an ego- and an allocentric perspective while remembering episodes of their life related to their body. High levels of embodiment were reported while embodied in a virtual body resembling their real perceived body size for ownership (p<0.0001), agency (p=0.04), and self-location (p=0.023). Negative affective state increase after session 2 (p=0.012), and positive affective state increase after session 4 (p=0.006) (PANAS). However, further iteration of the VR system is needed to improve the user experience and usability of the system.

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The Redundant Signals Effect and the Full Body Illusion: not Multisensory, but Unisensory Tactile Stimuli Are Affected by the Illusion

Multisensory Research ◽

10.1163/22134808-bja10046 ◽

2021 ◽

pp. 1-33

Author(s):

Lieke M. J. Swinkels ◽

Harm Veling ◽

Hein T. van Schie

Keyword(s):

Multisensory Integration ◽

Objective Measure ◽

Race Model ◽

Detection Task ◽

Head Mounted Display ◽

Person Perspective ◽

Tactile Stimuli ◽

Third Person Perspective ◽

Full Body ◽

Virtual Body

Abstract During a full body illusion (FBI), participants experience a change in self-location towards a body that they see in front of them from a third-person perspective and experience touch to originate from this body. Multisensory integration is thought to underlie this illusion. In the present study we tested the redundant signals effect (RSE) as a new objective measure of the illusion that was designed to directly tap into the multisensory integration underlying the illusion. The illusion was induced by an experimenter who stroked and tapped the participant’s shoulder and underarm, while participants perceived the touch on the virtual body in front of them via a head-mounted display. Participants performed a speeded detection task, responding to visual stimuli on the virtual body, to tactile stimuli on the real body and to combined (multisensory) visual and tactile stimuli. Analysis of the RSE with a race model inequality test indicated that multisensory integration took place in both the synchronous and the asynchronous condition. This surprising finding suggests that simultaneous bodily stimuli from different (visual and tactile) modalities will be transiently integrated into a multisensory representation even when no illusion is induced. Furthermore, this finding suggests that the RSE is not a suitable objective measure of body illusions. Interestingly however, responses to the unisensory tactile stimuli in the speeded detection task were found to be slower and had a larger variance in the asynchronous condition than in the synchronous condition. The implications of this finding for the literature on body representations are discussed.

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Head-Mounted Virtual Reality and Mental Health: Critical Review of Current Research (Preprint)

10.2196/preprints.9226 ◽

2017 ◽

Author(s):

Shaun W Jerdan ◽

Mark Grindle ◽

Hugo C van Woerden ◽

Maged N Kamel Boulos

Keyword(s):

Public Health ◽

Mental Health ◽

Virtual Reality ◽

Health Knowledge ◽

Three Dimensional ◽

Computer Hardware ◽

Future Research ◽

Head Mounted Display ◽

Current State ◽

State Of Research

BACKGROUND eHealth interventions are becoming increasingly used in public health, with virtual reality (VR) being one of the most exciting recent developments. VR consists of a three-dimensional, computer-generated environment viewed through a head-mounted display. This medium has provided new possibilities to adapt problematic behaviors that affect mental health. VR is no longer unaffordable for individuals, and with mobile phone technology being able to track movements and project images through mobile head-mounted devices, VR is now a mobile tool that can be used at work, home, or on the move. OBJECTIVE In line with recent advances in technology, in this review, we aimed to critically assess the current state of research surrounding mental health. METHODS We compiled a table of 82 studies that made use of head-mounted devices in their interventions. RESULTS Our review demonstrated that VR is effective in provoking realistic reactions to feared stimuli, particularly for anxiety; moreover, it proved that the immersive nature of VR is an ideal fit for the management of pain. However, the lack of studies surrounding depression and stress highlight the literature gaps that still exist. CONCLUSIONS Virtual environments that promote positive stimuli combined with health knowledge could prove to be a valuable tool for public health and mental health. The current state of research highlights the importance of the nature and content of VR interventions for improved mental health. While future research should look to incorporate more mobile forms of VR, a more rigorous reporting of VR and computer hardware and software may help us understand the relationship (if any) between increased specifications and the efficacy of treatment.

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