Search Results (30)

Fear of needles is common among child patients. It causes stress and can lead to difficulty in procedures and future treatment avoidance. Virtual reality (VR) has emerged as a promising tool to reduce pain and anxiety non-pharmacologically. However, a research gap exists regarding what VR content is most effective in decreasing periprocedural stress. This article reports a VR feasibility study conducted with 83 child patients aged 8–12 years during a cannulation procedure. It has a between-subjects design with four groups, comparing deep breathing and mindfulness-based relaxation in a virtual nature environment (VNE) to passive VNE and standard care. The results from both relaxation exercise groups have been previously reported. This follow-up article adds findings from passive VNE and control groups, comparing all four for effectiveness and patient experience. The key findings highlight that deep breathing was highly effective according to heart rate variability (HRV) data, but less enjoyable than the mindfulness-based relaxation, which achieved higher patient satisfaction but was less effective according to HRV. Passive VNEs were pleasant but did not cause measurable stress reduction. All VR interventions improved patient experience over standard care. Relaxation exercises in a VNE reduce periprocedural stress more efficiently than passive VNEs or standard care in pediatrics. Full article

Background/Objectives: Mental health and emotional well-being are critical yet often overlooked in older adults. Immersive virtual reality (VR) may offer novel strategies for promoting relaxation in this population, but the diversity of intervention designs and underlying mechanisms remains insufficiently mapped. This scoping review aimed to systematically examine head-mounted display (HMD) VR interventions for relaxation in older adults, focusing on core scenarios, mechanisms, and conceptual paradigms. Methods: Following the JBI Manual for Evidence Synthesis and PRISMA-ScR guidelines, comprehensive searches of MEDLINE, Cochrane Library, Web of Science, and Scopus were conducted for empirical studies of HMD-based VR relaxation interventions in adults aged 60 and older. Data on study characteristics, hardware, intervention scenarios, and reported physiological and psychological mechanisms were extracted and categorized into conceptual paradigms. Results: Twenty-four studies were included, covering diverse clinical and community samples. Four main VR relaxation paradigms emerged: environmental relaxation, guided meditation, psychotherapy integration, and interactive gamified relaxation. Reported mechanisms included parasympathetic activation, multisensory immersion, attentional distraction, positive affect induction, mindfulness, cognitive engagement, and reminiscence activation. Considerable heterogeneity was found in intervention design and outcomes, with mechanisms often inferred rather than directly described. Conclusions: Similar relaxation mechanisms were engaged across paradigms, including hybrid interventions combining multiple approaches, highlighting the adaptability of VR to meet diverse needs. Identifying these four paradigms provides a foundation for future research and development of targeted VR-based relaxation for older adults. Further studies should clarify mechanisms, use standardized physiological outcome measures, and assess long-term benefits of VR relaxation interventions in geriatric populations. Full article

(1) Background: Chronic pulmonary diseases (CPDs), such as COPD, asthma, and interstitial lung disease, are often accompanied by psychological distress and reduced quality of life. Mindfulness-Based Interventions (MBIs), including digital and virtual reality (VR) formats, have emerged as promising non-pharmacological approaches to improve symptom management and well-being. This systematic review aimed to evaluate the effectiveness of MBIs—delivered in-person or digitally—on anxiety, depression, disease-related stress, dyspnea, and health-related quality of life in individuals with CPDs. (2) Methods: A systematic review was conducted following PRISMA guidelines across PubMed, Scopus, and Web of Science (2005–2025). Thirteen studies (8 randomized controlled trials, 5 non-randomized) met inclusion criteria. Outcomes assessed included psychological distress, physical symptoms, and health-related quality of life (HRQoL). Risk of bias was evaluated using RoB 2 and ROBINS-I tools. (3) Results: MBIs were associated with improvements in anxiety, depression, stress, and HRQoL in several studies. Interventions were generally well-tolerated and effective across various delivery methods, including digital and VR-based formats. Improvements were especially notable when interventions were tailored and sustained. (4) Conclusions: MBIs, including digital and VR-delivered formats, show promise in supporting psychological and physical outcomes in CPD populations. They represent a feasible and complementary tool in modern respiratory care. Full article

