Background: The ongoing conflict in Ukraine has led to a rise in stress-related symptoms, including anxiety and depression, among veterans, necessitating accessible and effective mental health interventions. Traditional rehabilitation resources are often limited, prompting exploration into alternative therapies.Objective: This paper aims to assess the effectiveness of immersive 360° video-based Virtual Reality (VR) therapy as an enhancement to standard rehabilitation programmes for Ukrainian veterans experiencing anxiety and depression.Method: A randomised controlled trial (RCT) was conducted with 69 participants, who were randomly assigned to either the experimental group (n = 34), receiving daily VR sessions alongside standard rehabilitation, or the control group (n = 35), following standard rehabilitation alone. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) both at baseline and post-intervention. Additionally, momentary changes in anxiety and mood were measured immediately before and after each VR session to evaluate the immediate effects. The VR intervention was designed with veteran and expert feedback to enhance emotional regulation and stress resilience, integrating evidence-based psychotherapeutic techniques.Results: Results demonstrate significant rapid improvement in mood and reduction in anxiety following each session, along with significant reductions in anxiety (up to 14.5%) and depression (up to 12.3%) upon programme completion. Consistent results across all study iterations confirmed the reliability and scalability of 360-VR therapy as a short-term rehabilitation tool.Conclusions: Immersive VR therapy presents an effective, accessible solution for managing the psychological impact of war, particularly within the limitations of Ukraine's healthcare system.

Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease primarily affecting motor neurons but also leading to significant non-motor symptoms, including cognitive impairments, anxiety, depression, and behavioral changes, which severely impact quality of life. While mindfulness-based interventions (MBIs) have shown promise in alleviating psychological distress, their accessibility is often limited due to patients' physical impairments. Virtual reality (VR) could enhance engagement and immersion, offering a novel, more inclusive therapeutic approach. This randomized controlled trial (RCT) aims to evaluate the efficacy of a VR-based MBI compared to traditional mindfulness for ALS patients. Forty-six participants will be randomly assigned to an eight-week mindfulness program delivered either via VR or in a conventional format. The primary outcome is quality of life, assessed using the ALS-Specific Quality of Life Scale (ALSSQOL-R). Secondary outcomes include cognitive function, anxiety, depression, behavioral changes, and mindfulness propensity, evaluated at baseline, post-intervention, and three-month follow-up. The study will also examine VR usability and potential accessibility challenges for ALS patients. By addressing a critical gap in non-pharmacological psychological care, this study will provide key insights into the feasibility and benefits of VR-based MBIs. If effective, VR mindfulness could offer an innovative, scalable solution to improve emotional well-being and quality of life in ALS, making psychological support more accessible for patients with severe physical limitations.

The aim of this study was to determine the effectiveness of virtual reality on anxiety, pain, sleep quality, and posttraumatic stress disorder in critically ill patients within intensive care units.

The data sources included PubMed, EMBASE, Web of Science, CENTRAL, PsycINFO, and CINAHL DATA databases.

Two authors independently conducted the literature search and quality assessment process. The pooled results were calculated using the standardised mean difference (SMD) and its 95% confidence interval (CI) using the Review Manager software (Version 5.4).

Ten randomised controlled trials published from 2020 to 2024 were included. Most of the studies were classified as having a low risk of bias or some concerns. The evidence certainty varied from low to moderate for the different outcomes. The pooled results indicated statistically significant effectiveness in anxiety (SMD: -0.46, 95% CI: -0.80 to -0.11, P = 0.01) and sleep quality (SMD: 0.66, 95% CI: 0.29-1.03, P < 0.001) postintervention. No statistically significant effects were found for pain (SMD: -0.11, 95% CI: -0.79-0.57, P = 0.75) or posttraumatic stress disorder (SMD: -0.29, 95 % CI: -0.59-0.02, P = 0.06).

Virtual reality is practical for mitigating anxiety and enhancing sleep quality in critically ill patients within intensive care units; however, its effects on pain and posttraumatic stress disorder are nonsignificant. Virtual reality can broaden its utility and content within intensive care units by incorporating meditation, hypnosis, and cognitive behavioural strategies. Careful consideration should be given to the timing and frequency of virtual reality sessions for patients who are critically ill and unable to remain conscious.

Virtual reality is a promising complementary therapy in intensive care units. It can reduce anxiety and improve sleep quality. Still, its effects on pain and posttraumatic stress disorder are not significant, and future research should focus on optimising devices, expanding content, and selecting appropriate intervention timing and frequency.

There is burgeoning interest in the application of neuroscientific technology to facilitate meditation and lead to beneficial psychological outcomes. One popular approach is using consumer-grade neurofeedback devices to deliver feedback on brain targets during meditation (mindfulness-based neurofeedback). It is hypothesized that optimizing brain targets like alpha and theta band activity may allow meditators to experience deeper mindfulness and thus beneficial outcomes.

This study aimed to systematically review and meta-analyze the impacts of consumer-grade mindfulness-based neurofeedback compared with control conditions. Included studies involved mindfulness practice operationalized as open monitoring or focused attention meditation. This study was preregistered.

