ABSTRACT. People who strongly identify themselves with all humanity feel connected to people all over the world, perceive them as members of their own group, and care for them. In the current paper we are interested in investigating the correlations of using Online social media (OSM) for global knowledgy.

We collected data from (N=227 Saudi Arabia participants). The data collected via an online survey. Participants were asked how much they used social media (Twitter, Facebook, Snapchat, etc.) follow up on current events locally and pay attention to issues of Saudi society, and to follow up on current events globally and keep up with world issues. We also measured their Identification With All Humanity (IWAH) with subscales of citizen bonding, concern humanity bonding, humanity concern, people bonding, and people concern, as well as human rights, global concern, sustain goals willingness, and sustain goals actions.

We conducted two Pearson’s correlations to discover which factors correlated with Saudi participants’ use of social media to keep abreast of both local and global events. We found that only global concern was correlated with social media related to local issues. Saudi participants’ use of social media to track global events however was also correlated with global concern, but also with human rights, sustain goals actions, and citizens concern. Further findings will be discussed.

ABSTRACT. By December 2019, COVID-19 had spread worldwide, causing a worldwide pandemic and forcing counties to enter mandatory social isolation and quarantine. The immediate mandated closure of schools was one such measure executed by the Iranian government (Rahmanzade, 2020), which led to a countrywide online educational system. Consequently, the Internet became a major source of information (Ferri et al., 2020) exposing Iranian adolescents to an unprecedented degree of unsupervised access to net surfing increasing day by day (Khalajabadi Farahani, 2019). This study is a quantitative and correlational approach to evaluate the impact of net Surfing on sexual behavior during the COVID-19 pandemic. To evaluate the hypothesis, a sample population of 154 adolescent participants was chosen who completed the questionnaire. They were selected as an association for data collection incorporating an appropriate and targeted sampling strategy using social media. Data collection tools were Ghavidel's (2012) Sexual Behavior questionnaire and also Mojaradi questionnaire (2014) which have been validated and reliable in Iran. Through the correlation coefficient, there is a significant relationship between net surfing and sexual behavior among adolescents ages 15 to 17. Although the issue of the Internet and its widespread use has already been addressed, in the current quarantine situation the need to pay more attention to these vulnerable adolescent groups seems necessary. Given the taboos that are encountered in the field of sex education in Iran during the questionnaire, it is suggested that more attention be paid to future research.

ABSTRACT. Sexting includes sending, receiving, or forwarding sexually explicit messages, photographs, or videos through the internet. Although it could be consensual in cases when an individual agrees to send or receives sexually explicit personal content, in many cases sexting happens against someone’s will and could have detrimental psychological consequences. Because of this, the lines between non-consensual sexting and cyberbullying are blurred, as sharing one's (real or edited) sexually explicit photos or videos could be intended to harm, embarrass, or socially insult another person. In this study, we examined non-consensual sexting among high-school students from Serbia. The aim of the study was to examine the predictors of sexting perpetration, victimization, and bystander experience from the domain of individual characteristics and attitudes toward online sexual behaviors. A sample of 2635 high school students from Serbia aged 14-18 years (average age 15.8 years, 45% male) participated in the study. They filled out a series of questionnaires measuring non-consensual sexting perpetration, victimization, bystander experience, self-esteem, self-efficacy, social support, susceptibility to peer pressure, attitudes toward sexually disinhibited behaviors online, and beliefs about the consequences of sexting. Participants also reported their experience with romantic relationships and the frequency of use of social media. Data were analyzed by the hierarchical regression analyses where sexting perpetration, victimization, and bystander experience were treated as criterion variables, while gender, romantic relationship experience, frequency of social media use, individual characteristics, and attitudes were added in the model as predictor variables. In the analysis of sexting perpetration, victimization was controlled to rule out the two-way sexting and vice versa, while in the analysis of sexting bystander experience both perpetration and victimization were controlled. Regression models explained 39% of the variance of sexting perpetration, 37% of sexting victimization, and 38% of sexting bystander experience. Non-consensual sexting perpetration was uniquely predicted by the non-consensual sexting victimization (β=.46), gender (β=-.13, i.e. higher among males), self-esteem (β=.06) and affirmative attitudes toward sexually disinhibited behaviors online (β=.23). Sexting victimization was related to sexting perpetration (β=.47), gender (β=.12, i.e. higher among females), having experience with romantic relationships (β=.12), social support (β=-.07), susceptibility to peer pressure (β=.09) and affirmative attitudes toward sexually disinhibited behaviors online (β=.14). Finally, sexting bystander experience was related to both sexting perpetration (β=.32) and victimization (β=.13), frequency of social media use (β=.07), self-efficacy (β=.07) and affirmative attitudes toward sexually disinhibited behaviors online (β=.12) and believing in the negative consequences of sexting (β=.25). Results of the study suggest that non-consensual sexting perpetration, victimization, and bystander experiences are closely related and often coincide, which might indicate that the social norms of a group could greatly shape such behaviors. The significance of the affirmative attitudes toward sexually disinhibited behaviors online, which were the most consistent predictor of all three kinds of sexting experiences, additionally supports the conclusion that the normativeness of harming behaviors play important role in sexting and cyberbullying occurrence. Acknowledgment: Project was financially supported by the Center for missing and exploited children.

ABSTRACT. Online abuse is an increasing problem in society (e.g., Vidgen et al., 2019). Specifically, a lot of abuse is based on differences of political opinion (Akhtar & Morrison, 2019), and much occurs on the online platform Twitter (Ward et al., 2020). However, this has never been investigated systematically in the political context of Scottish independence. This situation has remained volatile since a failed independence referendum in 2014, and on which opinions are strong and partisan, with individuals typically strongly pro-independence, or strongly pro-(British) union. A series of recent studies (e.g., Scott et al., 2020, Hand et al., 2021) have investigated attributed victim blame and perceived incident severity and found that the valence of the initial tweet and the volume of abuse received both impact observer judgments. In this study we manipulated the political orientation of the initial tweet and the volume of abuse received to gauge observer perceptions of online abuse in the context of Scottish independence. Our experiment utilized a 3 (Tweet Content: pro-independence, neutral, pro-union) x 2 (Abuse Volume: low, high) within-participants design. We presented participants with manufactured screenshots of three Twitter interactions containing an initial tweet and six responses to that tweet. The initial tweet could either be pro-union, neutral, or pro-independence, and the responses could contain either two (low volume) or four (high volume) abusive comments. All tweets and responses were taken from Twitter and were normed in a separate study. Abusive comments and other aspects of the stimuli (e.g., names and pictures of tweets and responders) were counterbalanced across participant groups. After viewing each exchange, participants rated each interaction on a measure of victim blame and perceived severity (Weber et al., 2013). At the start of the experiment, as part of demographic information, participants were asked to report their nationality – this was an open text response so they had the option of identifying themselves as ’British’ or ‘Scottish’. Of 141 participants 8 were excluded because they identified as another European nationality. The final sample contained 133 participants (57 British, 75 Scottish; Mage = 26.3). Data was collected online via Questionpro. We constructed cumulative link mixed effects models for both victim blame and perceived severity. Fixed factors were the volume of abuse, the nationality of participant, and the congruency between the tweet and the participant’s own belief (i.e., for a self-identifying Scottish participant a pro-independence tweet was congruent, a pro-union tweet was incongruent). For victim blame there was a significant three-way interaction. British participants attributed higher victim blame when the initial Tweet was incongruent with their own beliefs and either a low or high volume of abuse was present; Scottish participants attributed higher victim blame when the Tweet was congruent but only when there was a high volume of abuse. There was also a two-way Nation × Congruence interaction: British participants attributed more blame following an incongruent tweet and Scottish participants following a congruent tweet. For perceived severity there was a significant three-way interaction with higher victim blame attributed when British participants saw an incongruent tweet with a low volume of abuse, and when a Scottish participant saw a congruent tweet with a low volume of abuse. There was also a two-way Nation × Congruence interaction: British participants judged abuse more severe following incongruent tweets and Scottish participants following congruent tweets. These results demonstrate a difference in perceptions of online abuse in the context of Scottish independence based on participants’ own stance. While British participants judge those they disagree with more harshly, Scots seem to engage in more self-blame. Alternatively, there could be differences in the severity of initial tweets.

ABSTRACT. Introduction In recent years, digital tools for virtual content and experiences had a tremendous increase in number and spread among laypeople and in the research field. Virtual Reality (VR), in particular, has become increasingly utilized in mental health, psychology, and well-being. These interventions usually target processes of distraction, relaxation and/or emotional regulation, and psychoeducational improvements. Creativity received some attention among the possible psychological processes that might be targeted with VR. Creativity is one intellectual ability to use personal knowledge to produce new ideas or valuable problem-solving solutions. Engaging people in creative activities would allow for the promotion of new solutions in response to challenging life events. The present study aims at assessing the differences between VR for creativity and control group in the evaluation of decisions made during the recalled past unpleasant autobiographical episode and related emotions.

Material and Methods Healthy volunteers will be enrolled in the study. After enrollment, participants were randomly assigned to one of two groups: 1) a painting group using VR, 2) a passive control group. The first group used a VR program for the painting experience with an Oculus Quest 2 device, while the second group was involved in a passive/neutral condition . Both experiences lasted 15 minutes. Before the experiences, participants were invited to think about a past unpleasant autobiographical episode and rate the emotional experience related to it (on Visual Analog Scale from 1 to 10) and evaluate the decision made in this situation (e.g. “Would you choose to act the same way today?” on Visual Analog Scale from 1 to 10). After the interventions, participants were also be asked to rerate the same dimensions in order to assess any potential influences of the experimental conditions on the explored variables. Psychological variables such as personality, emotional intelligence, and Self-Curiosity were also be explored to evaluate any possible influences of these variables on respondents' outcomes.

Results Results showed that participants in the creativity condition rated themselves as significantly more curious and felt that their creativity was stimulated compared to the control group. Furthermore, participants in the creative VR changed the perception of the how much they used System 1 in their choices, when controlling for emotional intelligence. Lastly, the creative experience led participants to feel less satisfied with their previous decision, possibly because it induced creative reasoning on possible alternatives.

Conclusion Results highlighted that VR for creativity can enhance creative feelings and shape emotions and individual relationship with decision-making.

ABSTRACT. Parkinson's disease (PD) is one of the most common neurodegenerative disorders of our time, with a prevalence generally estimated at 0.3% of the total population in industrialized countries. It is the second most common neurodegenerative disorder after Alzheimer's Disease, and its prevalence increases with age, reaching 1% in people older than 60 years. PD is mainly characterized by motor dysfunctions such as resting tremor, bradykinesia, muscular rigidity, and abnormal posture and gait [1], but also involves a wider range of mental health problems such as anxiety, depression, and insomnia that are due both to the condition itself and the difficulties of living with PD or medication side effects [2,3]. To date, studies related to PD have focused more on the containment of motor symptoms and only a few on the reduction of depressive symptoms [4,5,6]. Research on positive resources in PD is still scarce compared to other chronic illnesses [7]. Nevertheless, increasing emotional and psychological well-being is critical in moderating the negative effect of chronic diseases, cognitive impairment, and even mortality [8,9,10]. To reach this goal a promising approach is represented by savoring. Savoring is the ability to live, appreciate and increase positive experiences [11,12] and it can be considered a tool through which people can capitalize on positive emotions and enhance their well-being [13,14]. Thus, savoring-based intervention could positively affect the emotional well-being of PD patients [15]. The present study aims at investigating the feasibility and preliminary effects of a savoring online intervention in increasing emotional well-being and life satisfaction and in decreasing depression and anxiety in PD patients. It also examines the user experience and usefulness perceived by patients. The study is ongoing (the study has been approved by an Ethical Committee) and consists of a randomized controlled study including the experimental group (the savoring online group) and the control group without treatment. Forty-six hospitalized patients of the Fresco Parkinson Center, Department of Parkinson’s disease, Movement Disorders & Brain Injury Rehabilitation, ‘Moriggia-Pelascini’ Hospital - Gravedona ed Uniti of Como will be enrolled. The intervention lasts 2 weeks and includes six sessions, each lasting about 15 minutes. In each session, participants of the experimental group listen a recorded audio, each focused on a different savoring strategy used to amplify and intensify the positive experience such as building positive memories, listing positive achievements, getting absorbed in the moment, sharing positive feelings with others, or anticipating positive moments and gifts. Both groups are invited to complete the questionnaires at baseline and after two weeks. Repeated measures ANOVA will be conducted to analyse the effects generated by the online savoring intervention and descriptive analysis will be performed to explore the user experience and the perceived usefulness. Given the important role played by well-being and positive emotions in the adaptation to chronic illness, understanding the effect of a savoring online intervention could be of particular interest.

ABSTRACT. Background: Chronic Obstructive Pulmonary Disease (COPD) is a globally widespread pathology that causes a not completely reversible limitation of air flow. COPD is associated with a long course and frequent hospitalizations leading to high levels of depression, anxiety, and stress. In this context, Virtual Reality (VR) enhanced with savoring, that is the ability to generate and intensify positive emotions, can be a promising approach to promote well-being and relaxation in patients with COPD. Objective: This ongoing study aims to investigate the feasibility of a relaxation VR-based intervention enhanced with savoring in COPD patients in increasing emotional and psychological well-being, positive emotions, relaxation, oxygen saturation levels and in decreasing negative emotions. It also examines the acceptance of VR, the user experience and the sense of presence experimented by the participants. Methods: Forty-six hospitalized patients of the Pulmonary Rehabilitation Unit of IRCCS INRCA Casatenovo are enrolled in this randomized controlled trial study approved from Ethics Committee of the IRCCS INRCA Casatenovo. Together with the traditional pulmonary rehabilitation, the experimental group (N=23) takes part in the VR-based intervention, while the active control group (N=23) listens to relaxing music. The intervention lasts 2 weeks and includes four sessions, each lasting 20 minutes. In each session, participants of the experimental group watch a relaxing virtual scenario integrated with a narrative voice and lasting about 10 minutes. To consolidate and amplify the positive emotions elicited in VR, participants are guided in savoring the present moment and thought positive reminiscence. Both groups complete the questionnaires before and after the intervention (emotional and psychological well-being, positive and negative emotions, relaxation, oxygen saturation levels) and before and after each session (relaxation, oxygen saturation levels). Results: Repeated measures ANOVA will be conducted to compare the effects generated by the intervention with the ones generated in the control group. An increasing in emotional and psychological well-being, positive emotions, relaxation and saturation levels and a decreasing in negative emotions are expected in the experimental group compared to the control group. Furthermore, descriptive analysis related to the acceptance of VR, the sense of presence and user experience will be carried out. Conclusions: The integration of VR and savoring can be a promising path in promoting well-being in COPD patients. Indeed, savoring can amplify the positive effects of VR and create a connection with the positive experiences in patients' lives. Consequently, participants can build positive resources to counteract the harmful psychological effects caused by COPD.

ABSTRACT. Background. Savoring, which refers to “the capacity to attend to, appreciate and enhance the positive experiences in one’s life” (Bryant & Veroff, 2017, p. XI), has been shown to be crucial for mental health. According to the previous literature (Colombo et al., 2021; Van Roekel et al., 2019), positive emotions and savoring reciprocally influence each other. More specifically, individuals are more likely to increase the use of positive up-regulating strategies over time when feeling in a bad mood which, in turns, increases subsequent levels of positive affect. In other words, savoring might be considered as a highly adaptive mechanism that makes it possible to compensate for the lack of positive emotions by engaging in savoring strategies. Not surprisingly, depression has been associated with abnormal positive emotional functioning, characterized by both low levels of positive affect and impaired use of strategies to upregulate positive emotions. Although a growing body of research has explored positive emotion regulation impairments in depression, still little is known about the specific mechanisms that are affected in the daily regulation of positive emotions in individuals suffering from depression. The aim of the present investigation is to shed new lights on the mechanisms underlying impaired daily savoring in depression by using an Ecological Momentary Assessment design (EMA). We hypothesize that:(1) the aforementioned prototype of positive emotion regulation might not work in depression, so that low levels of positive emotions will not predict a subsequent increase in the use of savoring strategies in depressed individuals;and (2) low self-efficacy and a reduced preference for positive emotions might predict a reduced use of savoring strategies and enhanced implementation of dampening ones, thus partially explaining impairments in the regulation of positive emotions in depression. Methods. Sample: Our planned analyses with the higher risk to be underpowered consist in correlating between-individual differences in depression with between-individual differences in indicators of the interplay between positive emotions and savouring. If, by convention, we consider r = 0.15 as a weak correlation and r = 0.30 as a moderate correlation, then r = 0.225 indicates a weak-to-moderate correlation. To identify effects of this size with 80% power and statistical significance level at 0.05, a number of 152 participants will be recruited. Since data collection is still ongoing, we will present the preliminary results from 70 participants. Importantly, since between-individual differences in depression are distributed along a continuum (Beck et al., 1996) and are not dichotomous, we won’t specifically recruit individuals with a diagnosis of Major Depressive Rather, the level of depression will be assessed for each participant using the Patient Health Questionnaire-9 and used as a moderator in all the analyses. Design: Based on the previous literature (Vanderlind et al., 2022), we will conduct a 14-day EMA study. Participants will be prompted 6 times a day on their smartphone through a mobile application, asking about their current affect and savoring-related variables (strategies, self-efficacy, emotional preference). Data analysis: To examine the temporal relationship between affect, emotion preference and self-efficacy at a given time (t0) and the subsequent implementation of savoring strategies (t1), as well as savoring at a given time (t1) and the subsequent mood (t2), linear mixed-effects models containing one random intercept per participant will be estimated using maximum likelihood with the R “lmerTest” package (Kuznetsova et al., 2017) and taking into account the hierarchical nature of the data. In all models, depression will be included as a moderator variable. Conclusions. Shading new lights on the mechanisms underlying savoring in depression will allow to develop clinical targets to be addresses by psychological interventions.

ABSTRACT. Context: The thin female ideal is defined as the tendency, in Western cultures, “to idolise thin female body shape”. The subjective perceived discrepancy between one’s own body and the thin ideal gives rise to body dissatisfaction and risk of eating pathology. Recent technological advancements have been deployed to improve visual-perceptual methods to assess body image dissatisfaction and the thin ideal internalization. However, to the authors’ knowledge, the use of these advanced methods of assessment present limited generalizability since their validity has not been assessed in cross-countries studies. It has been suggested that some differences among societies exist, even between Western countries. However, cross-countries research on levels of body dissatisfaction and thin ideal internalization is limited and existing studies report inconclusive. Therefore, the objectives of this study were (1) to explore preliminary cross-country validity of a visual-perceptual method (based on a novel continuum of 18 virtual 3D bodies) to assess body image dissatisfaction and thin ideal internalization; (2) to examine potential differences and similarities in body image phenomena between women from Canada and Spain. Method: A total of 223 self-identified women participated in this cross-sectional study. Ideal, normal, and self-perceived body sizes were assessed through a visual-perceptual method, whereas body dissatisfaction was measured both with visual-perceptual method (VPBD) and questionnaire. In order to test objective 1, Pearson’s bivariate correlation analyses were used to explore the relationship between questionnaire body dissatisfaction and VPBD. Furthermore, one sample t tests and independent sample tests were also performed to explore the level and countries differences in terms of realism of the continuum of virtual 3D bodies. To test objective 2, mixed repeated measure ANOVAs and paired sample t test were computed to explore the discrepancy between normal vs ideal body size, normal vs self-perceived body size and ideal vs self-perceived body size, and if they differ according to the country. Results: VPBD was significantly correlated with questionnaire body dissatisfaction, suggesting a preliminary convergent validity between the two assessment methods. In addition, the novel 3D continuum of female virtual bodies was globally evaluated as realistic. Specifically, extremely thin body sizes were judged as the less realistic. Women from both countries desired a thinner body than their self-perceived body. Furthermore, participants’ ideal body was significantly thinner than their visual representation of a normal body size, indicating the presence of the thin ideal internalization, and this independently from participants’ country (effect size values for the differences between countries were mostly trivial according to Cohen’s criteria). Conclusion: This study suggests first evidence of the cross-cultural validity of a visual-perceptual assessment tool to evaluate body image phenomena in women of Western countries. The results of the current study confirm the presence of the “normative discontent”, and they suggest more cross-country similarities than differences in terms of body dissatisfaction and thin-ideal internalization among women from these two Western societies.

ABSTRACT. Introduction. Social Physique Anxiety (SPA) is the fear associated with one’s physical appearance being evaluated by others. State SPA, as opposed to Trait SPA, is triggered by specific situations that will elicit SPA. The context of the anxiogenic exposure is essential to assess State SPA, as opposed to Trait SPA which refers to a stable predisposition to experience SPA. Until now, no research has used virtual reality (VR) to create stimuli that can trigger State SPA.

Objective and hypothesis. The purpose of the study is to validate a virtual environment (VE) simulating an anxiogenic situation to induce State SPA. The VE is used in a pilot randomized control trial (ClinicalTrials.gov Identifier: NCT04630184) focusing on psychological and physical activity interventions to improve Trait and State SPA of women living with obesity. The primary hypothesis of the current validation study is that women living with obesity will have more State SPA post immersion in the VE compared to the control participants while controlling for Trait SPA. Secondly, the VE will be safe for the participant, will induce few or no cybersickness, and will be associated with high scores of presence.

Methods. In this cross-sectional study, 20 women (Body Mass Index (BMI) = 22.08 ± 2.42 Kg.m2; Trait SPA = 19.30 ± 4.89), reporting feeling “not at all” or “only a little uncomfortable” when wearing a swimsuit have been recruited as part of the control group. The experimental group consisted in 25 women living with obesity and elevated Trait SPA from the pilot randomized control trial (BMI = 39.82 ± 6.19 Kg.m2; Trait SPA = 34.92 ± 4.31). All participants had a 10-minute immersion in a virtual swimming pool environment using an Oculus Rift headset and an Intel® CoreTM i7-10700 computer with a core processor unit of 2.9GHz and RAM 32.0 Gb and a NVIDIQ GeForce GTX 1660 SUPER graphics card. Participants were not able to see their virtual body, but they experienced the immersion as if sitting on a chair, on the side of a swimming pool, and exposed to different virtual characters looking at them. Before the immersion, the characteristics of participants were assessed (i.e. anthropometric and sociodemographic data, immersive tendencies, body appreciation, internalization of weight bias, and Trait SPA). After the immersion, the State Social Physique Anxiety scale (S-SPAS) was administered and the sense of presence in VR was measured using the Independent Television Commission - Sense of Presence Inventory (ITC-SOPI). Cybersickness was assessed before and after immersion with the Simulator Sickness Questionnaire.

Results. The first hypothesis was tested using an ANCOVA, with Trait SPA used as a covariable to control for differences in SPA among participants before the immersion. Results showed a statistically significant difference (p=0.016) on the State SPA questionnaire, with estimated marginal mean (EMM) scores higher for the experimental group (EMM= 29.15, SE = 0.99) than for the control group (EMM= 24.29, SE = 1.18). The sense of presence factor scores for spatial presence, engagement and naturalness were above average (each of them close to 3/5) and the negative effects factor score was close to 1.7/5, without statistically significant differences between groups (spatial presence (p=0.218), engagement (p=0.583), naturalness (p=0.091) and negative effects (p=0.945)). All Cybersickness factor scores did not increase post immersion in both groups.

Conclusion. This study suggests that the VE induce State SPA in women with obesity and elevated SPA. Results about sense of presence and cybersickness confirmed the VE induces a good presence and can safely be used. The clinical implications for using this VE in clinical research with people with obesity will be discussed.

ABSTRACT. Introduction: Anorexia nervosa (AN) is an eating disorder (ED) characterized by low weight, body image disturbances and extreme fear of gaining weight (FGW). Previous studies showed that FGW and body anxiety towards specific own body areas (i.e., weight-related body areas) were some of the strongest risk and maintenance factors of AN symptomatology. Moreover, self-disgust (i.e., intense negative feelings of revulsion and an overwhelming and irresistible urge to avoid potential disgust elicitors) can make individuals vulnerable to relapse. Body exposure therapies have been used to reduce the effects of these factors through a habituation process but might be limited due to a body-related attentional bias (AB) (e.g., selective attention towards weight-related body areas). This study aims to investigate the possible predictors of AB, to better understand the underlying mechanisms that contribute to the maintenance of AN symptomatology.

Method: 116 college students from the University of Barcelona participated in the study (99 females, 17 males, M(age) = 24.43 years, SD(age) = 5.30 years; M(BMI) = 22.52 kg/m2, SD(BMI) = 2.99 kg/m2). Body Dissatisfaction was assessed through the EDI-BD subscale of the EDI-3 inventory (Garner, 2004), Self-Disgust through the Self-Disgust Scale (Overton et al., 2008), FGW and anxiety through Visual Analog Scales. After a virtual body was created using a photographic procedure, participants were immersed in a virtual environment using an HTC® VIVE Pro Eye head-mounted-display (HMD). A five-minute visuo-motor and visuo-tactile stimulation was then applied to elicit the Full Body Ownership Illusion (i.e., to perceive and regard a virtual body as one’s own real body). Subsequently, the body-related AB was assessed during 30-second free exposure to the participant’s avatar reflected in a mirror in the virtual environment. The fixation pattern was recorded through the eye-tracking feature of the HMD and then processed by OGAMA software (Freie Universität, Berlin, Germany). AB was assessed using complete fixation time (AB_CFT) and number of fixations (AB_NF), respectively defined as the difference between visual fixation durations (in seconds) and the number of fixations in weight-related body parts minus in non-weight-related body parts (classification based on the Weight Scale of body items of the PASTAS questionnaire; Reed et al., 1991). Stepwise multiple linear regression analyses were performed to identify possible predictors of AB (both AB_CFT and AB_NF).

