@phdthesis{Grossekathoefer2022,
  author    = {Großekath{\"o}fer, Jonas David},
  title     = {Virtually Valid? On the Importance of Ecological Validity and Virtual Reality for Social Attention Research},
  doi       = {10.25972/OPUS-26041},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260417},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Gazes are of central relevance for people. They are crucial for navigating the world and communicating with others. Nevertheless, research in recent years shows that many findings from experimental research on gaze behavior cannot be transferred from the laboratory to everyday behavior. For example, the frequency with which conspecifics are looked at is considerably higher in experimental contexts than what can be observed in daily behavior. In short: findings from laboratories cannot be generalized into general statements. This thesis is dedicated to this matter. The dissertation describes and documents the current state of research on social attention through a literature review, including a meta-analysis on the /gaze cueing/ paradigm and an empirical study on the robustness of gaze following behavior. In addition, virtual reality was used in one of the first studies in this research field. Virtual reality has the potential to significantly improve the transferability of experimental laboratory studies to everyday behavior. This is because the technology enables a high degree of experimental control in naturalistic research designs. As such, it has the potential to transform empirical research in the same way that the introduction of computers to psychological research did some 50 years ago. The general literature review on social attention is extended to the classic /gaze cueing/ paradigm through a systematic review of publications and a meta-analytic evaluation (Study 1). The cumulative evidence supported the findings of primary studies: Covert spatial attention is directed by faces. However, the experimental factors included do not explain the surprisingly large variance in the published results. Thus, there seem to be further, not well-understood variables influencing these social processes. Moreover, classic /gaze cueing/ studies have limited ecological validity. This is discussed as a central reason for the lack of generalisability. Ecological validity describes the correspondence between experimental factors and realistic situations. A stimulus or an experimental design can have high and low ecological validity on different dimensions and have different influences on behavior. Empirical research on gaze following behavior showed that the /gaze cueing/ effect also occurs with contextually embedded stimuli (Study 2). The contextual integration of the directional cue contrasted classical /gaze cueing/ studies, which usually show heads in isolation. The research results can thus be transferred /within/ laboratory studies to higher ecologically valid research paradigms. However, research shows that the lack of ecological validity in experimental designs significantly limits the transferability of experimental findings to complex situations /outside/ the laboratory. This seems to be particularly the case when social interactions and norms are investigated. However, ecological validity is also often limited in these studies for other factors, such as contextual embedding /of participants/, free exploration behavior (and, thus, attentional control), or multimodality. In a first study, such high ecological validity was achieved for these factors with virtual reality, which could not be achieved in the laboratory so far (Study 3). Notably, the observed fixation patterns showed differences even under /most similar/ conditions in the laboratory and natural environments. Interestingly, these were similar to findings also derived from comparisons of eye movement in the laboratory and field investigations. These findings, which previously came from hardly comparable groups, were thus confirmed by the present Study 3 (which did not have this limitation). Overall, /virtual reality/ is a new technical approach to contemporary social attention research that pushes the boundaries of previous experimental research. The traditional trade-off between ecological validity and experimental control thus becomes obsolete, and laboratory studies can closely inherit an excellent approximation of reality. Finally, the present work describes and discusses the possibilities of this technology and its practical implementation. Within this context, the extent to which this development can still guarantee a constructive classification of different laboratory tests in the future is examined.},
  subject      = {Aufmerksamkeit},
  language  = {en}
}
@article{DiemerAlpersPeperkornetal.2015,
  author    = {Diemer, Julia and Alpers, Georg W. and Peperkorn, Henrik M. and Shiban, Youssef and M{\"u}hlberger, Andreas},
  title     = {The impact of perception and presence on emotional reactions: a review of research in virtual reality},
  series = {Frontiers in Psychology},
  volume    = {6},
  journal   = {Frontiers in Psychology},
  number    = {26},
  doi       = {10.3389/fpsyg.2015.00026},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-144200},
  year      = {2015},
  abstract  = {Virtual reality (VR) has made its way into mainstream psychological research in the last two decades. This technology, with its unique ability to simulate complex, real situations and contexts, offers researchers unprecedented opportunities to investigate human behavior in well controlled designs in the laboratory. One important application of VR is the investigation of pathological processes in mental disorders, especially anxiety disorders. Research on the processes underlying threat perception, fear, and exposure therapy has shed light on more general aspects of the relation between perception and emotion. Being by its nature virtual, i.e., simulation of reality, VR strongly relies on the adequate selection of specific perceptual cues to activate emotions. Emotional experiences in turn are related to presence, another important concept in VR, which describes the user's sense of being in a VR environment. This paper summarizes current research into perception of fear cues, emotion, and presence, aiming at the identification of the most relevant aspects of emotional experience in VR and their mutual relations. A special focus lies on a series of recent experiments designed to test the relative contribution of perception and conceptual information on fear in VR. This strand of research capitalizes on the dissociation between perception (bottom up input) and conceptual information (top-down input) that is possible in VR. Further, we review the factors that have so far been recognized to influence presence, with emotions (e.g., fear) being the most relevant in the context of clinical psychology. Recent research has highlighted the mutual influence of presence and fear in VR, but has also traced the limits of our current understanding of this relationship. In this paper, the crucial role of perception on eliciting emotional reactions is highlighted, and the role of arousal as a basic dimension of emotional experience is discussed. An interoceptive attribution model of presence is suggested as a first step toward an integrative framework for emotion research in VR. Gaps in the current literature and future directions are outlined.},
  language  = {en}
}
@unpublished{HaendelSchoelvinck2019,
  author    = {H{\"a}ndel, Barbara and Sch{\"o}lvinck, Marieke},
  title     = {The brain during free movement - what can we learn from the animal model},
  series = {Brain Research},
  journal   = {Brain Research},
  edition   = {accepted manuscript},
  doi       = {10.1016/j.brainres.2017.09.003},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-251406},
  year      = {2019},
