Abstract
This paper presents the design, a pilot implementation and validation of eTher, an assistive virtual agent for acrophobia therapy in a Virtual Reality environment that depicts a mountain landscape and contains a ride by cable car. eTher acts as a virtual therapist, offering support and encouragement to the patient. It directly interacts with the user and changes its voice parameters – pitch, tempo and volume – according to the patient’s emotional state. eTher identifies the levels of relaxation/anxiety compared to a baseline resting recording and provides three modalities of relaxation - by determining the user to look at a favorite picture, listen to an enjoyable song or read an inspirational quote. If the relaxation modalities fail to be effective, the virtual agent automatically lowers the level of exposure. We have validated our approach with a number of 10 users who played the game once without eTher’s intervention and three times with assistance from eTher. The results showed that the participants succeeded to finish the game quicker in the last gameplay session where the virtual agent intervened. Moreover, their biophysical data showed significant improvements in terms of relaxation state.
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References
World Health Organization: Depression and other common mental disorders. Global health estimates. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf;jsessionid=4AB217A8ED8026E4C51BB9B57D58ADEE?sequence=1. Accessed 25 May 2020
Olesen, J.: Phobia statistics and surprising facts about our biggest fears. http://www.fearof.net/phobia-statistics-and-surprising-facts-about-our-biggest-fears/. Accessed 25 May 2020
Fadden, H.: Acrophobia (definition, causes, symptoms and treatment). https://www.thehealthyapron.com/acrophobia-definition-causes-symptoms-treatment.html. Accessed 25 May 2020
Berkley Wellness: The risks of anti-anxiety pills. https://www.berkeleywellness.com/healthy-mind/mood/sleep/article/risks-anti-anxiety-pills. Accessed 25 May 2020
Garcia-Palacios, A., Hoffman, H.G., See, S.K., Tsay, A., Botella, C.: Redefining therapeutic success with virtual reality exposure therapy. CyberPsychol. Behav. 4, 341–348 (2001)
Bălan, O., Moise, G., Moldoveanu, A., Leordeanu, M., Moldoveanu, F.: Automatic adaptation of exposure intensity in VR acrophobia therapy, based on deep neural networks. In: Twenty-Seventh European Conference on Information Systems (ECIS2019), Stockholm-Uppsala, Sweden (2019)
Bălan, O., Moise, G., Moldoveanu, A., Leordeanu, M., Moldoveanu, F.: Does automatic game difficulty level adjustment improve acrophobia therapy? Differences from baseline. In: 24th ACM Symposium on Virtual Reality Software and Technology, Tokyo, Japan (2018)
Bălan, O., Moise, G., Moldoveanu, A., Leordeanu, M., Moldoveanu, F.: An investigation of various machine and deep learning techniques applied in automatic fear level detection and acrophobia virtual therapy. Sensors 20, 496 (2020)
Moldoveanu, A., et al.: The TRAVEE system for a multimodal neuromotor rehabilitation. IEEE Access 7, 8151–8171 (2019). https://doi.org/10.1109/access.2018.2886271
Ferche, O., et al.: From neuromotor command to feedback: a survey of techniques for rehabilitation through altered perception. In: 2015 E-Health and Bioengineering Conference (EHB), Iasi, pp. 1–4 (2015). https://doi.org/10.1109/ehb.2015.7391454
Hodges, L.F., et al.: Virtual environments for treating the fear of heights. Computer 28(7), 27–34 (1995). https://doi.org/10.1109/2.391038. Accession Number: 5033494
Coelho, C.M., Waters, A.M., Hine, T.J., Wallis, G.: The use of virtual reality in acrophobia research and treatment. J. Anxiety Disord. 23(5), 563–574 (2009). https://doi.org/10.1016/j.janxdis.2009.01.014