This quantitative study investigates the effects of virtual reality immersion on enhancing scientific habits of mind (critical and creative thinking) through the mediation of flow experience, motivation, and self-regulation in high school biology classes in East Jerusalem. The random multi-stage cluster sample consisted of 347 high school students from three schools who learned biology concepts constructively during the first semester using VR-based instruction, complying with the principles of the Cognitive Affective Model of Immersive Learning (CAMIL). The results of PLS-SEM revealed that VRI significantly affected critical and creative thinking directly and indirectly. Cases of partial and complete mediation intervened, showing the effects of mediators on enhancing habits of mind through a sequence of mediation flowing from flow experience through motivation to self-regulation, which functioned as a key intermediary factor in the relationship between virtual reality immersion and habits of mind. Based on the results of the study, the complex structure warrants further investigation. The results of the study suggest that VRI’s impact on critical and creative thinking was intensified through mediation effects. In addition, the findings confirm that flow experience and motivation played essential roles in fostering a conducive learning environment that supports cognitive skill development. The results highlight that the enhancement of self-regulation was a necessary step for the enhancement of critical and creative thinking. The study recommends integrating VRI into teaching biology to enhance students’ higher-order thinking skills. Further studies on self-regulation should explore adaptive interventions that strengthen self-regulatory strategies to maximize the cognitive benefits of virtual reality immersion. Full article

Artificial intelligence (AI)-powered mental health chatbots have evolved quickly as scalable means for psychological support, bringing novel solutions through natural language processing (NLP), mobile accessibility, and generative AI. This systematic literature review (SLR), following PRISMA 2020 guidelines, collates evidence from 25 published, peer-reviewed studies between 2020 and 2025 and reviews therapeutic techniques, cultural adaptation, technical design, system assessment, and ethics. Studies were extracted from seven academic databases, screened against specific inclusion criteria, and thematically analyzed. Cognitive behavioral therapy (CBT) was the most common therapeutic model, featured in 15 systems, frequently being used jointly with journaling, mindfulness, and behavioral activation, followed by emotion-based approaches, which were featured in seven systems. Innovative techniques like GPT-based emotional processing, multimodal interaction (e.g., AR/VR), and LSTM-SVM classification models (greater than 94% accuracy) showed increased conversation flexibility but missed long-term clinical validation. Cultural adaptability was varied, and effective localization was seen in systems like XiaoE, okBot, and Luda Lee, while Western-oriented systems had restricted contextual adaptability. Accessibility and inclusivity are still major challenges, especially within low-resource settings, since digital literacy, support for multiple languages, and infrastructure deficits are still challenges. Ethical aspects—data privacy, explainability, and crisis plans—were under-evidenced for most deployments. This review is different from previous ones since it focuses on cultural adaptability, ethics, and hybrid public health incorporation and proposes a comprehensive approach for deploying AI mental health chatbots safely, effectively, and inclusively. Central to this review, symmetry is emphasized as a fundamental idea incorporated into frameworks for cultural adaptation, decision-making processes, and therapeutic structures. In particular, symmetry ensures equal cultural responsiveness, balanced user–chatbot interactions, and ethically aligned AI systems, all of which enhance the efficacy and dependability of mental health services. Recognizing these benefits, the review further underscores the necessity for more rigorous academic research into the development, deployment, and evaluation of mental health chatbots and apps, particularly to address cultural sensitivity, ethical accountability, and long-term clinical outcomes. Full article

In the context of sustainable architecture, buildings are no longer isolated entities but are integral components of a broader built environment that shapes and responds to human life. As part of this evolving architectural landscape, immersive digital cultural heritage spaces—such as virtual museums—are emerging as dynamic environments that contribute not only to cultural preservation but also to human well-being. This study examines how multisensory spatial design in virtual heritage environments can meet the physical, psychological, and emotional needs of users, aligning with the principles of smart, responsive architecture. A total of 325 participants experienced three immersive VR scenarios integrating different sensory inputs: visual–auditory, visual–auditory–tactile, and visual–auditory–olfactory. Through factor analyses, a three-dimensional model of user experience was identified, encompassing immersion, cultural engagement, and personalization. Structural equation modeling revealed that informational clarity significantly enhanced immersion (β = 0.617, p < 0.001), while emotional resonance was central to personalization (β = 0.571, p < 0.001). Moreover, ANOVA results indicated significant experiential differences among sensory conditions (F = 4.324, p = 0.014), with the visual–auditory modality receiving the highest user ratings. These findings demonstrate how digital cultural spaces—when designed with human sensory systems in mind—can foster emotionally rich, informative, and sustainable environments. By extending the role of architecture into the digital domain, this study offers insight into how technology, when guided by human-centered design, can create smart environments that support both ecological responsibility and enhanced human experience. Full article