  abstract  = {Animals, just like humans, can freely move. They do so for various important reasons, such as finding food and escaping predators. Observing these behaviors can inform us about the underlying cognitive processes. In addition, while humans can convey complicated information easily through speaking, animals need to move their bodies to communicate. This has prompted many creative solutions by animal neuroscientists to enable studying the brain during movement. In this review, we first summarize how animal researchers record from the brain while an animal is moving, by describing the most common neural recording techniques in animals and how they were adapted to record during movement. We further discuss the challenge of controlling or monitoring sensory input during free movement. However, not only is free movement a necessity to reflect the outcome of certain internal cognitive processes in animals, it is also a fascinating field of research since certain crucial behavioral patterns can only be observed and studied during free movement. Therefore, in a second part of the review, we focus on some key findings in animal research that specifically address the interaction between free movement and brain activity. First, focusing on walking as a fundamental form of free movement, we discuss how important such intentional movements are for understanding processes as diverse as spatial navigation, active sensing, and complex motor planning. Second, we propose the idea of regarding free movement as the expression of a behavioral state. This view can help to understand the general influence of movement on brain function. Together, the technological advancements towards recording from the brain during movement, and the scientific questions asked about the brain engaged in movement, make animal research highly valuable to research into the human "moving brain".},
  language  = {en}
}
@phdthesis{Genheimer2020,
  author    = {Genheimer, Hannah},
  title     = {The acquisition of anxiety and the impact of transcutaneous vagus nerve stimulation on extinction learning in virtual contexts},
  doi       = {10.25972/OPUS-20639},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-206390},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {This thesis aims for a better understanding of the mechanisms underlying anxiety as well as trauma- and stressor-related disorders and the development of new therapeutic approaches. I was first interested in the associative learning mechanisms involved in the etiology of anxiety disorders. Second, I explored the therapeutic effects of transcutaneous vagus nerve stimulation (tVNS) as a promising new method to accelerate and stabilize extinction learning in humans. For these purposes, I applied differential anxiety conditioning protocols realized by the implementation of virtual reality (VR). Here, a formerly neutral virtual context (anxiety context, CTX+) is presented whereby the participants unpredictably receive mildly aversive electric stimuli (unconditioned stimulus, US). Another virtual context (safety context, CTX-) is never associated with the US. Moreover, extinction of conditioned anxiety can be modeled by presenting the same contexts without US delivery. When unannounced USs were administered after extinction, i.e. reinstatement, the strength of the "returned" conditioned anxiety can provide information on the stability of the extinction memory. In Study 1, I disentangled the role of elemental and conjunctive context representations in the acquisition of conditioned anxiety. Sequential screenshots of two virtual offices were presented like a flip-book so that I elicited the impression of walking through the contexts. Some pictures of CTX+ were paired with an US (threat elements), but not some other screenshots of the same context (non-threat elements), nor the screenshots depicting CTX- (safety elements). Higher contingency ratings for threat compared to non-threat elements revealed elemental representation. Electro-cortical responses showed larger P100 and early posterior negativity amplitudes elicited by screenshots depicting CTX+ compared to CTX- and suggested conjunctive representation. These results support the dual context representation in anxiety acquisition in healthy individuals. Study 2 addressed the effects of tVNS on the stabilization of extinction learning by using a context conditioning paradigm. Potentiated startle responses as well as higher aversive ratings in CTX+ compared to CTX- indicate successful anxiety conditioning. Complete extinction was found in startle responses and valence ratings as no differentiation between CTX+ and CTX- suggested. TVNS did not affect extinction or reinstatement of anxiety which may be related to the inappropriate transferability of successful stimulation parameters from epilepsy patients to healthy participants during anxiety extinction. Therefore, in Study 3 I wanted to replicate the modulatory effects of tVNS on heart rate and pain perception by the previously used parameters. However, no effects of tVNS were observed on subjective pain ratings, on pain tolerance, or on heart rate. This led to the conclusion that the modification of stimulation parameters is necessary for a successful acceleration of anxiety extinction in humans. In Study 4, I prolonged the tVNS and, considering previous tVNS studies, I applied a cue conditioning paradigm in VR. Therefore, during acquisition a cue (CS+) presented in CTX+ predicted the US, but not another cue (CS-). Both cues were presented in a second context (CTX-) and never paired with the US. Afterward, participants received either tVNS or sham stimulation and underwent extinction learning. I found context-dependent cue conditioning only in valence ratings, which was indicated by lower valence for CS+ compared to CS- in CTX+, but no differential ratings in CTX-. Successful extinction was indicated by equal responses to CS+ and CS-. Interestingly, I found reinstatement of conditioned fear in a context-dependent manner, meaning startle response was potentiated for CS+ compared to CS- only in the anxiety context. Importantly, even the prolonged tVNS had no effect, neither on extinction nor on reinstatement of context-dependent cue conditioning. However, I found first evidence for accelerated physiological contextual extinction due to less differentiation between startles in CTX+ compared to CTX- in the tVNS than in the sham stimulated group. In sum, this thesis first confirms the dual representation of a context in an elemental and a conjunctive manner. Second, though anxiety conditioning and context-dependent cue conditioning paradigms worked well, the translation of tVNS accelerated extinction from rats to humans needs to be further developed, especially the stimulation parameters. Nevertheless, tVNS remains a very promising approach of memory enhancement, which can be particularly auspicious in clinical settings.},
  subject      = {Angst},
  language  = {en}
}
@article{RuboGamer2021,
  author    = {Rubo, Marius and Gamer, Matthias},
  title     = {Stronger reactivity to social gaze in virtual reality compared to a classical laboratory environment},
  series = {British Journal of Psychology},
  volume    = {112},
  journal   = {British Journal of Psychology},
  number    = {1},
  doi       = {10.1111/bjop.12453},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-215972},
  pages     = {301 -- 314},
  year      = {2021},