Freeman, D., et al.: Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychol. Med. 47, 2393–2400 (2017). https://doi.org/10.1017/s003329171700040x
Freeman, D., et al.: Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial. Lancet Psychiatry 5, 625–632 (2018)
Donker, T., et al.: Effectiveness of self-guided app-based virtual reality cognitive behavior therapy for acrophobia: a randomized clinical trial. JAMA Psychiatry 76(7), 682–690 (2019). https://doi.org/10.1001/jamapsychiatry.2019.0219
Levy, F., Leboucher, P., Rautureau, G., Jouvent, R.: E-virtual reality exposure therapy in acrophobia: A pilot study. Journal of telemedicine and telecare 22(4), 215–220 (2016). https://doi.org/10.1177/1357633x15598243
Hu, F., Wang, H., Chen, J., Gong, J.: Research on the characteristics of acrophobia in virtual altitude environment. In: Proceedings of the 2018 IEEE International Conference on Intelligence and Safety for Robotics, Shenyang, China, August 24–27, 2018 (2018)
Carl, E., et al.: Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. J. Anxiety Disord. 61, 27–36 (2019)
Boucsein, W.: Electrodermal Activity. Springer, Cham (2012). https://doi.org/10.1007/978-1-4614-1126-0
Steinman, S.A., Teachman, B.A.: Cognitive processing and acrophobia: validating the heights interpretation questionnaire. J. Anxiety Disord. 25, 896–902 (2011). https://doi.org/10.1016/j.janxdis.2011.05.001
Huppert, D., Grill, E., Brandt, T.: A new questionnaire for estimating the severity of visual height intolerance and acrophobia by a metric interval scale. Front. Neurol. 8, 211 (2017)
Cohen, D.C.: Comparison of self-report and behavioral procedures for assessing acrophobia. Behav. Ther. 8, 17–23 (1977)
Müller, J.P.: The Design of Intelligent Agents. LNCS, vol. 1177. Springer, Heidelberg (1996). https://doi.org/10.1007/BFb0017806. ISBN:978-3540620037
Nakano, M., et al.: A two-layer model for behavior and dialogue planning in conversational service robots. In: Proceedings of IEEE-IROS-05, pp. 1542–1547 (2005)
Shimmer Sensing GSR Unit. https://www.shimmersensing.com/products/shimmer3-wireless-gsr-sensor. Accessed 25 May 2020
Borkowska, B., Pawlowski, B.: Female voice frequency in the context of dominance and attractiveness perception. Anim. Behav. 82(1), 55–59 (2011)
Lee, G.Y., Kisilevsky, B.S.: Fetuses respond to father’s voice but prefer mother’s voice after birth. Dev. Psychobiol. 56(1), 1–11 (2014)
Sokhi, D.S., Hunter, M.D., Wilkinson, I.D., Woodruff, P.W.: Male and female voices activate distinct regions in the male brain. Neuroimage 27(3), 572–578 (2005)
Re, D.E., O’Connor, J.J., Bennett, P.J., Feinberg, D.R.: Preferences for very low and very high voice pitch in humans. PLoS ONE 7(3), 32719 (2012)
Audacity. https://www.audacityteam.org/. Accessed 25 May 2020
Ledalab. http://www.ledalab.de/. Accessed 25 May 2020
Benedek, M., Kaernbach, C.: Decomposition of skin conductance data by means of nonnegative deconvolution. Psychophysiology 47, 647–658 (2010)
Acknowledgements
The work has been funded by the Operational Programme Human Capital of the Ministry of European Funds through the Financial Agreement 51675/09.07.2019, SMIS code 125125, UEFISCDI proiect 1/2018 and UPB CRC Research Grant 2017.
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Bălan, O. et al. (2020). eTher – An Assistive Virtual Agent for Acrophobia Therapy in Virtual Reality. In: Stephanidis, C., Chen, J.Y.C., Fragomeni, G. (eds) HCI International 2020 – Late Breaking Papers: Virtual and Augmented Reality. HCII 2020. Lecture Notes in Computer Science(), vol 12428. Springer, Cham. https://doi.org/10.1007/978-3-030-59990-4_2
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