SummaryBackgroundEngaging, interactive, and automated virtual reality (VR) treatments might help solve the unmet needs of individuals with mental health disorders. We tested the efficacy of an automated cognitive intervention for fear of heights guided by an avatar virtual coach (animated using motion and voice capture of an actor) in VR and delivered with the latest consumer equipment.MethodsWe did a randomised trial of automated VR versus usual care. We recruited adults aged older than 18 years with a fear of heights by radio advertisements in Oxfordshire, UK. We diagnosed fear of heights if participants scored more than 29 on the Heights Interpretation Questionnaire (HIQ). We randomly allocated participants by computer in a 1:1 ratio to either automated VR delivered in roughly six 30-min sessions administered about two to three times a week over a 2-week period (intervention group) or to usual care (control group). Randomisation was stratified by severity of fear of heights. The research team, who were unaware of the random allocation, administered three fear-of-height assessments, at baseline (0 weeks), at the end of treatment (2 weeks), and at follow-up (4 weeks). The primary outcome measure was HIQ score (range 16–80, with higher scores indicating greater severity). This trial is registered with the ISRCTN registry, number ISRCTN11898283.FindingsBetween Nov 25, 2017, and Feb 27, 2018, 100 individuals were enrolled and underwent randomisation, of whom 49 were assigned to the VR treatment group and 51 to the control group. All participants completed the 4-week follow-up. The mean total treatment time in VR was 124·43 min (SD 34·23). Compared with participants in the control group, the VR treatment reduced fear of heights at the end of treatment (mean change score −24·5 [SD 13·1] in the VR group vs −1·2 [7·3] in the control group; adjusted difference −24·0, 95% CI −27·7 to −20·3; Cohen's d=2·0; p<0·0001). The benefit was maintained at follow-up (mean change score −25·1 [SD 13·9] in the VR group vs −1·5 [7·8] in the control group; adjusted difference −24·3, 95% CI −27·9 to −20·6; Cohen's d=2·0; p<0·0001). The number needed to treat to at least halve the fear of heights was 1·3. No adverse events were reported.InterpretationPsychological therapy delivered automatically by a VR coach can produce large clinical benefits. Evidence-based VR treatments have the potential to greatly increase treatment provision for mental health disorders.FundingOxford VR, and the National Institute of Health Research Oxford Health Biomedical Research Centre.

The brain's body representation is amenable to rapid change, even though we tend to think of our bodies as relatively fixed and stable. For example, it has been shown that a life-sized body perceived in virtual reality as substituting the participant's real body, can be felt as if it were their own, and that the body type can induce perceptual, attitudinal and behavioral changes. Here we show that changes can also occur in cognitive processing and specifically, executive functioning. Fifteen male participants were embodied in a virtual body that signifies super-intelligence (Einstein) and 15 in a (Normal) virtual body of similar age to their own. The Einstein body participants performed better on a cognitive task than the Normal body, considering prior cognitive ability (IQ), with the improvement greatest for those with low self-esteem. Einstein embodiment also reduced implicit bias against older people. Hence virtual body ownership may additionally be used to enhance executive functioning.

Recent advances in humanoid robot technologies have made it possible to inhabit a humanlike form located at a remote place. This allows the participant to interact with others in that space and experience the illusion that the participant is actually present in the remote space. Moreover, with these humanlike forms, it may be possible to induce a full-body ownership illusion, where the robot body is perceived to be one's own. We show that it is possible to induce the full-body ownership illusion over a remote robotic body with a highly robotic appearance. Additionally, our results indicate that even with nonmanual control of a remote robotic body, it is possible to induce feelings of agency and illusions of body ownership. Two established control methods, an SSVEP-based BCI and eye tracking, were tested as a means of controlling the robot's gesturing. Our experience and the results indicate that both methods are tractable for immersive control of a humanoid robot in a social telepresence setting.

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We show how a combination of virtual reality and robotics can be used to beam a physical representation of a person to a distant location, and describe an application of this system in the context of journalism. Full body motion capture data of a person is streamed and mapped in real time, onto the limbs of a humanoid robot present at the remote location. A pair of cameras in the robot's 'eyes' stream stereoscopic video back to the HMD worn by the visitor, and a two-way audio connection allows the visitor to talk to people in the remote destination. By fusing the multisensory data of the visitor with the robot, the visitor's 'consciousness' is transformed to the robot's body. This system was used by a journalist to interview a neuroscientist and a chef 900 miles distant, about food for the brain, resulting in an article published in the popular press.

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There is an alarming level of violence by police in the US towards African Americans. Although this may be rooted in explicit racial bias, the more intractable problem is overcoming implicit bias, bias that is non-conscious but demonstrated in actual behavior. If bias is implicit it is difficult to change through explicit methods that attempt to change attitudes. We carried out a study using virtual reality (VR) with 38 officers in a US police department, who took part in an interrogation of an African American suspect alongside an officer who was racially abusive towards the suspect. Seventeen of the participants witnessed the interview again from a third person perspective (Observer) and 21 from the embodied perspective of the suspect, now a victim of the interrogation (Victim condition), having been assigned randomly to these two groups. Some weeks later all witnessed aggression by an officer towards an African American man in a virtual cafe scenario. The results show that the actions of those who had been in the Victim condition were coded as being more helpful towards the victim than those in the Observer condition. We argue that such VR exposures operate at the experiential and implicit level rather than the explicit, and hence are more likely to be effective in combating aggression rooted in implicit bias.

Pro¢le matching methods are commonly used in searches in protein sequence databases to detect evolutionary relationships. We describe here a sensitive protocol, which detects remote similarities by searching in a specialized database of sequences belonging to a fold. We have assessed this protocol by exploring the relationships we detect among sequences known to belong to speci¢c folds. We ¢nd that searches within sequences adopting a fold are more e¡ective in detecting remote similarities and evolutionary connections than searches in a database of all sequences. We also discuss the implications of using this strategy to link sequence and structure space. ß