We combined virtual reality and multisensory bodily illusion with the aim to characterize and reduce the perceptual (body overestimation) and the cognitive-emotional (body dissatisfaction) components of body image distortion (BID) in anorexia nervosa (AN). For each participant (20 anorexics, 20 healthy controls) we built personalized avatars that reproduced their own body size, shape, and verisimilar increases and losses of their original weight. Body overestimation and dissatisfaction were measured by asking participants to choose the avatar that best resembled their real and ideal body. Results show higher body dissatisfaction in AN, caused by the desire of a thinner body, and no body-size overestimation. Interpersonal multisensory stimulation (IMS) was then applied on the avatar reproducing participant’s perceived body, and on the two avatars which reproduced increases and losses of 15% of it, all presented with a first-person perspective (1PP). Embodiment was stronger after synchronous IMS in both groups, but did not reduce BID in participants with AN. Interestingly, anorexics reported more negative emotions after embodying the fattest avatar, which scaled with symptoms severity. Overall, our findings suggest that the cognitive-emotional, more than the perceptual component of BID is severely altered in AN and that perspective (1PP vs. 3PP) from which a body is evaluated may play a crucial role. Future research and clinical trials might take advantage of virtual reality to reduce the emotional distress related to body dissatisfaction.

Real-world experience is typically multimodal. Evidence indicates that the facilitation in the detection of multisensory stimuli is modulated by the perceptual load, the amount of information involved in the processing of the stimuli. Here, we used a realistic virtual reality environment while concomitantly acquiring Electroencephalography (EEG) and Galvanic Skin Response (GSR) to investigate how multisensory signals impact target detection in two conditions, high and low perceptual load. Different multimodal stimuli (auditory and vibrotactile) were presented, alone or in combination with the visual target. Results showed that only in the high load condition, multisensory stimuli significantly improve performance, compared to visual stimulation alone. Multisensory stimulation also decreases the EEG-based workload. Instead, the perceived workload, according to the “NASA Task Load Index” questionnaire, was reduced only by the trimodal condition (i.e., visual, auditory, tactile). This trimodal stimulation was more effective in enhancing the sense of presence, that is the feeling of being in the virtual environment, compared to the bimodal or unimodal stimulation. Also, we show that in the high load task, the GSR components are higher compared to the low load condition. Finally, the multimodal stimulation (Visual-Audio-Tactile—VAT and Visual-Audio—VA) induced a significant decrease in latency, and a significant increase in the amplitude of the P300 potentials with respect to the unimodal (visual) and visual and tactile bimodal stimulation, suggesting a faster and more effective processing and detection of stimuli if auditory stimulation is included. Overall, these findings provide insights into the relationship between multisensory integration and human behavior and cognition.

New solutions in operational environments are often, among objective measurements, evaluated by using subjective assessment and judgment from experts. Anyhow, it has been demonstrated that subjective measures suffer from poor resolution due to a high intra and inter-operator variability. Also, performance measures, if available, could provide just partial information, since an operator could achieve the same performance but experiencing a different workload. In this study, we aimed to demonstrate: (i) the higher resolution of neurophysiological measures in comparison to subjective ones; and (ii) how the simultaneous employment of neurophysiological measures and behavioral ones could allow a holistic assessment of operational tools. In this regard, we tested the effectiveness of an electroencephalography (EEG)-based neurophysiological index (WEEG index) in comparing two different solutions (i.e., Normal and Augmented) in terms of experienced workload. In this regard, 16 professional air traffic controllers (ATCOs) have been asked to perform two operational scenarios. Galvanic Skin Response (GSR) has also been recorded to evaluate the level of arousal (i.e., operator involvement) during the two scenarios execution. NASA-TLX questionnaire has been used to evaluate the perceived workload, and an expert was asked to assess performance achieved by the ATCOs. Finally, reaction times on specific operational events relevant for the assessment of the two solutions, have also been collected. Results highlighted that the Augmented solution induced a local increase in subjects performance (Reaction times). At the same time, this solution induced an increase in the workload experienced by the participants (WEEG). Anyhow, this increase is still acceptable, since it did not negatively impact the performance and has to be intended only as a consequence of the higher engagement of the ATCOs. This behavioral effect is totally in line with physiological results obtained in terms of arousal (GSR), that increased during the scenario with augmentation. Subjective measures (NASA-TLX) did not highlight any significant variation in perceived workload. These results suggest that neurophysiological measure provide additional information than behavioral and subjective ones, even at a level of few seconds, and its employment during the pre-operational activities (e.g., design process) could allow a more holistic and accurate evaluation of new solutions.