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Is virtual reality (VR) already a reality in behavioral health? To answer this question, a meta-review was conducted to assess the meta-analyses and systematic and narrative reviews published in this field in the last twenty-two months. Twenty-five different articles demonstrated the clinical potential of this technology in both the diagnosis and the treatment of mental health disorders: VR compares favorably to existing treatments in anxiety disorders, eating and weight disorders, and pain management, with long-term effects that generalize to the real world. But why is VR so effective? Here, the following answer is suggested: VR shares with the brain the same basic mechanism: embodied simulations. According to neuroscience, to regulate and control the body in the world effectively, the brain creates an embodied simulation of the body in the world used to represent and predict actions, concepts, and emotions. VR works in a similar way: the VR experience tries to predict the sensory consequences of an individual's movements, providing to him/her the same scene he/she will see in the real world. To achieve this, the VR system, like the brain, maintains a model (simulation) of the body and the space around it. If the presence in the body is the outcome of different embodied simulations, concepts are embodied simulations, and VR is an embodied technology, this suggests a new clinical approach discussed in this article: the possibility of altering the experience of the body and facilitating cognitive modeling/change by designing targeted virtual environments able to simulate both the external and the internal world/body.

It is generally assumed that technology assists individuals in improving the quality of their lives. However, the impact of new technologies and media on well-being and positive functioning is still somewhat controversial. In this paper, we contend that the quality of experience should become the guiding principle in the design and development of new technologies, as well as a primary metric for the evaluation of their applications. The emerging discipline of Positive Psychology provides a useful framework to address this challenge. Positive Psychology is the scientific study of optimal human functioning and flourishing. Instead of drawing on a ''disease model'' of human behavior, it focuses on factors that enable individuals and communities to thrive and build the best in life. In this paper, we propose the ''Positive Technology'' approach-the scientific and applied approach to the use of technology for improving the quality of our personal experience through its structuring, augmentation, and/or replacement-as a way of framing a suitable object of study in the field of cyberpsychology and human-computer interaction. Specifically, we suggest that it is possible to use technology to influence three specific features of our experience-affective quality, engagement/actualization, and connectedness-that serve to promote adaptive behaviors and positive functioning. In this framework, positive technologies are classified according to their effects on a specific feature of personal experience. Moreover, for each level, we have identified critical variables that can be manipulated to guide the design and development of positive technologies.

Behavioral exposure therapy of anxiety disorders is believed to rely on fear extinction. Because preclinical studies have shown that glucocorticoids can promote extinction processes, we aimed at investigating whether the administration of these hormones might be useful in enhancing exposure therapy. In a randomized, doubleblind, placebo-controlled study, 40 patients with specific phobia for heights were treated with three sessions of exposure therapy using virtual reality exposure to heights. Cortisol (20 mg) or placebo was administered orally 1 h before each of the treatment sessions. Subjects returned for a posttreatment assessment 3-5 d after the last treatment session and for a follow-up assessment after 1 mo. Adding cortisol to exposure therapy resulted in a significantly greater reduction in fear of heights as measured with the acrophobia questionnaire (AQ) both at posttreatment and at follow-up, compared with placebo. Furthermore, subjects receiving cortisol showed a significantly greater reduction in acute anxiety during virtual exposure to a phobic situation at posttreatment and a significantly smaller exposure-induced increase in skin conductance level at follow-up. The present findings indicate that the administration of cortisol can enhance extinction-based psychotherapy.memory | retrieval | consolidation P hobic disorders can be characterized as disorders involving disturbed emotional learning and memory resulting in an enhanced fear response. A central mechanism in the pathogenesis of anxiety disorders is associative learning or conditioning that leads to formation of a fear memory (1-5). In phobic individuals, exposure to a phobic stimulus almost invariably provokes retrieval of stimulus-associated fear memory, which leads to the fear response (6-9). Exposure-based behavioral therapy of phobia is thought to rely on extinction of these fear responses (10-13). Extinction occurs when conditioned responding to a stimulus decreases when the reinforcer is omitted (12,14). Accordingly, fear reduction induced by exposure therapy is the result of decrements in the conditioned response over successive extinction trials. Extinction leads to the formation of an alternative set of nonfearful memory associations (extinction memory) that competes with, but does not erase original fear memory associations (14, 15). Considering the importance of extinction learning for exposure therapy, pharmacological interventions aimed at enhancing extinction processes are promising approaches to enhance exposure therapy, as it has been demonstrated with D-cycloserine (16-18).Glucocorticoids (cortisol in humans, corticosterone in rodents) are stress hormones released from the adrenal cortex and it has long been recognized that they readily enter the brain and affect learning and memory (19-24). Importantly, basic research studies in animals and humans have shown that the mnemonic effects of glucocorticoids can facilitate extinction processes (22,(25)(26)(27)(28)(29). Therefore, we aimed at investigating whether the administrati...

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The goal of this work is to delimit the field of Positive Technology--the scientific and applied approach to the use of technology for improving the quality of our personal experience. This new field combines the objectives of Positive Psychology with enhancements of Information and Communication Technologies (ICTs) by focusing on three key variables--emotional quality, engagement/actualization, and connectedness--that are able to transform our personal experience in a tool for building new and enduring personal resources. In fact, Positive Technologies include those designed to manipulate the quality of experience through its structuring, augmentation and/or replacement, with the goal of increasing wellness, and generating strengths and resilience in individuals, organizations, and society. This work describes existing Positive Technologies, classified according to their objectives: hedonic (mood-altering devices, which use ICTs to induce positive and pleasant experiences); eudaimonic (systems designed to support individuals in reaching engaging and self-actualizing experiences); and social/interpersonal (technologies that seek to improve the connectedness between individuals, groups, and organizations). Finally, possible directions of future developments are suggested.

Smokers who are exposed to smoking-related cues show cardiovascular reactivity and smoking craving compared with their responses to neutral cues, and increased cue reactivity predicts decreased likelihood of successful cessation. Several brain imaging studies suggested four candidate brain regions that might differ in gray matter volumes and densities between smokers and nonsmokers. However, in these studies, smokers were only exposed to smoking-related objects. In our pilot study utilizing a virtual reality (VR) technique, virtual environments (VEs) were more immersive and evoked smoking craving more effectively than traditionally used methods. In this study, we sought to test whether smokers could experience cue-induced smoking craving inside the MRI scanner by using the VR system. The smoking cue reactivity scenario was based in part on our preliminary task and consisted of 2D and 3D (or VE) conditions. The group mean of participants had increased activity in the prefrontal cortex (PFC), left anterior cingulate gyrus (ACC), left supplementary motor area, left uncus, right inferior temporal gyrus, right lingual gyrus, and right precuneus in the 2D condition. Areas of differential activation in the 3D condition were as follows: left superior temporal gyrus, right superior frontal gyrus, and left inferior occipital gyrus in the 3D condition. This finding is consistent with those of previous studies of nicotine craving showing PFC and ACC activation. However, in the 3D condition, the PFC including the superior frontal gyrus as well as the superior temporal gyrus, inferior occipital gyrus, and cerebellum were activated. Therefore, in the 3D condition, participants seemed to have more attention, visual balance, and coordinating movement than in the 2D condition.