A total of 16 randomized controlled training trials, as well as 5 randomized within-participant designs were included, encompassing 763 and 167 unique participants, respectively. Effects were categorized outcomes (ie, psychological distress, cognitive function, and physiological health) and process variables (ie, state mindfulness and brain measures). Study risk of bias, reporting bias, and publication bias were assessed.

Samples were typically small (n=30-50), and the majority of studies used mindfulness apps as controls. To deliver neurofeedback, most studies used the Muse device (11/16 randomized controlled trials [RCTs]). There was a modest effect for decreases in psychological distress compared with controls (k=11, g=-0.16, P=.03), and heterogeneity was low (I2< 0.25). However, there was no evidence for improvements in cognition (k=7, g=0.07, P=.48), mindfulness (k=9, g=0.02, P=.83), and physiological health (k=7, g=0.11, P=.57) compared to controls. Mechanistic modulation of brain targets was not found in RCTs or within-participant designs. Sex (male or female), age, clinical status, study quality, active or passive controls, sample size, and neurofeedback duration did not moderate effects. There was some evidence for reporting bias, but no evidence of publication bias. Adverse effects were not assessed in 19 out of 21 studies and not found in the 2 studies that assessed them.

Assertions that consumer-grade devices can allow participants to modulate their brains and deepen their meditations are not currently supported. It is possible that neurofeedback effects may rely on "neurosuggestion" (placebo effects of neurotechnology). Future research should examine more extensive calibration and individualization of devices, larger sample sizes, and gold-standard sham-controlled RCTs.

This study investigates the acceptability of Virtual reality (VR) technology for emotional regulation among cancer patients. Drawing from extensive literature, we enhanced external variables across user characteristics, product impact factors, and social environment influences, creating the "Theoretical Model of Cancer Patients' Acceptance of VR Intervention for Self-Emotion Regulation." Surveying 489 Chinese cancer patients validated the model's strong reliability through SPSS AMOS analysis. The acceptance of VR intervention for self-emotional regulation among cancer patients was assessed, revealing that the average scores across all 13 dimensions exceeded 3. This indicates that cancer patients hold a positive attitude toward VR-based emotional regulation interventions. Perceived usefulness, usage attitude, social norms, immersion, and personal innovation correlated positively with behavioral intention, while technological anxiety and perceived risk showed negative correlations. Findings support 15 hypotheses, offering theoretical backing for VR technology in emotional regulation for cancer patients. These insights provide medical institutions with valuable data on patient attitudes, facilitating the development of targeted treatment approaches.

Patients undergoing chemotherapy often experience side effects during treatment, including psychological distress and symptoms of anxiety and depression. Interventions during chemotherapy that divert attention from potentially aversive environmental factors have been demonstrated to have a beneficial impact on these symptoms. Virtual reality (VR) offers the potential to visually and audibly disengage from the surrounding environment and can create an alternative sense of presence. This could facilitate the implementation of active guided interventions that may prove more effective than receptive interventions, such as listening to music. The present study examines the feasibility, acceptance and effectiveness of a VR intervention and a music intervention during chemotherapy.

The single-centre three-arm, randomised-controlled trial investigates the efficacy of a VR mindfulness intervention and a music intervention in patients with cancer undergoing chemotherapy at the University Hospital Düsseldorf, Germany. Patients were randomly assigned to receive either (a) the VR mindfulness intervention, (b) the receptive music intervention or (c) the standard care (control group) in two consecutive chemotherapy sessions. A comprehensive psychological assessment and self-ratings using visual analogue scales will be conducted with situational anxiety as the primary outcome measure. Additionally, secondary measures will be employed to assess cancer-related anxiety, self-efficacy and chemotherapy-related side effects. Furthermore, salivary cortisol, heart rate and blood pressure will be recorded. At the end of the study, an evaluation questionnaire will be completed. It is planned to enrol 82 patients.

The study has been approved by the ethics committee of the medical faculty of the Heinrich-Heine-University Düsseldorf (2022-1880). Written informed consent is obtained from the patients prior to participation. The results will be published in international scientific, peer-reviewed journals. Conference presentations are also planned.

German Clinical Trials Register (DRKS00029738).

This study evaluated the effectiveness of a virtual reality (VR) based stress reduction program tailored for healthcare and information technology (IT) professionals during the coronavirus disease-2019 pandemic.

The 2-week program, based on forest healing principles, was designed to alleviate occupational stress and improve sleep quality. Participants (n=54; 46 healthcare, 8 IT professionals) underwent pre- and post-intervention assessments using validated psychological scales and physiological measurements.

Results showed significant reductions in stress (Perceived Stress Scale [PSS], p=0.001) and anxiety (Hospital Anxiety and Depression Scale [HADS] anxiety, p=0.002) across all participants. Healthcare professionals demonstrated significant decreases in depression (Patient Health Questionnaire-9, p=0.015), anxiety (HADS anxiety, p<0.001), and stress (PSS, p=0.001). Unexpectedly, weekday sleep quality (Pittsburgh Sleep Quality Index) worsened in the healthcare group (p=0.013). The IT group showed no significant changes, possibly due to the small sample size. Physiological measurements revealed significant differences between groups post-intervention, including melatonin levels (p=0.001) and electrocardiogram values (p=0.031), suggesting occupation-specific responses to VR interventions.