Results: Linear regression’s five assumptions (linearity, independence of errors, homoscedasticity, normality and non-multicollinearity) were satisfied. Analyses showed that both body dissatisfaction and self-disgust predicted AB_CFT with respectively B(EDI-BD→AB_CFT) = .360 (p < .001) and B(Disgust→AB_CFT) = -.176 (p = 0.011), in a model accounting for 14.1% of the explained variability (significant linear relation confirmed by ANOVA: p = .001). Similarly, both body dissatisfaction and self-disgust predicted AB_NF with respectively B(EDI-BD→AB_NF) = .914 (p < .001) and B(Disgust→AB_NF) = -.397 (p = .016), in a model accounting for 15.1% of the explained variability (significant linear relation confirmed by ANOVA: p < .001). None of the other variables analyzed as possible predictors (BMI, FGW and anxiety) explained a significant additional variance percentage of AB_CFT or AB_NF, so they did not become part of the respective regression equations.

Conclusion: Both body dissatisfaction and self-disgust are significant predictors of AB. However, while an increase in body dissatisfaction predicted greater AB towards weight-related body areas (positive regression coefficients), the opposite occurred with self-disgust (negative regression coefficients). Such results provide first evidence that self-disgust, which is a more intense negative feeling than body dissatisfaction, leads to gaze avoidance towards weight-related body areas, considered as disgust elicitors. Furthermore, this study shows how the combined use of virtual reality and eye-tracking technology offers new opportunities to assess body-related AB, improve research to understand AN and enhance its treatment.

ABSTRACT. Introduction. The presence of body-related dysfunctional attentional bias (AB) may be responsible for reducing the effectiveness of virtual reality (VR)-based mirror exposure therapy (MET), which has been proposed as an effective treatment for anorexia nervosa (AN). Patients with AN who may tend to focus more on weight-related body parts and ignore non-weight-related body parts could benefit less from MET because avoiding looking at the most anxiety-producing body parts can interfere with habituation. Attentional bias modification training (ABMT) is an effective technique to reduce AB by altering selective attention patterns. Our ABMT is based on a combination of VR and eye-tracking (ET) to reduce body-related AB in patients with AN by balancing attention between weight-related body parts and non-weight-related body parts. Method. This multiple-case study provides evidence of the usefulness of incorporating ABMT into VR and ET-based MET to improve its efficacy in the treatment of four female adolescents with AN. Over five exposure sessions, using a VR head-mounted display (HTC ® VIVE Pro Eye) with an integrated ET device (Tobii ®), patients were immersed in a virtual environment and were embodied in a real-size body virtual avatar reflected in a mirror that gradually increased body mass index (BMI) until reaching a healthy BMI in the last session. In every session, the participants completed the ABMT followed by the MET. BMI, body dissatisfaction (BD), drive for thinness (DT), weight-related body parts anxiety (WBA), body checking behaviours (BCB) and body appreciation (BA) were assessed before and after the overall intervention. Full body ownership illusion (FBOI), fear of gaining weight (FGW) and anxiety (ANX) were assessed in each of the treatment sessions, as well as before and after the overall intervention. The reliable changes index (RCI) for single cases was calculated for the post-assessment measurements only for the measures with clinical and community means and standard deviations, provided by the sources for each measure: BD, DT, WBA, BCB and BA. An RCI>1.96 denotes a statistically significant difference. Results. Patient 1 showed a significant reduction in BD, DT, WBA, and BCB and a significant increase in BA. Across all sessions, this patient maintained a medium-high level of FBOI and a very high level of FGW and ANX. Patient 2 showed a significant reduction in WBA and a very slight non-significant improvement in BD, BA and BCB. There was no change in DT. From the 4th treatment session onwards FBOI levels increased and FGW and ANX levels decreased. Patient 3 showed a very slight non-significant improvement in BD, DT, WBA, BA and BCQ. This patient showed very low FBOI levels, high ANX levels (except in the last session) and very high levels of FGW during all sessions. Patient 4 showed a significant improvement in BD, DT and BA and a non-significant improvement in BCB. The level of WBA pre-treatment was zero and this was maintained even post-treatment. A medium-high level of FBOI and absence of ANX were maintained across all sessions, while FGW levels decreased from the 4th treatment session onwards. The BMI of the participants increased slightly over the sessions (except for patient 1 whose BMI decreased slightly) but did not reach the minimum healthy weight for any patient. Conclusion. This augmentation of MET by means of VR-ET-based ABMT achieved promising results for targeting AN symptomatology by reducing BD, DT, WBA, BCB, FGW, and ANX and increasing BA. Two patients who did not show a reduction in FGW during the sessions also showed high ANX levels, which could have affected its reduction. To advance this preliminary study and evaluate the effectiveness of incorporating ABMT into MET, a controlled clinical trial will be conducted.

ABSTRACT. One of the most significant challenges that social and health systems face today is population aging. According to the World Health Organization, the population over 60 years old will account for 13.5% of the global population in 2020, growing at an alarming rate. In the meanwhile, the number of people suffering from cognitive problems due to aging is seriously increasing. One of the most common examples is Alzheimer's Disease (AD). On these bases, experts highlight the need for innovative interventions targeting the early preclinical stages of AD (i.e., Mild Cognitive Impairment - MCI, and Subjective Memory Complaints - SMC). In the field of non-pharmacological interventions, there has been a growing interest in dual-task (DT) training to improve cognitive and motor functioning. The DT is a paradigm that involves two exercises performed concurrently, as well as a physical activity and a cognitive task (e.g., walking while counting backward). Evidence suggests that DT is a successful approach in the rehabilitation field, and it benefits a variety of individuals, including older persons with frailty syndrome, neurological disease, and poststroke patients. However, most of these training have been carried out in aseptic laboratories, limiting the transfer of the ability in real life. Nowadays, innovative technology offers promising outcomes and 360° videos are an example. They are spherical videos captured by a special omnidirectional camera. This method provides to capture the real environment, providing a high level of visual realism that can increase participant engagement. The user-friendly design also makes 360° technologies suitable for interaction whit impaired patients who may have some difficulties interacting with more sophisticated devices. The aim of the current work is to design an intervention to train cognitive functions and motor ability concurrently, in situations as realistic as possible, simulating a real-life circumstance in a daily setting. Moreover, the added value is to create a tool to be provided through two phases: in-hospital and at-home rehabilitation, to enhance the cognitive functioning of individuals with a preclinical stage of dementia. The 360° dual-task training will consist of different exercises taking place in daily environments, such as houses, hospitals, offices, etc., and each exercise will reproduce different ordinary activities (i.e., cooking, using the telephone, and managing medications), requiring participants to perform motor tasks while interacting with the environment. During the exercises, subjects will have to perform motor tasks while interacting with the environment. The program will cover 10 bi-weekly sessions and will be available in two different modalities: immersive and non-immersive. The immersive modality requires the use of a head-mounted display, to train cognitive functions and a cycle ergometer for motor activity. The non-immersive one consists of the use of a table and a portable cycle ergometer. This technology-based intervention will provide older individuals with an innovative and personalized instrument to improve their quality of life by being cognitively engaged. Moreover, this offers the possibility to transfer abilities to real life. The structure of the application will be present during the conference.

ABSTRACT. Correct memory retrieval relies on cognitive control which envelops cognitive functions supporting goal-directed behavior such as inhibiting irrelevant information. High cognitive control aids in avoiding erroneous memory retrieval, also termed false memory, especially when memories are semantically closely related. Cognitive control has repeatedly been linked to heart rate variability (HRV), which is the natural fluctuation in the heart rate reflecting autonomous nervous system activity, and may be improved by stimulating HRV. However, the empirical evidence on the link between intra-subject changes in autonomic activity and cognitive control remains sparse and has never been studied at a memory level. HRV can almost instantaneously be increased by HRV biofeedback. The latter describes a training technique based on the self-regulation of the cardiac activity, typically by adapting slow breathing, in response to real-time cardiac feedback signals. We demonstrate here our attempt to uncover the potential of HRV biofeedback to improve cognitive control and memory functions and to clarify the mediating role of HRV stimulation during memory processing in healthy young adults.

HRV biofeedback was integrated into the Deese-Roediger-McDermott false memory paradigm to assess the immediate effects of HRV stimulation on true and false long-term memory retrieval. The task was implemented into a virtual reality environment to facilitate the biofeedback integration as well as to increase experimental control and training efficacy. 83 healthy adults (24.65 ± 5.51 years) were randomly divided into a biofeedback group and an active control group. Both groups completed two parallel task versions in a single 3-hour session. Participants were embodied by a human avatar of the same gender and age in the first-person perspective sitting on a lonely beach and gazing at the open sea. Instructions, cues, and response options were displayed on a marble stone wall appearing in front of the user. During each task participants were required to memorize 120 words divided into 8 associative lists (encoding). After a retention period (consolidation), they were asked to recognize some of these words among unrelated distractor items and semantically related lure items (retrieval). Participants exercised controlled breathing at a natural rhythm (no HRV stimulation) before encoding and retrieval. Only the biofeedback group performed HRV biofeedback at post-test during which the heart rate signal was displayed as changes in the color of the sea. An electrocardiogram and respiration amplitude were recorded during rest shortly prior to the task and throughout the task. True-to-false memory discrimination performance was assessed as the sensitivity index d’. HRV was measured as the root mean square successive difference (RMSSD) in heart period series during encoding and retrieval. Total as well as reactivity values (i.e., ratio to baseline at rest) were considered. The biofeedback effect was evaluated as the group-by-test interaction effect derived from linear mixed effect models.

Biofeedback did not increase RMSSD or RMSSD reactivity during memory processing nor did it improve d’. Moreover, RMSSD was not linked to d’. However, we found that heart rate reactivity at encoding and retrieval positively correlated with d’. As changes in heart rate bias RMSSD, RMSSD reactivity was adjusted for heart rate reactivity. After adjustment, a biofeedback effect on RMSSD reactivity during encoding and retrieval could be found. Moreover, after adjustment, RMSSD reactivity was linked to d’. The results suggest that distractor discrimination was more associated with cardiac activity at encoding, whereas lure discrimination was more associated to the cardiac activity at retrieval.

This research corroborates the interest in heart rate variability biofeedback as a medication-free and cost-effective neurophysiological stimulation tool. It therefore stresses its usefulness for psychophysiological research and for potential therapeutic and non-therapeutic approaches to improve neurocognition. Future protocols should account for heart rate bias.

ABSTRACT. Older age and cognitive inactivity have been associated with cognitive impairment, as seniors often face limited access to stimulating activities and cognitive training. Emerging non-pharmacological interventions using new technologies, such as virtual reality (VR), might offer a cost-effective alternative to maintain and/or improve cognition. We present SenopiMed, a VR-based cognitive intervention for older adults. After several usability tests with seniors and healthcare professionals in Switzerland, Norway and Sweden, Senopi is conducting a double-blind, prospective Randomized Clinical Trial (RCT) (Clinicaltrials.gov ID NCT05369897) to evaluate the efficacy and safety of SenopiMed. It consists of a warm-up module and three modules of cognitive training targeting attention, working memory and processing speed. Users perform cognitive exercises in different natural environments such as a 360 degrees mountain environment, while listening to their preferred music genre. To date, 70 healthy seniors (MoCA score >26) aged 65-84 years were randomly allocated to the experimental group using SenopiMed or to the control group using a VR headset showing nature videos. The 12-week cognitive intervention of 12 minutes was planned to be delivered 3 times per week (36 sessions). The users took on average 39.8 sessions (range 1-100), with 60% taking more than 36 sessions. Most of the users (95%) found the glasses easy to use and felt safe when using the glasses (96%). Between 79-97% of the users reported enjoying the exercises, and also high degrees of satisfaction with both the environments (78%) and the music (71% reported good mood while listening to music during the exercises). Most of the users (74%) reported being more likely to use the glasses if recommended by a medical doctor, and would pay out of pocket to use the glasses (52%). Our results show that the adherence to SenopiMed is high, with high degrees of satisfaction. SenopiMed is an easy tool with joyful virtual environment for cognitive interventions during aging.

ABSTRACT. Body Self-Consciousness (BSC) is based on a multisensory integration (MSI) process, in which bodily signals and information entering the space immediately surrounding the body - the Peripersonal Space (PPS) - are integrated. The PPS contributes to the development of self-presentation and plays a critical role in shaping how people interact with the surrounding physical and social environment. Alterations in the PPS have been found to be associated with conditions characterised by abnormal anxiety responses or altered states of the BSC, suggesting a possible role in the maintenance of pathological behaviour. Thus, previous research has explored the possibility of manipulating PPS through body illusions. In the present study, we investigated whether a full-body illusion (FBI) presented from an allocentric spatial frame was able to extend the PPS boundary. Participants performed the first run of the PPS task and were then presented with the FBI, followed by a second run of the PPS task for both synchronous and asynchronous conditions. Results showed that PPS increased after the synchronous FBI compared to baseline. As the PPS reflects a change in the MSI, future studies should investigate whether PPS enhancement and allocentric FBI can positively influence body experience in conditions characterised by BSC alterations, such as eating disorders, as well as their effects on the way people interact with their physical and social environment.

ABSTRACT. Introduction: Virtual Embodiment (VE) allows one to enter a VR environment and experience the illusion that the body seen in a virtual mirror is your own. Studies have shown that experiencing a different body in VE can lead to changes in implicit biases. This study aimed to examine the relationship between a specially designed Virtual Embodiment environment and subsequent changes in adolescents' self-perceptions (self-efficacy and self-esteem).

Method: The study was approved by the authors ’Ethics Committee’. The final sample will include 160 high school students; the initial results reported here include 37 students. Students are recruited via their schools. Inclusion criteria were the ability to provide informed consent, aged 12-18, and fluency in Hebrew. Exclusion criteria included a history of epilepsy or any adverse reactions in the past to bright or flashing lights.

Procedure: Participants were randomly divided into two groups (an experimental group using a VE scenario and a control group using a standard VR scenario). The participants' parents signed informed consent forms, and the participants consented orally. Participants completed self-efficacy and self-esteem questionnaires. They were then subjected to a VE or VR environment before completing the questionnaires again. The experimental group participants were exposed to a virtual space in which they saw themselves in a virtual mirror as heroes capable of performing tasks they could not perform in real life. The control group participants will be exposed to the same virtual space, but without a virtual mirror and without seeing themselves as heros. Along with self-report measures that assessed prior experience with VR, a,h both study groups completed immersion and absorption propensity questionnaires.

Virtual Reality and Virtual Embodiment Equipment: The VE was hosted on a DELL G5 5587 laptop with Oculus Rift and touch controllers, the software VE environment was written by Sonarion LTD using Unity

Results: The results presented here represent a pilot study of 37 participants, all of whom used the VE space. Anticipated results will include 160 students randomized into two groups. The average age of the sample was 13.5 (1.3), and 62.2% were boys. A paired samples T-test shows no significant difference in pre and post VE self-esteem levels (T(36)=0.1.2, ns) and a significant difference in pre and post VE self-efficacy levels (T(36)=-3.6, p<0.05).

Discussion:In recent decades, virtual reality has significantly increased its use to promote mental well-being. Virtual reality holds enormous promise for promoting successful, brief, cost-effective, and widely available mental health treatments. If the study's findings show that changes in self-efficacy are possible after a short period through VE, as predicted and seen in the pilot data, the findings are expected to be used to promote community or group programs that are low-cost, short-term, and accessible to the entire community. For the first time, this research looks into the potential of using virtual Embodiment to change self-perception among "healthy" teenagers. Its findings could pave the way for further research into using VE for other purposes.

ABSTRACT. Background: The sense that a virtual reality (VR) scenario is real, and the user feels as if they are physically within the scenario contributes to the quality of experience (Witmer & Singer, 1998). This sense of presence is related to both external characteristics of the technology as well as internal factors. Measuring presence in VR represents a complex challenge, since it is hard to capture presence using subjective self-report questionnaires filled out after existing VR (e.g., Slater, 2004), while objective measures, such as heart rate, eye movement, skin conductance, ECG, fMRI, and EEG require a level of arousal to be utilized. Furthermore, these are more challenging to use and integrate with existing VR systems. This dilemma is even more acute when considering full body illusions in VR: Virtual Embodiment (VE). Questionnaires regarding VE are particularly challenging, and preliminary data from our team suggests these are especially confusing in psychiatric populations. When using objective presence measures, it can be hard to distinguish between levels of presence with interoceptive information that change this level. This study describes a pilot study examining a behavioral response task that represents as a simple way to measure objective presence in VE. The study hypothesized that attention to the insertion of an unexpected element into the VE environment indicates an objective measure of presence and would be positively correlated with subjective measures. Procedure and sample The study was approved by the Ethics Committee. The sample included 20 healthy adult subjects. Recruitment took place in a public area of the University, where staff and students pass by. Inclusion criteria were ability to provide informed consent, over the age of 18, and fluency in Hebrew or English. Exclusion criteria included a history of epilepsy, or any adverse reactions in the past to bright or flashing lights. Procedure Participants signed informed consent and then entered the VE environment. They were instructed to look at themselves in the mirror, orient themselves to the figure in the mirror, and move their arms and head. After one minute, a figure in red entered the VE environment and walked behind them. The researcher noted what, if any, reaction occurred. The participant then exited the VE, and answered self-report measures: Body Representation Questionnaire (Banakou et al, 2013, 2018) and Presence questionnaire (SUS, Salter et al, 2000). Virtual Reality and Virtual Embodiment Equipment: The VE was hosted on a DELL G5 5587 laptop with Oculus Rift and touch controllers, the software was written by Sonarion LTD using Unity. Results The average age of the sample was 34.44 (SD=12.39), the average number of years of education was 15.27 (SD = 2.21) and 35% (7/20) were men. 90% of the participants showed an objective reaction to the figure that entered; these reactions included verbal responses (what is he doing there?), freezing, looking round at the figure, trying to hit the figure. Responses to the questionnaires were not significantly correlated with the objective reactions, nor did the two groups (reacted vs non reacted) differ significantly on the questionnaire results. Discussion The results found in this study suggest an extremely high percentage of participants showing a positive behavioral response to the figure. This indicates high levels of feeling that they were physically in the virtual space, and the specific reactions indicated feelings of agency (e.g., trying to stop the figure) and ownership (e.g., freezing). The extremely small number of participants not displaying a reaction (N=2) probably explains the lack of statistical significant between the two groups. Further studies might incorporate the figure as a means of testing its utility as a measure of presence in virtual embodiment.

ABSTRACT. Stefano De Gaspari, Elena Sajno, Daniele Di Lernia, Giulia Brizzi, Maria Sansoni, Giuseppe Riva

A great deal of research has been conducted in relation to the concept of 'break in presence' (BIP) coined by Slater. Break in presence refers to a condition in which a person immersed in a virtual reality environment becomes disengaged from it, due to certain factors, and tends to become aware of and interact with the reality around him rather than the VR environment in which he is immersed. BIP can be generated due to sensory errors produced within the virtual reality environment as well as by sensory stimuli from outside. Internal errors can correspond to when objects or VR environments behave inconsistently (e.g., chessboards floating or objects falling without making a sound) while external errors can be generated by reality stimuli that are perceived by the person while immersed in a VR experience (e.g., noises or changes in temperature). These errors or external stimuli affect the process of multisensory integration, i.e. a process in which the brain combines information from different sensory signals into a single coherent perception. These factors, underlying BIP, influence multisensory integration by generating multisensory conflicts. Furthermore, several BIP-related studies have analysed the physiological responses (e.g. ECG, GSR) of users in relation to these BIPs and have revealed that there is a correlation between physiological responses and this phenomenon. Full Body Illusion (FBI) corresponds to a paradigm in which the person, within a virtual reality environment, experiences two conditions of multisensory (visual-tactile) stimulation. In one condition the multisensory stimulation is synchronous, while in the other condition the stimulation is asynchronous. Asynchronous stimulation generates multisensory conflicts that may, again, underlie BIP. Machine learning (ML) is a key technology for the classification of physiological parameters, as it allows us to analyse large amounts of data and identify patterns to predict and classify the health status of individuals. In this study, we aim to use ML to classify physiological data (ECG) and identify multisensory conflicts, which underlie BIP, during a Full Body Illusion (FBI). We started collecting data with 15 female participants (mean age = 22, SD = 0.59). They were offered an FBI experience while we recorded their ECG tracing during the whole session. We intend to develop a ML model to classify the collected physiological parameters so that the ML model will be able to identify from these the multisensory conflicts underlying BIP, which should occur in the asynchronous FBI condition. The raw ECG data, before becoming part of the machine learning training process, will undergo the pre-processing and segmentation phase. In the next step, physiological characteristics (features) will be extracted, which will serve as input for the machine learning classification algorithm. Once this part of data preparation is completed, the data will be used as a training and testing set for the machine learning, thus generating a classification of the physiological stimuli in relation to a condition of presence or non-presence of the multisensory conflict (i.e. the synchronous or asynchronous condition of the FBI). The resulting ML model will then be able to identify and classify the presence of multisensory conflict underlying BIP by analysing ECG tracings only. Since virtual reality is an increasingly used tool in a wide range of fields (e.g. clinical, educational, entertainment) a ML model capable of identifying the presence of multisensory conflicts underlying BIP, without any active intervention on the part of the user, could be useful in improving the quality of the experience in virtual reality as it facilitates the identification of those factors that may negatively influence the experience.

ABSTRACT. Introduction The use of social networks (SN) has increased dramatically over the last few years. Many scholars argue that SN use may be addictive because some individuals experience symptoms like those experienced by people who suffer from other forms of addiction (e.g., mood modification, salience, and withdrawal). Cognitive models of addictive behaviors have highlighted the central role of Desire Thinking (DT) a conscious and voluntary cognitive process orienting to prefigure images and information about a positive target-related experience in increasing craving and in maintaining addictive behaviors. The role of DT in eliciting craving has been studied for substance-related addictive behaviors, and, more recently, for behavioral addictions such as gambling, and problematic social media use. The metacognitive model of DT (Caselli & Spada, 2015) posits that metacognition plays a central role in understanding dysregulation in DT. Metacognitions about DT refer to the information individuals hold about their own DT and desire-related thoughts. Positive metacognitions regard the usefulness of DT in distracting from negative thoughts and emotions and are involved in the initiation of DT when a target-related thought intrudes into awareness. Negative metacognitions regard the uncontrollability of target-related thoughts and play a role in the propagating of low control once a DT episode has started leading to an escalation of DT and craving. The metacognitive model of DT has been validated in clinical (e.g., alcohol use disorder, gambling disorder) and in community samples. However, no previous study has empirically tested this model in Problematic Social Networking Sites Use (PSNSU). The aim of the current study is to test the role of metacognitions about DT, DT, and craving in the relationship between some well-established predisposing psychological factors (i.e., Fear of Missing OutFoMo, boredom proneness, and negative emotional reactivity) and PSNSU. Method. A sample of 529 participants (mean age= 32.45 ± 13.33; Females = 62.9%) was recruited using a convenience sampling approach. The following instruments were administered online: The Boredom Proneness Scale-Short Form, the Fear of Missing Out Scale, the Negative Reactivity scale of the Perth Emotional Reactivity Scale – Short Form, the Metacognitions About Desire Thinking Questionnaire, the Desire Thinking Questionnaire, the Penn Alcohol Craving Scale modified for SNSs, and the Bergen Social Media Addiction Scale. The proposed model (where FoMO, boredom proneness, and negative emotional reactivity were considered as predictive variables, metacognition about DT, DT, and craving as mediating variables, and PSNSU as the outcome variable) was tested through path analysis. Results. The path analysis showed that the hypothesized model produced a good fit to the data [χ2 = 20.27, df = 16, p =.20; RMSEA [90%CI]=.02[.000-.05]; CFI= .99; SRMR=.02] and accounted for 63% of PSNSU variance. FoMO predicted positive metacognitions about DT, which in turn predicted DT that, in association with craving, predicted PSNSU. Boredom proneness positively predicted PSNSU both directly and indirectly through the serial mediation of positive metacognitions about DT, DT, and craving. Additionally, a direct path between negative emotional reactivity and PSNSU was found. Discussion The current findings provide preliminary evidence for the application of the metacognitive model of DT and craving in PSNSU. A relevant role for positive metacognitions about DT emerged. These beliefs may be involved in the initiation of DT when SNSs use-related thought intrudes into awareness. Positive metacognitions about DT and DT may be central cognitive processes in craving and PSNSU for individuals who experience boredom proneness and FoMo. Several implications for the assessment and treatment of PSNSU can be drawn. For example, applying Metacognitive Therapy techniques, like attention training and detached mindfulness, aimed at the modification of dysfunctional metacognitions that increase the intensity of DT in the context of PSNSU.

