The attention to the emotion dimension, in the context of interventions aimed at promoting psychological wellbeing as well as the treatment of some psychopathological conditions, allowed the development in recent decades important studies and reflections both from the point of view of theoretical scientific knowledge and therapeutic implications. Starting from the awareness of the important functions that emotions perform in intra and interpersonal dynamics, the question of emotion regulation becomes central, as a complex and dynamic psychic activity that allows the achievement of individual well-being and good social functioning. Experiments and therapeutic interventions based on virtual reality (VR) in recent years have opened new scenarios and led to new knowledge regarding emotion regulation in both normotypic and pathological samples. The aim of the following paper is to offer a review of the scientific literature of the last 10 years regarding the use of virtual reality in the context of emotion regulation.
A number of theorists, starting with Tomkins [
Although there is not yet full agreement among scholars, we can nevertheless estimate about five
primary emotions by relying on scientific evidence [
In support of this thesis, recent research finds identifying in a good interpersonal regulatory competence
a protective factor against psychopathology [
The essential aspects, from a technical point of view, that define a virtual reality technology are: a
computer capable of supporting real-time animations, controlled by a series of position trackers; a set
of input information that must be integrated and used to provide the user with an image modification,
possibly in a rapid time to the point of creating an illusion of concomitance; a stereoscopic headset
(head-mounted-display-HDM) for visual output [
Despite the importance of this description, it would be simplistic to consider virtual reality as a simple
sum of technologies, its founding element and what makes it such an important scientific frontier is that
it allows a new type of human-machine interaction [
The impact of emotion regulation interventions on well-being has been extensively documented in the
literature and the positive changes with respect to this process have also been important with regard to
mental health and relationship satisfaction [
Through virtual reality it was possible to improve the subjects' abilities to recognize and control their emotions. Lorenzetti et al. created a virtual environment in which it was possible to experience a game through which participants received sensory feedback in real time whenever they felt tenderness, distress or neutral emotion states in progress [19]. The neurofeedback system was based on BCI (neuronal interface based on EEG) for which neuronal activity was connected to the colorof the virtual environment which changed according to the fluctuation of the emotion state experienced by the subject. In this way, the participants were instructed to feel tenderness or anguish as intensely as possible and to voluntarily increase the intensity of their emotions in the sense of increasing their neural activity while experiencing complex emotions [19].
Over the years, some researchers have also investigated the issue of the use of VR in pathological
samples, with the aim of monitoring its effectiveness and usability in therapy [
The literature analysis was carried out using the main search engines PubMed and Google Scholar. Advanced searches were carried out which allowed to direct the bibliographic search towards results that presented the main keywords "virtual reality" and "emotion regulation" combined with the words "emotion", " psychological disorders", "gad", "anxiety disorders ", "borderline" emerged after the bibliographic searches. The words have been searched in thetitle section and, where possible, among the key words. The search was carried out in July 2020, including articles published over a period of time ranging from 2010 to 2020.
Exclusion criteria: No VR studies
The results of Table 1 show that virtual reality is a valid tool for implementing treatments aimed at improving emotion regulation strategies in patients and healthy subjects.
The studies by Lorenzetti et.al, Weerdmeester et al., investigated the use of biofeedback and neurofeedback within VR and found an improvement in the regulation of the emotion and physiological response and awareness through these techniques.
Konrad et al. and Bosse et al. both conducted two studies on non-clinical subjects and had satisfactory results with respect to the possibility of using virtual reality systems in order to generate learning of more adaptive ER strategies.
A series of VR interventions, carried out by Tarrant et al., Navarro-Haro et al. on the other hand, were found to be effective in subjects with generalized anxiety disorders by improving the conscious control of their anxious response using both relaxation techniques and meditation.
A single study was conducted by Navarro-Haro et al on borderline disorder. From this intervention, through VR, an improvement was seen with respect to the negative emotions generally experienced by BDP subjects.
With respect to phobic disorders, a review of nine studies presented by Wechsler et al. suggests that VR exposure shows a greater potential and is no less effective than in vivo exposure in specific phobia andagoraphobia.
Ultimately Wrzesien et al. they focused their intervention on the possibility of learning emotion regulation through the use of self-similar avatars in a virtual environment and the results indicate an improvement in emotion regulation through model observation (VRS). 371 phobic disorder pat.
effect sizes
greater potential and is no less effective than in vivo exposure in specific phobia and agoraphobia.
physiological reduction in anxiety.
Results show the crucial features that make walking positive for psychological
wellbeing activation in several relevant brains regions that are associated with sadness induction and that are associated with the application of emotion regulation strategies
The results of this systematic review show that VR should be a valid tool for improving the ability of individuals to manage emotions by allowing the learning of more adaptive emotion regulation strategies to the context.
The use of this innovative technology in this sense is promising because it allows to recreate realistic digital environments within which VR interventions can, for example, inspire new actions, increase the awareness of subjects regarding their emotions, allow the modification of the emotion response through the re-evaluation of emotion stimuli and, subsequently, memorize the re-evaluated experience. These results are relevant both for health promotion and prevention treatments for the onset of disorders, both for the treatment of subjects who already have more or less serious pathologies, as in the case of anxiety or borderline disorders.
It has also been shown that the effectiveness can be better than non-VR treatments and that adherence to the treatment was, in some cases, greater.
It has also been shown that the effectiveness can be better than non-VR treatments and that adherence to the treatment was also, in some cases, greater.
Considering, therefore, the different advantages of VR exposure and its high potential, its diffusion should be emphasized and a deeper investigation of what are the relevant operating mechanisms is necessary in order to develop improvements in technology and procedures that they could produce even greater effects in the future.
Research should aim to investigate the mechanisms and underlying factors that may contribute to the effectiveness of biofeedback systems when using VR interventions for ER in order to maximize their positive therapeutic outcomes, and furthermore, it would be interesting again, to be able to understand how way avatars and embodiment in virtual bodies can enhance the learning of emotion regulation strategies in a more engaging way.
As the introduction of avatars into mental health applications is relatively new, a deeper understanding of their influence on user behavior is of great importance.
emotion Regulation Interventions in Virtual Reality for the Improvement of Wellbeing in Adults and Older Adults : A Systematic Review. J Clin Med [Internet]. 2020 Feb 12 [cited 2020 Feb 28];9(2):1–22. Available from: http://www.ncbi.nlm. nih.gov/pubmed/32059514 [18] Colombo D.; Fernández-álvarez, J.; Palacios, A.G.; Cipresso P.; Botella, C.; Riva G. New technologies for the understanding, assessment, and intervention of emotion regulation. Front.
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