  abstract  = {People show a robust tendency to gaze at other human beings when viewing images or videos, but were also found to relatively avoid gaze at others in several real-world situations. This discrepancy, along with theoretical considerations, spawned doubts about the appropriateness of classical laboratory-based experimental paradigms in social attention research. Several researchers instead suggested the use of immersive virtual scenarios in eliciting and measuring naturalistic attentional patterns, but the field, struggling with methodological challenges, still needs to establish the advantages of this approach. Here, we show using eye-tracking in a complex social scenario displayed in virtual reality that participants show enhanced attention towards the face of an avatar at near distance and demonstrate an increased reactivity towards her social gaze as compared to participants who viewed the same scene on a computer monitor. The present study suggests that reactive virtual agents observed in immersive virtual reality can elicit natural modes of information processing and can help to conduct ecologically more valid experiments while maintaining high experimental control.},
  language  = {en}
}
@phdthesis{Kinateder2012,
  author    = {Kinateder, Max},
  title     = {Social Influence in Emergency Situations - Studies in Virtual Reality},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-76805},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2012},
  abstract  = {In 1999, a tragic catastrophe occurred in the Mont Blanc Tunnel, one of the most important transalpine road tunnels. Twenty-seven of the victims never left their vehicles as a result of which they were trapped in smoke and suffocated (Beard \& Carvel, 2005). Immediate evacuation is crucial in tunnel fires, but still many tunnel users stay passive. During emergency situations people strongly influence each other's behavior (e.g. Nilsson \& Johansson, 2009a). So far, only few empirical experimental studies investigated the interaction of individuals during emergencies. Recent developments of advanced immersive virtual worlds, allow simulating emergency situations which makes analogue studies possible. In the present dissertation project, theoretical aspects of human behavior and SI in emergencies are addressed (Chapter 1). The question of Social Influence in emergency situations is investigated in five simulation studies during different relevant stages of the evacuation process from a simulated road tunnel fire (Chapter 2). In the last part, the results are discussed and criticized (Chapter 3). Using a virtual reality (VR) road tunnel scenario, study 1 (pilot study) and 2 investigated the effect of information about adequate behavior in tunnel emergencies as well as Social Influence (SI) on drivers' behavior. Based on a classic study of Darley and Latan{\´e} (1968) on bystander inhibition, the effect of passive bystanders on self-evacuation was analyzed. Sixty participants were confronted with an accident and smoke in a road tunnel. The presence of bystanders and information status was manipulated and consequently, participants were randomly assigned into four different groups. Informed participants read a brochure containing relevant information about safety behavior in emergency situations prior to the tunnel drives. In the bystander conditions, passive bystanders were situated in a car in front of the emergency situation. Participants who had received relevant information left the car more frequently than the other participants. Neither significant effect of bystanders nor interaction with information status on the participants' behavior was observed. Study 3 (pilot study) examined a possible alternative explanation for weak SI in VR. Based on the Threshold Theory of Social Influence (Blascovich, 2002b) and the work of Guadagno et al. (2007), the perception of virtual humans as an avatar (a virtual representation of a real human being) or as an agent (a computer-controlled animated character) was manipulated. Subsequently, 32 participants experienced an accident similar to the one in study 1. However, they were co-drivers and a virtual agent (VA) was the driver. Participants reacted differently in avatar and agent condition. Consequently, the manipulation of the avatar condition was implemented in study 4. In study 4, SI within the vehicle was investigated, as drivers are mostly not alone in their car. In a tunnel scenario similar to the first study, 34 participants were confronted with an emergency situation either as drivers or co-drivers. In the driver group, participants drove themselves and a VA was sitting on the passenger seat. Correspondently, participants in the co-driver group were seated on the passenger seat and the VA drove the vehicle on a pre-recorded path. Like in study 1, the tunnel was blocked by an accident and smoke was coming from the accident in one drive. The VA initially stayed inactive after stopping the vehicle but started to evacuate after ca. 30 seconds. About one third of the sample left the vehicle during the situation. There were no significant differences between drivers and co-drivers regarding the frequency of leaving the vehicle. Co-drivers waited significantly longer than drivers before leaving the vehicle. Study 5 looked at the pre-movement and movement phase of the evacuation process. Forty participants were repeatedly confronted with an emergency situation in a virtual road tunnel filled with smoke. Four different experimental conditions systematically varied the presence and behavior of a VA. In all but one conditions a VA was present. Across all conditions at least 60\% of the participants went to the emergency exit. If the VA went to the emergency exit, the ratio increased to 75\%. If the VA went in the opposite direction of the exit, however, only 61\% went there. If participants were confronted with a passive VA, they needed significantly longer until they started moving and reached the emergency exit. The main and most important finding across all studies is that SI is relevant for self-evacuation, but the degree of SI varies across the phases of evacuation and situation. In addition to the core findings, relevant theoretical and methodological questions regarding the general usefulness and limitations of VR as a research tool are discussed. Finally, a short summary and outlook on possible future studies is presented.},
  subject      = {Notfall},
  language  = {en}
}
@article{LangePauli2019,
  author    = {Lange, Bastian and Pauli, Paul},
  title     = {Social anxiety changes the way we move—A social approach-avoidance task in a virtual reality CAVE system},
  series = {PLoS ONE},
  volume    = {14},
  journal   = {PLoS ONE},
  number    = {12},
  doi       = {10.1371/journal.pone.0226805},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200528},
  pages     = {e0226805},
  year      = {2019},
  abstract  = {Investigating approach-avoidance behavior regarding affective stimuli is important in broadening the understanding of one of the most common psychiatric disorders, social anxiety disorder. Many studies in this field rely on approach-avoidance tasks, which mainly assess hand movements, or interpersonal distance measures, which return inconsistent results and lack ecological validity. Therefore, the present study introduces a virtual reality task, looking at avoidance parameters (movement time and speed, distance to social stimulus, gaze behavior) during whole-body movements. These complex movements represent the most ecologically valid form of approach and avoidance behavior. These are at the core of complex and natural social behavior. With this newly developed task, the present study examined whether high socially anxious individuals differ in avoidance behavior when bypassing another person, here virtual humans with neutral and angry facial expressions. Results showed that virtual bystanders displaying angry facial expressions were generally avoided by all participants. In addition, high socially anxious participants generally displayed enhanced avoidance behavior towards virtual people, but no specifically exaggerated avoidance behavior towards virtual people with a negative facial expression. The newly developed virtual reality task proved to be an ecological valid tool for research on complex approach-avoidance behavior in social situations. The first results revealed that whole body approach-avoidance behavior relative to passive bystanders is modulated by their emotional facial expressions and that social anxiety generally amplifies such avoidance.},