Internet Gaming Disorder (IGD) has been recognized by the World Health Organization (WHO) in the International Classification of Diseases (ICD-11) and as an emerging condition in the DSM-5. IGD is increasingly prevalent, with various negative effects on individuals’ development and adaptation. To address this issue, different therapeutic interventions, like CBT, virtual reality, mindfulness, or family therapy, have been explored. This systematic review aimed to answer the following research question: What is the effectiveness of therapeutic interventions in reducing IGD symptoms in adolescents and young adults diagnosed with this disorder? Following PRISMA guidelines, 22 studies published between 2014 and 2025 were included. Results show that cognitive behavioral therapy (CBT) is the most effective intervention, significantly reducing IGD severity, anxiety, and depression. Combining CBT with physical exercise or mindfulness further enhanced outcomes. Other promising approaches include virtual reality (VR), transcranial direct current stimulation (tDCS), and family-based interventions. Additionally, treatments involving mindfulness and animal-assisted therapy showed potential in improving emotional regulation and interpersonal relationships. However, further research is needed to evaluate long-term efficacy and explore emerging therapies. Full article

The aging population increases the need for accessible interventions for cognitive training of the elderly to preserve cognitive health. Serious games have been widely used for this purpose, with many existing applications leveraging virtual reality (VR) technology. In contrast, this study explores the potential of augmented reality (AR) for cognitive training. The literature review shows that cognitive training interventions typically employ supermarket-themed serious games that are used extensively in such interventions. MarketMind AR is a supermarket-themed serious game that was created to train memory, attention, and executive function using mobile phone sensors such as cameras, accelerometers, and gyroscopes to interact and recognize the environment. Fifteen older adults participated in a three-attempt trial and completed the System Usability Scale (SUS), the in-game Game Experience Questionnaire (iGEQ), and an adapted version of the Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaires. Qualitative interviews and in-game data (e.g., completion times, PIN recall) were also examined. The results indicated that participants had a positive experience, confirming ease of use, immersive appeal, and perceived cognitive benefits, despite some difficulties with environment scanning and object detection. The results provide evidence that an AR supermarket game leveraging mobile sensors has the potential to be an effective cognitive training tool for older adults. Full article

Background: Serious games (SGs) are primarily aimed at promoting learning, skills training, and rehabilitation. Artificial intelligence, immersive technologies, the metaverse, and neurotechnologies promise the next revolution in gaming. Meta-skills are considered the “must-have” skills for thriving in the era of rapid change, complexity, and innovation. Μeta-skills can be defined as a set of higher-order skills that incorporate metacognitive, meta-emotional, and meta-motivational attributes, enabling one to be mindful, self-motivated, self-regulated, and flexible in different circumstances. Skillfulness, and more specifically meta-skills development, is recognized as a predictor of optimal performance along with mental and emotional wellness. Nevertheless, there is still limited knowledge about the effectiveness of integrating cutting-edge technologies in serious games, especially in the field of meta-skills training. Objectives: The current systematic review aims to collect and synthesize evidence concerning the effectiveness of advanced technologies in serious gaming for promoting meta-skills development. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was employed to identify experimental studies conducted in the last 10 years. Four different databases were employed: Web of Science, PubMed, Scopus, and Google Scholar. Results: Forty-nine studies were selected. Promising outcomes were identified in AI-based SGs (i.e., gamified chatbots) as they provided realistic, adaptive, personalized, and interactive environments using natural language processing, player modeling, reinforcement learning, GPT-based models, data analytics, and assessment. Immersive technologies, including the metaverse, virtual reality, augmented reality, and mixed reality, provided realistic simulations, interactive environments, and sensory engagement, making training experiences more impactful. Non-invasive neurotechnologies were found to encourage players’ training by monitoring brain activity and adapting gameplay to players’ mental states. Healthy participants (n = 29 studies) as well as participants diagnosed with anxiety, neurodevelopmental disorders, and cognitive impairments exhibited improvements in a wide range of meta-skills, including self-regulation, cognitive control, attention regulation, meta-memory skills, flexibility, self-reflection, and self-evaluation. Players were more self-motivated with an increased feeling of self-confidence and self-efficacy. They had a more accurate self-perception. At the emotional level, improvements were observed in emotional regulation, empathy, and stress management skills. At the social level, social awareness was enhanced since they could more easily solve conflicts, communicate, and work in teams. Systematic training led to improvements in higher-order thinking skills, including critical thinking, problem-solving skills, reasoning, decision-making ability, and abstract thinking. Discussion: Special focus is given to the potential benefits, possible risks, and ethical concerns; future directions and implications are also discussed. The results of the current review may have implications for the design and implementation of innovative serious games for promoting skillfulness among populations with different training needs. Full article