ABSTRACT. Introduction Photo Investment (PI) is a recent construct defined as individual emotions and concerns related to photo quality and how photos portray the person, and the efforts expended in choosing self-photos before sharing them on social networks (McLean, Paxton, Wertheim, Masters, 2015). The study of PI is at an early stage. Studies showed higher levels of PI among females than males (Lonergan, et al., 2019; Mingoia, Hutchinson, Gleaves, & Wilson, 2019). Research on PI mainly focused on its association with body satisfaction highlighting that higher levels of PI are associated with higher body-dissatisfaction (McLean, et al., 2015; Lonergan, et al., 2019). Recent studies focused on other photo-related constructs (i.e. photo-editing, selfie-posting) found also associations with self-esteem and personality traits (narcissism and extraversion) (Wang, 2019; Lau, & Idang, 2022; Guo, et al., 2018). In literature no studies have investigated the association between PI and both body-related constructs and personality traits yet. The present study aims at investigating the role of body-esteem in terms of Appearance (general feelings about appearance), Attribution (others’ evaluation of one’s own body) and Weight (weight satisfaction), self-esteem and personality traits (i.e., Narcissism, Extraversion, Agreeableness, Openness, Conscientiousness, and Neuroticism) in explaining photo investment in a sample of Italian young adults controlling for gender. Method Participants were 420 Italian young adults (males=35%, females=65%) aged 18-30 (M=23.64; S.D.=2.70). After providing their informed consent participants completed an online survey. We used: the Photo investment scale (McLean, et al., 2015; 10 items, α=.85) to assess individual emotions and concerns about photo posting; the Body-esteem scale (Confalonieri et al., 2008; 23 items, α=.86, α=.66, α=.90) to assess self-perceptions of one’s own body; the Self-esteem Scale (Prezza et al., 1997 ; 10 items, α=.88) to assess self-perception one’s own value; the Italian adaptation (Fossati, et al., 2008) of the abbreviated version of the Narcissistic Personality Inventory to assess grandiose narcissism (16 items, α=.73); the Big Five Inventory (Ubbiali et al., 2013; 44 items, α=.86, α=.69, α=.81, α=.81, α=.81) to assess Extraversion, Agreeableness, Openness, Conscientiousness, and Neuroticism.

Results Preliminary bivariate correlations were conducted showing that Photo Investment correlated with Appearance (r=-.498**), Weight (r=-.309**), Self-esteem (r=-.372**), Extroversion(r=-.216**), Conscientiousness (r=-.171**), and Neuroticism (r=.345**). Then a hierarchical regression analyses was conducted including only the variables that correlated with Photo Investment. We entered sex in the first step as a controlling variable, Appearance and Weight in the second step, followed by Self-esteem, Extroversion, Conscientiousness, and Neuroticism in the third step. Photo Investment was the dependent variable. Results showed that sex (β=.213, p < .001), Appearance (β=-.361, p < .001) and Self-esteem (β=-.138, p = .006) significantly explained Photo Investment (F(3,406)= 58.218, p < .001).The model explained 30% of the variance of the dependent variable (R2=.301).

Conclusion We believe that this study is a precious contribution since in literature there are few contributions on Photo Investment and there are no studies carried out in the Italian context. Moreover, the relationship between Photo Investment together with body-related constructs and individual characteristics has never been explored. Findings showed that within the sample young adults with a good general feeling about their appearance and about their own value are less concerned about their photo posting. This suggests that emotions and concerns related to photo posting of young adults are in general linked to individual evaluation about the self and in particular about body appearance. A further discussion of the data will be provided during the presentation distinguishing between males and females.

ABSTRACT. Young adults across the Global North engage with a multitude of technologies to support their physical fitness, including social media, diet and exercise apps, exergames and wearables. These technologies are typically used in an overlapping, complementary and complex way; an individual may use Youtube to access a workout, a Fitbit to assess heart rate and calories burned during the workout, and Instagram to post details of the workout once completed. The cumulative user experience of engaging with this digital fitness culture is an emerging area of research interest. To date, research has highlighted multiple positive benefits to using digital technologies to support physical fitness, including increased physical activity levels, and healthy eating practices and improved wellbeing. It has also highlighted many negative consequences, with some users reporting negative body image, anxiety, and engagement in disordered eating/exercise behaviour. These risks likely stem from unregulated and user-generated nature of diet and exercise content shared through these channels and may be more salient for some than others, e.g., individuals with pre-existing body image concerns or with experience of disordered eating. The present research aimed to understand young female students’ experiences of using digital fitness culture between March 2020 and March 2021, over the course of the covid-19 pandemic, wherein restrictions imposed by governments mandated the closure of gyms, leisure centres and other physical fitness spaces for prolonged periods of time. More specifically, it sought to understand how they made sense of their cumulative engagement with digital fitness culture before, during and after government-mandated lockdowns. Seventeen female students (Age M = 20.29, SD = 1.72; Ethnicity White = 94.12%, White-Asian = 6.92%) recruited from universities across the North of England took part in individual interviews where they discussed their engagement with digital fitness culture over the course of the pandemic. Data was analysed using narrative-informed reflexive thematic analysis. Three themes were developed that encapsulated young women’s experiences. The first theme - My lockdown #fitness transformation - encapsulates how young women constructed lockdown as an opportunity to focus on their health and appearance, with digital fitness culture providing crucial information, inspiration and support for this. The second theme – My unrealistic expectations – focuses on young women’s construction of digital fitness culture as a source of unrealistic expectations and social pressure, as well as the feelings of negativity associated with this over time. The final theme - My new resilient self - focuses on young women’s descriptions of how they had developed new ways of orientating towards their body and health, as well as digital fitness culture, over the course of the pandemic. These themes highlight how women’s experiences of digital fitness culture changed over time as a consequence of their technology use, sociocultural context and psychological meaning-making. Repeat engagement fostered a process of continuous learning, wherein users tested different technologies to find those that helped them and developed increased resilience to the more problematic aspects of digital fitness culture, such that present-day interactions were informed by past experiences. Crucially, the findings demonstrate the importance of studying the cumulative effects of engagement with digital fitness culture and the sense-making and learning processes employed by young women when engaging with digital technologies over time.

ABSTRACT. One of the main objectives of clinical neuropsychology is to be able to support and relieve patients with cognitive function disorders by offering objective and sensitive methods to assess and understand the functional difficulties encountered by these people in daily life. However, the classic assessment tools are often far removed from real-life situations. They may lack the sensitivity to detect the first symptoms early on or estimate the difficulties in real life. Virtual Reality (VR) is a tool increasingly used in neuropsychology because it makes it possible to create situations close to daily life, self-relevant and motivating for patients while maintaining high experimental control, even if the level of immersion and interaction of the virtual environments used in neuropsychology is still very varied, ranging from the use of computer screens and joysticks to head-mounted displays and sophisticated and embodied sensorimotor interfaces (e.g., movements of walking, incarnation of own avatar). Hence, the interest in VR in neuropsychology is principally in the ecological dimension, the great flexibility, and the fact that it can consider the role of the self in cognition. Through its multisensory and interactive aspect, VR makes it possible to simulate natural and familiar situations close to those experienced by patients in everyday life (e.g., acting in social situations, walking around a city and finding where you parked your car, remembering planned actions to execute at a specific time or place, doing shopping at the supermarket etc.) by mobilizing a wide range of their cognitive abilities guaranteeing the realism of the behaviour. It is noteworthy that the behaviours thus evaluated in VR can predict the personal and social difficulties of the patients and that the VR training is better transferred to the activities of daily life. This symposium will gather four lectures illustrating, using different immersive degrees of virtual reality in realistic urban environments, the assessment of cognitive skills in neurologic or psychiatric patients and the effect of a training program in elderlies. Eva-Flore Msika will present a new tool to assess social cognition which was validated in healthy controls and applied in traumatic brain injury. Pascale Piolino will present an experiment to assess in a virtual environment existence of the robust self-referential effect in memory encoding of the neurotypical population in patients with ultra-high-risk psychosis and schizophrenia. Delphine Yeh will show whether the body self-consciousness is preserved or impaired in patients with a first episode of psychosis. Finally, Dana Ladon-Evans will present validation of a new tablet-based virtual reality training program in healthy elderlies before it is proposed for early-stage Alzheimer’s disease. 1/ Multidimensional assessment of social cognition in severe traumatic brain injury: a pilot study using a non-immersive virtual reality serious game Eva-Flore Msika, Nathalie Ehrlé, Alexandre Gaston-Bellegarde, Eric Orriols, Pascale Piolino, Pauline Narme 2/Assessment of the self-reference effect at encoding in a naturalistic context: A study in people at ultra-high risk of psychosis and in schizophrenia during a virtual walk in the Latin Quarter of Paris Pascale Piolino, Célia Jantac, Sylvain Penaud, Eric Orriols, Alain Berthoz, Marie-Odile Krebs 3/ An immersive virtual reality study of the modulation of episodic memory of naturalistic events by the minimal Self in patients with a first episode of psychosis Delphine Yeh, Sylvain Penaud, Linda Scoriels, Marie-Odile Krebs, Pascale Piolino 4/ REVALZ: A new tablet-based virtual reality game to train cognitive skills in everyday life and application in seniors Dana Ladon-Evans, Valentina La Corte, Alexandre Gaston-Bellegarde, Pascale Piolino

ABSTRACT. Background and objectives: Social cognition abilities are frequently impaired in severe traumatic brain injury (TBI). On the one hand, these difficulties are likely to contribute to social, behavioral disorders. Such changes are frequent and reported by caregivers, but they remain under-examined and are rarely objectively quantified in clinical practice. Moreover, methodological limitations have been highlighted in existing social-cognitive tasks, especially their lack of ecological validity and the fact that social cognition processes are usually assessed separately from each other. This study aims at testing the feasibility of the REALSoCog task in severe TBI. This task is a new non-immersive virtual reality serious game for assessing social cognition, which has been pretested with a more extended version of the task in two case studies. This tool addresses some of the current gaps in social cognition assessment and aims to objectively investigate inappropriate social conducts. Its goal is to provide a measure reflecting real difficulties by using concrete scenarios that integrate stimuli encountered in a simulated real-world environment. Social cognition is then tested in an interactive context while respecting its multidimensional nature. On the other hand, from a theoretical perspective, very few studies have addressed the impact of individual factors such as post-traumatic stress-disorder (PTSD) on social-cognitive functioning, especially in severe TBI where PTSD is likely to occur. Thus, the secondary aim of the present study was to investigate the PTSD impact on patients' social-cognitive abilities. Participants and method: Social cognition and PTSD were assessed in 10 patients with severe TBI (33.5  13.6 years old) compared with 162 age-matched healthy controls (36.8  13.9 years old). Assessing social cognition, participants were asked to complete the REALSoCog task, a non-immersive virtual reality task, displayed on a computer screen. They watched a pre-recorded navigation in first-person perspective in a virtual city environment in which they encountered 16 social situations. These scenarios involved neutral interactions (i.e., 6 control situations), moral or conventional transgressions (4 situations each) and/or elicited empathy (5 situations). Experimental situations focused on negative emotions and/or malicious behaviors to test participants' response under these conditions. The social cues manipulated were verbal and/or nonverbal (e.g., prosody, body language and gestures). Participants were asked to judge these situations, guided by questions allowing the assessment of moral cognition, Theory of Mind (ToM; cognitive and affective), empathic concern, and the propensity to act inappropriately. A self-report questionnaire, the PCL-5 (the Post-traumatic Stress Disorder Checklist for DSM-5), was then used to detect the presence of PTSD in patients. Results: Intergroup comparisons using Mann-Whitney tests revealed social cognition disturbances in patients with severe TBI in comparison with healthy controls, by showing (i) a reduced emotional empathy, (ii) difficulties to infer others’ emotions (affective ToM), and (iii) higher proportion of inappropriate behavioral intentions when facing situations that involved a transgression or designed to elicit empathy for a victim. Considering the self-report questionnaire, a PTSD was suspected in 60% of our patients with severe TBI (PTSD+). When comparing patients from the PTSD+ group to healthy controls, intergroup comparisons confirmed the above mentioned social cognition disturbances. By contrast, those from the PTSD- group did not significantly differ from healthy controls.

Conclusions: This pilot study argues in favor of the validity of REALSoCog to objectively highlight social-cognitive disturbances in patients with severe TBI, by replicating social cognition deficits reported in the literature. These outcomes are possible thanks to a novel tool that innovatively measures behavioral intentions and integrated social-cognitive functioning.

ABSTRACT. It is now well-known that self-reference processing greatly benefits the long-term memory encoding of new material, which is crucial in the learning and distinctiveness of memory traces and thus contributes to both autonomy and well-being. The self-reference effect refers to a tendency for individuals to encode information more effectively when it is related in some way to themselves. Neuroimaging research has shown that this effect is linked to the additional involvement of cortical midline structures, including the medial prefrontal cortex and anterior and posterior cingulate and medial parietal cortex, in areas critical for long-term memory encoding. Using an ecological approach based on VR technology, we demonstrated in healthy populations the beneficial effects of self-reference on the encoding of specific events encountered during a walk in a virtual city resembling the Latin quarter of Paris. Examining the self-referential impact using VR tasks could be valuable in revealing self-disorders in early-stage pathologies. The first psychotic episode, the beginning of the active phase of schizophrenia (SCZ), is usually preceded by a "prodromal phase" during which clinical signs are present at a sub-threshold level, either in intensity or frequency. Individuals with these signs are considered as having a "mental state at risk of psychosis" (Ultra High Risk, UHR), where the risk of psychotic transition is 30% in the following three years. This study aimed to investigate self-referential alterations as predictive markers of the transition to psychosis to improve early detection and propose early interventions. We immersed 22 UHR and 16 patients with SCZ matched in age and gender with 29 healthy controls in the virtual Latin Quarter of Paris. The participants all signed a free and informed consent form, and the ethical committee of Saint Anne Hospital approved the study. The virtual environment (VE) was projected onto a large screen, and participants could move forward in the town using a joystick. The atmosphere was enriched with background sounds of the natural environment, such as noises of cars, voices, and specific events observed during the navigation (e.g., joggers in Place Saint Michel) or interactions with human avatars (e.g., a girl holding out a teddy bear). The participants navigated each half of the VE in two different experimental conditions (in a counterbalanced order). In the self-perspective condition, participants directly experienced events and interactions with avatars in the environment. In the other-perspective condition, they followed an independent virtual human (i.e., an avatar) who walked through the virtual environment and experienced events and interactions with other avatars (i.e., an avatar whose route did not follow the same path as that of the participants). In this condition, the participants had to decenter themselves and adopt the avatar's perspective instead of their self-perspective ("put yourself mentally in the avatar's shoes"). After navigation, they had to recall as many specific events as possible, indicating each event's spatiotemporal context, perceptual details, and subjective feelings. The condition by group ANOVA results showed fewer recalls in UHR and SCZ patients compared to healthy controls. Besides, healthy controls remembered better from the self-perspective than from the other perspective, while there was no difference between the two conditions in UHR and SCZ. The findings suggested that the self-reference effect is inefficient in patients from the prodromal phase. Thus, we argue that stimulating self-reference in VR could hold great promise for extending neuropsychological research to pave the way toward developing remediation methods based on self-reference to support the self and cognitive skills in daily life.

ABSTRACT. The minimal Self refers to the subject of the pre-reflexive experience of the world, anchored in one’s body. The Self acts as a processing bias that modulates cognition, especially episodic memory, i.e. the memory of personally experienced events, unique and located in time and space, that can be recalled with specific details. Studies had demonstrated in healthy subjects that stronger minimal Self lead to better episodic memory. Given that minimal Self disorders are a core feature of the schizophrenia spectrum, and that episodic memory deficits are associated with the pathology, we investigated whether the minimal Self modulated episodic memory in patients with a first episode of psychosis (FEP), i.e. who experienced psychotic symptoms (hallucinations, delusions, disorganised speech or behaviour) at high intensity and frequency for the first time. The hypothesis was that patients with a FEP would not experience episodic memory improvement with stronger embodiment compared to weaker embodiment, since their Self-disorders would impair the modulation of episodic memory by the minimal Self. The recruitment is ongoing (N=30 per group); 20 healthy young adults (55% men, 23.2 ± 4.5 y.o.) and 7 patients with a FEP (57% men, 20.7 ± 3.4 y.o.) have been enrolled so far. Immersive virtual reality enabled manipulating the minimal Self via the embodiment of a virtual avatar. The illusion of embodiment was induced before each navigation by a visuomotor stimulation facing a virtual mirror, with either synchronous or asynchronous (visual feedback with a 650 ms delay between the participant’s movements and those of the avatar) stimulation, inducing a strong or weak sense of embodiment, respectively, and therefore a stronger or weaker minimal Self. Indeed, the spatiotemporal synchronicity and coherence of multisensory and motor signals are necessary to ensure a correct multimodal integration, on which the minimal Self relies. Immersive virtual reality also provided a controlled experimental environment, with immersive 3D and multisensory naturalistic life scenes. Participants were immersed via a virtual reality headset in a city and visited two neighbourhoods in separate navigations, embodying from a first-person perspective a generic avatar matched with their gender, synchronous in one navigation and asynchronous in the other, and encountered daily life events that were incidentally encoded in memory. Questionnaires assessing embodiment (subcomponents: ownership, self-location, agency), presence, and cybersickness were completed after each navigation. Participants then performed a recognition memory task assessing the memory of objective (what, when, where, source, and binding – a measure of associative memory) and subjective (perspective, fidelity, emotional intensity, self-reference) information, and the degree of recollection (Remember/Know judgments). Preliminary analyses were performed on the data collected so far using 2x2 Group (controls/patients) x Avatar synchronisation (synchronous/asynchronous) ART-ANOVAs. There was a marginally significant interaction for self-location, suggesting higher scores for synchronous avatar than asynchronous i.e. successful manipulation of embodiment – further suggested by a marginally significant effect of synchronisation on ownership, using paired t-tests independently of the group – and higher scores for patients than controls, which could reflect an altered, more malleable, minimal Self in patients. As for memory scores, there was a significant interaction for the number of events recognised (“hits”): there was no group difference in asynchronous condition, and no synchronisation condition difference for controls, but fewer hits in synchronous condition for patients, suggesting lower memory performance with higher embodiment for patients as compared to controls. Preliminary results suggested that patients with a FEP might not experience episodic memory enhancement by the minimal Self. Developing prevention and treatment that aim at reinforcing the minimal Self (e.g. body-oriented psychotherapy) could, therefore, be an important lead to slow down episodic memory impairments, and other symptoms linked to Self-disorders, before the evolution towards chronic schizophrenia.

ABSTRACT. One of the most critical challenges of the moment is to develop and disseminate effective preventive measures and cognitive interventions for healthy aging with complete autonomy. Some trainings have been conceived for seniors as 2D mini games (e.g., go/no-go, puzzles, working memory tasks), even though the evaluation of pre/post-cognitive abilities is scarcely performed with standardized neuropsychological tests. This study aimed to validate a new serious game on a tablet using an ecological VR-based setting to improve cognitive abilities close to everyday life in the elderly. Thirty-four healthy elderly participants aged 60 to 84 years old (M= 70 years old), still professionally active or retired and autonomous, were recruited to test the validity of the tablet-based virtual reality REVALZ game. The participants all signed a free informed consent form. The participants were randomly separated into two groups (experimental and active control) to be equivalent in terms of gender, age, and socio-cultural level. During recruitment, we excluded people with neurological and psychiatric histories and disorders. The experimental group benefited from cognitive stimulation with the serious game Revalz on a touchscreen tablet. The control group was also active since the participants followed an immersive viewing program presenting the history of villages in France on a touchscreen tablet to eliminate the potential cognitive improvements linked to the practice of a tablet. The two programs were proposed for four weeks, and participants had to achieve several sessions per week. Moreover, they were tested before and after each program lasting four weeks using a standard neuropsychological tests battery (memory, attention, visuospatial and executive functions) and a VR test realized in a virtual city presented on a laptop and navigating via a joystick to assess both the retrospective and prospective memory. The Revalz cognitive stimulation program was created by the Memory, Brain and Cognition laboratory of the University of Paris Cité to stimulate both retrospective and prospective components of memory, time processing and visuospatial functions. The game represents a 3D urban environment in which the participant must move using the touch screen with a first-person view and perform many activities and missions with increasing difficulty. During the navigation, the participant has access to a clock and a map, allowing him to locate himself and the various places of interest in the city. The city comprises diverse well-known Parisian monuments (e.g., Eiffel Tower, Arc de Triomphe), specific areas (e.g., bakery, grocery store, cinema), public transport and non-player animated characters. Tutorials are included to help the participants to learn in-depth memory encodings strategies like mental imagery and self-reference methods to memorize information needed to complete tasks and accomplish new tasks such as acting planned intentions (e.g., meet a friend at the Fnac and wish him a happy birthday) or taking public transport. Moreover, a virtual agent frequently verbally refers to these strategies and encourages the participant to use them; feedback includes a points system and the possibility to choose gifts (e.g., a companion animal). The participant must complete 24 levels of increasing complexity at a rate of 6 per week. The group-by-time ANOVAs showed no significant difference between the two groups of participants before the tablet program and a significant increase in performances in the experimental group after the REVALZ program compared to the active control group after viewing the program presenting the history of villages in France. Both groups increased their speed processing after the programs. In conclusion, REVALZ seems to be a valuable new tablet-based virtual reality game to train cognitive skills used in everyday life for seniors. The next step will be to propose REVALZ in patients with early-stage Alzheimer’s disease.

ABSTRACT. Exponential technological development is rapidly changing all areas of human life. Klaus Schwab (2017) coined the term Fourth Industrial Revolution to describe a world in which individuals move between digital realms and offline reality, shaping and managing their lives through networked technology. The current revolution is redefining what it means to be human, changing not only what we do but who we are. Prominent examples of technologies include robotics, artificial intelligence, virtual and augmented reality, and positive technologies such as mobile and wearable devices. Those technologies represent scientific breakthroughs that profoundly change how we view social well-being and physical and mental health treatment. The health sector is one of the areas most exposed to technological development. Therefore, it is influenced by digitalisation, which is revolutionising the way healthcare is delivered, from the interaction between professionals and patients to governments and stakeholders. For instance, mobile technologies increased the number of people who are covered by diagnostic, treatment, and follow-up interventions, improving access to healthcare. The Covid-19 global pandemic has confirmed the potential of mobile devices as Assistive Technology to provide psychological care across geographical boundaries. In addition, the development of intelligent robotics and exoskeletons is paving the way for Assistive and Rehabilitative Technologies for people with disabilities and their caregivers. These technologies could, for example, help people with neuromotor deficits to improve their cognitive and motor skills to regain autonomy and self-efficacy in daily life activities. At the same time, Virtual Reality continues to confirm its effectiveness in clinical rehabilitation. Enterprises, industries and almost any kind of work-related organization are also deeply affected by the digital revolution, where robots, automated machines, AI-powered agents and humans have become closer partners. For several years, literature has shown that human-robot collaboration can increase productivity and make companies more flexible. In this scenario, Human Factors and Cognitive Ergonomics, as well as Work and Organizational Psychology, play a key role because they help to ensure that the design and use of technology consider the needs and abilities of the humans who will be interacting with it, and that work environments are supportive and conducive to productivity and well-being. This includes considering factors such as usability, engagement, safety, and security in order to create technology and work environments that are user-friendly, efficient, and supportive of the health and well-being of workers. Given the growing field of human-technology interaction that ensures engagement with technology, the human-centred paradigm leads us to the Fifth Industrial Revolution, in which technological development revolves around people. The human-centred approach involves end-users at the earliest stages of technology design by seeking users' evaluations and opinions about the system in terms of acceptability, usability, ease of use, usefulness and appropriateness of the proposed solution. The bottom-up approach increases acceptance and adoption of the technology and can prevent the abandonment of technologies that contribute to the achievement of the technology's goal. Considering the background, the symposium aims to present novel studies about the design and development of advanced technologies to enhance psycho-social well-being. The thread of the proposed studies is the human-centric approach where the end-user is the core of the (r)evolution.

ABSTRACT. Background. According to the World Report on Disability, the global prevalence of disability is almost 20%. The most frequent causes are acquired brain injuries (vascular or traumatic) and spinal cord injuries (traumatic and non-traumatic) and the main consequences are mild or severe motor deficits of upper and/or lower limbs with the consequent loss of autonomy in daily life activities. Despite the alarming data on disability and the progress of knowledge related to neurogenesis and neuronal plasticity, no short-term solutions can firm a complete recovery based on the regeneration of damaged nerve tissue. In this scenario, Assistive Technologies (ATs) represent a prominent solution. However, to ensure the users’ acceptability and avoid ATs’ abandonment, research suggests analysing end users’ attitudes towards ATs, the experience of control, the ease of use and usefulness, the matching between the needs featuring both end-users and their primary caregivers. Objective: The present study is a part of a European Project to develop MAIA (Multifunctional, adaptive, and interactive AI system for Acting in multiple contexts), a human-centered AI aiming to allow end-users to control assistive devices. Specifically, the study aims to investigate the end-users' needs and the features that MAIA should have to fit these needs. Method. People with traumatic brain injury, stroke or spinal cord injury and their caregivers are invited to participate in semi-structured interviews. Inclusion criteria: age between 18 and 80 years old; the disability must have occurred from six months to ten years before the study and be from moderate to severe (score ranging from 3 to 5 on the Modified Rankin Scale); no cognitive disorders according to the 4AT test; good language comprehension and verbal expression to lead the interview. Thematic analysis was conducted to explore the participants’ needs, and an inferential analysis to investigate the difference between groups. Results. 46 participants were interviewed: 28 patients (59.6%) and 18 caregiver (38.3%) with acquired brain injury (36.2%), stroke (38.3%), and spinal cord injury (23.4%), the time from injury were 0-2 years (39.1%), 3-5 years (39.1%) and > 5 years (21.7%). 31 were female (66%), with an average age of 57.70 years, and education > 10 years (87%). 58.7% of patients had a mild walking deficit, and 41.3% were wheelchair users. Regarding technology, 63% looked for rehabilitative technology, while 37% for assistive technology. The results of no-parametric analysis showed a significant difference between type of technology needed (assistive and rehabilitative) and years from injury (0-2 years 3-5 years; and >5 years) F(1,44) = 4.148, p = .048: people in the first period from injury look more for rehabilitative technology. Moreover, there is also difference between patients and caregiver and assistive and rehabilitative t(44) = -1.472, p = .055: patients are more interested in rehabilitative technology compare to caregiver. The qualitative analysis revealed that patients look for a technology to rehab the uppers and/or lower limb abilities, especially to walk again. On the other side, caregivers look for a technology to help them in care activities with the patient. Moreover, the technology should be easy to use due to the low technological skill of the participants. Conclusions. The present study demonstrated the importance to develop a technology in accordance to the human-centre design, and to reduce as much as possible the gap between the technology and the real end-users needs. This approach could contribute to improve the acceptability of a human-centered AI system like MAIA improving also the quality of life of the users. Following these results, MAIA is now focusing on navigation tasks (to assist either wheelchair and exoskeletons) and reaching and grasping tasks and is going to be tested with patients.