  language  = {en}
}
@article{PeperkornDiemerAlpersetal.2016,
  author    = {Peperkorn, Henrik M. and Diemer, Julia E. and Alpers, Georg W. and M{\"u}hlberger, Andreas},
  title     = {Representation of Patients' Hand Modulates Fear Reactions of Patients with Spider Phobia in Virtual Reality},
  series = {frontiers in Psychology},
  volume    = {7},
  journal   = {frontiers in Psychology},
  number    = {268},
  doi       = {10.3389/fpsyg.2016.00268},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-165307},
  year      = {2016},
  abstract  = {Embodiment (i.e., the involvement of a bodily representation) is thought to be relevant in emotional experiences. Virtual reality (VR) is a capable means of activating phobic fear in patients. The representation of the patient's body (e.g., the right hand) in VR enhances immersion and increases presence, but its effect on phobic fear is still unknown. We analyzed the influence of the presentation of the participant's hand in VR on presence and fear responses in 32 women with spider phobia and 32 matched controls. Participants sat in front of a table with an acrylic glass container within reaching distance. During the experiment this setup was concealed by a head-mounted display (HMD). The VR scenario presented via HMD showed the same setup, i.e., a table with an acrylic glass container. Participants were randomly assigned to one of two experimental groups. In one group, fear responses were triggered by fear-relevant visual input in VR (virtual spider in the virtual acrylic glass container), while information about a real but unseen neutral control animal (living snake in the acrylic glass container) was given. The second group received fear-relevant information of the real but unseen situation (living spider in the acrylic glass container), but visual input was kept neutral VR (virtual snake in the virtual acrylic glass container). Participants were instructed to touch the acrylic glass container with their right hand in 20 consecutive trials. Visibility of the hand was varied randomly in a within-subjects design. We found for all participants that visibility of the participant's hand increased presence independently of the fear trigger. However, in patients, the influence of the virtual hand on fear depended on the fear trigger. When fear was triggered perceptually, i.e., by a virtual spider, the virtual hand increased fear. When fear was triggered by information about a real spider, the virtual hand had no effect on fear. Our results shed light on the significance of different fear triggers (visual, conceptual) in interaction with body representations.},
  language  = {en}
}
@phdthesis{Bruetting2013,
  author    = {Br{\"u}tting, Johanna},
  title     = {Psychotherapie spezifischer Phobien: Die Bedeutung der Angstaktivierung f{\"u}r Therapieprozess und Therapieerfolg},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-80578},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2013},
  abstract  = {In der vorliegenden Arbeit wurde untersucht, inwiefern die Angstaktivierung Einfluss auf den Therapieprozess und den Therapieerfolg bei der Behandlung spezifischer Phobien hat. Obwohl expositionsbasierte Therapieverfahren nachweislich effektiv sind und vor allem bei der Behandlung spezifischer Phobien als die Methode der Wahl gelten, sind deren genauen Wirkmechanismen doch noch nicht v{\"o}llig gekl{\"a}rt. In zwei empirischen Studien wurde hier die von Foa und Kozak (1986, 1991) in der „Emotional Processing Theory" als notwendig postulierte Rolle der Angstaktivierung w{\"a}hrend der Exposition untersucht. In der ersten Studie wurde auf Grundlage tier- und humanexperimenteller Befunde untersucht, ob durch eine Reaktivierung der Angst und darauffolgende Exposition innerhalb eines bestimmten Zeitfensters (= Rekonsolidierungsfenster) die R{\"u}ckkehr der Angst verhindert werden kann. Ziel dieser Untersuchung war die {\"U}bertragung bisheriger Ergebnisse aus Konditionierungsstudien auf eine klinische Stichprobe. Die spinnenphobischen Untersuchungsteilnehmer (N = 36) wurden randomisiert entweder der Reaktivierungsgruppe (RG) oder einer Standardexpositionsgruppe (SEG) zugewiesen. Die RG bekam vor der Exposition in virtueller Realit{\"a}t (VRET) f{\"u}nf Sekunden lang einen Reaktivierungsstimulus - eine virtuelle Spinne - dargeboten, woraufhin zehn Minuten standardisierte Wartezeit folgte. In der SEG wurde die Angst vor der Exposition nicht reaktiviert. 24 Stunden nach der VRET wurde in einem Test die spontane R{\"u}ckkehr der Angst erfasst. Entgegen der Annahmen f{\"u}hrte die Reaktivierung vor der VRET nicht zu einer geringeren R{\"u}ckkehr der Angst in der Testsitzung 24 Stunden sp{\"a}ter. Die Angst kehrte in keiner der beiden Versuchsgruppen zur{\"u}ck, was sich bez{\"u}glich subjektiver Angstratings, f{\"u}r Verhaltensdaten und auch f{\"u}r physiologische Maße zeigte. Auch zeigte sich ein grunds{\"a}tzlich positiver Effekt der Behandlung, bei der im Anschluss noch eine Exposition in vivo stattfand. Ein Follow-Up nach sechs Monaten ergab eine weitere Reduktion der Spinnenangst. Die Ergebnisse legen nahe, dass sich die experimentellen Befunde zu Rekonsolidierungsprozessen aus Konditionierungsstudien nicht einfach auf ein Therapiesetting und die Behandlung spezifischer Phobien {\"u}bertragen lassen. Die zweite Studie befasste sich mit der Frage, ob Koffein die initiale Angstaktivierung erh{\"o}hen kann und ob sich dies positiv auf den Therapieerfolg auswirkt. Die spinnenphobischen Studienteilnehmer (N = 35) wurden in einem doppelblinden Versuchsdesign entweder der Koffeingruppe (KOFG) oder der Placebogruppe (PG) zugeordnet. Die KOFG erhielt eine Stunde vor Beginn der VRET eine Koffeintablette mit 200 mg Koffein, die PG erhielt als {\"A}quivalent zur gleichen Zeit eine Placebotablette. Eine Analyse der Speichelproben der Probanden ergab, dass sich die Koffeinkonzentration durch die Koffeintablette signifikant erh{\"o}hte. Dies f{\"u}hrte jedoch nicht, wie erwartet, zu einer h{\"o}heren Angstaktivierung w{\"a}hrend der VRET, weshalb unter anderem diskutiert wird, ob evtl. die Koffeinkonzentration zu niedrig war, um anxiogen zu wirken. Dennoch profitierten die Teilnehmer beider Versuchsgruppen von unserem Behandlungsangebot. Die Spinnenangst reduzierte sich signifikant {\"u}ber vier Sitzungen hinweg. Diese Reduktion blieb stabil bis zum Follow-Up drei Monate nach Studienende. Zusammengefasst l{\"a}sst sich zur optimalen H{\"o}he der Angstaktivierung aufgrund der hier durchgef{\"u}hrten beiden Studien keine exakte Aussage machen, da sich die Versuchsgruppen in beiden Studien hinsichtlich der H{\"o}he der Angstaktivierung zu Beginn (und auch w{\"a}hrend) der Exposition nicht unterschieden. Es l{\"a}sst sich aber festhalten, dass die VRET und auch die in vivo Exposition in beiden Studien effektiv Angst ausl{\"o}sten und dass sich die Angst in beiden Gruppen signifikant bis zu den Follow-Ups (sechs bzw. drei Monate nach Studienende) signifikant reduzierte. Die Behandlung kann also als erfolgreich angesehen werden. M{\"o}gliche andere Wirkfaktoren der Expositionstherapie, wie z.B. die Rolle der wahrgenommenen Kontrolle werden neben der H{\"o}he der Angstaktivierung diskutiert.},
  subject      = {Psychotherapie},
  language  = {de}
}
@article{HerbortKrauseKunde2021,
  author    = {Herbort, Oliver and Krause, Lisa-Marie and Kunde, Wilfried},
  title     = {Perspective determines the production and interpretation of pointing gestures},
  series = {Psychonomic Bulletin \& Review},
  volume    = {28},
  journal   = {Psychonomic Bulletin \& Review},
  issn      = {1069-9384},
  doi       = {10.3758/s13423-020-01823-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235293},