This study explores the use of immersive Virtual Reality (VR) cave environments to investigate hypotheses concerning altered states of consciousness, creativity, and flexible thinking in archaeological contexts. Building on the premise that ancient humans used caves as sites for rituals involving altered consciousness, we recreated a virtual cave environment to simulate these experiences and examine their impact on participants’ cognitive processes. Participants engaged in pareidolic tasks within both a virtual cave and a virtual open-space environment, allowing for comparative analysis of semantic network organization and subjective experiences. Our findings show that the cave environment elicited higher emotional arousal and spiritual engagement, as well as an improvement in the aspects of creativity and flexible thinking. These results suggest that VR can serve as a powerful tool in archaeology for reconstructing early humans’ experiences and investigating their psychological and cognitive states, thus providing new insights into their use of caves for mind-altering or ritualistic purposes. This interdisciplinary approach contributes to both cognitive archaeology and the development of immersive VR technologies in scientific research. Full article

Novel treatment approaches for Internet Gaming Disorder (IGD) include the use of mindfulness and technology-based interventions. Mindfulness has been shown as a protective factor against IGD, but the treatment dropout rates are high due to long sessions and treatment duration. Pathological gamers show approach bias towards technological gadgets, and the inclusion of Virtual Reality has been effective in IGD treatment. Due to the effectiveness of mindfulness and the attractiveness of VR, a combined intervention could decrease treatment time and willingness for treatment. Therefore, the aim of this study was to examine the effectiveness of a brief VR-based mindfulness intervention on IGD symptomatology. Nine participants meeting the IGD symptom criteria, ten recreational game users, and eight healthy controls without a gaming history participated in the study. The intervention consisted of four weekly 20-min-long Attentional Focus Mindfulness sessions. The results indicate a significant reduction in IGD symptoms and weekend gaming time in the treatment group. Despite the small sample size in the treatment group (n = 9) and lack of randomization, the findings constitute a valuable starting point. As a cost- and time-effective intervention, this approach could reduce dropout rates and increase treatment adherence, especially in younger gamers. Additional studies with a larger sample size, randomization, and a longitudinal approach are needed to further validate the found results. Full article

Background: Anxiety disorders significantly reduce patients’ quality of life. Current pharmacological treatments, primarily benzodiazepines and antidepressants, are associated with numerous side effects. Consequently, there is a continual search for alternative methods to traditional therapies that are less burdensome for patients and broaden their therapeutic options. Our objective was to determine the role of selected alternative methods in the treatment of anxiety disorders. Methods: In this review, we examined recent evidence on alternative treatments for anxiety disorders, including physical activity, mindfulness, virtual reality (VR) technology, biofeedback, herbal remedies, transcranial magnetic stimulation (TMS), cryotherapy, hyperbaric therapy, vagus nerve stimulation (VNS), 3,4-methylenedioxymethamphetamine (MDMA), electroconvulsive therapy (ECT), and eye movement desensitization and reprocessing (EMDR) therapy. For this purpose we reviewed PubMed and after initial search, we excluded works unrelated to our aim, non-orginal data and animal studies. We conducted second search to cover all minor methods. Results: We included 116 studies, which data is presented in Tables. We have investigated which methods can support treatment and which can be used as a stand-alone treatment. We assessed the risks to benefits of using alternative treatments. Conclusion: Alternative treatments significantly expand the options available to patients and clinicians, with many serving as adjuncts to traditional therapies. Among the methods presented, mindfulness has the most significant therapeutic potential. Full article

