Our lives have drastically changed during the COVID-19 pandemic. Information and communications technologies (ICTs) have replaced other media as the primary means of work, communication, expression, and entertainment throughout this time. As society's reliance on technology increases throughout and possibly after the pandemic, it is critical to fully understand the multifaceted nature of engagement with technology and develop reliable instruments capable of accurately evaluating its processual nature. Therefore, this study aimed at describing and psychometrically validating a novel instrument to measure the dynamics of engagement with technology, namely the Technology Engagement Scale (TES). Data were collected from a representative sample of 2021 participants in Italy. Results from both the confirmatory analysis and the Rasch model suggested the mono-dimensionality of the 5-item TES. Moreover, empirical ordinal alpha indicated a very good internal consistency. Findings provide also solid evidence for the convergent validity of the proposed instrument. Finally, it emerged that TES levels were able to predict the frequency of online activities during the COVID-19 pandemic. Globally, these findings suggest that the TES could be considered a reliable and valid tool, able to evaluate the complex process of engagement with technology in a simple, quick, and easy-to-administer manner.

‘BenEssere Mamma’ app is a mobile self-help intervention containing mindfulness meditations and ‘savoring the present moment’ exercises for use during pregnancy. The goal of this study is to investigate the effectiveness of this app in enhancing the psychological well-being of healthy childbearing women. A quasi-experimental controlled study was conducted with 74 pregnant women randomly assigned to experimental group (APP – mobile app and antenatal care) or control group (routine antenatal care). Participants were assessed on their psychological well-being before, after the 4 weeks of use of the app, and after the childbirth, using Ryff’s Psychological Well-Being Scale. Women’s acceptance and user experience with the app were also assessed through an ad hoc questionnaire. Experimental group reported an increase in sense of autonomy after intervention and after childbirth, and greater self-acceptance after the childbirth compared to the control group. Results are promising and future investigations are needed to understand if a more interactive or a longer intervention could lead to more effective results and if other populations could benefit of this opportunity. Furthermore, to take advantage of potentialities of mobile apps for promoting well-being in pregnant women, the integration of these tools within a wide public health project is encouraged.

Recent years have seen a growing research interest towards designing computer-assisted health interventions aiming to improve mental health services. Digital technologies are becoming common methods for diagnosis, therapy, and training. With the advent of lower-cost VR head-mounted-displays (HMDs) and high internet data transfer capacity, there is a new opportunity for applying immersive VR tools to augment existing interventions. This study is among the first to explore the use of a Multi-User Virtual Reality (MUVR) system as a therapeutic medium for participants at high-risk for developing Eating Disorders. This paper demonstrates the positive effect of using MUVR remote psychotherapy to enhance traditional therapeutic practices. The study capitalises on the opportunities which are offered by a MUVR remote psychotherapeutic session to enhance the outcome of Acceptance and Commitment Therapy, Play Therapy and Exposure Therapy for sufferers with body shape and weight concerns. Moreover, the study presents the design opportunities and challenges of such technology, while strengths on the feasibility, and the positive user acceptability of introducing MUVR to facilitate remote psychotherapy. Finally, the appeal of using VR for remote psychotherapy and its observed positive impact on both therapists and participants is discussed.

Attention, control inhibition, and visual-spatial working memory represent the three basic sets of cognitive processes involving on executive functions (EF). Basic EF are relevant abilities in daily life that allow to control and monitor adapted behaviors in order to achieve specific goals. In the educational field, EF are related to academic achievement, social functioning, as well as the inhibition of maladaptive behaviors. Their impairment often leads to an incapacity to perform multiple and simultaneous mental activities, as well as to plan and monitor learning. The main aim of cognitive neuropsychology intervention is to identify effective methods that allow transferring trained strategies and abilities to daily life. Accordingly, virtual reality games (VRG) are showing ecological validity effectiveness in EF training. In this framework, the aim of this study was to examine the effectiveness of a VRG cooking-based for improving basic EF processing. 31 healthy subjects (M=24.3; SD=2.51) participated to 3 training sessions of 25 minutes each. Each session involved 6 VRG characterized by different levels of difficulties. Three traditional measures were administered to participants pre- and post-VRG: The Corsi test for assessing visual-spatial working memory, the Dual-task, and the Flanker task for attention and inhibition control respectively. The results reported a significant improvement of the three EF abilities after training, showing the potential effectiveness of a VRG along with the traditional measures. Future studies on students with learning disabilities are needed to compare performance and effectiveness.

Abstract Recently, computer-mediated communication has incorporated animated characters (ACs) as interface technologies. These digital entities are animated by mimicry and can be used either to deliver pre-recorded messages or to live communicate with others. The interlocutors can choose the physical appearance of the character and decide to use a character that may or may not represent their actual self. In this respect, it is important to investigate the psychological mechanisms describing how the user responds to ACs and the resulting effects on communication. To do this, a 2 × 2 experiment was conducted (n = 85) to evaluate the effects of human-likeness (human-like vs. non-human-like) and self-representation (actual self vs. ideal self) on users’ subjective experience, in terms of para-social relationship, identification and emotions, and its effect on communication-related variables such as source credibility. Results showed that, unlike self-representation, human-likeness had a significant effect on the interaction between the user and an AC, with non-human-like ACs stimulating a more engaging and positive interaction compared with human-like ACs. Data also confirmed the importance of para-social relationship and identification in fostering source credibility. Theoretical and practical implications are discussed.