  pages     = {641-648},
  year      = {2021},
  abstract  = {Pointing is a ubiquitous means of communication. Nevertheless, observers systematically misinterpret the location indicated by pointers. We examined whether these misunderstandings result from the typically different viewpoints of pointers and observers. Participants either pointed themselves or interpreted points while assuming the pointer's or a typical observer perspective in a virtual reality environment. The perspective had a strong effect on the relationship between pointing gestures and referents, whereas the task had only a minor influence. This suggests that misunderstandings between pointers and observers primarily result from their typically different viewpoints.},
  language  = {en}
}
@article{ZiebellRodriguesForsteretal.2023,
  author    = {Ziebell, Philipp and Rodrigues, Johannes and Forster, Andr{\´e} and Sanguinetti, Joseph L. and Allen, John JB. and Hewig, Johannes},
  title     = {Inhibition of midfrontal theta with transcranial ultrasound explains greater approach versus withdrawal behavior in humans},
  series = {Brain Stimulation},
  volume    = {16},
  journal   = {Brain Stimulation},
  number    = {5},
  doi       = {10.1016/j.brs.2023.08.011},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-349890},
  pages     = {1278-1288},
  year      = {2023},
  abstract  = {Highlights • Transcranial ultrasound neuromodulation/stimulation (TUS) is a growing field. • We conducted a double-blind sham-controlled within-subjects large sample TUS study. • Right prefrontal cortex TUS inhibits midfrontal theta electroencephalography (MFT). • TUS MFT inhibition explains greater approach versus withdrawal in a virtual T-maze. • This distinct TUS-MFT-behavior link merits future basic and applied research. Abstract Recent reviews highlighted low-intensity transcranial focused ultrasound (TUS) as a promising new tool for non-invasive neuromodulation in basic and applied sciences. Our preregistered double-blind within-subjects study (N = 152) utilized TUS targeting the right prefrontal cortex, which, in earlier work, was found to positively enhance self-reported global mood, decrease negative states of self-reported emotional conflict (anxiety/worrying), and modulate related midfrontal functional magnetic resonance imaging activity in affect regulation brain networks. To further explore TUS effects on objective physiological and behavioral variables, we used a virtual T-maze task that has been established in prior studies to measure motivational conflicts regarding whether participants execute approach versus withdrawal behavior (with free-choice responses via continuous joystick movements) while allowing to record related electroencephalographic data such as midfrontal theta activity (MFT). MFT, a reliable marker of conflict representation on a neuronal level, was of particular interest to us since it has repeatedly been shown to explain related behavior, with relatively low MFT typically preceding approach-like risky behavior and relatively high MFT typically preceding withdrawal-like risk aversion. Our central hypothesis is that TUS decreases MFT in T-maze conflict situations and thereby increases approach and reduces withdrawal. Results indicate that TUS led to significant MFT decreases, which significantly explained increases in approach behavior and decreases in withdrawal behavior. This study expands TUS evidence on a physiological and behavioral level with a large sample size of human subjects, suggesting the promise of further research based on this distinct TUS-MFT-behavior link to influence conflict monitoring and its behavioral consequences. Ultimately, this can serve as a foundation for future clinical work to establish TUS interventions for emotional and motivational mental health.},
  language  = {en}
}
@phdthesis{Ewald2014,
  author    = {Ewald, Heike},
  title     = {Influence of context and contingency awareness on fear conditioning - an investigation in virtual reality},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-111226},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2014},
  abstract  = {Fear conditioning is an efficient model of associative learning, which has greatly improved our knowledge of processes underlying the development and maintenance of pathological fear and anxiety. In a differential fear conditioning paradigm, one initially neutral stimulus (NS) is paired with an aversive event (unconditioned stimulus, US), whereas another stimulus does not have any consequences. After a few pairings the NS is associated with the US and consequently becomes a conditioned stimulus (CS+), which elicits a conditioned response (CR). The formation of explicit knowledge of the CS/US association during conditioning is referred to as contingency awareness. Findings about its role in fear conditioning are ambiguous. The development of a CR without contingency awareness has been shown in delay fear conditioning studies. One speaks of delay conditioning, when the US coterminates with or follows directly on the CS+. In trace conditioning, a temporal gap or "trace interval" lies between CS+ and US. According to existing evidence, trace conditioning is not possible on an implicit level and requires more cognitive resources than delay conditioning. The associations formed during fear conditioning are not exclusively associations between specific cues and aversive events. Contextual cues form the background milieu of the learning process and play an important role in both acquisition and the extinction of conditioned fear and anxiety. A common limitation in human fear conditioning studies is the lack of ecological validity, especially regarding contextual information. The use of Virtual Reality (VR) is a promising approach for creating a more complex environment which is close to a real life situation. I conducted three studies to examine cue and contextual fear conditioning with regard to the role of contingency awareness. For this purpose a VR paradigm was created, which allowed for exact manipulation of cues and contexts as well as timing of events. In all three experiments, participants were guided through one or more virtual rooms serving as contexts, in which two different lights served as CS and an electric stimulus as US. Fear potentiated startle (FPS) responses were measured as an indicator of implicit fear conditioning. To test whether participants had developed explicit awareness of the CS-US contingencies, subjective ratings were collected. The first study was designed as a pilot study to test the VR paradigm as well as the conditioning protocol. Additionally, I was interested in the effect of contingency awareness. Results provided evidence, that eye blink conditioning is possible in the virtual environment and that it does not depend on contingency awareness. Evaluative conditioning, as measured by subjective ratings, was only present in the group of participants who explicitly learned the association between CS and US. To examine acquisition and extinction of both fear associated cues and contexts, a novel cue-context generalization paradigm was applied in the second study. Besides the interplay of cues and contexts I was again interested in the effect of contingency awareness. Two different virtual offices served as fear and safety context, respectively. During acquisition, the CS+ was always followed by the US in the fear context. In the safety context, none of the lights had any consequences. During extinction, a additional (novel) context was introduced, no US was delivered in any of the contexts. Participants showed enhanced startle responses to the CS+ compared to the CS- in the fear context. Thus, discriminative learning took place regarding both cues and contexts during acquisition. This was confirmed by subjective ratings, although only