ABSTRACT. Unwanted loneliness in the elderly is a major problem worldwide because of its negative effects on quality of life and health. In addition, public resources aimed to take care of elderly people living alone are limited. The DIAL project aims to develop an innovative and easy-to-use technological solution for the detection and management of unwanted loneliness in the elderly. This solution consists of a virtual voice assistant (DIAL), which will provide support and promote the autonomy of the elderly, assisting them in daily activities in their environment, and providing solutions to everyday needs targeting unwanted loneliness. To achieve this goal, it is necessary to obtain information about the daily needs of the elderly, and possible solutions through a co-design methodology. This paper presents an innovative methodology based on hexagonal cards used in the context of two focus groups and created to learn about the difficulties faced by the elderly in their daily lives and to generate different solutions. This methodology includes 335 hexagonal cards containing 17 different sections: empathizing, defining, devising, prototyping, evaluating, devices, services, co-creation, problem, typology solutions, deficiencies, solutions, unwanted loneliness, fun-leisure, emotions and daily activities. The hexagonal cards act as visual triggers and were designed taking into account the different degrees of frailty of the elderly. The cards allow working on the 5 existing dimensions in the co-design process in DIAL: empathizing (understanding what they do in their daily life and what is important to them), defining (knowing the difficulties they face), devising (looking for alternative solutions), prototyping (turning the idea into a digital prototype) and evaluating (validating the technological solution). In addition, a "Devices" and a "Services" section were added to complement the project needs.

A sample consisting of a total of 11 elderly people (women=63.6%; M=77.36, SD=7.24). They were asked about their needs and the search for possible solutions. The information obtained through the cards was analyzed qualitatively. Results showed that the participants faced significant limitations in their daily routines, particularly related to mobility and memory, with difficulties reported in activities such as showering, cleaning, shopping, and remembering tasks like medication schedules and hydration. Additionally, concerning loneliness, they struggle with the feeling mainly at night and they refer to missing different social activities (such as drinking coffee with friends). Based on these findings, specific functionalities were identified and incorporated into the design of the DIAL prototype. We are currently conducting a pilot study to test the effectiveness of the technology in detecting and treating unwanted loneliness.

ABSTRACT. The lecture will present the virtual reality exposure therapy (VRET) techniques for anxiety disorders. Several therapeutic tools designed for the immersive HMD technology will be presented with an emphasis on the co-design of these methods centered on the needs of the target population. During the lecture we will present an overview of several studies performed in the National Institute of Mental Health in Czech Republic aimed at evaluating the acceptability, feasibility and/or validity of these VRET methods in the target population. During the presentation we will introduce several virtual applications and scenarios created for exposure therapy of phobic disorders (specific phobias, social phobias, and agoraphobia), general anxiety disorder and obsessive-compulsive disorder. These scenarios include environments such as virtual city with various building interiors, family house and magnetic resonance imaging lab. These methods can be used in a targeted treatment procedure for cognitive-behavioral therapy sessions or as an enrichment or augmentation of standard pharmacological and psychotherapeutic treatment procedures. The presentation will focus mainly on the principles of design and development of the presented applications and design decisions that shaped the development of individual solutions. These decisions were based not only on clinical experience of the therapists but also on the feedback provided by clinical samples participating in the pilot and feasibility studies (sample sizes ranging from 10 to 50 patients) that led to the proposal of the necessary design adjustments of the environment and functionality corresponding to their specific needs. In addition, the presentation will introduce the subjective scales and objective evaluation methods (psychiatric scales, physiological response measures) applied in the presented clinical studies and main findings of selected studies. The presented methods were created with the financial support of TAČR projects ÉTA no. TL03000223, and TAČR GAMA project Braintech no. TP01010062, internal project no. 318A_2020 with the support of the Ministry of Health of the Czech Republic – RVO (Identity number: 00023752).

ABSTRACT. Given the recent development in digital and robotic technologies to assist workers, organizations are increasingly integrating smart solutions in multiple contexts, such as manufacturing, logistics and transport. Those technologies are deployed to interact with workers as human partners, augmenting their capabilities. Such solutions include collaborative industrial robotics systems, AI-powered agents, Augmented Reality systems, or automated machines. Increased human-robot collaboration (HRC) has brought substantial benefits for enterprises and industries, such as increased productivity and efficiency, greater flexibility, and the potential for organizations to scale their operations more efficiently. At the same time, however, collaborative industrial robotics systems bring a change in work characteristics, such as job content or work environment. Current research on HRC focuses primarily on technical aspects and often overlooks the importance of cognitive ergonomics and human factors in improving worker well-being and production performance. However, as human workers and collaborative robots have become closer partners, new risk factors and ergonomic-related challenges have become apparent, such as safety, stress and burnout, frustration, information overload and increasing cognitive load. It has been demonstrated that high levels of cognitive workload and cognitively straining conditions may pose risks to workers’ health, well-being, and safety, negatively affecting overall productivity and work-related performance. Such risks associated with task design, as well as the design of work environments and technologies, may negatively affect employees’ mental and physical health. Consequently, designers must consider cognitive ergonomics and human factors to develop human-centred collaborative work systems. The present contribution stems from previous works of the authors, in which guidelines for the design of Collaborative Assembly Systems based on scientific literature have been developed. The guidelines have been evaluated through several experiments, demonstrating that the system features and interaction patterns could improve assembly performance and the operator’s cognitive response to HRC. As the research field of HRC is rapidly evolving, the purpose of the present work is to enhance and extend the existing set of guidelines to support non-experts in the field of human factors during the initial design stages of human-centred and collaborative work systems. To improve the guidelines in terms of relevance and clarity, a literature search was carried out including papers published between 2020 and 2022. The search was performed with Scopus as the electronic database in January 2022 following PRISMA guidelines. The keywords used in the literature search were chosen based on relevant articles and classified into two groups: (1) keywords related to cognitive responses and human factors, such as "human factors" and "cognitive", and (2) keywords related the field of HRI, such as “collaborative robotics” and “Human-Robot”. The literature search resulted in a total of 825 papers. After 215 duplicates have been removed, 610 papers remained for screening titles and abstracts of articles concerning established inclusion and exclusion criteria. A total of 93 papers remained for full-text review. Finally, based on the 64 identified articles identified through the systematic literature search, new design guidelines were developed and existing guidelines from the previous research work were updated, resulting in a total set of 53 design guidelines. The design guidelines were classified into five categories according to similar contents, being “Workstation and Robot System Features”, “Robot System Performance and Interaction Patterns”, “Human-Robot Communication and Interfaces”, “Control measures”, and “Organizational Measures and Training”. Finally, an online questionnaire was conducted with experts in the field, asking them to give their professional feedback on the guidelines, specifically in terms of clarity and relevance, to propose practical solutions for the guidelines’ implementation, as well as metrics used to evaluate their effectiveness.

ABSTRACT. Eating disorders have historically been associated with straight, emaciate, young, white females. However, the reality is far different. Eating disorders affect people from all demographic groups. Recent studies have shown that a large number of individuals who does not fit in the DSM-5 classification of eating disorders, still suffer from dysfunctional eating attitude and behaviors (DEAB) associated to body perceptual disturbances. The continuum of DEAB – which includes eating disorders - have a complex and holistic etiology involving transactions among sociocultural, psychological, and biological factors. There is a need for a deep understanding and inclusive assessment methods to improve health intervention strategies. In the last two decades, new technologies have proved to be valuable tools to be implemented in mental health research and practice. More specifically, new technologies (e.g., virtual reality, Internet, mobile app) have been successfully implemented for DEAB associated to body perceptual disturbances. This symposium, titled “A Transdisciplinary e-Health Approach Applied to Dysfunctional Eating Attitudes and Behaviors”, proposes to aggregate transdisciplinary contributions on innovative and promising methodological advancements in new technologies (i.e., virtual reality, online-based and app-based assessment and intervention methods, machine learning) aimed to the understanding, assessment and intervention on DEAB.

ABSTRACT. Context: A growing number of studies have used virtual reality (VR) for the assessment and treatment of body image disturbances. In this presentation, the results of two validation studies of two VR-based figure rating scales are presented. More specifically, the first study (study 1) was conducted in a community sample of adult and aimed to test the convergent and discriminant validity between the traditional paper-based Figure Rating Scale (FRS) and the VR-based FRS eLoriCorps-IBRS 1.0. The second study was conducted in a community sample of adolescents and aimed to document the convergent and discriminant validity between the traditional paper-based FRS and a revised version of the VR‐based FRS (i.e., the eLoriCorps‐IBRS 1.1). Method: A total of 53 women and 13 men (M= 23.2, 18 to 52 years old), recruited at the Université du Québec à Trois-Rivières (Trois-Rivières, Québec, Canada), via brief classroom presentations and emails sent to university students, faculty, and staff participated to study 1. Regarding study 2, a total of 93 adolescents (M= 15.4, 14 to 18 years old), recruited at schools and community organizations, participated to this study. Ideal body size, perceived body size, body dissatisfaction and body distortion were assessed through the paper‐based FRS, the eLoriCorps‐IBRS 1.0 (study 1) and the eLoriCorps‐IBRS 1.1 (study 2) . Eating disorder symptoms, body image avoidance, and social physique anxiety were also measured in the two studies. Correlation analyses were performed. Results: Outcomes for study 1 showed convergent validity between body image variables (with the exception of ideal body size) measured in the allocentric perspectives with the traditional paper-based FRS and the eLoriCorps-IBRS 1.0. On the contrary, body image variables assessed in an egocentric VR perspective, showed smaller correlations with the ones collected in both allocentric perspectives (i.e., paper-based and VR). Overall, the results of study 2 showed a good and statistically significant convergence between allocentric perspectives as measured by the paper-based FRS and the eLoriCorps‐IBRS 1.1 , when assessing perceived body size, ideal body size, body dissatisfaction, and body distortion. In line with the results of study 1, discriminant validity between the egocentric- and allocentric-based assessments was confirmed for all body image-related variables with the exception of body distortion. Conclusions: In conclusion, these validation studies provide first evidence of the validity of the two VR-based versions of the eLoriCorps-IBRS to assess body image dimensions in different populations. Furthermore, the results of these two studies are consistent with emerging evidence highlighting a difference between experiencing the body from an egocentric (i.e., the body as a subject) and allocentric (i.e., the body as an object) perspective. Internal body sensation could influence the egocentric representation of the body, whereas the allocentric body size and shape representation could be influence by inter-individual comparisons.

ABSTRACT. Context. The Quebec Mental Health Plan 2022 is clear, numeric interventions are necessary to promote access to mental health resources as well as the autonomy of individuals and their recovery. The use of applications based on the self-help approach allows for autonomous solutions in the daily life of the individual while educating them. The self-help approach has already proven efficacity in the field of eating disorders (ED). Indeed, coupled with the cognitive-behavioral approach, studies have demonstrated a lasting reduction in bulimic and hyperphagic symptoms as well as a prevention up to 50% of relapses. Based on these evidence and societal needs a mobile and self-help application named “Intervenant de poche - Loricorps” was developed. This application is composed by five modules: (i) Perceptions, (ii) relationships, (ii) occupations and (iv) sensations related to the (v) Act of eating like dysfunctional eating attitudes and behaviors (Pros-A approach). The Intervenant de poche is based on the Ecological Momentary Assessment method (EMA). For each module, self-reported data are collected through visual analogic scales and open questions. The content of this presentation is the synthesis of three studies related to the Intervenant de poche. The first study is a validation of this mobile application as an assessment method to evaluate body image distortions in adolescents. The second study used the Intervenant de poche as an assessment method of physical self-perception during the eSILENCE 1.0 program. The third and last study will present how the Intervenant de poche could be implemented in clinical practice through two clinical cases.

Results. Regarding the first study, the Intervenant de poche was used to documents the convergent and discriminant validity between (a) the traditional paper-based Figure Rating Scale, (b) the Virtual Reality‐based Body Rating Scale (eLoriCorps‐IBRS 1.1), and (c) the mobile app‐based Body Rating Scale (eLoriCorps‐IBRS 1.1‐Mobile), delivered through the Intervenant de poche app. A total of 93 adolescents participated in the study. Body dissatisfaction and body distortion were assessed through the paper‐based FRS, the eLoriCorps‐IBRS 1.1 and the eLoriCorps‐IBRS 1.1‐ Mobile. Correlation analyses support the validity of the eLoriCorps‐IBRS 1.1‐Mobile with promising perspectives of implementation among young populations. In the second study, the mobile application was used to measure disturbances in physical self-perception during a blind integrated prevention program of mental and physical health, the eSILENCE 1.0 program. Completed by 61 adolescents during 14 consecutive weeks, analysis conducted on data collected through the Intervenant de poche, demonstrated a positive evolution of specific physical self-perception components (global self-esteem, perceived physical appearance, etc.) compared to an ED-only program and a control condition. Finally, the Intervenant de poche app was used to document the perceptual and occupational dynamics of two clinical cases by drawing an idiographic portrait of the evolution of the Perception and occupation modules. Both intra and interindividual variability in Perception and occupation modules were translated through visual, descriptive, and explanatory time series analysis combined with verbatim extracted from written comments. The results confirmed that the presence of the perceptual disorder influence the perception of daily functioning. The data’s precision obtained thanks to EMA methodology allows the results to show a higher level of fluctuation during moments related to eating, physical activity and occupations that involve looking at oneself.

Conclusion. Thus, studies shown that in addition to providing significant support for empowerment and self-reliance, the Intervenant de poche could be a reliable instrument to measure (dys-)functional eating attitudes and behaviors (including eating disorders) and could be a valid solution to the societal need for evidence-based mental health programs.

ABSTRACT. Context: This study is part of a larger transdisciplinary research project in eMental health and eEducation. More specifically, this first study is aimed to identify and document eaters profiles in the general population in order to develop an online-based intervention which specifically responds to the characteristics and needs of the eaters profiles in terms of prevention of- and intervention on- dysfunctional eating attitudes and behaviors. To identify eaters profiles, we adopted the Machine Learning (ML) approach. ML approach may be more efficient than traditional regression analyses to discover relationships between body image disturbances and eating attitudes and behaviors. However, to the best of our knowledge, only few studies have adopted this approach to body perceptions and dysfunctional eating attitudes and behaviors. Method: A total of 317 participants completed an online-based survey including measures of body image dissatisfaction, bulimia, restraint, and intuitive eating. To analyse our dataset, we applied ML clustering algorithms and reasoning techniques. Results: Seven eaters profiles emerged from the ML analysis. The average scores of each profile for body image dissatisfaction, bulimia, restraint, and intuitive eating were compared to means scores reported by previous validation studies. A continuum of eaters’ profiles is presented as the result of the comparison of profiles’ means to normative means for each variable included in this study. Four categories emerged. The first category, which could be placed at dysfunctional pole of the continuum, includes two eaters’ profiles characterized by high levels of body dissatisfaction and severely dysfunctional eating attitudes and behaviors. These two eaters seem to be disconnected from their physical sensations of hunger and satiety, and to eating for reasons other than physicals. The second category includes two eaters who are less dissatisfied with their body, but who still present a problematic relation between their internal body sensations and their eating attitudes and behaviors. The third category includes only one eater profile. This eater experiences high body dissatisfaction and presents difficulties in connecting with their internal signals but does not engage in dysfunctional eating attitudes and behaviors. The fourth category includes two eaters profiles that could be placed at the functional pole of the eaters continuum. These two eaters report low body dissatisfaction, good levels of intuitive eating and low levels of restraint and bulimia. Conclusions: Despite the promising advantages of using ML approach applied to body perceptions and eating attitudes and behaviors, the number of studies using this approach is still scarce in the scientific literature. The present study provides a portrait of eating profiles, highlighting the presence of a risky patterns of attitudes and perceptions in a community population. Finally, the results of this study permitted to design and develop an online e-Health Education program specifically addressed to answer to the needs of the eaters profiles. This intervention program will be the object of the last presentation of the symposium.

ABSTRACT. Context: The previous presentation of this symposium highlighted the presence of seven eaters profiles, placed on a continuum characterized by a functional and dysfunctional pole. The object of this presentation is an e-Health education program, the eSILENCE 1.2 program, which was designed and developed according to the needs of the eaters profiles previously identified. This research falls within the field of health education, a field that had to digitally transform into e-Health education during the COVID-19 pandemic. The eSILENCE 1.2 program is based on the Pros-A approach, which targets Perceptions, relationships, occupations and sensations related to the Act of eating. The general objective of this program is to help individuals to transform their dysfunctional eating attitudes and behaviors into functional eating attitudes and behaviors or maintain them. In this presentation the digital content of the program (e.g., 180s animated videos and digital pamphlets delivered via the Audit-Me-Lori Platform) and as well as the evaluation protocol (including virtual reality assessment) would be presented.

Methods: The eSILENCE 1.2 program is characterized by seven modules (in addition to an introduction and conclusion module): Myths and Realities (first), Perception, Relation, Occupation, Sensation, Myths and Realities (second). Each module is characterized by a short video and an explanatory digital pamphlet integrating virtual reality via online and mobile applications. This program is addressed to people aged 16 years and over from the general population and to individuals at risk of developing dysfunctional eating attitudes and behaviors. Self-reported questionnaires would be used to evaluate the preliminary effects of the program on eating attitudes and behaviors and virtual reality-based methods would be used in order to assess the presence and potential changes in body image perceptual distortions, at pre-, post- and at 3-month follow-up. Pre-post- module assessments will allow to monitor idiographic changes in eating attitudes and behaviors and in body image perceptions. Satisfaction with the intervention program will be assessed at post-test.

Conclusion: Responding to a public health concern, this innovative project is part of a self-management perspective in eating education using a mobile application integrated to social media, to promote functional Pros-A. The relevance of the eSILENCE 1.2 program is to bet on the powerful combination of (i) social media as a medium of accessibility to reach populations anywhere and at any time, (ii) virtual reality as a process of bodily immersion and (iii) internet applications as optimization of secure data collection and storage. Faced with the new societal realities in terms of well-being/health and difficulties in accessing health services brought to light by the pandemic of COVID-19, the eSILENCE 1.2 program has the potential to be a valid resource for those in needs of guided self-administered intervention program targeting eating attitudes and behaviors.

ABSTRACT. First proposed by the French naturalist Buffon (1707-88) in the form "Le style, c'est l'homme lui-même" (style is the man himself) about eloquence. This terminology was then commonly used in literature and art history. Let us note that in the three cases, eloquence, writing, art crafts, style is a sensorimotor activity. We therefore propose to extend the concept to the field of physiology and more particularly to the field of sensorimotor transformations. We adopt the definition of perceptual-motor style as any distinctive and recognizable way of performing an action or processing a perception.

Why is it important to track perceptual-motor style over time? It is now recognized that the human species endangers its environment which, contrary to past beliefs, is not unlimited and infinite in resources. It is to the point that our survival would be at stake. Are human physiology and cognition not facing the same challenge as our natural environment? Where is it written that the human brain, musculoskeletal, digestive and vascular systems can still function in today's and tomorrow's environment? Could it be that we have reached the point where human evolution, in the Anthropocene, has put our bodies at risk, as effectively as we are destroying our environment? Obesity, psychiatric diseases, video game addiction, overwork, screen addiction, overtraining, doping, etc. must be seen in this context. In short, we are polar bears like any other.

In this context, it is therefore important to follow in the perceptive-motor style by longitudinal follow-up at any age because progress is accompanied by systemic physiological and psychological risks. These systemic risks can lead to frailty at any age and not only in the elderly. It is therefore necessary to assess systemic risks and to detect pre-fragile states in order to prevent them, by quantifying normal and pathological human behavior in the field and in simulators. This quantification leads to the compilation of interoperable databases at the origin of the person's digital twin, the key to individual longitudinal monitoring and to prevention and precision medicine

This quantitative monitoring of normal and pathological human behavior requires the use of measurements in the field. These measures will be detailed in PP Vidal's presentation on a program to prevent frailty in senior citizens in Reunion Island. This follow-up also involves behavioral measurements on simulators in the broadest sense of the word. Indeed, the methods of digitalization and dematerialization are progressing rapidly. They contribute to the development of more and more sophisticated virtual environments, such as video games, industrial simulators and more recently the metaverse. This point will be illustrated by the presentation of Y. James about the description of the behavior of operators in interaction with complex man-machine interfaces and in the field of learning involving these interfaces. Finally, the exploitation of data collected over time in the digital twins for prevention purposes calls for sophisticated statistical methods and AI. These methods will be illustrated by I. Bargiotas on a population of seniors who have never fallen and whose future risk of falling in the coming year is to be assessed.

ABSTRACT. In 2060, according to INSEE, France could have around 23.6 million people aged over 60, including 12 million aged over 75 and 5 million aged over 85. It is in this demographic context that the concept of "frailty of the elderly" becomes crucial. Frailty is defined by a decrease in physiological reserve capacities which alters the mechanisms of adaptation to stress. Its clinical expression is modulated by comorbidities and psychological, social, economic and behavioral factors. The American Geriatrics Society's Frailty Task Force adopted the definition proposed by Fried et al (2001), considering frailty as a clinical syndrome defined by the presence of three or more of the following symptoms: - Involuntary weight loss - Self-reported subjective sense of exhaustion - Decreased muscle strength - Slow walking speed - Reduced physical activity This frailty phenotype is independently predictive at three years of falls, deterioration in walking or loss of functional autonomy for activities of daily living, hospitalization and death. The presence of one or two of the symptoms defines the pre-fragile state, whereas three symptoms correspond to frailty. However, there is considerable scientific evidence that these complications can be significantly reduced. Given these definitions, 45% of French people aged 65 or over are considered pre-fragile and 13% frail (IRDES study in 2012). The 2011 European study SHARE (Survey of Health, Ageing and Retirement in Europe) estimates that 50% of French people over 65 are pre-fragile and 18% are frail. The two surveys converge in highlighting the greater frailty among women, an exponential increase with advancing age, and a higher prevalence in the case of a history of chronic diseases. Income and education levels may also be correlated with frailty risk, indicating social inequalities in frailty. Therefore, a major challenge in the coming years will be to test persons over 50 to detect pre-frailty and frailty and bring them back to robustness using targeted interventions if necessary. This was at the heart of our program at La Réunion. This project, financed by the CGSS and the ARS, has been conducted by the Borelli Centre and CEPED, in partnership with the IRD. This program attempted to put into practice in the field a largely automated quantitative approach for detection of pre-fragility and fragility states defined by L. Fried (see above). Indeed, these concepts and their corollary, robustness, are still largely based on clinical tests that are part of current medical practice since the 1990s. We therefore wished to revisit these tests in order to promote what can be defined as precision prevention for seniors and their entourage (family caregivers, medical and social professionals), at large scale, in the field. To this end, our program aimed to measure static balance, locomotion, muscular strength, prediction of falls, psychological tests in large population of outpatients, drawing on the skills of the Borelli center in the field of artificial intelligence, the IOT (Internet of Things) and clinical psychology. This approach led to the development and industrialization of Smartcheck, a digital tool that measures the physiological and psychological markers that define frailty and pre-fragility and which can be used by paramedics. Tested on 100 people in 2020, we will now validate this approach on 1200 persons in 2023 in the city of Lille. It remains that this quantification effort essentially concerns the person's sensorimotricity. In that context, the program that we are beginning in Lille consists also in broadening the basis of the robustness concept so that it takes into account more largely the psychological context and that it includes the socio-economic and cultural dimensions of the person we will monitor in the field.