This paper reports the design and assessment of a neuro-fuzzy model to support clinicians during virtual reality therapy. The implemented model is able to automatically recognize the perceived stress levels of the patients by analyzing physiological and behavioral data during treatment. The model, consisting of a self-organizing map and a fuzzy-rule-based module, was trained unobtrusively recording electrocardiogram, breath rate and activity during stress inoculation provided by the exposure to virtual environments. Twenty nurses were exposed to sessions simulating typical stressful situations experienced at their workplace. Four levels of stress severity were evaluated for each subject by gold standard clinical scales administered by trained personnel. The model's performances were discussed and compared with the main machine learning algorithms. The neuro-fuzzy model shows better performances in terms of stress level classification with 83% of mean recognition rate. RESEARCH HIGHLIGHTS Stress levels were predicted on the basis of physiological computing using a neuro-fuzzy model during virtual reality therapy. Features were extracted from ECG and respiration obtaining high accuracy and optimization of computational costs. The neuro-fuzzy model shows better performance than the more frequently adopted classifiers. This approach may enhance the use of physiological computing for stress treatment in clinical practice.

The authors first give a brief overview of how computers can afford multiple forms of transformational experiences. Some of these experiences can be purposely designed, for example, to detect and regulate students' affective states to improve aspects of their learning experiences. They can also be used in computer-based psychological interventions that treat psychological illness or that preventively promote wellbeing, healthy lifestyles, and mental health. This special section aims to contribute ideas, methods and case studies for how affective computing can move toward the goal of promoting wellbeing. The papers spread across some of the multiple modalities and techniques used to perceive and detect affect from text, physiology facial expressions, and gaze, and some of the approaches to analyze the expression of sentiments shared via online communities by depressed patients. The articles in this special section discuss how information that computers collect about our behaviour, cognition - and particularly affect - can be used in the further understanding, nurturing or development of wellbeing and human strengths: e.g. self-understanding, empathy, intrinsic motivation toward wellbeing healthy lifestyles.

Different neuropsychological studies clearly show that the perception of our body and its surrounding space is not a given fact but it is influenced by the outcome of our actions (both direct and mediated by the use of tools). In this view, a possible starting point for a better understanding of Presence in computer-mediated interactions is the study of mediated action and its effects on our spatial experience. Following a cognitive perspective, the presented framework describes Presence as an intuitive feeling which is the outcome of an experience-based metacognitive judgment that controls our action. This process monitors pre-reflexively our activity by using an embodied intuitive simulation of the intended action developed through practice (implicit learning). When actions are implemented using one or more tools, it is possible to distinguish between two different types of mediated action: first-order (I use the body to control a proximal artifact, e.g. a tennis player striking the ball with the racquet) or second-order (I use the body to control a proximal artifact that controls a different distal one, e.g. a cranemen using a lever to move a mechanical boom to lift materials). These two mediated actions, when produced intuitively, have different effects on our experience of body and space: a successfully learned first-order mediated action produces incorporation – the proximal tool extends the peripersonal space of the subject – while a successfully learned second-order mediated action produces also incarnation – a second peripersonal space centered on the distal tool.

Is it possible to experience more presence in doing the same thing in virtual reality than in reality? According to the well known definition of presence as “disappearance of mediation”, the answer is no: technology is a barrier, a mediating tool that can only reduce the level of presence experienced in an interaction. However, the increasing diffusion of a technology like augmented reality that adds a technological layer of information to the real world suggests the opposite: the experience of “being there” may be influenced by the ability of “making sense there”. To explore this issue we used a sample of 20 university students to evaluate the level of presence experienced in two different settings: an immersive virtual reality job simulation and a real world simulation that was identical to its VR counterpart (same interviewer, same questions) but without technological mediation and without any social and cultural cues in the environment that may give a better meaning to both the task and its social context. Self-report data, and in particular the scores in the Spatial Presence and the Ecological Validity ITC-SOPI scales, suggest that experienced presence was higher during the virtual interview than in the real world simulation. This interpretation was confirmed by subjective (higher in VR) but not by objective (Skin Conductance) anxiety scores. These data suggest a vision of presence as a social construction, in which reality is co-constructed in the relationship between actors and their environments through the mediation of physical and cultural artifacts.

As researchers and practitioners we have been exploring the topic of presence, and in particular the contribution of the sense presence to interactive experiences, for several years. We have learned that the user experience of information technology is profoundly affected by the extent to which we experience ourselves to be really present in the mediated world that the technology makes available to us. Over the last two decades, many researchers, artists and designers have explored the role of the sense of presence in interactive experience (so-called ‘mediated presence’). While there is still not a general consensus about what presence actually is, it is fair to say that most investigators agree about what it is not. Presence is not the degree of technological immersion, it is not the same thing as emotional engagement, it is not absorption or attention or action; but all of these and several other factors have a potential role in understanding the experience of presence in interaction.