for participants with explicit contingency awareness. Generalization of fear to the novel context after conditioning did not depend on awareness and was observable only on trend level. In a third experiment I looked at neuronal correlates involved in extinction of fear memory by means of functional magnetic resonance imaging (fMRI). Of particular interest were differences between extinction of delay and trace fear conditioning. I applied the paradigm tested in the pilot study and additionally manipulated timing of the stimuli: In the delay conditioning group (DCG) the US was administered with offset of one light (CS+), in the trace conditioning group (TCG) the US was presented 4s after CS+ offset. Most importantly, prefrontal activation differed between the two groups. In line with existing evidence, the ventromedial prefrontal cortex (vmPFC) was activated in the DCG. In the TCG I found activation of the dorsolateral prefrontal cortex (dlPFC), which might be associated with modulation of working memory processes necessary for bridging the trace interval and holding information in short term memory. Taken together, virtual reality proved to be an elegant tool for examining human fear conditioning in complex environments, and especially for manipulating contextual information. Results indicate that explicit knowledge of contingencies is necessary for attitude formation in fear conditioning, but not for a CR on an implicit level as measured by FPS responses. They provide evidence for a two level account of fear conditioning. Discriminative learning was successful regarding both cues and contexts. Imaging results speak for different extinction processes in delay and trace conditioning, hinting that higher working memory contribution is required for trace than for delay conditioning.},
  subject      = {Klassische Konditionierung},
  language  = {en}
}
@article{WinterKernGalletal.2021,
  author    = {Winter, Carla and Kern, Florian and Gall, Dominik and Latoschik, Marc Erich and Pauli, Paul and K{\"a}thner, Ivo},
  title     = {Immersive virtual reality during gait rehabilitation increases walking speed and motivation: a usability evaluation with healthy participants and individuals with multiple sclerosis and stroke},
  series = {Journal of Neuroengineering and Rehabilitation},
  volume    = {18},
  journal   = {Journal of Neuroengineering and Rehabilitation},
  number    = {1},
  issn      = {1743-0003},
  doi       = {10.1186/s12984-021-00848-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258698},
  year      = {2021},
  abstract  = {Background: The rehabilitation of gait disorders in patients with multiple sclerosis (MS) and stroke is often based on conventional treadmill training. Virtual reality (VR)-based treadmill training can increase motivation and improve therapy outcomes. The present study evaluated an immersive virtual reality application (using a head-mounted display, HMD) for gait rehabilitation with patients to (1) demonstrate its feasibility and acceptance and to (2) compare its short-term effects to a semi-immersive presentation (using a monitor) and a conventional treadmill training without VR to assess the usability of both systems and estimate the effects on walking speed and motivation. Methods: In a within-subjects study design, 36 healthy participants and 14 persons with MS or stroke participated in each of the three experimental conditions (VR via HMD, VR via monitor, treadmill training without VR). Results: For both groups, the walking speed in the HMD condition was higher than in treadmill training without VR and in the monitor condition. Healthy participants reported a higher motivation after the HMD condition as compared with the other conditions. Importantly, no side effects in the sense of simulator sickness occurred and usability ratings were high. No increases in heart rate were observed following the VR conditions. Presence ratings were higher for the HMD condition compared with the monitor condition for both user groups. Most of the healthy study participants (89\%) and patients (71\%) preferred the HMD-based training among the three conditions and most patients could imagine using it more frequently. Conclusions For the first time, the present study evaluated the usability of an immersive VR system for gait rehabilitation in a direct comparison with a semi-immersive system and a conventional training without VR with healthy participants and patients. The study demonstrated the feasibility of combining a treadmill training with immersive VR. Due to its high usability and low side effects, it might be particularly suited for patients to improve training motivation and training outcome e. g. the walking speed compared with treadmill training using no or only semi-immersive VR. Immersive VR systems still require specific technical setup procedures. This should be taken into account for specific clinical use-cases during a cost-benefit assessment.},
  language  = {en}
}
@article{GromerMadeiraGastetal.2018,
  author    = {Gromer, Daniel and Madeira, Oct{\´a}via and Gast, Philipp and Nehfischer, Markus and Jost, Michael and M{\"u}ller, Mathias and M{\"u}hlberger, Andreas and Pauli, Paul},
  title     = {Height Simulation in a Virtual Reality CAVE System: Validity of Fear Responses and Effects of an Immersion Manipulation},
  series = {Frontiers in Human Neuroscience},
  volume    = {12},
  journal   = {Frontiers in Human Neuroscience},
  number    = {372},
  issn      = {1662-5161},
  doi       = {10.3389/fnhum.2018.00372},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196113},
  year      = {2018},
  abstract  = {Acrophobia is characterized by intense fear in height situations. Virtual reality (VR) can be used to trigger such phobic fear, and VR exposure therapy (VRET) has proven effective for treatment of phobias, although it remains important to further elucidate factors that modulate and mediate the fear responses triggered in VR. The present study assessed verbal and behavioral fear responses triggered by a height simulation in a 5-sided cave automatic virtual environment (CAVE) with visual and acoustic simulation and further investigated how fear responses are modulated by immersion, i.e., an additional wind simulation, and presence, i.e., the feeling to be present in the VE. Results revealed a high validity for the CAVE and VE in provoking height related self-reported fear and avoidance behavior in accordance with a trait measure of acrophobic fear. Increasing immersion significantly increased fear responses in high height anxious (HHA) participants, but did not affect presence. Nevertheless, presence was found to be an important predictor of fear responses. We conclude that a CAVE system can be used to elicit valid fear responses, which might be further enhanced by immersion manipulations independent from presence. These results may help to improve VRET efficacy and its transfer to real situations.},
  language  = {en}
}
@article{MadeiraGromerLatoschiketal.2021,
  author    = {Madeira, Octavia and Gromer, Daniel and Latoschik, Marc Erich and Pauli, Paul},
  title     = {Effects of Acrophobic Fear and Trait Anxiety on Human Behavior in a Virtual Elevated Plus-Maze},
  series = {Frontiers in Virtual Reality},
  volume    = {2},
  journal   = {Frontiers in Virtual Reality},
  doi       = {10.3389/frvir.2021.635048},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258709},
  year      = {2021},