Despite limitations such as unequal sample sizes, this study provides valuable insights into the potential of VR-based stress management programs. The findings underscore the need for occupation-specific approaches and further research with larger, balanced samples to validate these results and explore long-term effects.

Increased stress, anxiety, and depression hinder recovery of hospitalized patients. Mindfulness therapies, which adopt a holistic approach to patient care, reduce anxiety, and depression. This quality improvement initiative evaluated the implementation of a virtual reality (VR) therapeutic art program at Stanford Health Care from February to June 2024, providing an innovative and scalable adjunct to traditional art and music mindfulness therapies. This mixed methods project piloted 84 cumulative hours with 105 participants. Outcomes investigated satisfaction and the impact on hospitalization experience via survey questions. Data were analyzed using descriptive statistics and thematic analysis. Results (n = 40) indicated substantial improvements in patient experience, with 85% recommending the program and 97.5% reporting positive impacts from VR engagement. Thematic analysis of open-ended survey responses identified 4 key themes: escape and distraction, therapeutic benefits, enjoyment of the interactive activity, and positive facilitator interactions. Participants also expressed interest in additional VR offerings, including virtual mindfulness, and meditation. The results suggest that VR can serve as an effective adjunct to conventional mindfulness therapies and improve the inpatient experience.

The global aging population and rapid development of digital technology have made health management among older adults an urgent public health issue. The complexity of online health information often leads to psychological challenges, such as cyberchondria, exacerbating health information avoidance behaviors. These behaviors hinder effective health management; yet, little research examines their mechanisms or intervention strategies.

This study investigates the mechanisms influencing health information avoidance among older adults, emphasizing the mediating role of cyberchondria. In addition, it evaluates the effectiveness of mindfulness meditation as an intervention strategy to mitigate these behaviors.

A mixed methods approach was used, combining quantitative and qualitative methodologies. Substudy 1 developed a theoretical model based on self-determination theory to explore internal (positive metacognition and health self-efficacy) and external (subjective norms and health information similarity) factors influencing health information avoidance, with cyberchondria as a mediator. A cross-sectional survey (N=236) was conducted to test the proposed model. Substudy 2 involved a 4-week mindfulness meditation intervention (N=94) to assess its impact on reducing health information avoidance behaviors.

Study 1 showed that positive metacognition (β=.26, P=.002), health self-efficacy (β=.25, P<.001), and health information similarity (β=.29, P<.001) significantly predicted health information avoidance among older adults. Cyberchondria mediated these effects: positive metacognition (effect=0.106, 95% CI 0.035-0.189), health self-efficacy (effect=0.103, 95% CI 0.043-0.185), and health information similarity (effect=0.120, 95% CI 0.063-0.191). Subjective norms did not significantly predict health information avoidance (β=‒.11, P=.13), and cyberchondria did not mediate this relationship (effect=‒0.045, 95% CI ‒0.102 to 0.016). Study 2 found that after the 4-week mindfulness intervention, the intervention group (group 1: n=46) exhibited significantly higher mindfulness levels than the control group (group 2: n=48; Mgroup1=4.122, Mgroup2=3.606, P<.001) and higher levels compared with preintervention (Mt2=4.122, Mt1=3.502, P<.001, where t1=preintervention and t2=postintervention). However, cyberchondria levels did not change significantly (Mt1=2.848, Mt2=2.685, P=.18). Nevertheless, the results revealed a significant interaction effect between mindfulness and cyberchondria on health information avoidance (effect=‒0.357, P=.002, 95% CI ‒0.580 to ‒0.131), suggesting that mindfulness intervention effectively inhibited the transformation of cyberchondria into health information avoidance behavior.

This study reveals the role of cyberchondria in health information avoidance and validates mindfulness meditation as an effective intervention for mitigating such behaviors. Findings offer practical recommendations for improving digital health information delivery and health management strategies for older adults.

Breast cancer is one of the most common types of cancer in China and worldwide. Apart from cancer, a majority of breast cancer patients suffer from various psychological disorders concurrently. The purpose of this study is to understand the actual experiences of breast cancer patients participating in Virtual Reality (VR) for psychological intervention, and to provide a theoretical basis for the development of VR psychological rehabilitation in China.

Twenty-three breast cancer patients who met the inclusion criteria were selected using purposive sampling method for this qualitative study. Semi-structured interviews were conducted to explore their experiences with VR psychological rehabilitation. The data were analyzed, summarized, and generalized using the Colaizzi analysis method.

The results of the interviews were consistent with the PAC structural analysis. Three themes and six sub-themes captured how patients felt about adopting VR for their psychological rehabilitation, including parent ego state (the feeling of loss when expectations are not met, improvement of sleep), adult ego state (relief of psychological stress, optimization, and recommendations for VR therapy), and child ego state (novel and fun immersive experience, contagiousness of variable emotions).

