Arguing in Favor of Revising the Simulator Sickness Questionnaire Factor Structure When Assessing Side Effects Induced by Immersions in Virtual Reality

Abstract

Two issues are increasingly of interest in the scientific literature regarding unwanted virtual reality (VR) induced side effects: (1) whether the latent structure of the Simulator Sickness Questionnaire (SSQ) is comprised of two or three factors, and (2) if the SSQ measures symptoms of anxiety that can be misattributed to unwanted negative side effects induced by immersions in VR. Study 1 was conducted with a sample of 876 participants. A confirmatory factor analysis clearly supported a two-factor model composed of nausea and oculomotor symptoms instead of the 3-factor structure observed in simulators. To tease-out symptoms of anxiety from unwanted negative side effects induced by immersions in VR, Study 2 was conducted with 88 participants who were administered the Trier Stress Social Test in groups without being immersed in VR. A Spearman correlation showed that 11 out of 16 side effects correlated significantly with anxiety. A factor analysis revealed that items measuring general discomfort, difficulty concentrating, sweating, nausea, and vertigo loaded significantly on the anxiety factor comprised of items from the State-Trait Anxiety Inventory. Finally, a multiple regression indicated that the items measuring general discomfort and difficulty concentrating significantly predicted increases in anxiety. The overall results support the notion that side effects associated with immersions in VR consist mostly of a nausea and an oculomotor latent structure and that a few items are confounding anxiety and cybersickness. The data support the suggestion to revise the scoring procedures of the Simulator Sickness Questionnaire when using this instrument with immersions in VR.

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

“…Currently, no existing literature directly correlates cybersickness similarities to a physical symptom of anxiety. However, many neuroscientist iVR interventional researchers stated that some SSQ items and anxiety traits are commonly encountered [ 63 ]. Anxiety can have a partial modulating effect on cybersickness within the immersive environment [ 64 ].…”

The simulator sickness questionnaire, and the erroneous zero baseline assumption

“…We present these results, and discuss, in the context of any potential differences between medical and healthy participants, whether frequent medication usage could influence SSQ scores, as proposed previously in the literature (Kruk, 1992;McCauley & Sharkey, 1992). Results of the SSQ will be presented using Bouchard et al (2007Bouchard et al ( , 2021 unweighted scoring approach. We discuss the benefits to an unweighted scoring approach, versus the traditional weighted scoring approach (Kennedy et al, 1993), including how the application of either could influence respective outputs and conclusions.…”

“…Data has primarily been presented using Bouchard's proposed revised factor structure (Bouchard et al, 2007), as opposed to Kennedy et al (1993 initial factor structure. Bouchard's structure was used because an unweighted approach is a more suitable method of determining differences between groups (Bouchard et al, 2007), and better reflects users of the general population (Bouchard et al, 2021), in contrast to Kennedy's which was conducted amongst specified personnel (Kennedy et al, 1993). Results using Kennedy's weighted scoring approach have also been included in Supplementary Appendices B,C for transparency and replicability.…”

“…Although the SSQ was initially intended for simulator sickness assessment, it has been used in recent times more frequently for cybersickness assessment (Bouchard et al, 2021;Brown et al, 2021;Munafo et al, 2017), and has been administered in conflict of the initial interpretation by its authors, with evidence existing that it is also beneficial under certain circumstances for pre-exposure administration (Bliss et al, 1997;Zanbaka et al, 2004;Bouchard et al, 2007Bouchard et al, , 2021Munafo et al, 2017). While the benefits of pre-exposure assessment have been previously explored, the justification and application of its use often contradict the benefits that pre-exposure assessment may provide, and all too often, dissemination of pre-exposure SSQ results is lacking (Kim et al, 2005;Min et al, 2004;Munafo et al, 2017;Zanbaka et al, 2004).…”

eLoriCorps Immersive Body Rating Scale and eLoriCorps Mobile Versions: Validation to Assess Body Image Disturbances from Allocentric and Egocentric Perspectives in a Nonclinical Sample of Adolescents

“…In our sample, Cronbach’s alpha was 0.84, indicating excellent internal consistency [ 61 ]. SSQ total raw scores were calculated, as recommended by Bouchard et al [ 66 ].…”