Danaë Stanton Fraser

Background: Obsessive-compulsive disorder (OCD) is a common mental health disorder that can cause significant impairment to occupational and social functioning. While effective treatments exist, outcomes are often hampered by issues outside of the treatment protocol. Virtual reality (VR) presents a potential solution to help support the effective administration of treatment, but its application in the field of OCD has thus far been limited to replicating real-world environments used in exposure exercises, despite the potential to generate environments and stimuli beyond what is possible in reality. Participatory design methods are an effective way to ensure that the development of novel interventions is relevant to the intended end users and is grounded in their expertise and experiences. Objective: The aim of the workshops conducted in this study was 2-fold. First, to understand the opinions of relevant stakeholders (clinicians and people with lived experience of OCD) on the current state of OCD treatment. Second, to generate novel ideas with the direct input of stakeholders for how VR might effectively be applied to support the treatment of OCD. Methods: In total, 6 clinicians with experience of treating OCD and 6 people with lived experience of OCD participated in a combination of round-table discussions in large groups, and creative design exercises conducted in smaller groups and individual interviews. All workshops and interviews were audio-recorded, transcribed, and analyzed using collaborative qualitative analysis. Themes were then synthesized via narrative synthesis. Results: Three themes relating to the first aim were identified: socializing to the model, effective exposure work, and therapeutic alliance (predominantly raised by people with lived experience of OCD). Five themes relating to the second aim were identified, with ideas for VR use covering 5 mechanisms by which it might support treatment: enabling effective exposure work, modeling, illustrating metaphors and the treatment framework, anxiety management, and motivation. Conclusions: Findings from the first workshops largely restate previous findings emphasizing the importance of clients developing a comprehensive shared understanding of the cognitive model of treatment with their therapist. People with lived experience of OCD also highlighted the importance of developing trust in their therapist’s expertise and ability to understand nuances of individual cases. Findings from the second workshop produced a wide variety of ideas for how VR could support the treatment of OCD. Many of these go beyond the concept of simply enabling exposure work as seen in previous literature. Methods to increase client engagement with the cognitive model during treatment were described, and people with lived experience proposed methods of managing anxiety experienced during treatment to facilitate approach behaviors. Avenues for further development of these ideas and areas for further refinement are discussed.

Immersion is a widely experienced yet conceptually contested phenomenon, particularly within Human–Computer Interaction. The Two-Competitor Model proposes that immersion arises from shifts in attentional focus between actual and induced realities. Although the model provides a testable framework for quantifying immersive experiences, it assumes these realities compete along orthogonal dimensions which overlooks instances in which sensory input from the actual reality can enhance, rather than reduce, immersion. This position paper examines three concise examples to demonstrate how cross-sensory interactions can increase the salience of sensory streams in the actual reality while simultaneously supporting the induced reality. By highlighting these dynamics, we argue that cross-sensory interactions challenge the competitive structure of the Two-Competitor Model and offer productive avenues for empirical investigation. This work aims to stimulate further discussion on how multisensory and crossmodal processes contribute to the psychological experience of immersion.

Facial expressions transmit information about internal states, both during social interaction and in response to shared stimuli such as films. When individuals view the same content, synchrony in their expressions reflects shared information processing, and the degree to which their expressions correlate indicates how similarly their perceptual and affective systems are responding to the common input. This makes interindividual expression synchrony a potential marker of engagement and subjective experience. However, the acquisition and analysis of facial data pose both ethical and technical challenges to researchers. ‘Trace’ is a research media player implemented in PsychoPy’s online platform Pavlovia, which captures anonymised facial landmark coordinates through a webcam, without the ethical and technical constraints of capturing and storing video images of participants. Nonetheless, its usefulness is currently limited due to the lack of available preprocessing and analysis tools. This paper describes the functionality of TraceLAB, a MATLAB-based toolbox designed for the preprocessing of Trace data: specifically, the formatting, aligning, and filtering of data. In addition, TraceLAB implements some novel analysis techniques to allow researchers to quantify interindividual synchrony of expressions (through correlated component analysis) and head movements (through Surrogate Synchrony), which may be interpreted as measures of shared information processing. These techniques are demonstrated here on both simulated and real datasets.