Breast cancer patients participating in the VR psychological rehabilitation had a favorable experience. To maximize the benefit of VR psychological rehabilitation, healthcare professionals should comprehensively assess the psychological state of breast cancer, optimize VR technology, and enable patients to enter the adult ego state. The new model of VR psychological rehabilitation needs to be further explored.

Virtual reality (VR) has been proposed as a technology to support mindfulness practice through promoting increased engagement and presence. The proposed benefits of this technology have been largely unexamined with clinical populations. Further research is required to understand its clinical potential and utility in improving and managing mental health symptoms.

This study aims to investigate the proximal impacts of a single, brief, VR-supported mindfulness practice for individuals with a mood or anxiety disorder and to understand user experiences, which may affect the acceptability and efficacy of VR mindfulness for this population.

This mixed methods study recruited 28 participants with a primary diagnosis of major depressive disorder, bipolar disorder, or anxiety disorder. Participants completed a mindfulness practice wearing a VR headset that was presenting an omnidirectional video of a forest scene, which was overlaid with a guided audio voiceover. Before and after the practice, measures were completed assessing state mindfulness (Toronto Mindfulness Scale), affect (Positive and Negative Affect Schedule), and anxiety (State-Trait Anxiety Inventory Y-1; n=27). Semistructured interviews were then held inquiring about the user experience and were analyzed using thematic analysis (n=24).

After completing the VR-supported mindfulness practice, both measures of state mindfulness on the Toronto Mindfulness Scale, mean curiosity and decentering, increased significantly (Cohen d=1.3 and 1.51, respectively; P<.001). Negative affect on the Positive and Negative Affect Schedule (Cohen d=0.62; P=.003) and State-Trait Anxiety Inventory Y-1 state anxiety (Cohen d=0.84; P<.001) significantly reduced. There was no significant change in positive affect (Cohen d=0.29; P=.08). Qualitative analysis of interviews identified 14 themes across 5 primary theme categories. The results suggested that being mindful during the use of the app was experienced as relatively effortless because of the visual and immersive elements. It was also experienced as convenient and safe, including when compared with prior traditional experiences of mindfulness. Participants also identified the uses for VR-supported mindfulness in managing emotions and symptoms of mental illness.

The results provide preliminary evidence that VR-supported mindfulness can improve emotional states and manage mental health symptoms for those with mood or anxiety disorders. It offers some potential clinical applications for those with mood or anxiety disorders for exploration within future research.

People with type 2 diabetes can experience diabetes distress which can negatively affect health outcomes. Non-pharmacological interventions such as mindfulness can help address diabetes distress. However, face-to-face programmes can be constrained by cost, poor accessibility and lack of availability. Mobile apps for mindfulness may overcome these issues but evidence of their effectiveness is limited, and some have poor interface design with basic visualisations and feedback.

Our study will explore using virtual reality (VR) as an immersive and interactive technology that could support mindfulness practice to help reduce diabetes distress. We will use a mixed-methods design to pilot a new co-design process called Artificial Intelligence-informed Experience-Based Co-Design. Phase 1 will identify and evaluate existing VR mindfulness apps, followed by interviews with mindfulness experts to gain their perspectives on practising mindfulness in virtual settings. This will be followed by a participatory design phase with a series of five co-design workshops where adults with type 2 diabetes will (1) discuss diabetes distress and learn about mindfulness, (2) evaluate commercially available VR mindfulness apps, (3) employ artistic methods to produce a personalised mindfulness experience, (4) create digital content for a virtual mindfulness experience via generative artificial intelligence tools and (5) prioritise key design features, functionality and content for a tailored VR mindfulness app. The final phase will focus on developing a bespoke VR mindfulness app and evaluating it with adults with type 2 diabetes using interviews, questionnaires and VR app analytics to determine if the new digital mental health intervention can help reduce diabetes distress and improve quality of life.

We received ethical approval from The University of Manchester (2024-18262-32710 and 2024-21170-37093). Written informed consent will be obtained from all participants. Dissemination will include scientific publications and presentations, social media, knowledge translation events and educational resources for teaching students.

This study compared the influence of virtual reality (VR)-based and traditional (e.g., imagery-based) guided meditation on stress and concentration levels among South Korean adults. In addition, we examined whether concentration levels differed between individuals who are new to meditation and those who are experienced.

Seventy participants were randomly assigned to either the VR or imagery condition, where they engaged in breathing and waterfall concentration meditation. Pretest and posttest measures of heart rate (HR), galvanic skin response (GSR), negative affect, and concentration during meditation were recorded.

Both VR- and imagery-based guided meditation significantly reduced HR, GSR, and negative affect. However, no significant differences in outcomes were observed between the two groups. Still, participants in the VR condition reported higher concentration levels during meditation, particularly novice meditators. In addition, qualitative feedback indicated that VR-based meditation was more effective in inducing positive emotions, such as calmness and enjoyment.