ABSTRACT. Background: Postural control is an individual's capacity to maintain a controlled, upright position. The loss of postural control and, eventually, falling is one of the significant causes of injury among the elderly that promotes decreased mobility, loss of autonomy in daily activities (bathing, cooking), institutionalization, or even death. Falls are the second leading cause of accidental death, the fifth leading cause of death for those >65 years old and a significant source of stress for the elderly. Almost 30% of the population > 65 years old, 50% of those >85 years old and 60% of the patients who have Parkinson's disease face at least one fall per year. Moreover, the fear of falling again, even after falls that did not require medical treatment, is associated with a vicious circle of further avoidance of activities of daily living, less physical activity, multiple falls, depression, and lower quality of life. It has been reported that having history of fall increases by 3-10 times the risk of ending up in a nursing home. Therefore, the prospective prediction of fall should be able to identify the significant degradations of postural control before (the sooner, the better) any fall occur. The causes of falls are multifactorial (medication use, complex activities, stress, environmental complexities, and sleep quality). In addition, individuals entering a pre-frail or frail condition experience deterioration and de-harmonization in neuromuscular, sensory, and cognitive functions. Finally, considering the fact that static postural control, locomotion, and navigation are tasks that have high cognitive demands, especially in terms of attention as well as executive functioning, deterioration at the sensorimotor and cognitive levels leads to gait and balance disorders increasing the risk of fall. Unfortunately, the limited ability of the functional clinical tests to provide quantified/objective values about the future risk of falling (fRoF), makes any medium/long-term longitudinal analysis practically impossible and, therefore, limits the capacity to predict personalized fRoF In this context, it is not surprising that over the past 15 years, numerous studies have been devoted to preventing falls. A common way to evaluate posture is by recording the centre-of-pressure displacement (posturography) with force platforms. The objective of this study was to create universal and diseased-specific models of personalized prospective prediction of fall and fRoF evaluation considering each individual’s past assessments and constantly monitor the his/her state compared to those with low fRoF individuals. Methods: We included 1537 individuals, with up to 11 posturographic follow-up assessments (irregular time intervals), without excluding any neurological or other impairment that underwent a Romberg test (30sec standing still, eyes open and eyes closed). The resulting posturographic signals were analyzed, and 184 unique fRoF-related features were calculated. We proposed an incremental machine learning classification framework for 1) managing the follow-up dataset, 2) prospectively predicting the individual's fRoF, 3) monitoring the evolution of the individual's balance control compared to those without a history of falls from his/her particular groups (if the individual is diagnosed for any particular deficit) as well as from the general population. Results/Conclusions: The study proposed a meaningful global and disease-related risk of fall evaluation, as well as an elegant visualization/monitoring of the risk of fall compared to non-fallers "normal" state. The performance of our findings was assessed using the receiver operating characteristics (ROC) analysis and the area under the curve (AUC). The encouraging results indicate that such a framework might provide supplementary information about the fRoF of an individual even in distance and be of significant usefulness in the easy, rapid and massive screening of the pre-frail population about early and "weak" signs of fall-related deficits.

ABSTRACT. 1. Helicopter Simulators

What motivates the use of simulators is the possibility to safely recreate real critical situations already encountered, in order to allow the crew to react in a timely manner, with good practices. The quality of this training is constantly evolving because air transport is still faced with man-made accidents, which is not acceptable.

If the goal of simulators is to create the illusion of being in a real system, they still have many limitations, including sensorimotor and cognitive biases. It is therefore necessary to be aware of these limits in order to avoid "negative" training. This is all the more important as, in the future, the hours of training in simulators will only increase. This will reduce the number of hours of real flights for the same level of skill, which will reduce the cost of initial training.

2. The simulator sickness

The number of people affected (discomfort) in simulators is decreasing with time, but their number is still too important. The main cause of this discomfort is associated with VIMS (Visually Induced Motion Sickness). To minimize VIMS and make the simulator acceptable, the quality of the visual scene is crucial. To achieve this, the industry uses image generators specifically designed to guarantee the fluidity and quality of the content.

A minority of simulators have a motion platform to produce vestibular and proprioceptive stimuli and make the system more realistic. These stimulations have low amplitudes of +/- 2 g and for a short duration. The inclinations of the cabin do not exceed +/-20° around the vertical [6]. The reproduction of angular accelerations around the vertical axis is very limited.

As an example and with simulators with motion platform, here are two returns that illustrate our approach to kinetosis:

1 - Review of an helicopter simulator “not completely adjusted” : - Results: SSQ level Confort & slight discomfort | discomfort | Sick % of Pilots 60 | 40 | 0

2 – Report on another helicopter simulator that has been in operation for several years: - Results: SSQ level Confort slight discomfort discomfort Sick % of Pilotes 67 22 11 0

We have come to the conclusion that the development of a simulator remains a delicate operation. And there remains a threshold of discomfort below which it is difficult to go. It would be useful to understand in detail what the cause is in order to be able to reduce this threshold further.

ABSTRACT. Revisiting what happened during (or after) a traumatic event is an important part of the treatment process in trauma-focused cognitive therapy. However, clients may have difficulty retrieving these memories voluntarily or engaging with this content for sufficient periods. As such, tools to support the access and delivery of imaginal exposure content within treatment may prove to be particularly useful for therapists.

The aim of the presented case study was to incorporate innovative, low-cost VR into a standardised Trauma-Focused Cognitive Behavioural Therapy treatment protocol. This case report introduces work undertaken with Mr A, a 38-year-old male, who two years prior had experienced a city centre assault. Initial assessment revealed a PCL-5 score of 64 and he met DSM-5 criteria for Post-Traumatic Stress Disorder. Mr A received 10 sessions wherein the traditional imaginal exposure components were implemented via a newly developed Virtual Reality (VR) development workflow called ‘VR Photoscan’.

After 10 sessions, results showed PCL-5 scores decreased from 64 to 19 and Mr A no longer met DSM-5 PTSD criteria. VR Photoscan, was used during 4 out of 10 sessions and included (1) reliving; (2) memory updating and (3) stimulus discrimination activities. Mr A also reported VR Photoscan as helpful regarding preparation for site visits. In conclusion, the technology provided a more visceral exposure experience which supported Mr A to revisit the trauma memory. He reported high levels of satisfaction with the quality of the virtual environment and no issues using the VR technology. Produced with lower-costs and shorter development times than typical computer- generated environments, VR Photoscan may be more easily implemented within routine care, although further research is required to explore its added value compared to conventional treatment.

ABSTRACT. Introduction. Bereavement process is defined as a painful response following the loss of a loved one. Grief response is unique for each individual and the related symptomatology tends to decrease over time. However, in approximately 10% of cases, grieving people develop Prolonged Grief Disorder (PGD). Although Evidence-based Psychological Treatments for PGD are now available, there is a problem of accessibility to these interventions. To overcome this limitation the use of internet-related interventions could be a suitable option. Previous studies with PGD patients seem to indicate that these interventions can reduce grief-related symptomatology in a similar way to traditional face-to-face treatments. The aim of this study is to explore the feasibility of GROw, a novel Internet-based CBT treatment for PGD in comparison to the same intervention delivered in face-to-face videoconferencing format. Method. The study consisted of a randomized feasibility trial with two arms: (1) an experimental group receiving an Internet-based CBT treatment for PGD (GROw) and (2) an active control group receiving the same intervention delivered in face-to-face videoconferencing format. This study was approved by the Ethical Committee of the Universitat Jaume I (Castellón, Spain) (06 March 2019) (file number CD/002/2019) and registered on the clinicaltrials.gov database (NCT04462146, 8 July 2020). A total of 31 participants (29 female and 2 male) with a mean age of 39.13 (SD = 12.57) and diagnosed with PGD were randomly assigned to the different treatment conditions. Specifically, 16 participants were assigned to the experimental group and 15 to the active control group. The web-platform was an individual self-applied program that included videos, texts, audios, photos, downloadable pdfs, customised graphics and review questions on treatment content. The treatment components were based on CBT with the addition of mindfulness and compassion exercises. Assessment instruments included feasibility measures such as preferences, expectations and satisfaction with each intervention format, a qualitative interview about the opinion of the treatment and the adherence rates. In this study pre-post treatment data will be presented.

Results. Both treatment formats, the internet-based intervention and the face-to-face videoconference intervention, were well-accepted by most participants. However, in terms of participants’ preferences before the intervention, the majority chose the videoconference format, whereas at the end of the treatment, 80% of the participants who finished the GROw treatment preferred GROw to the face-to-face videoconference intervention. Overall, both conditions showed high scores related to the expectations (at pre-treatment) and satisfaction (at post-treatment) with the intervention. However, statistically significant differences were found between the groups related to the logic of the intervention (higher scores in the videoconferencing group) and the recommendation of the treatment to other people (higher scores in the GROw group) at pre-treatment. There were no significant differences in the post-treatment satisfaction variables. In both conditions the treatment components were rated as useful. The dropout rate was 50% in the experimental group and 33.33% in the active control group. Conclusion. GROw, a novel Internet-based CBT intervention for PGD was a feasible well-accepted treatment for adults with PGD. However, the dropout rate in the experimental group was high. These results support scaling up the treatment using complex designs (i.e., randomized clinical trials) and larger samples. The data obtained contribute to help people with PGD in need of treatment to easily access an evidence-based intervention.

ABSTRACT. Background: Compassion-based interventions (CBI) have been recognized as a potential transdiagnostic intervention by targeting maladaptive processes contributing to psychopathology and by activating affiliative processing systems to foster better mental health and well-being. Despite advances in compassion research showing great benefits on mental health, little is known about their working mechanisms and how they can be enhanced. Compassion practice falls into the constructive category of meditative practice, where mental imagery abilities are essential. During compassion meditation practice, the individual is invited to use mental imagery to direct feelings of warmth, nurture and benevolence towards the self. Thus, the quality of compassion practice can be defined as the capacity of the practitioner to “(1) produce mental imagery (in terms of generation, maintenance, inspection, and transformation/manipulation of the mental images) and (2) activate somatosensory component of compassion to evoke and sustain a compassionate state”. Surprisingly enough, no studies have intended to foster mental imagery capacities in order to enhance the clinical effectiveness of compassion practice. Only few efforts have targeted the activation of the somatosensory component via pharmacological pathway by either using 3,4-methylenedioxy-N-methylamphetamine (MDMA)/ “ecstasy”, or intra-nasal oxytocin, without considering the mental imagery component. Immersive technologies such as Virtual Reality (VR) can be a very useful tool to overcome mental imagery-related limitations during compassion practice. VR allows to create virtual and fully immersive worlds, making the person feeling present and real, and has been applied in the treatment of numerous mental health disorders. Specifically, regarding compassion practice, from one side it can facilitate the creation, sustainment, inspection, and transformation of mental images during compassion practice but also boost the activation of somatosensory pathways with multisensory integration, and therefore help to achieve therapeutic goals. Until now only very few studies have been using VR in compassion training; and to the authors’ knowledge, no studies have been using VR to enhance compassion in Tonglen, a specific compassion practice that uses a high amount of mental imagery.

Objectives: This study aims to describe the developed VR environment and to provide some preliminary data on feasibility.

Methodology and results: 10 participants will be invited to practice one compassion session supported by the VR environment. They will attend to one laboratory session and complete the following baseline and post-self-report measurements: positive and negative affect, compassion, and self-criticism states. Also, the following post-test measurements will be collected: usability, satisfaction questionnaire, presence, and reality judgment questionnaires.

Conclusions: Although the compassion field is still in their “adolescence phase”, by finding innovative ways to enhance compassion we aim to gain more understanding of the underlying mechanisms of compassion practice and bring more individual and social well-being to the world.

ABSTRACT. Abstract. Many studies comparing in-person therapy with telehealth online resulted in participants reporting improvements in anxiety, better access to support and advice, greater satisfaction with the support they received, and improvements in self-management and health literacy. Comparatively, Awareness Integration Theory (AIT) has created a comprehensive cyberpsychology and telehealth model that can be narrated in multiple languages and cultural competencies to proactively address the scarcity of global mental health resources. Numerous studies on the use of AIT have validated its effectiveness in reducing depression and anxiety while increasing self-esteem and self-efficacy in in-person psychotherapy and self-help journaling modalities. Due to the Covid19 pandemic, the AIT therapeutic model has been redesigned for virtual audiences through telehealth, and a mobile App, and is utilized in Mental Health courses in universities across the globe, enabling a greater population to benefit from similar positive results. The modular construct of AIT can be taught online and in virtual modes in self-improvement areas like empowerment, self-reliance, autonomy, self-efficacy, and personal responsibility. The proposed paper demonstrates how AIT can be applied virtually as a self-help model or by a trained facilitator in helping individuals learn how to examine each particular component of their life, including all relationships while learning essential skills in restoring vulnerable areas of self and finally gaining skills in creating healthier building blocks to reach a holistic self and a fulfilling life.

ABSTRACT. Overview: Nurse’s clinical judgement is important to provide optimal and safe care, particularly in a critical care unit. Clinical surveillance is an activity that nurses use every day and which requires crucial components to manage patients' risk of complications. To carry out this process, several cognitive functions and psychological attitudes are needed such as information and attention processing, judgement, decision-making, stress and anxiety regulation. Since 2018, Milhomme, Banville et al. have been working to develop a complete Virtual Care Unit (VCU), using immersive virtual reality, intended to train future nurses to improve their competence towards clinical surveillance process skills. The VCU is a virtual hospital which includes several care units: intensive care, obstetric, oncology and gerontology. Aim: The aim of this qualitative descriptive study was to determine the pertinence to use VCU simulation with graduating nurses’ students to improve clinical surveillance skills in a critical care context. In this paper, we focused on the psychological perspectives of these results. Method: A scientific interdisciplinary team in the Quebec University Network had developed a scenario in the VCU to improve clinical surveillance process in a critical care context. Overall, 13 nursing students were recruited in three universities of the Province of Quebec to test the scenario through the VCU. These students were invited to participate to this study because they were registered a critical care course. Participants were instructed to carry surveillance process on a specific patient who suffer of an instability after a surgery. At the end of scenario exposure, participants were seeing in a semi-structured interview in order to explore user experiences. An interview guide of 11 questions was used for the data collection. A first step of the Grounded Theory method (Strauss and Corbin, 1998) was used to analyse verbatims. Results: The results show there are 10 facilitating et 10 restricting factors in the VCU that may play a role in nursing students’ learning clinical surveillance processes. Among these elements, four of them have an important link with a psychological perspective: Virtual reality related 1) sense of presence; 2) cybersickness and individual related 3) reflexive environment and 4) stress reduction and safety. Discussion: Results show an important contribution of several cognitive function in the clinical surveillance process learning by the virtual reality technology. Within this research, we notify that the VCU will be helpful to expose students to authentical situations. This research will also be helpful to pinpoint main factors that researchers must consider in the future studies related to the topic that is learning with virtual reality.

ABSTRACT. Doyle and Ford (1998) have noticed that although the concept of mental models (MMs) frequently appears in literature, there are surprisingly few explicit definitions of them. However, MMs are relatively often defined as mental constructs describing the knowledge a person has about a particular domain of the world. On the one hand, they represent the operation of cognitive processes, but they are also their results (Hemforth & Konieczny, 2006). They are subjective (Pauen, 2006), do not require direct experience (van Ments & Treur, 2021), and create a map of a object’s relationship with the environment (St.Amant, 2021). The research problem concerned the nature of changes in the MMs of academic teachers in the area of online education during the COVID-19 pandemic announced by the World Health Organization in March 2020. The global lockdown limited the economic functioning and influenced the education process, also in Poland. At that time, teachers’ digital competences proved to be an important element enabling them to work remotely. The pandemic had a modifying effect on the use of information and communication technologies – during lessons, teachers used smartphones more often and also visited websites and used applications (for example on a computer) unrelated to lessons (Ptaszek et al., 2020). Empirical research was conducted three times in: March 2020 (wave I of the pandemic – MMs largely based on imaginations), October 2020 (wave II - MMs modified with direct experience) and April 2021 (wave III – as in wave II). The research was carried out with a specially constructed eight-dimensional tool using the Osgood semantic differential (Heise, 1969) and ten five-point Likert scale questions. The research involved teaching staff of Poznań (Poland) universities. The first group (March 2020) had a total of 98 people, the second group (October 2020) consisted of 245 respondents, while the third (April 2021) included 263 teachers. In order to identify MMs, a two-step cluster analysis was performed using the method of checking the distance between logarithms. The scale was based on eight dimensions. The Silhouette method measuring cohesion and separation indicated the correct clustering (the average Silhouette value = 0.3) and it was established that there were three types of models: enthusiastic, neutral and reluctant.

To determine the nature of the differences between the MMs, an analysis was carried out using the Kruskal-Wallis test. The Bonferroni-Dunn test was used for a post hoc analysis. During the pandemic, increasingly more teachers had reluctant MMs and the number of enthusiasts decreased.

Table 1 Analysis of the frequency of particular MMs in three studies

March 2020 October 2020 April 2021 n % n % n % Reluctant Mental model 18a 18,4 79b 32,2 97b 36,9 Neutral Mental Model 46a 46,9 122a 49,8 110a 41,8 Enthusiastic Mental Model 34a 34,7 44b 18,0 56b 21,3

In order to compare the distinguished MMs in terms of the professional functioning of academic teachers, an analysis was carried out using the Kruskal-Wallis test. The differences between the MMs proved to be statistically significant in the sphere of individual functioning and related to the assessment of student behaviour, which was confirmed by the Bonferroni-Dunn post-hoc test. However, the supportive activities of the organisation otherwise perceived by teachers are not related to the type of MMs developed by teachers. Thus, a key task for educational institutions should be to modify factors that adversely affect the perception of organisational support.

The project financed within the Regional Initiative for Excellence programme of the Minister of Education and Science of Poland, years 2019-202

ABSTRACT. The processes underlying note-taking with different devices in asynchronous distance learning are complex yet necessary to understand when attempting to assist learning. Digital devices permeate today’s classroom landscape–and of the various ways these devices are used, note-taking seems one of the most controversial. Note-taking is a complex process, yet an important facilitator of learning. As such, various studies have attempted to discern whether digital devices enhance or inhibit its effectiveness. For instance, Mueller and Oppenheimer(2014) famously suggested that taking notes with an ink pen is more effective than typing on a keyboard. These results are contested, however; studies such as Morehead et al. (2019) and Urry et al. (2021) were unable to replicate their findings. Luo et al. (2018) suggest that this lack of consensus is caused by different note-taking strategies being used with different writing media. Laptop users often record notes in a more text-based, verbatim fashion, while those who use longhand tend to include more spatial images in a generative way in their notes. This points to differences in learning processes according to notetaking media. Moreover, previous studies tended to either focus on post-test centered behavioral measures such as accuracy and response time, or, if they did view neural data related to learning processes, often dealt with simplified tasks far removed from the context of online learning. As such, additional research is needed to elucidate how writing devices are connected to different learning processes. The current study attempts to achieve this goal by applying the ICAP framework and viewing neural data within a context of asynchronous online learning. The ICAP framework(Chi & Wylie, 2014) consists of four types of learning activities: interactive, constructive, active, and passive. Of these four activities, note-taking within asynchronous online learning contexts are often either constructive or active. Constructive note-taking includes creating questions, while active note-taking may refer to writing key words verbatim. In our study, we observe how constructive and active note-taking are supported by different writing devices, using neural data to track variations during the learning process. Furthermore, we endeavor to bridge the gap between note-taking devices used in concrete contexts and neural processes underlying learning by analyzing EEG(electroencephalography) time-frequency data collected during constructive and active note-taking in the midst of video lectures. Our ongoing study has thus far collected 32 participants’ data, with the following experimental process. Participants’ brain waves were recorded with EEG while they watched three videos, each containing explanations of 10 pseudowords. During each video, they took notes using either an ink pen, a digital pen, or a keyboard; for the first half of each video they took notes either constructively or actively, and in the second half they took notes using the other method. The order in which participants experienced each writing device and note-taking method was randomized. The analyzed results of 32 participants show distinct frequency-based differences between active and constructive note-taking for each of the writing devices. In particular, electrodes in the parietal and occipital areas of the brain seem to show differences for each condition. Taking constructive notes with the ink pen seems to incite more activity in high beta and low gamma frequency bands compared to active notes, whereas taking notes constructively with a digital pen or keyboard leads to more synchronization in alpha and theta bands, respectively. These results seem to indicate that sustained attention is more enhanced in constructive note-taking with an ink pen, and in active note-taking with keyboards. Thus, it appears that different learning processes can be supported by distinct writing devices. Future studies could explicate more aspects of online learning contexts of note-taking, such as multitasking.

ABSTRACT. Background: Regular physical activity (PA) is recommended before and after bariatric surgery due to its multiple benefits. More than 70% of adults are inactive before and after bariatric surgery. Theory-based behavioural intervention could be an effective strategy to increase PA, especially if delivered using novel technologies (i.e., telehealth interventions) to address potential invention engagement barriers (e.g., lack of time, travel to health centers) and help to promote greater intervention enrollment and adherence. However, it is important to initially assess whether telehealth interventions and methods proposed to evaluate them are feasible and acceptable in the context of bariatric surgery so necessary modifications can be made before undertaking efficacy studies. Objective: The first objective of this study was to assess the feasibility and acceptability of the research methods and a theory-based telehealth behavioural intervention designed to increase moderate-to-vigorous intensity PA (MVPA) in adults awaiting bariatric surgery (TELE-BariACTIV). The second objective was to generate an estimate of the effect of the TELE-BariACTIV on presurgical MVPA to inform sample size calculates for a future definitive trial. Methods: A multicenter study using a repeated single-case experimental design with multiple baseline assessments (ABAB’A) was conducted, where A phases were observational phases without intervention, and B phases were interventional phases with PA counseling via videoconferencing (Zoom). The sample comprised inactive adults awaiting bariatric surgery who had access to a computer with internet and an interface with a camera. Before bariatric surgery, participants received six 45-minutes weekly sessions face-to-face with the same PA counselor. Session content was informed by self-determination theory and social cognitive theory, and the PA counselor use motivational interviewing techniques. Three months after bariatric surgery, participants were offered three 45-minute monthly booster sessions, to help them maintain or increase their PA. The feasibility of the research methods was determined by the recruitment (number of participants recruited per month), refusal (% of participants who declined to participate) and retention (% of participants who complete all assessments) rates. The feasibility of the intervention was assessed by the attendance (% of sessions completed) and attrition (% of participants who discontinued the intervention) rates. The anticipated and retrospective acceptability of the intervention were evaluated with a 7-item questionnaire, developed according to the Theoretical Framework of Acceptability. Technical quality of the Zoom platform, achievement of clinical objectives, and global satisfaction were reported by the PA counselor immediately after each intervention session. Daily MVPA was assessed by having participants wear an accelerometer before, during, and post-intervention. Results: The recruitment rate from 9/2021 to 7/2022 was 2.2 participants/month. Among the 24 adults referred by clinicians during the 11-month recruitment period, 7 were non-eligible or unreachable, 5 declined to participate (20.8%) and 12 (92% females; 50.5 (45.8-56.8) years ; 46.6 (44.7-51.8) kg.m² provided consent and completed baseline assessments. The retention rate was 83.3% (10/12); 1 participant dropped out due to discomfort with accelerometer during the baseline assessment, and 1 did not want to remain in the study after the first six intervention sessions were completed. No participant dropped out of the pre-surgery intervention (attrition rate=0%), and the attendance rates was 98.6%. Anticipated and retrospective acceptability of the intervention were 80.4% (71.4-83.9) and 75.0% (73.2-77.7), without statistically significant difference between them. The mean score for technical quality assessment of all sessions was 92.0±18.6%, as well as the scores for clinical objectives achieved and global satisfaction were 95.7±13.9%, and 91.7±14.5%, respectively. Statistical analysis of MVPA data are forthcoming. Conclusion: Findings generally support the feasibility and acceptability of the TELE-BariACTIV intervention and study methods in inactive adults awaiting surgery, despite a low recruitment rate that may be explained in part by the specific context of COVID-19.

ABSTRACT. Introduction. One barrier to physical activity (PA) is social physical anxiety (SPA; i.e., a social anxiety subtype resulting from person’s concerns about others’ evaluation of their physical appearance). Greater SPA can lead to avoidance and poor adherence to PA programs. This is concerning as greater SPA is frequently found in women with obesity. Yet, psychological intervention aimed at reducing SPA in this population are scarce. Exposure-based therapy is the treatment of choice for general social anxiety. However, conducting this form of therapy in vivo can result in patient discomfort and prevent complete control of the environment by the clinician. Virtual reality (VR), commonly employed in the treatment of anxiety disorders, offers a solution to these problems by allowing better control over exposure stimuli. Objectives. This pilot randomized controlled trial aims to 1) assess the feasibility and acceptability of the research protocol and a novel psychological intervention with VR exposure-based and exercise training aiming to reduce SPA in women with obesity and elevated SPA, and 2) generate intervention’ effects sizes on SPA to determine the appropriate sample size for a definitive trial. Methods. Preliminary data from 32 women with obesity and elevated SPA (Mage=40.4±4.4 years; MBMI=40.6±5.6 kg.m2) (target sample size: n=45) were randomized to: 1) exercise training plus psychological intervention with VR exposure (VR group); 2) exercise training plus supportive therapy (support group); or 3) waiting list (WL group). The VR group received 8 face-to-face psychological sessions over a 12-week period including cognitive restructuring plus 2 exposure sessions in VR. The support group received 8 face-to-face support sessions including active listening, rewording, emotions and stress management strategies over a 12-week period. VR and support groups also received 2 weekly 45 minutes individually supervised endurance training sessions for 12 weeks. Recruitment (number of participants recruited per month), refusal (% of participants who declined to participate), retention (% of participants who complete all assessments), and randomization refusal (% of participants who refuse the randomization) rates are used to evaluate research protocol feasibility. Attendance (% of sessions completed) and attrition (% of participants who discontinued the intervention) rates were used to evaluate intervention feasibility. The anticipated and retrospective acceptability of the intervention are assessed with a 7-item questionnaire (maximal mean score of 4), developed according to the Theoretical Framework of Acceptability. Intervention’ effects sizes for SPA were analyzed using pre- and post-intervention results from the validated SPA scale. Results. The recruitment rate is 8.3 participant/month from date to date. Among the 149 women who contact us during the 18-month recruitment period, 19.4% were not interested in participating in the study. No enrolled participants refused randomization, and the retention rate is 90.6%. Preliminary data show one intervention attrition in the VR group because of lack of time. In the VR group, attendance rates are 97.7% and 94.3% for the psychological intervention and the exercise training, respectively. Technical problems occurred in 4 out of 22 VR sessions. Attendance rates in the support group were 95.5% and 84.8% for the supportive therapy intervention and the exercise training, respectively. The mean anticipated and retrospective acceptability of the intervention (exercise training plus psychological intervention) was 2.99±0.28, and 3.09±0.31. A statistically significant effect of time x group interaction was found for SPA (interaction F(2, 27)=5.36, p=.011, ηp2=.284). Interaction contrasts showed a statistically significant greater SPA decrease in VR group compared to support group (t(1)=2.57, p=.02), and WL group (t(27)=2.98, p=.005). Conclusion. The feasibility and acceptability of the research protocol and a novel psychological intervention with VR exposure are supported by our preliminary findings in women with obesity and elevated SPA, while providing data to inform a future definitive trial.