Perturbations to visual feedback disrupt one's ability to use vision to guide movement, leading to disrupted visuomotor control. The visuomotor adaptation mechanism recovers control by updating the visuomotor mapping to accommodate the visual perturbation during movement. A hallmark of adaptation is savings, where individuals demonstrate faster adaptation upon subsequent exposure to the same perturbation. Although faster adaptation to a previously experienced delay has been observed in response to constant visual feedback delays in two-dimensional tracking tasks, they have not been investigated in ecologically relevant contexts where individuals perform more complex visuomotor control tasks with varying delays. Previously, delay variability has been shown to significantly impair performance within these tasks, but it remains unclear how delay variability will impact adaptation and savings. Therefore, we investigated adaptation to constant and varying delays in a driving simulator over four sessions spaced 7 days apart. Across these sessions, participants exhibited savings, reflected in reduced average absolute spatial error, a shift in the average directional road position toward the middle of the road (instructed position), and flatter learning slopes, indicating a faster approach to asymptote. Crucially, there were no significant differences between the constant and varying delay conditions in any measure. Therefore, participants adapted to the delayed visual feedback with increased efficiency upon subsequent exposure to the same temporal perturbation. Additionally, delay variability did not disrupt adaptation or savings within the driving simulator task.

BACKGROUND Obsessive-compulsive disorder (OCD) is a common mental health disorder that can cause significant impairment to occupational and social functioning. While effective treatments exist, outcomes are often hampered by issues outside of the treatment protocol. VR presents a potential solution to help support the effective administration of treatment, but its application in the field of OCD has thus far been limited to replicating real-world environments used in exposure exercises, despite the potential to generate environments and stimuli beyond what is possible in reality. Participatory design methods are an effective way to ensure the development of novel interventions are relevant to the intended end users and are grounded in their expertise and experiences. OBJECTIVE The aim of the workshops conducted in the present study was twofold. Firstly, to understand the opinions of relevant stakeholders (clinicians and people with lived experience of OCD) on the current state of OCD treatment. Secondly, to generate novel ideas with the direct input of stakeholders for how VR might effectively be applied to support the treatment of OCD. METHODS In total, six clinicians with experience of treating OCD and six people with lived experience of OCD participated in a combination of round table discussions in large groups and creative design exercises conducted in smaller groups and individual interviews. All workshops and interviews were audio recorded, transcribed and analyzed using collaborative qualitative analysis. Themes were then synthesized via narrative synthesis. RESULTS Three themes relating to the first aim were identified: socializing to the model, effective exposure work and therapeutic alliance (predominantly raised by people with lived experience of OCD). Five themes relating to the second aim were identified, with ideas for VR use covering five mechanisms by which it might support treatment: enabling effective exposure work, modelling, illustrating metaphors and the treatment framework, anxiety management and motivation. CONCLUSIONS Findings from the first workshops emphasize the importance of clients developing a comprehensive shared understanding of the cognitive model of treatment with their therapist. People with lived experience of OCD also highlighted the importance of developing trust in their therapist’s expertise and ability to understand nuances of individual cases. Findings from the second workshop produced a wide variety of methods through which VR can support the treatment of OCD. Many of these go beyond the concept of simply enabling exposure work as seen in previous literature. Methods to increase client engagement with the cognitive model during treatment were described and people with lived experience proposed methods of managing anxiety experienced during treatment to facilitate approach behaviors. The number and novelty of ideas generated in this study demonstrates the value of participatory design with stakeholders. Avenues for further development of these ideas and areas for further refinement are discussed.

Digital theatre broadcasting has risen in popularity, yet it remains relatively novel, meaning the production norms for such content have yet to be established. We measured heart rate synchrony within three live streamed performances and provided data to the filming team to inform the creative direction for the following performance. The audience demonstrated greater heart rate synchrony on the final night compared to the first two nights and rated the final night as significantly more enjoyable. We also measured movement data and narrative engagement and found that movement negatively correlated to narrative engagement and narrative engagement positively correlated with enjoyment. These results highlight the benefits of using physiological assessment of moment-by-moment audience experience and the potential for these data to shape the creative process.

In visually guided movement tasks, visual feedback delays disrupt visuomotor control and impair performance. Adaptation then occurs as compensatory visuomotor updates are generated to accommodate the delay and recover control. Following the removal of the delay, an after-effect is observed, where the retention of this visuomotor update impairs post-exposure performance relative to the pre-exposure baseline. Although adaptation has previously been explored in response to constant delays, there has been no investigation into how continuously varying delays affect adaptation. In this experiment, participants completed a mouse-based target acquisition task with either a constant or varying delay between the mouse and cursor movements. At first exposure to the delays, completion times were large, and both delay conditions frequently overshot the target. With repeated exposure, the precision of the movements improved, resulting in lower completion times and fewer overshoots. The constant and varying delay conditions showed similar rates of change throughout the exposure phase, suggesting similar adaptation rates. Following the removal of the delay, the two delay conditions demonstrated similar post-exposure after-effects, as they systematically undershot the target and showed a decrease in overshooting relative to the pre-exposure baseline. Despite delay variability imposing an unstable error signal between the expected and actual cursor locations, this did not disrupt adaptation. These results suggest that the participants in the varying delay condition adapted to the mean delay and that the fluctuations away from this value did not disrupt the generation of the visuomotor updates.