While both VR- and imagery-based guided meditation effectively reduce stress and negative affect, VR-guided meditation shows promise for enhancing concentration, particularly for novice meditators.

Mindfulness-Based Cognitive Therapy (MBCT) is a non-pharmacological approach to alleviating depression and anxiety. While technology based MBCT is a standardized cost-effective approach, there have been concerns about its feasibility and effectiveness in clinical settings.

The purpose of this study was to investigate the longitudinal relationship between improved emotional regulation resulting from participation in Immersive Virtual Reality Meditation (IVRM) and Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) as monitored by electrocardiogram.

This study was a longitudinal single-arm clinical trial in which the intervention was conducted three times a week for 10 weeks at a behavioral health unit in a community hospital (n = 26). We measured Coherence Achievement Score (CAS), depression, and anxiety. The relationships between CAS, anxiety, depression, and covariates were analyzed using a Generalized Estimated Equation (GEE).

The findings of our study provide evidence that the CAS scores indicative of emotional regulation function after IVRM participation were associated with a reduction in depression and anxiety.

Among the many technology-based complementary health care interventions that are available to reduce depression and anxiety, IVRM program use increases emotional regulatory function and decrease depression and anxiety.

Anxiety disorder is one of the most common mental disorders and often accompanied with sleep disturbance which can in turn exacerbate anxiety symptoms, creating a vicious cycle. In addition to psychopharmacological therapy, the effectiveness of psychotherapy as cognitive behavioral therapy (CBT) for treating anxiety disorders and insomnia has been well documented and widely accepted, but it is labor-intensive and costly. However, virtual reality (VR)-integrated CBT may improve this condition but needs more evidences to support its extensive application in routine clinical practice.

This explorative study was aimed to conduct a retrospective analysis to evaluate the acute (2 weeks) augmented effect of VR-integrated relaxation and mindfulness exercising in improving anxiety and insomnia symptoms for patients who were diagnosed with anxiety disorders and concurrently with prominent insomnia symptoms and admitted to the Department of Psychiatry, The Affiliated Guangdong Second Provincial General Hospital of Jinan University during January 2021 to June 2021.

All patients who were admitted to the department of psychiatry during January 1, 2021 to June 30, 2021 were screened with inclusion criteria and exclusion criteria, and the sociodemographic and clinical data of those included patients were collected from the electronic medical record system of the hospital using a self-designed case report form (CRF). Subjects who were administrated with medication alone were designated as conventional group, and those receiving treatment of medication combined with VR-integrated CBT (VR relaxation and mindfulness exercising) as VR group. The baseline and 2-week posttreatment data were compared between the two groups.

In total, there were 103 patients (70 female, 68%) included in the study. Among all, 68 (66.02%) were designated as the "VR group," and 35 (33.98%) as the "conventional group." The majority of patients (67%) were diagnosed with generalized anxiety disorder (GAD). Twenty-three (22.3%) patients had a comorbid diagnosis with primary insomnia, and insomnia was just one of the accompanying symptoms with anxiety for the rest 80 subjects. No statistically significant differences were found between VR and conventional groups in all baseline sociodemographic and clinical characteristics except for occupation. There were statistically significant differences for the remission rates of anxiety symptoms or insomnia symptoms and reduction of Hamilton Anxiety Rating Scale or Insomnia Severity Index total scores between conventional and VR groups. Greater remission rates or score reductions were found in VR group than in conventional group either for anxiety or for insomnia. Robust differences still existed when controlled for the variable "occupation."

Two-week augmented VR-integrated relaxation and mindfulness exercising is acutely beneficial for relieving both anxiety and insomnia symptoms and worth being recommended for routine clinical practice. Further prospective and randomized study compared to traditional CBT to explore its acute and long-term effect on anxiety and insomnia is needed.

Current rates of mental illness are worrisome. Mental illness mainly affects females and younger age groups. The use of the internet to deliver mental health care has been growing since 2020 and includes the implementation of novel mental health treatments using virtual reality, augmented reality, and artificial intelligence. A new three dimensional digital environment, known as the metaverse, has emerged as the next version of the Internet. Artificial intelligence, augmented reality, and virtual reality will create fully immersive, experiential, and interactive online environments in the metaverse. People will use a unique avatar to do anything they do in their "real" lives, including seeking and receiving mental health care. In this opinion review, we reflect on how the metaverse could reshape how we deliver mental health treatment, its opportunities, and its challenges.

Mindfulness training is effective in recovery from substance use disorders; however, adoption can be difficult due to environmental and personal distractions. Virtual reality (VR) may help overcome these challenges by providing an immersive environment for practicing mindfulness, but there is currently limited knowledge regarding patient and provider perceptions of VR-based tools.

The present study investigated the feasibility and acceptability of VR mindfulness training for veterans in residential substance use treatment as well as potential benefits of VR mindfulness interventions in this population. We conducted a pilot feasibility/acceptability study as a first step toward conducting a larger randomized controlled trial (RCT).