ABSTRACT. Introduction: Over the past three decades, there has been a significant increase in the prevalence of obesity worldwide. To reduce its impact, it is essential to investigate new effective interventions for People Living With Obesity (PLWO). To this end, new opportunities attempt to integrate new technologies with sound psychological techniques. One such project is SOCRATES, which aims to evaluate the effectiveness of ConVRself, a Virtual Reality platform designed to help PLWO to adopt a healthier lifestyle by combining embodiment and body-swapping elements, together with Motivational Interview (MI) techniques. After having presented the randomized controlled trial (RCT) protocol in CYPSY25, this work will present the results of the ongoing RCT, whose data collection is expected to end in April 2023. Objective: The main objective of this study is to explore how the virtual experience with ConVRself can improve motivation to adopt healthy eating and physical exercise habits in PWLO. We expect that those participants trained on MI, who will engage in a motivational self-conversation, will show higher scores on motivation to adopt healthier habits in terms of eating healthier and doing more physical exercise. Methods: By now, 60 outpatients with obesity from the Endocrinology and Obesity Unit of the Vall d´Hebron University Hospital have been included in the RCT and were randomly assigned to one of three treatment conditions. Participants of Experimental Group 1 (EG1), after completing an intensive 4-hour training on MI, received a virtual intervention where they engaged in a virtual self-conversation using the embodiment and body-swapping technique, which allowed them to alternatively change roles between their own avatar and a counselor’s avatar. The Experimental Group 2 (EG2) underwent a virtual intervention consisting of a pre-registered speech led by a virtual counselor who gave them psychoeducational advice. EG2 participants only embodied in their own avatar, without the body-swapping technique. All virtual interventions consisted of a weekly session (20-30 minutes) for 4 consecutive weeks supervised by a trained psychologist at the hospital. The Control Group (CG) received treatment as usual. All participants completed self-reported questionnaires on their motivation to change lifestyle [(Readiness Rulers (RR), Processes of Change questionnaire in weight management (P-W)] at baseline (T0), post-intervention (T1), and 4 weeks follow-up (T2). Two-level hierarchical linear models (HLMs) with intent-to-treat analysis will be performed to examine longitudinal changes in outcomes. Results: Sociodemographic results indicate that the majority of the sample were women (78.3%). The mean age of the sample was of 44.22 years (range 18-61), and the mean Body Mass Index (BMI) was 43.88 (range 34.51-56.68) kg/m2. Before their inclusion in the study, participants had been in the circuit of bariatric surgery for a mean of 20 months. Regarding the presence of current pathology, 20% of the sample is diagnosed with a mental illness, with depression and anxiety being the most common, and 81.7% have a current physical illness, including relevant pain, cardiovascular, and metabolic complications. As regards the analysis of the data from the questionnaires, which will start at the end of April, we will perform a two-level HLMs with an intent-to-treat analysis to estimate outcomes over time utilizing all available data of participants. Finally, we will also examine the moderating influence of sociodemographic and clinical variables (such as age, gender, and BMI) on the measures. Conclusions: Through the ongoing RCT, we aim to demonstrate the effectiveness of the motivational self-conversation with ConVRself to help PLWO initiate and maintain their process of change. Likewise, we also seek to promote the use of similar platforms using the self-conversation paradigm to address other behavioral problems, such as eating disorders or addictions. Funding: SOCRATES project (CI: PR(AG)224/2021) EU HORIZON 2020 GA number: 951930.

ABSTRACT. Introduction: Negative affect has been identified as a risk factor for the development and maintenance of eating disorders (Stice et al., 2017), that has been associated with body dissatisfaction (i.e., the affective dimension of body image disturbance (BID)) and the alteration of body size estimation (i.e., the perceptual dimension of BID) (Garner & Garfinkel, 1981). Conversely, the positive affect has been proposed as a possible BID protective factor (Trentowska et al., 2013); nonetheless, its role on the affective and, especially, the perceptive dimension of the BID (i.e., perceived or ideal body size estimation) has been scarcely documented. In this study, we used virtual reality (VR) for conducting a positive mood induction procedure (MIP) (based on Baños et al., 2016) and for assessing the perceptive dimension of BID (based on Gledhill et al., 2016). The aim of his study was to analyze the role of positive affect in changing the perceptual and affective dimensions of BID. Method: Forty-two female adolescents ranging in age from 13 to 18 years (M = 15.88; SD = 1.40) were included. All patients were admitted to the Acute Child and Adolescent Hospitalization Unit of the Psychiatry Department of the Hospital Clínico Universitario Lozano Blesa, receiving inpatient or outpatient care. Measures: All participants filled out sociodemographic and clinical data (ad-hoc), self-report measures of state body dissatisfaction (BISS; Cash et al., 2002), state positive and negative affect (PANAS, Watson et al., 1988), and depressive symptomatology (BDI-II; Beck et al., 1996). Procedure: After filling out the pre-test questionnaires, participants were exposed to a VR assessment method displayed with Oculus Rift to perform 2 tasks (based on Gledhill et al., 2016): assessment of the body size estimation of the perceived body (task 1 – i.e., “This body is: thinner/fatter than me”) and the ideal body size estimation (task 2 – i.e., “This body is: thinner/fatter than my ideal body). Each task consisted of 19 female avatars with Body Mass Index (BMI) ranging from 13 to 31 kg/m2. Avatars were displayed on the screen with a two-alternative forced choice (“thinner” vs. “fatter”) in each task. After filling out the pre-experimental measures and the VR tasks, participants received the positive MIP that included a Velten’s task, visualization of images from the international affective picture system, and the recall of a positive autobiographical memory. After the MIP, participants filled in again the post-test BISS, PANAS, and both VR tasks. Results: Paired t-tests were used to evaluate significant changes in outcomes over time. Firstly, the results indicated that the MIP of happiness was effective in decreasing scores of the negative affect, t(40)= 6.80, p <.001, and increasing the positive affect, t(40)= -5.06, p <.001. Secondly, the results indicated that there was a significant increase in state body dissatisfaction, t(40)= -1.77, p =.042, and the BMI of the ideal body, t(40)= -2.36, p =.012, from the pre- to post-measures. Additionally, there was a marginal effect of the MIP on the body size estimation of the perceived body, t(40)= 1.39, p =.086. Conclusion: This study shows that the positive affect may be related to positive changes in the affective and the perceptive BID. Although further research needs to be carried out with other age groups, designing interventions that focus not only on the decrease of the negative affect but also on the promotion of a positive mood (e.g., self-compassion training) could be a promising method to improve BID.

ABSTRACT. Major depressive disorder (MDD) is a global problem with an increasing incidence and prevalence. Behavioral activation (BA) is an evidence-based treatment (EBT) for MDD that can be successfully implemented with brevity and encourages people to increase engagement in pleasurable and/or mastery activities, decrease engagement in activities that maintain depression, and solve problems that limit access to reward. However, there are many barriers to engagement that clients encounter in BA, with lack of mobility, financial constraints, and amotivation being some examples. Virtual reality (VR) has been successfully used to enhance EBT’s for a variety of mental health conditions, but its use in depression and mood disorders is lacking. Specifically, VR had not been studied or reported on as a method of simulating BA within a clinical population. Using VR to engage in BA can eliminate barriers that may prevent implementation and fidelity by providing repeated accessible pleasant activities. Our previous research confirmed the feasibility, acceptability, and tolerability of using VR video 360 as a method of simulating pleasant activities during a remote 3-week, 4-session BA protocol for adults diagnosed with MDD during a global pandemic. Results also illustrated that VR BA has potential clinical utility in treating symptoms of depression, as the average VR BA participant diagnosis yielded a clinically significant change from a moderate severity level to mild depression, with an average decrease of 5.67 on the Patient Health Questionnaire-9 (PHQ-9), outperforming a control group using traditional BA. Qualitative results revealed that VR may additionally increase users’ motivation to engage in real-life pleasant activities and may therefore have utility as a bridge between simulated and real-life behavioral activation. The current study expands on the previous findings and feedback by using a larger sample of 40 participants in a randomized controlled trial and allowing participants to select novel immersive and interactive VR experiences using a Meta Quest 2 headset with 6 degrees of freedom, designed to simulate real-world BA opportunities more closely. Participants were recruited within the United States, primarily via online advertisement, and met study criteria if they currently had MDD, were 18 years of age or older, and were English speaking. Participants were excluded if they had a substance use disorder in the past year, were diagnosed with psychosis or bipolar disorder, experienced any seizures in the past 6 months or had untreated epilepsy, experienced current suicidal urges and intent, experienced current non-suicidal self-injury, had changed psychotherapy treatment within four months of study entry, or had changed psychotropic medication(s) within two months of study entry. The presentation will discuss the present study’s findings to date, including the feasibility, acceptability, and tolerability of using an immersive and interactive VR headset as a method of simulating BA for adults diagnosed with MDD. Measures include dropout rates, serious adverse events, completion of homework, an adapted presence scale, a simulator sickness questionnaire, an adapted technology acceptance model, and a system usability scale. The presentation will also review clinical efficacy of using an immersive VR headset to engage in simulated BA compared to traditional BA treatment, as measured by the PHQ-9. Strengths, limitations, and conclusions of the data to date will also be discussed in detail.

ABSTRACT. Virtual reality (VR), as synthetic 3D environment generated by a pc, in which a person can navigate and interact with objects present within the simulation, has gained the interest of researchers from different disciplines in the last 20 years. The potential of this medium still needs to be fully exploited, and one of the most unexplored domain concerns VR as an affect or emotion-induction technique. Increasing evidence has unveiled the potential of synthetic environments for conveying even complex emotions, mainly depending on the illusion of being really ‘present’ within the simulation, that is, the individuals’ sense of presence. Sense of presence is a multifaceted phenomenon including different psychological and technological variables. Realistic simulations, immersive and interactive environments can convey high sense of presence, which emerged as closely related to a wide array of affective and emotional states, as psychological factors. With this regard, the affect/emotions-presence link emerged as not fully dependent on technological features. It was suggested that these mixed findings could mainly depend on the high heterogeneity of methods employed as well as on the different definitions of emotions, affect and mood adopted in studies investigating the link between presence and emotions in virtual environments. For instance, realism has been operationalized in various ways. Kwon, Powells, Challmers (2013), who exposed participants to avatars featuring an increasing level of graphical realism during a job interview and measured affect and presence as ‘mental immersion’, did not find a linear link between anxiety (as a negative arousing affect) and graphical realism of the virtual avatar, but they reported a high correlation between anxiety and the sense of presence. Other works, relying on a different conceptualization of realism, did not find significant differences between emotions elicited by a real and an equivalent realistic virtual natural content, except from the complex emotion of awe. Moreover, also mixed findings emerged in relation to immersion, defined as the extent to which a user is fully immersed and sensorially surrounded in a virtual environment (Coelho, 2006). As suggested by Diemer (2015), immersion may impact on emotions depending on the nature of the emotional state itself. Therefore, a more accurate operationalization of emotions (vs. affect), as well as a shared definition of technological features of realism and immersion can be a crucial step to significantly advance the understanding of emotion-presence link. The goal of this work is to unpack presence in terms of realism (high vs. low) and immersion (3D vs. 2D), in order to explore their unique contribution in eliciting discrete emotions. Specifically, following a within-subject design, participants are exposed to the same interactive synthetic blooming green scenario developed using photogrammetry (tree-lined landscape) – since nature is as a renowned elicitor of emotional states - either featured with high vs. low realism in a 3D vs. 2D format. Participants’ discrete emotional states are measured using AESTHEMOS (for aesthetic emotions) and single items (Chirico et al., 2020), their sense of presence is assessed using ITC-SOPI Inventory. Previous level of expertise, dispositional emotions (DPES) and desire for aesthetic appreciation (DFAS) are measured. Connectedness with nature is assessed using Mayer and Frantz’s (2004) scale. To evaluate an individual’s dispositional tendency to be emotionally aroused by nature’s beauty, it is also administered the Engagement with natural beauty scale developed by Diessner et al. (2008) In addition, the Nature Relatedness Scale (Nisbet et al., 2009) is used to measure the affective, cognitive, and experiential connection with nature. In this pilot exploratory study, we expect highly intense emotions in the most realistic and immersive condition compared to the others. Data collection is ongoing.

ABSTRACT. Objective. Arc screen with real time projection is used to reduce surgical stress during cesareans and improve human health care in global pandemic. Methodology. 40 Young pregnant mothers under regional anesthesia (peridural block) participated using an arc screen, they watched their babies 30 cm in front their faces while their hands explored and caressing them from the first moment of birth together with the Gynecologist. Pediatrician explore the newborn together with the mother while she is laying down watching the arc screen. This experience is shared with remote families by videoconference. Eva scale was used to measure anxiety where 0 = no anxiety and 10 highest anxiety. This technique is used since February 2020. Results. Mothers anxiety was reduced, X 2 square was ρ= 0.05 x = 27.28 (picture 1), 63% stress, 100% satisfaction in mothers, relatives, surgical team. No complications was presented related with the system. 163 relatives were linked from 8 countries and 3 continents (picture 2). We avoid fentanyl and midazolam. This system is in patent pending: International Application number: PCT/IB2022/050674 Application date: January 26, 2022 WIPO: World Intellectual Property Organization. Conclusions. With this arc screen system is possible reduce in pregnant mothers during cesareans the followings responses: fear, social distance, concerns, anxiety, surgical stress in global pandemic and all emergences that needs lockdown. Real time baby projection emerging uterus is one of the best moment of mothers lives and touch them is singular. This method has been used in pediatric surgery, neonatal care unit, in the postoperative (hospitalization in adult).

ABSTRACT. The objective of this evidence map is to provide an overview of the use of Metaverse for Mental Health Care. Concretely, the purpose of this study was to review the scientific literature of those studies involving Metaverse and mental health care, to answer the following question: What kind of Metaverse-based treatments/protocols have been used for improving mental health care? We conducted a systematic review of the peer-reviewed literature from EBSCO, Ovid, PubMed, Scopus y WOS (Web of Science), following the PRISMA statements and using “Metaverse" as keywords on December 1st, 2022. Those studies published between 2012 to 2022, in English or Spanish language were reviewed. A total of 1,644 records were retrieved, and only 23 publications met the inclusion criteria. Of those, only 23 studies were finally included: 7 records were empirical studies, 1 systematic review, 1 study protocol, and 14 no empirical studies. Metaverse-based protocols used were varied, as well as topic addressed. Results will be useful to develop innovative Metaverse strategies to improve mental health care, due to the lack of empirical studies focused on this area. More information is needed to evaluate the role of Metaverse technology in clinical care and, more specifically, in mental health care.

ABSTRACT. Technology has permeated all areas of society today, offering a broad range of opportunities for the therapist, for example to facilitate access to a therapist in situations of restricted mobility, as in the recent Covid-19 worldwide sanitary crisis. Although more and more clinicians use teleconsultation nowadays as a complement, very few of them have been trained with the specific features of these new forms of clinical practice. This raises numerous questions for research and practice in clinical care. Very few programs currently exist to train professionals in healthcare and in the related fields that enable these new practices, e.g. engineering, applied mathematics, computer science, etc. In the specific area of mental health, professionals must be prepared to face in clinical practice the digital dimension of the experience, as well as achieve the necessary knowledge about all that equipment, devices, apps, that facilitate and improve the quality of mental health intervention. This is not detrimental to the therapist's basic skills, but, quite the opposite, leads her/him to adapt them to the new supports. The Erasmus Mundus CYBER Master’s degree started in 2022. This research Master aims to provide mental healthcare professionals with the IT related concepts and tools of intervention in the areas associated with human behaviour and mental health. The Master is focused on two main areas of knowledge, on the one hand the importance of an accurate management of the data processing derived from the quantification of human behaviour. And on the other, the use of IT applications in the comprehension, research, assessment and intervention in human behaviour and mental health. This Master is coordinated by Universidade Lusófona of Portugal in Lisbon, the consortium is composed of the University of Barcelona and Université Paris Cité. CYBER Erasmus Mundus Joint Master Degree (EMJMD) has a length of 2 academic years, structured in four semesters. Each semester is conducted in one of the universities of the consortium and the last semester is dedicated to field internships. This new international academic training aims to train new professionals and researchers in the field of mental health. This will strengthen the presence of cyberpsychology in European universities.

ABSTRACT. 360-degree storytelling footage recorded in the Rhino Camp refugee settlement in West Nile the Northern part of Uganda with South Sudanese Trauma survivors who are now refugees. In the videos, the survivors narrate their stories relating to their trip from their home country to the refugee camps, the difficulty, and stress they experienced while fleeing the violence, and their relationship with others. The 360-degree footage produced is then loaded into smartphones and viewed offline via inexpensive VR headsets. The content is then interchanged e.g. survivor X views, listens, and learns from survivor Y and vice vasa with an aim of making them have shared learning as well as empathy, trust, and psychological healing. The VR content is accompanied by other activities like cultural galas and riddles. And later feedback sessions to check the lessons learned and how they feel after engaging with the tool. This experiential and interactive learning since its launch in 2020 has contributed positively to reconciliation, reduced tension, and built social cohesion as well as mental well-being. Psychologically 7/10 of the refugee women and youth were stressed due to the situation they went through back in their home countries. They still carry the emotional baggage that tribe X who are present in the refugee settlement caused them troubles and stress. But it started with virtual meetings and later in-person, creating friendships, and coexistence. The virtual and storytelling exchanges and the shared learnings have contributed positively to shaping the character of the refugees. Before these survivors live in fear and distrust towards each other for example tribe Y cannot cross to the refugee settlement hosting tribe X and often time’s when they meet they exchange bitter expressions. This is because of the ethnic division back in their home country. With the political, and tribal unrest and military confrontation in many parts of South Sudan, the majority of the population escaped to the neighboring countries in pursuit of better protection of their lives. Women and children make up 86% of the refugee population, they possess all forms of Sexual and Gender-Based Violence (SGBV) cases recorded by police and Refugee Welfare Committees including defilement, rape, early marriages, indecent assault, and domestic violence. Given the significant gender gaps in education and traditional practices, South Sudan‘s diverse socio-cultural groups are overall strongly influenced by patriarchal norms and values, which has contributed to higher stress, anxiety, and depression for girls and women. Meanwhile, many who witnessed their own relatives murdered or abused crossed carrying along with them severe mental disorders that have resulted in suicides and suicide attempts, increased patients in the hospitals yet without any serious sickness, cases of drug abuse, and among others as a result of frustrations. But finding a low-cost and rapid way to generate healing is rapidly scalable, saves time and money in a situation like the refugee camps where there is a shortage of mental health workers as well as reduces the need to spend much time in unproductive engagements. Using innovative fun technology associated with entertainment improves the desirability and acceptability of this novel approach Instead of a didactic training model. With this exciting model, providers will engage with the tool and show it to others even during their off-duty hours.

ABSTRACT. Fear of public speaking is widespread. While sufferers typically avoid eye contact with the audience, it is not known if reducing gaze avoidance can alleviate their fear. We developed a stand-alone, virtual reality (VR) gaze exposure treatment and tested its effectiveness in a single-blind, parallel-group, randomized controlled trial in 89 healthy adults with fear of public speaking. The gaze exposure focused on the maintenance of eye contact with virtual audiences across increasingly difficult social situations. The primary outcome was subjective fear in a real-life public speaking test (PST), measured by the Subjective Units of Distress Scale. Secondary outcomes included the relative dwell time on faces during public speaking, as measured by eye-tracking, as well as a global speech quality assessment during the PST. Assessments were done at baseline, after a single 1-h app use (phase 1), and after additional repeated (9 × 20 min) app use at home (phase 2). We applied linear mixed models to analyze the primary and secondary outcomes in separate models. For the primary outcome analysis, a linear mixed model included the SUDS fear rating during the PST as the dependent variable. Group (treatment vs. control group; between-subject factor), time point (t0: baseline, t1: after study phase 1, t2: after study phase 2; within-subject factor) as well as their interaction were included as independent variables. The Participant-ID was included as the random intercept effect. For the subjective fear during the PST we found a significant interaction between group and time point (i.e., baseline, post treatment 1, post treatment 2) (F [2,154] = 23.32, p < 0.0001). For the relative dwell time on faces we again found a significant interaction between group and time point (F [2,151] = 8.71, p = 0.00026). For the global performance as assessed by the committee, there was no significant interaction between group and time point (F [2,154] = 0.24, p = 0.79). Post-hoc tests revealed that after the additional home-treatment, the repeated use of the treatment app led to a significant reduction of subjective fear during the PST in study phase 2, 34.00 days [SD 4.44] after the last use of the app (treatment group, post intervention phase 2: 26.60 [SD 19.23]; control group, post intervention phase 2: 56.34 [SD 28.15]; p < 0.0001; adjusted group difference = −29.82, 95% CI: −41.77 to −17.87; Cohen’s d = − 1.07). For the main secondary outcome, the home treatment with the app benefitted the relative dwell time on faces (treatment group, post intervention phase 2: 0.30 [SD 0.09]; control group, post intervention phase 2: 0.19 [SD 0.12]; p < 0.0001; adjusted group difference=0.09, 95% CI: 0.05 to 0.13; Cohen’s d = 0.97). The repeated use of a VR-based gaze exposure treatment leads to a large reduction of fear in a real-life speech situation, suggesting high effectiveness of a treatment focused on gaze behavior. Stand-alone, widely accessible, and scalable treatment tools offer evidence-based solutions and alternatives at a low threshold for initiation, thereby countering the dissemination problem of traditional in-vivo treatment.

ABSTRACT. Background The Trier Social Stress Test (TSST) is a valid and gold standard for inducing psychosocial stress and is widely used in research and diagnostics. The downsides of the TSST are that it is labor-intensive and the difficulty of maintaining the same experimental conditions. A TSST in a virtual reality environment (TSST-VR) is easy-to-use and remains exactly the same with repetition. A classic version of the TSST-VR exists, however to differentiate between the effects of different levels of stress in diagnostics, prognosis and therapy, our version aims to test three levels of stress induction (no stress, moderate and high level of stress), all fully within virtual reality.

Aim The aim is to investigate whether there is a statistically significantly greater increase directly after the TSST-VR in psychological and physiological stress parameters in the moderate and high-stress levels compared to the no-stress condition (control) and when comparing the moderate and high stress level to each other.

Method A three-arm single-blind randomized placebo-controlled trial is conducted in healthy adults, with the three stress levels as conditions. The “no stress” condition consists of an easy interview task (e.g., questions on favourite holidays) and an easy arithmetic task. The panel members have friendly facial expressions and gestures and respond positively. The moderate stress condition is identical to the classic TSST: a difficult interview task (job interview) and a difficult arithmetic task. The panel members have neutral facial expressions and gestures and respond minimally, withholding social evaluative reassurance. The high-stress condition consists of the same tasks, but the panel shows negative facial expressions and gestures and makes negative social-evaluative remarks. At baseline, sociodemografic characteristics were recorded, as well as the Social Phobia Inventory for measuring baseline social phobia. Measurements on anxiety (6 item-State Anxiety Inventory, STAI-6 )and perceived physical arousal (Physical Activity Questionnaire, PAQ) and cortisol response (salivary cortisol) were measured at baseline and at several time points during the experiment: at the end of a 20-minute resting baseline period, directly after the tasks and after 20- and 40-minutes recovery. Heart rate variability is measured continuously and adverse events are recorded during the experiment and at one-week follow-up.

Results Preliminary data showed a mean score of 11.15 points (SD 1.71, N=4) on the STAI-6 directly after the stress test in the no-stress condition, a mean score of 14.00 points (SD 4.52, N=5) in the moderate stress condition and a mean score of 13.50 points (SD 2.07, N=8) in the high-stress condition. The mean scores on the PAQ directly after the stress test were 12.25 points (SD 9.91, N=4) in the no-stress condition, 13.20 (SD 4.44, N=5) in the moderate stress condition and 15.88 points (SD14.93, N=8) in the high-stress condition. Physiological data is also collected and will be analyzed soon. Further inclusion is ongoing and all results will be available in July 2023.

Conclusion This study focuses on the effect of the TSST-VR on psychological and physiological stress. When effective, the TSST-VR provides an accessible way to include incremental stress-responsiveness measures in diagnosis, prognosis and treatment allowing for an individualized, fine-grained approach.

ABSTRACT. Context. Biofeedback is a practical tool to provide real-time information on physiological arousal when practicing emotion regulation techniques. Using biofeedback while immersed in virtual reality (VR) has the advantage of offering a variety of contexts to master emotion regulation skills in progressively challenging situations. It is possible to practice emotion regulation skills such as relaxation when under stress levels that are kept at optimal levels. However, there is not much data on personality variables that contribute to the user’s engagement in stressors used for biofeedback training in VR. It has been shown that perfectionism is a significant predictor of stress in competitive performance tasks such as those used as VR stressors (e.g., a gamified stressful game). More information on the relevance of perfectionism may guide the development of further VR applications.