Stress and its related comorbid diseases are responsible for a large proportion of disability worldwide. In particular, chronic stress is the main responsible for the dramatic increase of premature mortality in the Western countries. However, advanced simulation and sensing technologies, such as virtual reality and mobile biosensors offer interesting opportunities for innovative personal health-care solutions to stress. In this work, we describe a technology-based approach to the assessment and treatment of stress that is based on the vision of Interreality. The main feature of interreality is the creation of a hybrid-augmented experience merging the physical and virtual world. This is achieved through: a) an extended sense of presence: in interreality advanced simulations (3-D virtual worlds) are used to transform health guidelines and provisions into experience; b) an extended sense of community (social presence): interreality uses hybrid social interaction and dynamics of group sessions to provide each user with targeted social support in both the physical and virtual world; c) real-time feedback between the physical and virtual worlds: interreality uses bio and activity sensors and devices (e.g. smartphones) to track both the behavior and the health status of the user in real time and to provide targeted suggestions and guidelines. The feedback activity is twofold: (1) behavior in physical world influences the experience in the virtual one, and (2) behavior in the virtual world influences the experience in the real one.

The main goal of this paper is to preliminarily evaluate the efficacy of a virtual-reality (VR)-based multidimensional approach in the treatment of body image attitudes and related constructs. The female binge eating disorder (BED) patients (n = 20), involved in a residential weight control treatment including low-calorie diet (1200 cal/day) and physical training, were randomly assigned either to the multidimensional VR treatment or to psychonutritional groups based on the cognitive-behavior approach. Patients were administered a battery of outcome measures assessing eating disorders symptomathology, attitudes toward food, body dissatisfaction, level of anxiety, motivation for change, level of assertiveness, and general psychiatric symptoms. In the short term, the VR treatment was more effective than the traditional cognitive-behavioral psychonutritional groups in improving the overall psychological state of the patients. In particular, the therapy was more effective in improving body satisfaction, self-efficacy, and motivation for change. No significant differences were found in the reduction of the binge eating behavior. The possibility of inducing a significant change in body image and its associated behaviors using a VR-based short-term therapy can be useful to improve the body satisfaction in traditional weight reduction programs. However, given the nature of this research that does not include a followup study, the obtained results are preliminary only.

The great potential offered by virtual reality (VR) to clinical psychologists derives prevalently from the central role, in psychotherapy, occupied by the imagination and by memory. These two elements, which are fundamental in our life, present absolute and relative limits to the individual potential. Using VR as an advanced imaginal system-an experience that is able to reduce the gap existing between imagination and reality-it is possible to transcend these limits. In this sense, VR can improve the efficacy of a psychological therapy for its capability of reducing the distinction between the computer's reality and the conventional reality. Two are the core characteristics of this synthetic imaginal experience: the perceptual illusion of nonmediation and the possibility of building and sharing a common ground. In this sense, experiencing presence in a clinical virtual environment (VE), such as a shared virtual hospital, requires more than reproduction of the physical features of external reality. It requires the creation and sharing of the cultural web that makes meaningful, and therefore visible, both people and objects populating the environment.

Virtual reality (VR) is usually described in biology and in medicine as a collection of technologies that allow people to interact efficiently with three-dimensional (3-D) computerized databases in real time using their natural senses. This definition lacks any reference to head-mounted displays (HMDs) and instrumented clothing such as gloves or suits. In fact, less than 10% of VR healthcare applications in medicine are actually using any immersive equipment. However, if we focus our attention on behavioral sciences, where immersion is used by more than 50% of the applications, VR is described as an advanced form of human- computer interface that allows the user to interact with and become immersed in a computer-generated environment. This difference outlines a different vision of VR shared by psychologists, psychotherapists, and neuropsychologists: VR provides a new human-computer interaction paradigm in which users are no longer simply external observers of images on a computer screen but are active participants within a computer-generated 3-D virtual world. This special issue investigates this vision, presenting some of the most interesting applications actually developed in the area. Moreover, it discusses the clinical principles, human factors, and technological issues associated with the use of VR in the behavioral sciences.

Virtual environments (VE's) let users navigate and interact with computer-generated three-dimensional (3-D) environments in real time, allowing for the control of complex stimuli presentation. These VE's have attracted much attention in medicine, especially in remote or augmented surgery, and surgical training, which are critically dependent on hand-eye coordination. Recently, however, some research projects have begun to test the possibility of using VE's for the study and rehabilitation of human cognitive and functional activities. This paper highlights recent and ongoing research related to the applications of VE's in the neuroscience arena. In particular, it focuses on the American and European initiatives in this field, including a description of the European Commission (EC)-funded VREPAR projects. Finally, the paper provides a general introduction to virtual reality (VR), as it relates to its impact on cognitive and functional abilities.