The study recruited participants (N = 32) from a 30-day residential substance use program and collected both qualitative and quantitative feedback on the VR mindfulness intervention using a mixed-methods approach. Patients (n = 20) and providers (n = 12) rated the acceptability, usability, and satisfaction of the intervention. Using a within-subjects design, patients provided pre-post emotion ratings and reported on state mindfulness and VR presence after completing a single-session self-guided VR mindfulness intervention. Patients provided qualitative interview data on their overall impressions, while providers gave the same information via survey.

Both patients and providers reported high satisfaction and confidence in the intervention. Moreover, within subjects t-tests showed that patients experienced significant reductions in negative affect and significant increases in positive affect from pre-post, along with high levels of state mindfulness and presence. Results of thematic analysis revealed that the intervention facilitated focused attention on the present moment, induced a state of calm and relaxation, and reduced negative thoughts and emotions. Participants requested improvements such as better integration of audiovisual elements, a more personalized and longer intervention, and more comfortable fitting headset. Finally, the intervention presented with several advantages compared to other mindfulness experiences including reduced distractions and a sense of safety and privacy.

Self-guided VR mindfulness intervention is feasible and acceptable to patients and providers. VR mindfulness training provides an immersive experience that uplifts mood and reduces distractions. VR may provide a scaffolding tool to set the stage for deepening mindfulness skills. Results of the present study could inform further development and tailoring for future interventions.

Arts therapies offer effective non-pharmacological intervention for Sleep Initiation and Maintenance Disorders (SIMDs), encompassing both passive and active modalities. This review assesses their effectiveness and ethical considerations, focusing on music therapy, meditation, and Tai Chi.

Following PRISMA guidelines, a detailed search across PubMed, the Cochrane Library, Web of Science, and CNKI identified 17 relevant RCTs. Utilizing the Joanna Briggs Institute (JBI) quality criteria and the PICO(S) framework for data extraction ensured methodological integrity.

Analysis shows arts therapies significantly improve sleep quality. Music therapy and meditation yield immediate benefits, while Tai Chi and Qigong require longer commitment for significant outcomes.

The link between SIMDs and mental health issues like anxiety, stress, and depression suggests arts therapies not only enhance sleep quality but also address underlying mental health conditions. The evidence supports a wider adoption of arts therapies in treating SIMDs due to their dual benefits.

PROSPERO, ID: CRD42024506393.

The aim is to examine whether the addition of Virtual Reality (VR) meditation training to a standard 8-week Mindfulness-Based Health Care Program (MBHC-VR) results in a significantly increased improvement in occupational, mental health, and psychological functioning versus MBHC-only in university students.

A randomized controlled clinical trial with three arms (MBHC, MBHC-VR, Control Group), four assessment time points (pre-intervention, inter-session, post-intervention, and 3-month follow-up), and mixed methodology will be proposed. University students (undergraduate, master, or doctoral) interested in participating and who meet the inclusion/exclusion criteria will be included over two years. Data will be collected from different ad hoc questionnaires, several standardized tests, and an Ecological Momentary Assessment. We will use R software to carry out descriptive analyses (univariate and bivariate), multilevel modeling, and structural equation models to respond to the proposed objective. The qualitative analysis will be carried out using the MAXQDA program and the technique of focus groups.

It is expected that with the proposed intervention university students will learn to relate in a healthier way with their mental processes, so as to improve their occupational balance (OB) and their psychological well-being.

ClinicalTrials.gov Identifier NCT05929430.

In recent years, there has been a growing awareness of the potential health benefits of the natural environment for human well-being. Given the fast-paced nature of contemporary lifestyles, research into the use of virtual environments as a means to provide various seasonal landscapes has gained increasing importance.

The aim of this study is to investigate the impact of different sensory modes on the preferences and therapeutic effects of virtual autumn landscapes on university campuses.

In this study, 320 participants, with an average age of 21.11 years (±1.21 years), were exposed to virtual environments featuring autumn color landscapes and bare tree landscapes using visual, auditory, and combined conditions. A control group was included for comparison. Differences in participants' physiological indicators (EEG, heart rate) and psychological measures (POMS, PANAS, SVS, ROS) were analyzed, with the use of the Holm correction (P < 0.05).

(1) Autumn virtual landscapes with color had a superior therapeutic effect. (2) There were significant differences in the therapeutic effects of different sensory modes within the same season's landscape categories, suggesting that incorporating additional sensory dimensions may enhance therapeutic outcomes.

Based on the study's findings, we recommend that when designing therapeutic environments, attention should be given to seasonal variations and the integration of various sensory modes to optimize therapeutic results.

