This review is designed to systematically examine the available evidence about virtual reality exposure therapy's (VRET) efficacy for phobias, critically describe some of the most important challenges in the field and discuss possible directions. Evidence reveals that virtual reality (VR) is an effective treatment for phobias and useful for studying specific issues, such as pharmacological compounds and behavioral manipulations, that can enhance treatment outcomes. In addition, some variables, such as sense of presence in virtual environments, have a significant influence on outcomes, but further research is needed to better understand their role in therapeutic outcomes. We conclude that VR is a useful tool to improve exposure therapy and it can be a good option to analyze the processes and mechanisms involved in exposure therapy and the ways this strategy can be enhanced. In the coming years, there will be a significant expansion of VR in routine practice in clinical contexts.

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Recent Progress in Virtual Reality Exposure Therapy for Phobias: A Systematic Review

The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate, however, VR content also plays a significant role. The primary objective of this systematic review and meta-analysis was to examine the literature on HMDs that report Simulator Sickness Questionnaire (SSQ) scores to determine the impact of content. User factors associated with VR sickness were also examined. A systematic search was conducted according to PRISMA guidelines. Fifty-five articles met inclusion criteria, representing 3,016 participants (mean age range 19.5-80; 41% female). Findings show gaming content recorded the highest total SSQ mean 34.26 (95%CI 29.57-38.95). VR sickness profiles were also influenced by visual stimulation, locomotion and exposure times. Older samples (mean age ≥35 years) scored significantly lower total SSQ means than younger samples, however, these findings are based on a small evidence base as a limited number of studies included older users. No sex differences were found. Across all types of content, the pooled total SSQ mean was relatively high 28.00 (95%CI 24.66-31.35) compared with recommended SSQ cut-off scores. These findings are of relevance for informing future research and the application of VR in different contexts.

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Factors Associated With Virtual Reality Sickness in Head-Mounted Displays: A Systematic Review and Meta-Analysis

Lapses of attention are commonplace, potentially because they are detected too late to be prevented. The authors use real-time fMRI to provide participants continuous access to their attentional state. Real-time feedback, particularly from frontoparietal cortex, improved sustained attention abilities and modified representations in visual cortex and basal ganglia.

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Closed-loop training of attention with real-time brain imaging

This paper describes Guided Search 6.0 (GS6), a revised model of visual search. When we encounter a scene, we can see something everywhere. However, we cannot recognize more than a few items at a time. Attention is used to select items so that their features can be "bound" into recognizable objects. Attention is "guided" so that items can be processed in an intelligent order. In GS6, this guidance comes from five sources of preattentive information: (1) top-down and (2) bottom-up feature guidance, (3) prior history (e.g., priming), (4) reward, and (5) scene syntax and semantics. These sources are combined into a spatial "priority map," a dynamic attentional landscape that evolves over the course of search. Selective attention is guided to the most active location in the priority map approximately 20 times per second. Guidance will not be uniform across the visual field. It will favor items near the point of fixation. Three types of functional visual field (FVFs) describe the nature of these foveal biases. There is a resolution FVF, an FVF governing exploratory eye movements, and an FVF governing covert deployments of attention. To be identified as targets or rejected as distractors, items must be compared to target templates held in memory. The binding and recognition of an attended object is modeled as a diffusion process taking > 150 ms/item. Since selection occurs more frequently than that, it follows that multiple items are undergoing recognition at the same time, though asynchronously, making GS6 a hybrid of serial and parallel processes. In GS6, if a target is not found, search terminates when an accumulating quitting signal reaches a threshold. Setting of that threshold is adaptive, allowing feedback about performance to shape subsequent searches. Simulation shows that the combination of asynchronous diffusion and a quitting signal can produce the basic patterns of response time and error data from a range of search experiments.

Guided Search 6.0: An updated model of visual search

This article extends psychological methods and concepts into a domain that is as profoundly consequential as it is poorly understood: intelligence analysis. We report findings from a geopolitical forecasting tournament that assessed the accuracy of more than 150,000 forecasts of 743 participants on 199 events occurring over 2 years. Participants were above average in intelligence and political knowledge relative to the general population. Individual differences in performance emerged, and forecasting skills were surprisingly consistent over time. Key predictors were (a) dispositional variables of cognitive ability, political knowledge, and open-mindedness; (b) situational variables of training in probabilistic reasoning and participation in collaborative teams that shared information and discussed rationales (Mellers, Ungar, et al., 2014); and (c) behavioral variables of deliberation time and frequency of belief updating. We developed a profile of the best forecasters; they were better at inductive reasoning, pattern detection, cognitive flexibility, and open-mindedness. They had greater understanding of geopolitics, training in probabilistic reasoning, and opportunities to succeed in cognitively enriched team environments. Last but not least, they viewed forecasting as a skill that required deliberate practice, sustained effort, and constant monitoring of current affairs.

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The psychology of intelligence analysis: drivers of prediction accuracy in world politics.