Objective and method. This study explored the influence perfectionism may have on change in psychological stress perceived by participants immersed in VR practising biofeedback. The sample will consist of 40 participants and 39 have been enrolled so far (62% women) with an age range of 18 to 64. Participants were subjected to two tasks: (a) a standardized stressor, and (b) an immersion in VR to practise biofeedback-assisted relaxation. The Montreal Imagery Stress Task (MIST) is a validated computerized protocol to induce moderate psychological stress. It is a performance-based stressor consisting of a series of challenging computerized mental arithmetic tasks combined with social evaluative threats. In the current study, the MIST was used as a reference condition to confirm perfectionism was indeed associated with stress in the sample. Participants were randomly assigned to one of the following conditions: (a) low stress VR, where participants walked through a virtual forest while receiving visual feedback on their stress level; and (b) high stress VR, where participants played a stressful performance game in VR while receiving visual feedback on their stress level. The biofeedback was experienced as a fog progressively masking the user’s field of view based in heart rate levels compared to baseline levels. The main measures used were the SCOPE (measuring levels of perfectionism) administered at pre-immersion and the Measure of Psychological Stress (MPS) administered at the pre-experiment baseline, after the MIST and after the immersions in VR. To replicate previous findings in our sample, it was predicted that perfectionism would predict change from pre to post MIST. Our principal hypothesis was that perfectionism would predict change from pre to post VR tasks after statistically controlling for the two VR conditions.

Results and Conclusions. Perfectionism was included as the “dependent” variable in a hierarchical regression with two control variables entered in the first step (VR condition and pre scores on the MPS) and MPS scores after the MIST and after the VR immersions. The final regression model was significant (F(4,38) = 5.2, p = .002, Adj R2 = .31). Perfectionism was significantly associated with stress after the MIST task (t = 3.84, p < .001, sr = .52) but, contrary to expectations, not to the VR task (t = -.3, p = .75, sr = -.0). Exploratory analyses are being conducted to identify alternative predictors of the stress response during the VR tasks. While awaiting to complete the expected sample, preliminary analyses are suggesting gaming experience, sensation seeking and coping strategies are significantly associated with stress experienced in the VR environments. More refined analyses will be conducted in the coming weeks. Results will be discussed in light of methodological limitations and will include recommendations to improve the stressors used to practise emotion regulation and suggestions to take users characteristics into account when providing instructions on the use of biofeedback in VR.

ABSTRACT. In the past decade digital interventions based on serious games have emerged as an effective therapeutic tool for several areas of mental health. In clinical psychology the use of technologies has been developed in the field of various treatments and less for the assessment of psychological dimensions. While traditional assessment methods in clinical psychology have high validity and reliability, they may lack ecological validity, ability to capture real-life behaviours. In addition, they’re limited by the subjective perceptions of the clinician conducting the assessment, leading to inconsistencies in diagnoses. Digital behaviour biomarkers have the potential to improve psychological assessment by providing objective data of human behaviour observed in cyberspace and analysed by machine learning algorithms. This method allows us to evaluate not only the current psychological state, but also stable personality traits. Stable traits can be measured with stealth assessment by designing tasks or situations within a game that produce observable indicators of the traits, without directly asking users to self-report information about their personality or behaviour. In the current study we’re planning to analyse digital behaviour biomarkers of participants through the framework of Grawe’s consistency model of four basic psychological needs. According to Grawe all human beings attempt to fulfil some basic psychological needs in congruence with their motivations, memories of past experiences and actual aims. He identified four basic psychological needs (attachment, self-esteem, control, and pleasure) for optimal psychological functioning, each of these needs are associated with specific stable traits. Grawe proposes that stable traits may be linked to the occurrence of anxiety and depression. Assessing stable traits can be useful in identifying individuals who may be at risk of anxiety and depression, and in developing interventions meeting their specific needs. The use of digital behaviour biomarkers may provide an objective way to assess these stable traits.

This study follows previous research exploring the use of serious games to assess the aforementioned needs through the related stable traits. Current study aims to create a serious game, in Android and web formats, that enable the assessment of stable traits through the use of metaphors and scenarios designed within the games, which can then be analysed to identify potential behaviour biomarkers of anxiety and depression. The study aims to enhance the effectiveness of trait assessment by providing an engaging environment that enables the observation of human behaviour in the digital space through games. Our methodology will explore the connection between stable traits and the possible occurrence of depressive and anxiety disorders by selecting the traits that may be related. Next, we will search for methodologies to measure and assess these traits. Once this basic framework is established, we will design scenarios and metaphors that take into account traits and related behaviour biomarkers inside a game and develop the 2D game itself. We plan to conduct a study on 150 consenting adult participants, assessing each of the traits and collecting comparison data for each. Data collection will be performed before gameplay sessions using questionnaires, as well as in the sessions using gameplay data and stealth assessment of the traits following the designed scenarios and metaphors. This will be followed by statistical analysis of the correlation between traditional tools' scores and the game metrics. Finally, we will draw conclusions based on the results. Our study proposes a novel way to assess mental health. We hope the implementation of game elements will have a positive impact on mental health care practices, and that the defined behaviour biomarkers linked to the stable traits will help to improve earlier diagnosis for depression and anxiety disorders, ultimately leading to better outcomes and quality of life for patients.

ABSTRACT. Background: The investigation and classification of anxiety using biosignals is being more frequently used by several authors (Ancillon, Elgendi & Menon, 2022). The usual option to assess anxiety are ECG, EDA, RESP and EEG (Petrescu et al., 2020). Recent studies are focusing in using Machine Learning models to predict with good accuracy the signs of anxiety, in order to facilitate the tracking (Ancillon, Elgendi & Menon, 2022) and also to try to reduce the dependency on self-assessment measures to compare with the biosignals results (Khatri et al, 2022). This study aims to build a high accuracy machine learning model capable of recognizing signs of anxiety based on the combination of biosignals in a Virtual Reality Environment.

Method: The present study intends to collect data from between 60 to 80 adult participants, preferably with a similar number of men and women. Participants who are currently in psychiatric treatment will be excluded. Non-invasive PLUX biosensors will be used to measure the physiological signals like ECG, EDA, RESP, and EEG.

Procedure: In this experiment, two VR/digital scenarios—one relaxing to acquire the baseline and one stressful—will be presented to the participants. The relaxing environment consists of scenes generally considered relaxing, such as nature scenes and sounds, available on Unity Asset Store. The environment that will induce biological activation for anxiety is a task that consists in a matching game to accomplish in a shorter amount of time than necessary to do, designed by Gamito et al. (2023). The self-reported instrument Beck Anxiety Inventory (BAI) will be provided to the participants to complete in order to assess their baseline anxiety level (pre). The participants will be then fitted with biosensors to measure their ECG, EDA, RESP, and EEG signals, as well as a VR headset to do the experiment tasks. A unique data model will be used to record and process the biosensor data. After the experiment, the participants will be asked to fill the BAI questionnaire again (post). The duration of the experiment is intended to be around 20 minutes. The difference between pre and post experiment questionnaires will be used as a measure of anxiety induced by the scenarios, which are then compared to the data model aimed to predict and classify the anxiety levels.

Data analysis: Cross-validation and several performance measures, including accuracy, precision, recall, and F1-score, will be used to assess the model. A supervised machine learning algorithm is used for the analysis of the data from biosensors. Preprocessing is done to filter out the data and do feature selection by removing uninformative data. Machine learning algorithms such as Random Forest Tree (RFT), Support Vector Machine (SVM) for classifying data. The model is then trained with the collected data. And finally, the model is tested with the new data from the participant. In order to evaluate the validity and reliability of the biosignal-based anxiety assessment, the model will also be compared with the participants' subjective assessments. It is expected that the biosignal based anxiety assessment will produce accurate results that can be used to reduce the need for the questionnaires.

ABSTRACT. Affective states—namely, behavioral, subjective, and psychophysiological changes associated with an emotional episode—are generally structured in two dimensions: arousal or psychophysiological activation (low vs. high) and hedonic valence or pleasantness (positive vs. negative). These two dimensions can be represented in a Cartesian plane to demonstrate positive and negative valence interacting with low and high arousal. An individual’s specific elicited emotion as a reaction can be identified in the space with a specific value of arousal and valence that we can use to define that individual’s state in the specific moment. Affective states represent a combination of valence and arousal per several time-points (states) in several individuals; however, the transition from one state to another is not normally taken into account. This situation represents a problem as the affective state needs to be defined as a process considering the change over time. Although affective states have always been described as dynamic, studies tend to operationalize them in a static and disjointed way; in other words, studies analyze one affective state at a time, in its arousal and valence dimensions, linking them to the eliciting stimulus, which is also generally static. Affect dynamics refer to the study of emotions and their influence on behavior, cognition, and decision-making. As such, a valence-arousal model representing states is perfect for analyzing transitions from one state to another and, thus, the dynamic over time. In this regard, affect dynamics—namely, the study of how affective states change over time—is a developing field in psychology. Affect dynamics encompass both the generation and regulation of emotions as well as their effects on individuals and groups. Affect dynamics stress the importance of studying affect as a process that occurs within individuals over time. A second important aspect is to compare processes between individuals as groups (or patient typology). To study affect dynamics, we need to consider the transition from one stimulus to another or dynamic stimuli. This second kind of stimulation is quite difficult because it requires a dynamic change from one stimulus to another along a continuum that becomes impossible to elicit with photos and very difficult to be created to elicit with videos. In this sense, the use of classic stimuli in the valence-arousal model (e.g., International Affective Picture System [IAPS]) would have no efficacy. On the other hand, the use of virtual reality (VR) for modeling affect dynamics could be an easy and ecological way to study affective dynamics. VR can represent the change from one elicitation to another, in a fluid and continuous way. On the other hand, static images or videos would represent the transition from one stimulus to another in a discrete and direct way. The objective of our study is to investigate the dynamics of affect by using VR environments changing smoothly over time. Considering the four quadrants of affective states, we created 6 virtual environments to consider all the transitions from one quadrant to another. These 6 environments represent 12 transitions (doubled as we consider a transition and its return). For example, considering only valence, we created a park where it rains (negative valence) and then becomes gradually sunny (positive valence). After each VR environment, we assess the two dimensions of valence and arousal using the Self-Assessment Manikin (SAM). Prior research on VR and affective states has examined the potential impact of VR on assessing emotional responses. However, virtual reality offers a unique opportunity to examine the physiology and behavior associated with the transition between distinct emotional states.

ABSTRACT. Although cognitive changes in aging can be considered physiological, the incidence of neurodegenerative diseases drastically increases with age. While symptoms vary from person to person, memory problems are often the most common. Traditionally clinicians assess these deficits using paper-and-pencil tests. However, in recent years, there has been an ongoing debate regarding the use of traditional techniques, which is linked to their ecological validity. As a result, researchers emphasize the necessity of observing cognitive and behavioral functioning in a life-like setting. In this scenario, Virtual Reality is a promising tool to improve the quality of the neuropsychological assessment process since it can provide realistic environments in a controlled and safe way. Among these technologies, 360° videos offer additional opportunities. In particular, they are spherical videos recorded by a special camera able to collect images from around the environment. In this way, users can look around the scene, similarly as they would in real life: by moving the device, users can control the viewing direction, and they may observe what is going on all around. These features are crucial for the assessment process, improving the accuracy of the procedure allowing a considerable increase in the ecological validity of the tests, and promoting an embodied experience. 360° videos have also a friendly design which makes them more suitable for patients with mild impairments who may have some difficulties interacting with more sophisticated devices. In this scenario, we propose an innovative 360°-based tool to fit this promising panorama: semApp. Based on previous research, we implemented existing tools thanks to cutting-edge software to increase the ecological validity of the assessment and the control of the environments, with standardized multimodal stimulation, precisely calibrated feedback about the performance, and automatic registration of outcomes. In particular, we provide a tool composed of two memory tasks: an object recognition task and a spatial memory task. In the first task users are immersed in a living room, they must encode and then recall some target objects that have been moved. In the second, users must freely navigate in an apartment visiting rooms and then have to recognize the map of the house. This cross-platform tool can be deployed on a portable device (e.g., tablet) and guarantee an objective and standardized evaluation of memory to also keep patients monitored even without requiring further visits and movements of the patients. In the present study, we tested the usability of this novel application for the assessment of memory. Usability refers to the degree to which a user can utilize a given system effectively, efficiently, and satisfactorily. It is a crucial factor when employing new technologies, allowing clinicians to identify barriers and facilitators, and developing appropriate tasks for the target. For this purpose, we enrolled volunteers at the IRCCS Istituto Auxologico Italiano. To collect realistic data on end-users’ experience, 7 patients with Mild Cognitive Impairment (MCI) were involved. Participants were examined in two sessions. First, we administered neuropsychological tests to verify MCI. Then, users tested the app evaluating its usability. The usability has been assessed using quantitative instruments such as the System Usability Scale, the Senior Technology Acceptance Model, the Independent Television Commission Sense of Presence Inventory, and a qualitative technique: the thinking aloud protocol to collect users’ opinions regarding the technology’s employment and criticism while performing the task. Results show that patients evaluate semApp as usable, reporting interest and fascination in trying this new assessment methodology. Users also confirmed their propensity to accept and usage of the proposed application. Our findings are promising to encourage the use of 360°-based applications for memory evaluation.

ABSTRACT. Background: Studies have shown that the most common types of acquired brain injury that need cognitive intervention are Stroke and Traumatic Brain Injury (TBI). Stroke and TBI survivors may experience a range of cognitive function impairments. Among these cognitive impairments, memory, orientation, language, attention, and executive dysfunction are the most frequently observed (Tatemichi, 1994, Kramer, 2002). Virtual Reality (VR) is a proven effective tool that’s capable of stimulating cognitive abilities (Maggio et al., 2019). Patients who suffer from a cognitive disability often need to go through rehabilitation in a clinical facility, however, when they are sent home the rehabilitation abruptly stops. Longitudinal studies found that the quality-of-life scores reported at the rehabilitation discharge usually don’t last (Schindel et al, 2021).

This study proposes the introduction of a “virtual coach/therapist” to an existing 3D virtual application (Systemic Lisbon Battery - SLB) to overcome this challenge. The “Virtual coach/therapist” will help the patient to proceed with performing the simple daily routine tasks in VR. This way, the patients can continue their rehabilitation process for a longer time after they leave the hospital, or the rehab center. The goal is to maximize the functional independence of patients who suffer from the various cognitive impairment. The application will have levels of difficulty. The app actively collects the data regarding patient’s progress and gives various tips and tasks for the patient to follow, while also being monitored by a real therapist on a timely basis. A clinician/therapist has access to the performance report remotely which is provided and sent by the application.

Methodology: Outpatients from Alcoitão Rehabilitation Medicine Center in Lisbon, Portugal, will take home the virtual application where they will train twice a week. Before the discharge from the center, one training session will take place for the patient/caregiver to better understand how to use the application. To assess the outcome, the following measures will be used: Montreal Cognitive Assessment (MoCA) as a cognitive screening test; Frontal Assessment Battery (FAB) to assess executive functions; Rey Complex Figure (RCF) to assess visuoconstructive abilities and visual memory; d2 test to measure attention/concentration; Lawton Instrumental Activities of Daily Living Scale (IADL) to evaluate functionality, all validated for the Portuguese population. Each outpatient will be evaluated two times, once before the discharge and the second time will be after finishing the period of three months. The test results will be compared and analyzed by the end of the study in near future.

ABSTRACT. Introduction : The Uncanny Valley is depicted by the drop of the affinity felt by a person when the anthropomorphism of an avatar is high. It is the feeling of rejection towards an android that is physically too similar to a human being (MacDorman, 2019). With a multimodality (visual and auditory) approach, we seek to understand the causes of this feeling with predictors such as : Sociability, Animacy, Agency and Disturbance.

Materials and Methods : Pre-testing : (6 Participants : 3 women, 3 men). Several strategies to introduce uncanniness in vocal communication were examined. According to the results of pretesting, 5 seconds stunts are the most disturbing. Tests : (40 participants) A video of one of the conditions was shown to the participants and in each of them, the visual (human face/ with a robot face filter) and the speech (without stunts/ with stunts) were manipulated. At the end, they answered the « Human-Robot interaction Scale » with a Likert scale (Spatola et al., 2011). Data was processed with Jamovi.

Results : For the sociability, the animacy and the disturbing look of the avatar, a principal significatif effect of the voice is present. About the agency, we observed a marginal effect. In opposition of our initial hypothesis, the visual appearance doesn’t seem to have a principal and significatif effect, as well as the interaction effect.

Conclusion: Based on the results, we cannot determine whether or not multimodality has an effect on the feeling of rejection caused by the Uncanny Valley. The effect of the voice on the feeling of rejection is surprisingly important.

ABSTRACT. Limited empirical evidence exists regarding information processing and behavioral patterns in metaverse-based virtual reality. Previous resarch suggests that the perspective from which an individual experiences a virtual environment (i.e., first-person or third-person perspective) influences the accuracy of their memory for that environment (Iriye & Jacques, 2021). First-person perspective experiences have been found to enhance visual memory accuracy due to their greater sense of presence and immersion in the environment, while, third-person perspective experiences enhance spatial memory accuracy due to their wider camera field of view. In this study, we aimed to extend these findings to a metaverse expereince and compared memory performance between two groups: thosse who directly exeperienced the metaverse with an avatar and those who watched a video of a metaverse experience. We also measured subjective expereinces such as metaverse immersion and intesion to use. Eighty participants aged 18 tp 29 years were randomly assigned to either a metaverse tour group (experimental) or a metaverese tour video viewing group (control). Participants in the experimental group directly accessed the metaverse platform spance through pre-created avatars and toured exhibition and party spaces with a guide. Participants in the control gorup watched a video of the experimental group's metaverse tour in real time. Key outcome measures included visual memory performance (immediated and delayed recognition) and metaverse experiences (immersion, perceived usefulness, usage intention, perceived enjoyment, and metaverse self-efficacy). Memory performance was tested immediately and following a 1-week delay. Metaverse expereicnes were also measured after experiening or watching the metaverse tour. The two groups did not differ in terms of depression symtoms, loneliness, personality (extraversion and neuroticism), video streaming usage, and social networking site usage time. Immediate memory was better for the watching group than the metaverse tour group, while there was no group difference in delayed memory (both groups showed a similar rate of forgetting during the one-week period). Metaverse experiences appeared to be more positive in the metaverse tour group (i.e., more immersive experience, higher metaverse usage intention, higher perceived enjoyment) than the watching group. Results imply that the virtual reality experience through avatars within the metaverse increases presence and immersion, but it does not necessarily enhance memory performance. Further exploration of the results is needed by considering users of various age groups and individual characteristics.

ABSTRACT. The Therapeutic metaphors use the symbolic language, the same of the unconscious and are a formidable synthesis of cognitive and affective-emotional aspects and dimensions. Metaphors are an excellent indicator of trauma and the emotional state associated with it, of the individual's map (historical events, emotionally significant figures, relationships, belief systems, attitudes and values, etc.). They widen the network of reference experiences to allow the restructuring process and the recovery, in a rehabilitative key, of alternative adaptation strategies. The following contribution, the result of the work of a multidisciplinary research team, provides further evidence and confirmation of the usefulness of applying emerging technologies (Immersive, 3D, V/R, A/R) to the field of clinical psychology and psychotherapy. Here we present an innovative psychotherapeutic technique, that of transformative therapeutic metaphors (MTT), based on Mills', Crowley's and Gordon's therapeutic metaphors, which we have already used in a different and innovative way at a clinical level, but which, translated, interpreted and used in a virtual and immersive context (MTT-VR/AR), offer, from a clinical point of view, the possibility of enhancing the expression and representation of psychic contents as well as the advantage of initiating and rendering a more effective transformative dialogue with the metaphors. Furthermore, what emerges from the clinical observations of the experimentation is that treatment with MTT-VR/AR allows subjects to interface, in the transformative dialogue of traumatic contents, no longer directly and exclusively with the figure of the therapist, with whom it takes time to establish a therapeutic alliance based on trust, but with the virtual metaphor, which becomes the representation of preconscious and unconscious contents (or rather the representation of unconscious traumatic contents) with which the subject dialogues more easily precisely because they represent an externalised part of himself/herself. The use of this technique, therefore, would lead to a threefold advantage: it could circumvent the resistance of individuals suffering from anxiety, obsessive disorders, depressive disorders, post-traumatic stress disorder, etc., to open up immediately with a change specialist with whom they interact for the first time; would implement the effectiveness of the treatment due to the fact that the subject is as if in dialogue with himself/herself or rather with an interface of internal and personal contents that s/he himself/herself has helped to generate and create; the subject has the possibility of seeing and manipulating what makes him/her feel bad. Although not entirely real since it is virtual, but precisely because of this characteristic, s/he can more easily deconstruct and change, crossing and transcending the interlocking and rigid limits of reality. Methodology The subjects who participated in the research were subjected to, pre- and post-experiment, with a view to measure their anxiety level by means of a self-administered psychometric instrument, the STAI-X, which detects state, trait and post-treatment anxiety. The metaphors used in the research were independently chosen by each subject and for each of them, two were used. Both the subjects in the control group and those in the experimental group were treated with the technique of therapeutic metaphors, which incorporates Gordon's model and Mills and Crowley's technique, but extends it and makes it innovative thanks to the fact that a transformative dialogue is established with them, with the difference that in the group that we could define as the control group, taken from clinical practice, the interaction took place only at an imaginative level and was simultaneously shared with the therapist, in the group subjected to the experiment, the metaphors were translated on a virtual level and used in an immersive context.

ABSTRACT. Language serves as a crucial function for humans as it enables verbal communication and involves abilities like the expression and comprehension of phonological, semantic, and syntactic components. According to the Embodied Cognition approach, cognitive processes, including language, are based on multimodal representations whose inputs derive from activation of sensory and motor systems. Based on the involvement of the motor system in linguistic processing, confirmed by increasing neuroscientific evidence, empowerment interventions should be designed following a "neuroscience-based" strategy in which language is acted upon by stimulating the motor system. Nevertheless, there is still a lack of tools for testing and training language abilities through the involvement of motor representations. To fill this gap, the present study aimed at recording and validating a set of videotaped actions to be used in anomia rehabilitation protocols. Furthermore, to exploit the established effect of immersive virtual reality on the sense of embodiment, we aimed at producing, other than standard 2D videos, an egocentric spheric version of the video stimuli to be observed through a virtual reality head-mounted display. In this type of videos, the egocentric view allows the user to observe the virtual world from a first-person perspective, while the stereoscopic vision and continuous updating of the scenario congruently with the user’s head and body movements increases the subjective experience both in terms of embodiment and self-attribution of the action being performed by the subject in the video. We hypothesized that the connection between the motor and linguistic systems would be enhanced by the first-person perspective. First, we built 80 short sentences including a verb with a first singular person, taken from a common action verb list, and an object. The sentences describe everyday actions such as “I water the plants”. For each sentence, a spherical video has been recorded displaying the action in the first-person perspective. For this purpose, the camera was placed in the middle of the forehead of the actor performing the action. As a result, during the playback, the user has the impression of being the agent of that action. In addition, the same action has also been recorded from the third-person perspective in a standard non-spherical video. In watching this video, the user sees someone else performing the action. On the whole, the complete set of stimuli comprised 160 videos, 80 spherical and 80 standard videos, representing the same actions and objects. These stimuli have been tested in a validation study where two age-matched groups (N=40 healthy adults, Italian native speakers) watched either the spherical or the standard version of the videos. After each visualization, the participants were asked to name the represented action and object. Spontaneous productions were transcribed. Based on the response frequency of the alternative labels, a set of correct responses for each stimulus has been defined. According to our initial hypothesis, the comparison between video types revealed that naming was significantly more accurate in spherical egocentric videos than frontal. The creation of this validated set of videotaped actions and objects will allow researchers and clinicians to carry out embodied rehabilitation protocols to train naming abilities in aphasic patients.

ABSTRACT. Introduction. Interacting with digital content has become an almost everyday behavior when using devices like smartphones, tablets, or touch monitors. Particularly, direct contact with valence-laden objects in the context of manual interactions is a very important natural setting in which valence evaluations have a crucial role to play. However, embodied interactions with affective digital objects have only been scarcely investigated from theoretical perspectives on cognitive and affective processing.

Goals. The work here (in progress) proposes a model of embodied affective interaction integrating three theoretical perspectives: (a) The near-hand effect hypothesis postulates that hand proximity to visual stimuli can intensify their attentional prioritization and processing; (b) Action planning paradigms in psychology indicate that action contexts are pivotal in the processing of stimulus characteristics, such as their emotional valence. For example, reach-to-grasp actions toward positive or negative stimuli can lead to different mental action representations (e.g., approach-avoidance). (c) the Body Specificity Hypothesis states that space-valence associations in terms of right-positive and left-negative are linked to the motor fluency of the dominant (right) hand. Prior studies show that valence evaluations of affective pictures can be in line with these associations when using interactive devices. However, a broader theoretical integration such as the one proposed here, is still missing. Accordingly, the work presents novel experimental paradigms based on touch interactions (i.e., reach-to-grasp) to investigate affective evaluations of emotional digital pictures. Experiment 1 will address lateral touch interactions (near-hand condition) with stimuli located at the right vs left margins of the touchscreen (pictures' affective spatial location) versus observing the stimuli (far-hand condition) displayed at the same affective locations. Experiment 2 will address lateral touch interactions with stimuli located at the center of the screen ( pictures' neutral spatial location) versus observing the stimuli. It is expected that touching (vs. observing) stimuli will lead to more intense evaluations (near-hand hypothesis). Moreover, compatibility effects are expected so that touching positive pictures to the right and negative pictures to the left will lead to more positive (and faster) evaluations than the inverse patterns (positive-left and negative-right -Space-valence association hypothesis).