Virtual reality (VR)-based mindfulness is a promising method to improve the health of older adults. Therefore, many attempts have been made to explore the application of VR-based mindfulness, such as VR meditation and mind-body exercises, in older adults. Generally, current studies indicate the heavy reliance on apparatus for implementing VR-based mindfulness interventions. In VR meditation, the crucial apparatus is VR headsets. In VR mind-body exercises, three essential components are required: motion capture sensors, main consoles, and display screens. In the aspect of health promotion, VR meditation is an effective method for improving mental health, pain, and quality of life in older adults. VR mind-body exercises contribute to increasing the mental health and physical function of older adults. Furthermore, VR mind-body exercises may be combined with other forms of exercise as a mixed method to promote the health of older adults. VR-based mindfulness interventions enhance the meditation and mind-body exercises experience for older adults while improving accessibility. However, their implementation still encounters a series of challenges, such as cost, technical anxiety, and apparatus-related issues. Additionally, we recommend future research to examine the optimal exercise dose for VR mind-body exercises to maximize their health benefits.

Although the prognosis of ovarian cancer can be significantly improved through standardized surgery and chemotherapy, 70% of epithelial ovarian cancer (EOC) patients would suffer from drug resistance and recurrence during the long chemotherapy cycle.

To explore the impact of a training mode based on the integration of virtual reality technology and mindfulness on anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy.

Through virtual reality technology, a mindfulness training software was designed and developed, and a mindfulness training mode based on virtual reality technology was constructed. Using a self-controlled design, 48 ovarian cancer patients undergoing chemotherapy who were hospitalized in a tertiary hospital in Beijing from August 2022 to May 2023 were conveniently selected as the research subjects. The patients were subjected to four weeks of mindfulness training based on virtual reality technology, and the acceptance of the mindfulness training mode using virtual reality technology was evaluated. The Hospital Anxiety and Depression Scale (HADS) and Cancer Related Fatigue Scale (CRF) were used to evaluate the anxiety, depression, and fatigue of patients before and after intervention.

The virtual reality based mindfulness training mode includes four functional modules: personalized curriculum, intelligent monitoring, emotion tracking, and Funny Games. 48 patients had a high acceptance score (139.21 ± 10.47), and after using mindfulness training mode based on virtual reality technology, anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy were significantly reduced, with a statistically significant difference (p< 0.001).

Ovarian cancer patients during chemotherapy have a high acceptance of virtual reality based mindfulness training mode. The application of this mode can reduce the psychological problems of anxiety, depression, and cancer-related fatigue in ovarian cancer patients during chemotherapy, and is worth promoting and using.

Mindfulness-based, in-person programs are effective at reducing stress and enhancing resilience in military and civilian samples, yet few studies have examined or compared training offered via real-time, interactive social media. Such a program would have a wider-reach and could include those unable to attend in-person. There is also interest in resolving ambiguity about the effects of mindfulness training on individual difference variables, such as self-compassion.

The purpose of this research was to compare pre/post self-compassion for three interventions; Mindfulness-based Stress Reduction delivered in-person (IP), mindfulness meditation training delivered via a Virtual World (VW), and a wait-list Control Group (CG) among active duty and veteran U.S. military.

A 2 (pre/post)×3 (group) factorial design was conducted with 250 active duty and veteran U.S. Military service members, with self-compassion measures as dependent variables.

Self Compassion improved 10% for the IP group and 14% for the VW group, while the CG group did not improve. Combined treatment groups yielded a 10.3% improvement in self-compassion compared with no change in the CG and with a group×time interaction effect (p < 0.01). Participants with lower initial self-compassion experienced greater benefits than those with higher baseline self-compassion (p < 0.01).

IP and VW Mindfulness Meditation training were equally effective in increasing self-compassion. Adding effective on-line mindfulness delivery will promote self-compassion among a more extensive audience, likely yielding improved coping, confidence, connectedness, cheerfulness, steadiness, and self-satisfaction, while lessening anxiety, fear-of-failure, and stress among participants.

The present article used a pilot study to determine the effectiveness of digital cognitive mindfulness training developed based on dialectical behavioral therapy (DBT) in reducing attention deficit hyperactivity disorder (ADHD) symptoms in children. The sample consisted of 90 children (8-10 years old) diagnosed with ADHD. The participants were randomized into two groups: an experimental group (n = 45) and a control group (n = 45). Results were assessed at three time points: before, after the study, and one month after the end of the study. Regarding ADHD symptoms, the ANCOVA results showed that there were no statistically significant differences between the study groups for inattention and hyperactivity/impulsivity after testing. One month after completion of the program, there was a significant alleviation in symptoms of inattention, executive functioning, learning problems, aggression, and peer relationships. Hyperactivity was the only variable that showed a decrease both post-test and during follow-up. These results suggest that a DBT-based mindfulness program is a promising method of reducing ADHD symptoms in children.

Emotional eating (EE), or eating in response to negative emotions or stress, can be understood as a manifestation of difficulties regulating emotions among individuals with eating disorders. To date, many virtual reality treatments for eating disorders have focused on body image or exposure methods and have not exclusively targeted EE. There has been a call made by experts in the field for a "new generation" of virtual reality interventions, capable of utilizing virtual reality's potential more fully. We developed a novel emotion regulation (ER) intervention based upon virtual reality to improve EE among adults with an eating disorder diagnosis. The study hypothesized that a novel ER protocol utilizing evidence-based strategies, as well as innovative techniques, would be feasible and acceptable and show preliminary signals of effectiveness for EE.