Accuracy is paramount in radiology and security screening, yet many factors undermine success Target prevalence is a particularly worrisome factor, as targets are rarely present (eg, the cancer rate in mammography is ~05%), and low target prevalence has been linked to increased search errors More troubling is the fact that specific target types can have extraordinarily low frequency rates (eg, architectural distortions in mammography-a specific marker of potential cancer-appear in fewer than 005% of cases) By assessing search performance across millions of trials from the Airport Scanner smartphone application, we demonstrated that the detection of ultra-rare items was disturbingly poor A logarithmic relationship between target detection and target frequency (adjusted R (2) = 92) revealed that ultra-rare items had catastrophically low detection rates relative to targets with higher frequencies Extraordinarily low search performance for these extraordinarily rare targets-what we term the ultra-rare-item effect-is troubling given that radiological and security-screening searches are primarily ultra-rare-item searches

The Ultra-Rare-Item Effect Visual Search for Exceedingly Rare Items Is Highly Susceptible to Error

Some visual searches depend upon accuracy (e.g., radiology, airport security screening), and it is important for both theoretical and applied reasons to understand what factors best predict performance. The current study administered a visual search task to both professional (Transportation Security Administration Officers) and nonprofessional (members of Duke University) searchers to examine group differences in which factors predict accuracy. Search speed—time taken to terminate search—was the primary predictor for nonprofessional searchers (accounting for 59% of their accuracy variability) and for the least experienced professional searchers (37% of variability). In contrast, consistency—how similarly (in terms of search speed) an individual spent searching from trial to trial—was the primary predictor for the most experienced professional visual searchers (39% of variability). These results inform cognitive theory by illuminating factors that differentially affect search performance between participants, and real-world issues by identifying search behaviours (consistency in particular) important to experienced professional searchers.

Assessing visual search performance differences between Transportation Security Administration Officers and nonprofessional visual searchers

Shooting a firearm involves a complex series of cognitive abilities. For example, locating an item or a person of interest requires visual search, and firing the weapon (or withholding a trigger squeeze) involves response execution (or inhibition). The present study used a simulated shooting environment to establish a relationship between a particular cognitive ability and a critical shooting error-response inhibition and firing on civilians, respectively. Individual-difference measures demonstrated, perhaps counterintuitively, that simulated civilian casualties were not related to motor impulsivity (i.e., an itchy trigger finger) but rather to an individual's cognitive ability to withhold an already initiated response (i.e., an itchy brain). Furthermore, active-response-inhibition training reduced simulated civilian casualties, which revealed a causal relationship. This study therefore illustrates the potential of using cognitive training to possibly improve shooting performance, which might ultimately provide insight for military and law-enforcement personnel.

Cognitive Training Can Reduce Civilian Casualties in a Simulated Shooting Environment

Summary: Security checkpoints are used to keep potentially dangerous items and individuals out of secure areas. Although technological advances can enhance security efficacy through both accuracy and speed, ultimate success or failure is largely determined by human performance. As such, it is necessary to minimize any shortcomings that stem from the limits of human cognitive abilities. Cognitive performance can be influenced by numerous factors, including those imposed by the search task (e.g., the number of prohibited items) and the basic abilities of the searchers themselves (e.g., competency and experience). Here, we review and discuss four specific challenges of the task itself that can negatively affect the accuracy of a security screening: target visibility, an unknown target set, the possible presence of multiple targets, and low target prevalence. For each, we present the challenge faced and the potential significance of the challenge and then offer possible solutions on the basis of the existing literature. Copyright © 2014 John Wiley & Sons, Ltd. Security checkpoints, such as those employed at airports, sporting events, schools, and other similar environments, are designed to maintain a secure environment by preventing the introduction of dangerous items and/or individuals. Each checkpoint provides a controlled location where permissible elements can pass through and prohibited elements can be kept out. Although security at each individual checkpoint might have unique components, visual search—looking at individuals and their belongings to identify potential threats —is a common denominator. Unfortunately, visual search is fraught with pitfalls that can lead to costly mistakes, and this poses an important threat to security performance

Improving the Efficacy of Security Screening Tasks: A Review of Visual Search Challenges and Ways to Mitigate Their Adverse Effects

Mobile technology (e.g., smartphones and tablets) has provided psychologists with a wonderful opportunity: through careful design and implementation, mobile applications can be used to crowd source data collection. By garnering massive amounts of data from a wide variety of individuals, it is possible to explore psychological questions that have, to date, been out of reach. Here we discuss 2 examples of how data from the mobile game Airport Scanner (Kedlin Co., http://www.airportscannergame.com) can be used to address questions about the nature of visual search that pose intractable problems for laboratory-based research. Airport Scanner is a successful mobile game with millions of unique users and billions of individual trials, which allows for examining nuanced visual search questions. The goals of the current Observation Report were to highlight the growing opportunity that mobile technology affords psychological research and to provide an example roadmap of how to successfully collect usable data.

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Adam T. Biggs

Papers

The Ultra-Rare-Item Effect Visual Search for Exceedingly Rare Items Is Highly Susceptible to Error

Assessing visual search performance differences between Transportation Security Administration Officers and nonprofessional visual searchers

Cognitive Training Can Reduce Civilian Casualties in a Simulated Shooting Environment

Improving the Efficacy of Security Screening Tasks: A Review of Visual Search Challenges and Ways to Mitigate Their Adverse Effects

What Can 1 Billion Trials Tell Us About Visual Search