Methods. Stimuli. Forty positive and forty negative pictures including social content (animals and people) and non-social content (objects and landscapes) will be retrieved from the Nencki Affective Picture System database (NAPS) and International Affective Picture System (IAPS). Two equivalent sets of pictures will be created to minimize learning effects. Apparatus. A large touchscreen monitor Dell S2340T will be used to emphasize the movements. Design. 2 x 2 x 2 x 2 design. Analyses will be performed by means of linear mixed models (LMM) with pictures and participants as random factors. Pictures’ Valence category (positive vs. negative), Interaction direction (right vs. left), and hand proximity (interaction vs. observation) will be manipulated within participants. The factor action context (“affective” spatial location vs "neutral" spatial location) will be manipulated between participants. Participants. Data simulations via R package simr estimated that for each experiment, a sample of n = 60 participants is appropriate to detect a medium effect size of d = .50 with a power of 1 - ß = .80. Measures. Self-reports: valence and arousal will be measured via grey-scaled sliders after each picture. The sliders will range from -50 to +50 but numbers won’t be displayed. Behavioral data: Release picture time and Touch time.

Results. Pictures’ description and selection analyses based on valence, arousal, and luminance are reported. Discussion. Findings will contribute to advance (a) theory on embodied interactions with affective digital content, and (b) potential benefits for digital interaction design such as mobile applications based on lateral movements. Funding. Deutsche Forschungsgemeinschaft (DFG) Grant nr. 466076299

ABSTRACT. Episodic Memory (EM) is a part of long-term memory that has the recollection of specific experiences, situations, and events. EMs are personally meaningful and related to our sense of self (Tulving, 2002). There is always an “I” that encounters the real event and an ”I” that re-experiences the event while remembering it (Bergouignan et al., 2014). A feature of the “I” experience is Bodily Self Consciousness (BSC) – conscious experiences such as self-location and self-identification (Ehrsson, 2007; Lenggenhag et al., 2007; Petkova & Ehrsson, 2008; Aspell et al., 2013) along with the first-person perspective (Ionta et al., 2011; Pfeiffer et al., 2014; Pfeiffer et al., 2016). BSC is achieved by the automatic and constant processing of multisensory bodily signals (Blanke, 2012)

This within-subjects design aims to create a spatial perspective memory task with immersive virtual reality to study the effects of perspective manipulation during encoding and retrieval on learned material (e.g., faces). Participants will encode stimuli in the 1st and 3rd person perspective, then they will recognize the stimuli with Remember-Know (RK) procedure from a 1st and 3rd person perspective.

Sample will consist of 24 healthy male and female participants (Effect Size (f) = 0,39, α err prob = 0.05, Power (1-β err prob) = 0,95) (Bergouignan et al., 2014) aged 20-30 considering long-term memory starts declining after 30 years of age (Park et al., 2002).

The encoding phase will have four sets of conditions: encoding of list 1 with 1st person perspective and RK list 1 with 1st person perspective; encoding list 2 with 3rd person perspective and RK list 2 with 3rd person perspective; encoding list 3 with 3rd person perspective and RK list 3 with 1st person perspective; encoding list 4 with 1st person perspective and RK list 4 with 3rd person perspective. All the conditions will be counterbalanced to avoid order effects.

We hypothesize that stimuli encoded and retrieved from a 1st person perspective will be better recalled than stimuli encoded and retrieved from a 3rd person perspective and mismatch encoding-retrieval conditions.

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ABSTRACT. Virtual reality (VR) allows the simulation of real-life situations to investigate complex human behavior in a highly controlled setting. This tool is increasingly used in the assessment and the treatment of psychiatric or psychological disorders (e.g., anxiety, eating disorders, addictions, specific phobias (for reviews and meta-analyses, see Cieślik et al., 2020; Dellazizzo et al., 2020). VR technology relies on the ability to induce emotional responses, cognitions and behaviors similar to those experienced in reality (Parsons, 2015). Then, the sense of presence is generally considered a necessary mediator for inducing emotions, cognitions and behaviors during immersion in VR (Diemer et al., 2015; Price et al., 2011). Presence is a dimensional construct that describes the cognitive feeling (Schubert, 2009) or a perceptual illusion (Slater, 2009) of “being there” in the VR environment. Many conceptions of presence and its assessment have emerged. Unfortunately, the conceptualization of the sense of presence is still subject to debates. Further, although several self-reported presence questionnaires already exist, most of them do not rely on any theoretical model and very few of them are validated in French. Consequently, in this communication, we propose (1) a modern and integrative conceptualization of presence based on the literature, and the (2) the creation of a new questionnaire to assess presence. Based on the existing literature, we developed a 63-items questionnaire (i.e., Self-Reported Presence Questionnaire). We recruited 607 adults from the general population, aged between 18 and 50 years, between March 2019 and August 2021. Exclusion criteria were color blindness, brain injury (e.g., tumor, surgery), epilepsy, cancer, hepatic disease, and carbon intoxication. Participants were randomly assigned to the VR “Awake”, “Anxiety”, or “Alcohol” environment. Participants in the “Alcohol” VR environment were also required to drink at least one alcoholic drink per month (AUDIT score>0). Participants were tested one by one in a small, quiet room during a session lasting about 45 min. They were informed that the aim of the study was to validate a new questionnaire of presence in the general population. After signing a consent form, participants complete a demographic and medical questionnaire, the ITQ, VR familiarity questionnaire, the SSQ, and the STAI-Y A. Depending on the experimental condition, participants were asked to complete the KSS and the Pichot scale (awakeness-related environment) or the alcohol craving scale (alcohol-related environment). After receiving some instructions, the participants were invited to start the immersion. They were immersed either in the bar, in the snowballs environment or the villa. Once the time was up, participants removed the helmet and were asked to fill in questionnaires related to the environment: KSS and Pichot scale (awakeness-related environment), STAI-Y A (anxiety-related environment) or craving scale and AUDIT (alcohol-related environment). They then completed the SSQ, the Gatineau Presence Questionnaire, and the new Self-Reported Presence Questionnaire. The current study used confirmatory factor analysis to validate the Self-Reported Presence Questionnaire and path analysis method for investigating the integrative model. Concerning the new questionnaire, the internal consistency was acceptable in all dimensions (ω ranging from 0.75 to 0.91). expect for the visual and interactivity dimension in the craving group. Further, after item selection, the goodness-of-fit indices for the model in each experimental condition were acceptable, with the exception of the RMSEA of the Awake condition. Then, it seems like the new Self-Reported Presence Questionnaire could accurately assess the sense of presence in French-speaking participants. Concerning the new model of presence, it had a moderate level of predictive accuracy for all dimensions of presence, absorption and flow (except in anxiety condition) in each environment. All results will be further discussed during the conference as well as their experimental and clinical perspectives.

ABSTRACT. Sujeto52 is a VR serious game designed as a didactic learning complement for psychology students. Where you impersonate a laboratory subject that must complete a series of logical puzzles based on the learning principles of behaviorism, which will allow the understanding of concepts such as classical and operant conditioning, generalization, discrimination, habituation and sensitization of stimuli. It has been developed in the Unreal Engine videogame engine, specifically in its 5.1 version, also built through the use of blueprints, C++ and assets such as 3D models elaborated with Blender 3.3. It is currently under the final testing phase in order to fix bugs and performance issues. Furthermore, we are working on multiplatform support (Meta Quest 2, Pico Neo, and a version adapted to PC in which the gameplay does not involve VR) as well. Once this last testing phase is completed, the game will be implemented, and the learning acquired by the participating students from 4 universities (Colombia and Spain) will be evaluated, in order to collect information to determine the impact of this videogame.

ABSTRACT. The logic behind the neuropsychological rehabilitation of the impulsive criminal is to treat the behavioral manifestations of these individuals as the product of a real pre-frontal syndrome, capable of causing deficits in the planning of behavior, in self-regulation, in the inhibition of impulsiveness and more generally in social and interpersonal skills. With the term prefrontal workout, literally “prefrontal workout” Eagleman (2011) refers to a real form of rehabilitation intended for subjects characterized by strong impulsive tendencies. Neurofeedback is used in prefrontal training. This technique mainly uses electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) as indicators of brain function. The premise of prefrontal training is that through rehabilitation, and therefore repeated practice, the frontal areas of our brain can be trained in order to improve the "control" of subcortical circuits and limbic areas responsible for impulsive and potentially destructive behavioral forces. Neurofeedback would be able to produce structural changes both in the gray matter (layer that includes the body of neurons) and in the white matter (connective tissue that includes the axons of neurons gathered in bundles) of the brain, strengthening not only the existing connections but also creating new ones, and thus triggering mechanisms that are completely analogous to what occurs in learning processes. Although this rehabilitation proposal does not specifically concern deviant individuals, it is intended for subjects with impulsive tendencies and difficulty in repressing a stimulus-seeking behavior, skills that fall within the category of frontal functions. It is possible that similar strategies can also be used effectively against deviant individuals, working to improve their ability to inhibit a behavioral tendency and reinforcing everything with real-time feedback. There is a very high incidence of attention deficit, hyperactivity disorder and related symptoms among people convicted of crimes, and a great many criminal acts involve impulsive behavior or loss of emotional control such as anger. Better control of behavior and emotions are among the most commonly reported outcomes of neurotherapeutic treatment. Research and clinical experience also demonstrate the positive effects of neurofeedback with alcohol and drug abuse and depression, both common accompaniments of criminal behavior ( Fielenbach S. 2019; Margarita R. 2016; Konicar L. 2015).

ABSTRACT. Psychometrics is widely used in clinical practice and thousands of validated scales are available in the literature. However, practitioners face several limitations in the use of these tools. Hence, can we consider these items to be totally representative of the individual's intrapsychic experience? Several demonstrated biases exist in psychological assessment situations: social desirability bias (Fisher & Katz, 2000) ; related to the format of passing, whether through the interview or through the questionnaire (Morgado et al., 2017). The rise of cyberpsychology is leading to an evolution of practices and offers new possibilities. However, relatively little scientific work exists to date in the context of psychometric assessment.

The first objective of our study is to evaluate the influence of environmental variations on the anxiety state and stress level of the participant in a psychometric evaluation situation, through the use of virtual reality and neurophysiological sensors. We consider that the environment in which the assessment takes place can be experienced as anxiety-provoking and stressful for the patient and thus influence his psychological state and the responses he gives. If the environment influences the individual's state of anxiety and stress level at the time of the assessment, this may underline the idea that current psychometrics assess the individual's psychological state in relation to the environment and not only in relation to daily life. The second is to investigate the complementarity between the use of virtual reality and neurophysiological sensors during a psychometric assessment of anxiety.

We raise the following research questions: Does the change of environment in virtual reality impact the level of anxiety and the state of stress of “all coming” young adults in a psychometric assessment situation? Is there a complementarity between declarative data and neurophysiological data collected during a psychometric evaluation of anxiety of “all coming” young adults?

First, a pre-test will take place during which we will recruit participants in order to evaluate and classify our environments into three categories: anxious, soothing and neutral. All environments will be created in collaboration with the company FeelU.

After that, in order to test our hypotheses, we will recruit 80 young adults who will be received in random groups for four sessions. All participants will complete an in-vivo control session to create a baseline with a psychometric anxiety collection (STAI) followed by the Perceveid Stress Scale. A neurophysiological data collection will take place throughout the session with neurophysiological sensors. The participants will then be reviewed 3 times to complete test sessions. They will all take place in virtual reality. The environments will come from the three categories. Each participant will be immersed in an environment of each category, defined according to his own feelings. the three sessions take place in the same way, only the environment will change. The participant will complete an in-virtuo anxiety assessment and the Perceveid Stress Scale and an assessment of presence (ITC-SOPI) after the immersion. Neurophysiological data will be collected during the entire session and a clinical interview with a psychologist.

Currently, we are in the preparation and implementation of the pre-test protocol. We hope to collect during our PhD work exploratory results that would allow us to demonstrate the impact of the environments on the psychological and neurophysiological state of the individual in a psychometric situation and to study the complementarity of the subjective and neurophysiological data. We assume that the results of our study will show an influence of the environment on the psychometric evaluation. We also assume a link between qualitative and neurophysiological data. The validation of these assumptions would provide initial data that could be helpful to create innovative tools in psychometric assessment

ABSTRACT. 1.Introduction: Low back pain (LBP) is one of the most widespread conditions affecting up to 80% of individuals worldwide (Urits et al., 2019). Studies have shown that individuals who suffer from LBP often experience negative body image due to the limitations on their body functionality which can further exacerbate the negative effects of the pain (Levenig et al., 2019). Body image (BI) refers to people’s attitudes, perceptions, and thoughts about their bodies, yet research has largely focused on the negative aspects of BI while ignoring its positive components (Guest et al., 2022). A crucial component of positive BI is body functionality, which includes physical abilities, internal processes, senses, creativity, and communication with others (Alleva & Tylka, 2020). Research has shown that interventions focused on the appreciation of body functionality (ABF) can help improve BI in patients with pain (Alleva et al., 2018; Guest et al., 2019). Additionally, following the positive embodiment theory, activities like yoga and physical exercise can also increase ABF by directing practitioners’ attention to what their bodies can accomplish (Munroe, 2022). Virtual Reality (VR) is an effective tool for managing pain. Among other effects, VR has been used in people with LBP for redirecting attention away from the pain by replacing their “damaged” bodies with healthy ones by using avatars (Tack, 2019). VR has also been used to provide training to individuals with pain in different body regions, including the LBP, for improving BI and pain management (Harvie et al., 2020; Alemanno et al., 2019). However, interventions promoting positive BI in patients with chronic and acute LBP are still scarce. Therefore, the objective of this study is to present the development of a VR program for enhancing ABF and evaluate its acceptability, satisfaction, and potential negative side effects.

Hypotheses: - Participants will show an improvement in the ABF after the use of the VR program. - Participants will perceive high levels of satisfaction and acceptance, and will not report any negative side effects after the use of the VR program.

2.Methodology 2.1 Participants The sample will include 10 participants with LBP (acute LBP = 5, chronic LBP = 5) that will evaluate the VR program.

2.2 Study design The VR program will consist of a variety of exercises designed to enhance participants' ABF. For instance, the program will involve interaction with the VR environment and will present participants with two types of sentences - one promoting positive ABF and the other referring to negative body functionality. Positive feedback will be given when participants direct their gaze towards positive ABF stimuli, while negative feedback will be provided if they focus on negative stimuli. Each exercise will target a specific construct within ABF, helping participants to develop a more positive BI.

2.3 Measurements Participants will fulfil Body Appreciation Scale (Tylka & Wood-Barcalow, 2015) before and after the use of VR. Additionally, the following measures will be administered after the use of VR: Cybersickness Simulator Sickness Questionnaire (SSQ; Kennedy et al., 1993); Acceptability Credibility Expectancy Questionnaire (CEQ; Borkovec & Nau 1972); Satisfaction with the VR program (ad-hoc measurement)

3. Expected results: We anticipate that the VR-based program will lead to an increase in ABF levels among participants and that they will respond positively to it, expressing good levels of satisfaction and acceptance while experiencing few or no negative side effects. Should the program prove effective, it would provide healthcare professionals with an effective, innovative, and valuable resource for treating individuals with LBP.

ABSTRACT. Problematic. Women who have experienced sexual assault are at risk of developing posttraumatic stress disorder (PTSD) and negative posttraumatic cognitions such as self-blame. Cognitive behavioral therapies (CBT) for PTSD are effective treatments for these symptoms, but this population’s access to face-to-face therapies is limited. Online self-treatment, with or without professional support, is an accessible and effective treatment modality. However, low engagement has been observed in several studies on self-treatments, which may indicate a lack of acceptability of the assessed interventions. Personalizing an e-health intervention to the characteristics and needs of a target population is associated with better adherence, but few studies have isolated the effect of this strategy on acceptability and effectiveness. Gamification is a design strategy that involves incorporating game elements into a system to enhance user experience. This strategy is associated with improved engagement and e-health intervention effectiveness, but data on gamification in e-mental health are limited. Objectives. The objective of this pilot study is to test the impact of an online intervention personalized to women who have experienced sexual assault and adapted using gamification principles on PTSD, anxiety and depression symptom severity, posttraumatic cognitions, acceptability and user experience. Method. Twelve participants were recruited through emails sent to the Laval University community and announcements on the Facebook social network. Inclusion criteria were to (a) identify as female; (b) be at least 18 years old; (c) report having experienced at least one sexual assault since the age of 12 years; d) have a score of at least 10 on the Posttraumatic Stress Disorder Symptoms Checklist for DSM-5 (PCL-5); and e) have a score of at least 3 on the Posttraumatic Maladaptive Beliefs Scale (PMBS). Participants completed the gamified and personalized version of an online cognitive restructuring intervention over a period of five weeks. Self-report questionnaires to measure PTSD symptoms (PCL-5), posttraumatic cognitions (PMBS), self-blame (Rape Attribution Questionnaire [RAQ]), anxiety (General Anxiety Disorder-7 [GAD-7]), and depression (Patient Health Questionnaire-9 [PHQ-9]) were completed before, during (after the 3rd session) and after the intervention. Questionnaires assessing acceptability (Acceptability E-Scale) and user experience (Attrakdiff2) were completed after the intervention. Intervention. The intervention was developed using the cognitive restructuring component of the original online self-treatment RESILIENT (www.resilient.ulaval.ca). The personalized and gamified intervention includes psychoeducation on PTSD, a description of posttraumatic cognitions and cognitive distortions, as well as several exercises to apply cognitive restructuring. The content and examples have been adapted for women who have experienced sexual assault, and gamification principles were incorporated (for example, interactive feedback and a progress bar). Results. Experimentation being underway, preliminary analyses were conducted with 7 of the 12 participants (results for all participants will be presented at the conference). Mixed-models repeated-measure analyses of variance showed significant decreases on the PCL-5 and GAD-7 total scores. Significant decreases were also observed on the PMBS total score and the RAQ self-blame subscale. No significant effects were observed on the PHQ-9 total score (p > .05). A high level of acceptability was observed for the Satisfaction and Usability dimensions of the Acceptability E-Scale, as well as a good user experience for the Identification and Pragmatic dimensions of the Attrakdiff2. Discussion. These preliminary results suggested that the personalized and gamified online intervention decreases PTSD and anxiety symptom severity, posttraumatic cognitions, and self-blame. The results also suggested that the intervention is acceptable and associated with a good user experience. These pilot data will lead to the development of a randomized controlled trial to compare the effectiveness, acceptability and user experience of RESILIENT personalized and gamified version compared to its original version.

ABSTRACT. Background: Autism Spectrum is a neurodevelopmental disorder, in which individuals may show intellectual disability, deficits of social communication and interaction, excessively repetitive behaviors, restricted interests and insistence on sameness. Children and adolescents with ASD constantly experience difficulties in their daily lives due to their lack of social skills such as interpreting social cues, empathy, and communicating effectively, limiting the ability to establish social relationships. These disabilities can lead to adverse childhood experiences such as social isolation, bullying, depression, anxiety, having social and academic negative impact. Considering that social skills are fundamental for the cognition development and adaptability of children, different innovative therapies have been established according to the different needs of children with ASD. A systematic review about the uses of cognition training technologies in the treatment of ASD, commonly reported that patients who used technology reported enjoyable therapies because it requires attention to detail, it is generally predictable, and is emotional-free. Additionally, studies about the effectiveness of Virtual Reality (VR) as a treatment for ASD, shows an improvement in activities in daily life and communication, especially social and emotional skills. Objective: The project aims to immerse children and adolescents with ASD, Social Anxiety and/or Selective Mutism in a VR school that mimics a real one, where they will train social skills under the guidance of a therapist. Method: The participants will be children and adolescents with ASD, Social Anxiety and/or Selective Mutism, aged between 8 and 15 years old. The system will use Unity Personal, powered by Unity Hub 3.4.1, for scene development and interaction design, and use C# style coding to develop interactive actions, and to record user behavior and analyze the data collected by the collector. Measure: The performance of the participants will be recorded by system automatically upon being notified. After proper preprocessing, the data will be analyzed using Social Anxiety Scale, Performance Anxiety State-Trait Anxiety Inventory (STAI), General Self-Efficacy Scale (GSE) And Social Communication Questionnaire (SCQ). Procedures: The project will consist of a VR school, in which participants will train their social skills through six different activities, where they will have verbal dialogues with their parents, classmates and professors, create relationships with their peers, respond to tasks assigned by the teacher while having psychological intervention.

ABSTRACT. Adjustment Disorder (AJD) is defined as a set of negative emotional and behavioral reactions that appear after a stressful life event or facing adversity (APA, 2013). Common classification systems like DSM 5 and ICD-10 have been criticized due to the inaccuracy of the symptoms in terms of number, duration, and combination. This makes it difficult to differentiate between AJD and other common disorders such as depression one. Also, in these systems, there is no clear distinction between a normal and maladaptive emotional response to the experience of a stressor (Bachem & Casey, 2018). To address these limitations ICD-11 (WHO,2018) removes AJD from a subclinical status to a complete diagnosis with delimited diagnostic criteria. Main change in this classification is the identification of two core symptoms: (1) worry about the stressor and its consequences and (2) failure to adapt. There is a significant lack of standardized measures to assess AJD. The New Module for the Measurement of Adjustment Disorder (ADNM-20; Einsle et al., 2010; Glaesmer et al., 2015) is a German self-report questionnaire, based on the diagnostic criteria recently proposed by the ICD-11 which contemplates two central symptoms: worry and failure to adapt and four accessory symptoms: anxiety, depression, avoidance, and impulsivity. It is composed of 20 items and is divided into two sections, first one presents a list of 18 stressors that collect a wide range of acute and chronic life events in the last two years, and the second part assesses the frequency and duration of symptoms in response to stressful events on a Likert-type scale ranging from 1 (never) to 4 (often) and < 1 month, 1 to 6 months and 6 months to 2 years, respectively. Despite research has shown its adequate psychometric properties, there is still no solid evidence of its dimensionality (Einsle et al., 2010). Aim: To carry out the validation of the ADNM-20 in Mexican socio-cultural context in general population. Method: ADNM-20 was translated into Spanish and submitted to a judgment of seven experts who provided suggestions about the linguistic relevance of the items, the corrections were carried out until a culturally adapted version was obtained, 285 people between 18 and 70 years answered a digital survey composed of the adaptation Mexican ADNM-20, the Checkable List of Posttraumatic Stress Disorder for the DSM-5, it was used to assess convergent validity and The Abbreviated Multidimensional Scale of Coping Styles, to assess discriminant validity. Results: 77% of the sample were female, vast majority were single (60%) and currently worked (45%). Main stressors informed by participants were the illness of a loved one and family problems (59%), overwork/low workload (57.4%), financial problems (53.7%), pressure for deadlines (49.8%), and death of a loved one (47%). Following algorithm proposed by Lorenz et al. (2016) to identify people at high risk for an AJD diagnosis, about 52% of the population were at high risk. Exploratory factorial analysis suggested the structure of a single factor composed of 14 items that was confirmed after a confirmatory factorial analysis. Internal consistency index was adequate (α=.937), discriminant validity measures showed moderate to high negative correlations with active coping (problem-focused coping) and coping through social support (emotion-focused coping). Scale invariance was showed when comparing different restriction models according to two age groups: young (18-30 years old) and old adults (31-60 years old). Conclusions: The results suggest that in Mexican population the adjustment disorder is reflected as a single entity represented on a one-dimensional scale, with several reduced questions and with adequate psychometric properties.

ABSTRACT. Background: This study aims to in vestigate the relationship between fear of falling, sense of presence, and physiological data in healthy individuals. Fear of falling is a common problem among older adults, people with physical impairment, and obesity which can limit their mobility and reduce their quality of life (De Albuquerque Angelo et al., 2022 & Ercan et al., 2019). Understanding the psychological and physiological mechanisms underlying this fear 1S essential to develop effective interventions to improve their mobility and well-being (Raffegeau et al., 2022). The hypotheses of this study are that fear of falling will Increase the sense of presence environments with the possibility to fall, and higher physiological activation will be associated with higher scores in fear of falling and anxiety scales. 'This study will contribute to our understanding of the relationship between fear of falling, sense of presence, and physiological data in healthy individuals and the results may have implications for the development of interventions to improve the mobility and quality of life of people with fear of falling, physical impairment, and obesity. Method: To test these hypotheses, we will recruit 30 healthy participants (15 women and 15 men) aged between 18 and 35 years old. Participants will complete series of a questionnaires to assess their levels of anxiety, including the State-Trait Anxiety Inventory (STAI). They will also undergo physiological measurements, including resprration, galvanic response, and heart rate, while exposed to the virtual reality environments with and without possibility to fall. To assess fear of falling, wve will use the Falls Efficacy Scale (FEIS-I) (Yardley et al., 2005), a self-reported questionnaire designed to measure confidence in performing daily activities without falling. We will also use a platform that measures balance and changes in posture to evaluate the participants physical ability to maintain balance. The Romberg test, with eyes closed and open, will also be used to assess the participants ability to maintain balance while standing still. The statistical analysis will consist in performing a correlation test to determine the relationship between fear of falling, sense of presence, and physiological data. Additionally, a multivariate analysis of variance (MANOVA) can be conducted to examine the effects of the virtual reality environments on physiological measures (respiration, galvanic response, and heart rate), anxiety levels, balance, and fear of falling.