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Background and Objective: With the rise of autonomous e-mental health applications, virtual agents can play a major role in improving trustworthiness, therapy outcome and adherence. In these applications, it is important that patients adhere in the sense that they perform the tasks, but also that they adhere to the specific recommendations on how to do them well. One important construct in improving adherence is psychoeducation, information on the why and how of therapeutic interventions. In an e-mental health context, this can be delivered in two different ways: verbally by a (virtual) embodied conversational agent or just via text on the screen. The aim of this research is to study which presentation mode is preferable for improving adherence.Methods: This study takes the approach of evaluating a specific part of a therapy, namely psychoeducation. This was done in a non-clinical sample, to first test the general constructs of the human-computer interaction. We performed an experimental study on the effect of presentation mode of psychoeducation on adherence. In this study, we took into account the moderating effects of attitude towards the virtual agent and recollection of the information. Within the paradigm of expressive writing, we asked participants (n= 46) to pick one of their worst memories to describe in a digital diary after receiving verbal or textual psychoeducation.Results and Conclusion: We found that both the attitude towards the virtual agent and how well the psychoeducation was recollected were positively related to adherence in the form of task execution. Moreover, after controlling for the attitude to the agent and recollection, presentation of psychoeducation via text resulted in higher adherence than verbal presentation by the virtual agent did. [ABSTRACT FROM AUTHOR]

Although virtual reality exposure has been reported as a method to induce paranoid thought, little is known about mechanisms to control specific virtual stressors. This paper reports on a study that examines the effect of controlling the stream of potential paranoia evoking events in a virtual restaurant world. A 2-by-2 experiment with a non-clinical group (n = 24) was conducted with as two within-subject factors: (1) the cycle time (short/long) for when the computer considers activation of a paranoia evoking event and (2) the probability that a paranoia-evoking event (low/high) would be triggered at the completion of a cycle. The results showed a significant main effect for the probability factor and two-way interaction effect with the cycle time factor on the number of paranoid comments participants made and their self-reported anxiety. [ABSTRACT FROM AUTHOR]

Freeman et al. reported that a substantial minority of the general population has paranoid thoughts while exposed in a virtual environment. This suggested that in a development phase of a virtual reality exposure system for paranoid patients initially a non-clinical sample could be used to evaluate the system's ability to induce paranoid thoughts. To increase the efficiency of such an evaluation, this paper takes the position that when appropriately primed a larger group of a non-clinical sample will display paranoid thoughts. A 2-by-2 experiment was conducted with priming for insecurity and vigilance as a within-subject factor and prior-paranoid thoughts (low or high) as a between-subjects factor. Before exposure into the virtual world, participants (n = 24) were shown a video and read a text about violence or about mountain animals. While exposed, participants were asked to comment freely on their virtual environment. The results of the experiment confirmed that exposure in a virtual environment could induce paranoid thought. In addition, priming with an aim to create a feeling of insecurity and vigilance increased paranoid comments in the non-clinical group that otherwise would less often exhibit ideas of persecution. [ABSTRACT FROM AUTHOR]

The paper discusses the design and evaluation of a multimedia software application, which can be used in the treatment of combat-related posttraumatic stress disorder (PTSD). The application allows patients and therapist to visualize the patients' past experience using maps, personal photos, stories and self-created 3D virtual worlds. The tool aims to allow patients to restructure and relearn about their past experience involving the problematic stressors. Findings of a first experiment with non-patients (N=18) suggests that the tool can facilitate more detailed storytelling. Participants stated that using the application was appealing and enjoyable. Insights were also acquired with a case study of a veteran suffering from combat-related PTSD. This case study showed how a patient uses and interacts with the system in a therapeutic setting. [ABSTRACT FROM AUTHOR]

In accordance with the global trend, in The Netherlands approximately 45% of the population is overweight. Existing studies show that patient self-management can reduce these figures, but medical non-adherence is a persistent problem. eHealth can potentially increase adherence to self-management. Consequently, we designed a persuasive computer assistant and evaluated its influence on self-management, i.e., the use of an online lifestyle diary called DieetInzicht.nl. The assistant is represented by an animated iCat, which shows different facial expressions and provides cooperative feedback following principles from the motivational interviewing method. We conducted a randomized controlled trial with 118 overweight people over a period of four weeks and studied the difference between diary use with and without computer assistant feedback. Results show that the computer assistant contributed to filling in the diary more frequently, reduced the decline in motivation to perform self-management, lowered the (reported) BMI, and improved the ease of use. Furthermore, diary use increased knowledge of maintaining a healthy lifestyle. Finally, personal characteristics, i.e., locus of control, vocabulary, computer experience, age, gender, education level and initial BMI, explained the variance in the diary use and its outcome. Of the 118 participants 35 filled in the closing survey, covering motivation, BMI, lifestyle knowledge and ease of use, which implies that the findings based on these results are mainly representative for motivated participants. In general, this study shows that the Dieetinzicht eHealth service, including a personal computer assistant, is likely to support motivated overweight people and lifestyle related diseases to get a better insight in and adhere to their self-management. [ABSTRACT FROM AUTHOR]

The paper discusses the design and evaluation of a multimedia software application, which can be used in the treatment of combat-related posttraumatic stress disorder (PTSD). The application allows patients and therapist to visualize the patients' past experience using maps, personal photos, stories and self-created 3D virtual worlds. The tool aims to allow patients to restructure and relearn about their past experience involving the problematic stressors. Findings of a first experiment with non-patients (N=18) suggests that the tool can facilitate more detailed storytelling. Participants stated that using the application was appealing and enjoyable. Insights were also acquired with a case study of a veteran suffering from combat-related PTSD. This case study showed how a patient uses and interacts with the system in a therapeutic setting.