  abstract  = {The Elevated Plus-Maze (EPM) is a well-established apparatus to measure anxiety in rodents, i.e., animals exhibiting an increased relative time spent in the closed vs. the open arms are considered anxious. To examine whether such anxiety-modulated behaviors are conserved in humans, we re-translated this paradigm to a human setting using virtual reality in a Cave Automatic Virtual Environment (CAVE) system. In two studies, we examined whether the EPM exploration behavior of humans is modulated by their trait anxiety and also assessed the individuals' levels of acrophobia (fear of height), claustrophobia (fear of confined spaces), sensation seeking, and the reported anxiety when on the maze. First, we constructed an exact virtual copy of the animal EPM adjusted to human proportions. In analogy to animal EPM studies, participants (N = 30) freely explored the EPM for 5 min. In the second study (N = 61), we redesigned the EPM to make it more human-adapted and to differentiate influences of trait anxiety and acrophobia by introducing various floor textures and lower walls of closed arms to the height of standard handrails. In the first experiment, hierarchical regression analyses of exploration behavior revealed the expected association between open arm avoidance and Trait Anxiety, an even stronger association with acrophobic fear. In the second study, results revealed that acrophobia was associated with avoidance of open arms with mesh-floor texture, whereas for trait anxiety, claustrophobia, and sensation seeking, no effect was detected. Also, subjects' fear rating was moderated by all psychometrics but trait anxiety. In sum, both studies consistently indicate that humans show no general open arm avoidance analogous to rodents and that human EPM behavior is modulated strongest by acrophobic fear, whereas trait anxiety plays a subordinate role. Thus, we conclude that the criteria for cross-species validity are met insufficiently in this case. Despite the exploratory nature, our studies provide in-depth insights into human exploration behavior on the virtual EPM.},
  language  = {en}
}
@article{EwaldGlotzbachSchoonGerdesetal.2014,
  author    = {Ewald, Heike and Glotzbach-Schoon, Evelyn and Gerdes, Antje B. M. and Andreatta, Marta and M{\"u}ller, Mathias and M{\"u}hlberger, Andreas and Pauli, Paul},
  title     = {Delay and trace fear conditioning in a complex virtual learning environment - neural substrates of extinction},
  series = {Frontiers in Human Neuroscience},
  volume    = {8},
  journal   = {Frontiers in Human Neuroscience},
  number    = {323},
  issn      = {1662-5161},
  doi       = {10.3389/fnhum.2014.00323},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-116230},
  year      = {2014},
  abstract  = {Extinction is an important mechanism to inhibit initially acquired fear responses. There is growing evidence that the ventromedial prefrontal cortex (vmPFC) inhibits the amygdala and therefore plays an important role in the extinction of delay fear conditioning. To our knowledge, there is no evidence on the role of the prefrontal cortex in the extinction of trace conditioning up to now. Thus, we compared brain structures involved in the extinction of human delay and trace fear conditioning in a between-subjects-design in an fMRI study. Participants were passively guided through a virtual environment during learning and extinction of conditioned fear. Two different lights served as conditioned stimuli (CS); as unconditioned stimulus (US) a mildly painful electric stimulus was delivered. In the delay conditioning group (DCG) the US was administered with offset of one light (CS+), whereas in the trace conditioning group (TCG) the US was presented 4s after CS+ offset. Both groups showed insular and striatal activation during early extinction, but differed in their prefrontal activation. The vmPFC was mainly activated in the DCG, whereas the TCG showed activation of the dorsolateral prefrontal cortex (dlPFC) during extinction. These results point to different extinction processes in delay and trace conditioning. VmPFC activation during extinction of delay conditioning might reflect the inhibition of the fear response. In contrast, dlPFC activation during extinction of trace conditioning may reflect modulation of working memory processes which are involved in bridging the trace interval and hold information in short term memory.},
  language  = {en}
}
@article{NeuederAndreattaPauli2019,
  author    = {Neueder, Dorothea and Andreatta, Marta and Pauli, Paul},
  title     = {Contextual fear conditioning and fear generalization in individuals with panic attacks},
  series = {Frontiers in Behavioral Neuroscience},
  volume    = {13},
  journal   = {Frontiers in Behavioral Neuroscience},
  doi       = {10.3389/fnbeh.2019.00152},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201318},
  pages     = {152},
  year      = {2019},
  abstract  = {Context conditioning is characterized by unpredictable threat and its generalization may constitute risk factors for panic disorder (PD). Therefore, we examined differences between individuals with panic attacks (PA; N = 21) and healthy controls (HC, N = 22) in contextual learning and context generalization using a virtual reality (VR) paradigm. Successful context conditioning was indicated in both groups by higher arousal, anxiety and contingency ratings, and increased startle responses and skin conductance levels (SCLs) in an anxiety context (CTX+) where an aversive unconditioned stimulus (US) occurred unpredictably vs. a safety context (CTX-). PA compared to HC exhibited increased differential responding to CTX+ vs. CTX- and overgeneralization of contextual anxiety on an evaluative verbal level, but not on a physiological level. We conclude that increased contextual conditioning and contextual generalization may constitute risk factors for PD or agoraphobia contributing to the characteristic avoidance of anxiety contexts and withdrawal to safety contexts and that evaluative cognitive process may play a major role.},
  language  = {en}
}
@article{GromerReinkeChristneretal.2019,
  author    = {Gromer, Daniel and Reinke, Max and Christner, Isabel and Pauli, Paul},
  title     = {Causal interactive links between presence and fear in virtual reality height exposure},
  series = {Frontiers in Psychology},
  volume    = {10},
  journal   = {Frontiers in Psychology},
  number    = {141},
  doi       = {10.3389/fpsyg.2019.00141},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201855},
  year      = {2019},
  abstract  = {Virtual reality plays an increasingly important role in research and therapy of pathological fear. However, the mechanisms how virtual environments elicit and modify fear responses are not yet fully understood. Presence, a psychological construct referring to the 'sense of being there' in a virtual environment, is widely assumed to crucially influence the strength of the elicited fear responses, however, causality is still under debate. The present study is the first that experimentally manipulated both variables to unravel the causal link between presence and fear responses. Height-fearful participants (N = 49) were immersed into a virtual height situation and a neutral control situation (fear manipulation) with either high versus low sensory realism (presence manipulation). Ratings of presence and verbal and physiological (skin conductance, heart rate) fear responses were recorded. Results revealed an effect of the fear manipulation on presence, i.e., higher presence ratings in the height situation compared to the neutral control situation, but no effect of the presence manipulation on fear responses. However, the presence ratings during the first exposure to the high quality neutral environment were predictive of later fear responses in the height situation. Our findings support the hypothesis that experiencing emotional responses in a virtual environment leads to a stronger feeling of being there, i.e., increase presence. In contrast, the effects of presence on fear seem to be more complex: on the one hand, increased presence due to the quality of the virtual environment did not influence fear; on the other hand, presence variability that likely stemmed from differences in user characteristics did predict later fear responses. These findings underscore the importance of user characteristics in the emergence of presence.},