The need for sustainability-oriented K–12 engineering education that expands beyond the classroom and the increased accessibility of educational technologies create an opportunity for examining the affordances of educational technologies in low-stakes informal engineering education settings. In this paper, we share our experiences of using novel technologies to develop sustainability-oriented mental models in K–12 informal engineering education. Through the use of technologies including Augmented Reality (AR), Virtual Reality (VR), Minecraft video games, Tinkercad (browser-based application for computer-aided design (CAD)), and physical computing, we have designed and tested approaches to introduce students to engineering design and engineering habits of mind with an overarching theme of developing sustainability-oriented mental models among K–12 youth in informal engineering education spaces. In this paper, we share our approaches, and lessons learned, and outline directions for future research. Full article

Understanding and detecting human emotions is crucial for enhancing mental health, cognitive performance and human–computer interactions. This field in affective computing is relatively unexplored, and gaining knowledge about which external factors impact emotions could enhance communication between users and machines. Furthermore, it could also help us to manage affective disorders or understand affective physiological responses to human spatial and digital environments. The main objective of the current study was to investigate the influence of external stimulation, specifically the influence of different light conditions, on brain activity while observing affect-eliciting pictures and their classification. In this context, a multichannel electroencephalography (EEG) was recorded in 30 participants as they observed images from the Nencki Affective Picture System (NAPS) database in an art-gallery-style Virtual Reality (VR) environment. The elicited affect states were classified into three affect classes within the two-dimensional valence–arousal plane. Valence (positive/negative) and arousal (high/low) values were reported by participants on continuous scales. The experiment was conducted in two experimental conditions: a warm light condition and a cold light condition. Thus, three classification tasks arose with regard to the recorded brain data: classification of an affect state within a warm-light condition, classification of an affect state within a cold light condition, and warm light vs. cold light classification during observation of affect-eliciting images. For all classification tasks, Linear Discriminant Analysis, a Spatial Filter Model, a Convolutional Neural Network, the EEGNet, and the SincNet were compared. The EEGNet architecture performed best in all tasks. It could significantly classify three affect states with 43.12% accuracy under the influence of warm light. Under the influence of cold light, no model could achieve significant results. The classification between visual stimulus with warm light vs. cold light could be classified significantly with 76.65% accuracy from the EEGNet, well above any other machine learning or deep learning model. No significant differences could be detected between affect recognition in different light conditions, but the results point towards the advantage of gradient-based learning methods for data-driven experimental designs for the problem of affect decoding from EEG, providing modern tools for affective computing in digital spaces. Moreover, the ability to discern externally driven affective states through deep learning not only advances our understanding of the human mind but also opens avenues for developing innovative therapeutic interventions and improving human–computer interaction. Full article

Outdoor exercise is beneficial for psychophysical well-being. Limited studies have compared outdoor and virtual reality (VR) indoor physical activities, especially in coastal settings. Therefore, this study aimed to assess the impact of outdoor coastal walking and indoor walking in a VR simulation with a similar environment on physiological and psychological variables in healthy adults. A total of 26 subjects (14 M and 12 F, age 25.2 ± 2.5 years) voluntarily participated in this crossover randomized controlled and counterbalanced study and were allocated under three conditions: VR indoor walking (INVR), outdoor walking (OUT) and standard indoor walking (IN). IN and INVR conditions were performed on a treadmill (speed 4.5 km/h) and the OUT was performed on a seaside pedestrian road. The same outdoor environment was displayed in the visor during the INVR. Heart rate (HR_mean/max), physical activity enjoyment (PACES-It) and state of mindfulness for physical activity (SMS-PA) were assessed at the end of each condition. The OUT condition showed significantly greater PACES-It scores and HR_mean than IN and INVR (p < 0.001) and greater SMS-PA scores and HR_max than IN (p < 0.01 and p < 0.05, respectively). No significant differences were found between OUT and INVR regarding HR_max and SMS-PA scores (p > 0.05). Findings suggest that physical activity in an immersive technology may lead to physiological loads comparable to the outdoor environment. OUT is more enjoyable than IN and INVR but exhibits a mindfulness response comparable to INVR. Therefore, INVR could be an alternative to OUT for those who cannot engage in outdoor activities for various reasons. Full article