  language  = {en}
}
@phdthesis{Baur2016,
  author    = {Baur, Ramona},
  title     = {Adult Attention-Deficit/Hyperactivity Disorder (ADHD), Emotion Processing, and Emotion Regulation in Virtual Reality},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142064},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2016},
  abstract  = {Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by symptoms of inattentiveness and hyperactivity/impulsivity. Besides, increasing evidence points to ADHD patients showing emotional dysfunctions and concomitant problems in social life. However, systematic research on emotional dysfunctions in ADHD is still rare, and to date most studies lack conceptual differentiation between emotion processing and emotion regulation. The aim of this thesis was to systematically investigate emotion processing and emotion regulation in adult ADHD in a virtual reality paradigm implementing social interaction. Emotional reactions were assessed on experiential, physiological, and behavioral levels. Experiment 1 was conducted to develop a virtual penalty kicking paradigm implying social feedback and to test it in a healthy sample. This paradigm should then be applied in ADHD patients later on. Pleasant and unpleasant trials in this paradigm consisted of hits respectively misses and subsequent feedback from a virtual coach. In neutral trials, participants were teleported to different spots of the virtual stadium. Results indicated increased positive affectivity (higher valence and arousal ratings, higher zygomaticus activations, and higher expression rates of positive emotional behavior) in response to pleasant compared to neutral trials. Reactions to unpleasant trials were contradictory, indicating increased levels of both positive and negative affectivity, compared to neutral trials. Unpleasant vs. neutral trials revealed lower valence ratings, higher arousal ratings, higher zygomaticus activations, slightly lower corrugator activations, and higher expression rates of both positive and negative emotional behavior. The intensity of emotional reactions correlated with experienced presence in the virtual reality. To better understand the impact of hits or misses per se vs. hits or misses with coach feedback healthy participants' emotional reactions, only 50\% of all shots were followed by coach feedback in experiment 2. Neutral trials consisted of shots over the free soccer field which were followed by coach feedback in 50 \% of all trials. Shots and feedback evoked more extreme valence and arousal ratings, higher zygomaticus activations, lower corrugator activations, and higher skin conductance responses than shots alone across emotional conditions. Again, results speak for the induction of positive emotions in pleasant trials whereas the induction of negative emotions in unpleasant trials seems ambiguous. Technical improvements of the virtual reality were reflected in higher presence ratings than in experiment 1. Experiment 3 investigated emotional reactions of adult ADHD patients and healthy controls after emotion processing and response-focused emotion regulation. Participants successively went through an ostensible online ball-tossing game (cyber ball) inducing negative emotions, and an adapted version of the virtual penalty kicking game. Throughout cyber ball, participants were included or ostracized by two other players in different experimental blocks. Participants were instructed to explicitly show, not regulate, or hide their emotions in different experimental blocks. Results provided some evidence for deficient processing of positive emotions in ADHD. Patients reported slightly lower positive affect than controls during cyber ball, gave lower valence ratings than controls in response to pleasant penalty kicking trials, and showed lower zygomaticus activations than controls especially during penalty kicking. Patients in comparison with controls showed slightly increased processing of unpleasant events during cyber ball (higher ratings of negative affect, especially in response to ostracism), but not during penalty kicking. Patients showed lower baseline skin conductance levels than controls, and impaired skin conductance modulations. Compared to controls, patients showed slight over-expression of positive as well as negative emotional behavior. Emotion regulation analyses revealed no major difficulties of ADHD vs. controls in altering their emotional reactions through deliberate response modulation. Moreover, patients reported to habitually apply adaptive emotion regulation strategies even more frequently than controls. The analyses of genetic high-risk vs. low-risk groups for ADHD across the whole sample revealed similar results as analyses for patients vs. controls for zygomaticus modulations during emotion processing, and for modulations of emotional reactions due to emotion regulation. To sum up, the virtual penalty kicking paradigm proved to be successful for the induction of positive, but not negative emotions. The importance of presence in virtual reality for the intensity of induced emotions could be replicated. ADHD patients showed impaired processing of primarily positive emotions. Aberrations in negative emotional responding were less clear and need further investigation. Results point to adult ADHD in comparison to healthy controls suffering from baseline deficits in autonomic arousal and deficits in arousal modulation. Deficits of ADHD in the deliberate application of response-focused emotion regulation could not be found.},
  subject      = {Aufmerksamkeitsdefizit-Syndrom},
  language  = {en}
}
@article{KiserGromerPaulietal.2022,
  author    = {Kiser, Dominik P. and Gromer, Daniel and Pauli, Paul and Hilger, Kirsten},
  title     = {A virtual reality social conditioned place preference paradigm for humans: Does trait social anxiety affect approach and avoidance of virtual agents?},
  series = {Frontiers in Virtual Reality},
  volume    = {3},
  journal   = {Frontiers in Virtual Reality},
  issn      = {2673-4192},
  doi       = {10.3389/frvir.2022.916575},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-293564},
  year      = {2022},
  abstract  = {Approach and avoidance of positive and negative social cues are fundamental to prevent isolation and ensure survival. High trait social anxiety is characterized by an avoidance of social situations and extensive avoidance is a risk factor for the development of social anxiety disorder (SAD). Therefore, experimental methods to assess social avoidance behavior in humans are essential. The social conditioned place preference (SCPP) paradigm is a well-established experimental paradigm in animal research that is used to objectively investigate social approach-avoidance mechanisms. We retranslated this paradigm for human research using virtual reality. To this end, 58 healthy adults were exposed to either a happy- or angry-looking virtual agent in a specific room, and the effects of this encounter on dwell time as well as evaluation of this room in a later test without an agent were examined. We did not observe a general SCPP effect on dwell time or ratings but discovered a moderation by trait social anxiety, in which participants with higher trait social anxiety spent less time in the room in which the angry agent was present before, suggesting that higher levels of trait social anxiety foster conditioned social avoidance. However, further studies are needed to verify this observation and substantiate an association with social anxiety disorder. We discussed the strengths, limitations, and technical implications of our paradigm for future investigations to more comprehensively understand the mechanisms involved in social anxiety and facilitate the development of new personalized treatment approaches by using virtual reality.},
  language  = {en}
}