Due to COVID-19, the study pivoted from the original completely immersive intervention to a 2-D intervention deliverable over telehealth. Twenty-one patients were recruited from the Adult Eating Disorders Program within Stanford University to receive seven weekly one-hour virtual experiences (VEs) focusing on ER. Participants were not randomized but, as part of a pragmatic study design, chose between the novel VE-Emotion Regulation (VE-ER) intervention or continuing their treatment as usual. Before and after the seven sessions, participants completed an assessment by filling out online questionnaires.

Overall, VE-ER treatment was feasible, and the participant and therapist acceptability of VE-ER treatment was fairly high. In terms of preliminary effectiveness, the results showed a significant reduction in the frequencies of disordered eating behaviors in both groups, but a greater improvement in EE in the VE-ER group and a significant reduction in emotion dysregulation after the treatment.

This novel pilot study makes a valuable contribution to the scant literature by demonstrating the feasibility, acceptability, and preliminary effectiveness of combining somatic, multisensory, and cognitive manipulations delivered via telemedicine to help patients with EE to manage their emotions. The findings can serve as the basis for larger, controlled studies evaluating the translation of the somatic marker theory from the research literature into real-world U.S. clinic settings.

Depression in adolescents is a large and growing problem; however, access to effective mental health care continues to be a challenge. Digitally based interventions may serve to bridge this access gap for adolescents in need of care. Digital interventions that deliver components of cognitive behavioral therapy (CBT) have been shown to reduce symptoms of depression, and virtual reality (VR) may be a promising adjunctive component. However, research on these types of treatments in adolescents and young adults is limited.

This study aims to evaluate the feasibility, acceptability, and preliminary efficacy of Spark (v1.0), a 5-week, self-guided, CBT-based digital program using a mobile app and VR experiences to target symptoms of depression in adolescents.

A single-arm, open-label study of the Spark program was conducted with a community sample of 30 adolescents and young adults aged 12 to 21 years with self-reported moderate to severe depression symptoms. Participants completed a weekly depression assessment (Patient Health Questionnaire-8) in the app during the 5-week intervention period as well as web-based baseline, postintervention, and 1-month follow-up self-report assessments. The participants also completed a qualitative postintervention interview. For participants aged <18 years, caregivers completed assessments at baseline and postintervention time points. Feasibility outcomes included recruitment rate (the proportion of participants who enrolled in the study divided by the total number of participants screened for eligibility) and retention rate (the proportion of participants who completed postintervention assessments divided by the total number of participants who received the intervention). Acceptability outcomes included engagement with the program and quantitative and qualitative feedback about the program. Preliminary efficacy was evaluated based on the Patient Health Questionnaire-8.

The study recruitment (31/66, 47%) and retention (29/30, 97%) rates were high. Participants provided higher ratings for the ease of use of the Spark program (8.76 out of 10) and their enjoyment of both the mobile app (7.00 out of 10) and VR components (7.48 out of 10) of the program, whereas they provided lower ratings for the program's ability to improve mood (4.38 out of 10) or fit into their daily routines (5.69 out of 10). We observed a clinically and statistically significant reduction in depression scores at postintervention (mean difference 5.36; P<.001) and 1-month follow-up (mean difference 6.44; P<.001) time points.

The Spark program was found to be a feasible and acceptable way to deliver a self-guided CBT-focused intervention to adolescents and young adults with symptoms of depression. Preliminary data also indicated that the Spark program reduced the symptoms of depression in adolescents and young adults. Future studies should evaluate the efficacy of this intervention in an adequately powered randomized controlled trial.

ClinicalTrials.gov NCT04165681; https://classic.clinicaltrials.gov/ct2/show/NCT04165681.

Mindfulness interventions are effective in improving mood, reducing stress, and increasing quality of life. New developments in technology bring important channels to deliver mindfulness interventions that can increase accessibility, such as the Internet, computerised interventions, mobile apps and recently, virtual reality (VR). The aim of the present study is to enhance our current understanding of the use of VR in mindfulness, namely we examined in a pilot randomised trial the efficacy of an immersive VR-based mindfulness approach compared to an active control (computerised-based mindfulness meditation) on improving mood. A secondary objective was to examine whether VR use resulted in simulator sickness which could affect user engagement.

Forty-seven (Mage = 29.22 years) healthy participants were randomly assigned to the experimental or control group.

A mixed 2X3 ANOVA showed a significant Time effect. Namely, negative emotions were reduced in both groups, with non-significant differences between groups. For positive emotions, on the other hand, our results showed no significant impact. Simulator sickness in VR was not present, according to t-test, making VR a safe delivery method.

Future research should investigate VR dosage and combine VR with other interventions (e.g., blended with face-to-face mindfulness interventions, with Internet-delivered interventions).

The environment at a psychiatric inpatient ward can lead to emotional distress and behavioural deviations in vulnerable individuals potentially resulting in conflicts, increased use of need-based medication and coercive actions, along with low satisfaction with treatment. To accommodate these challenges, recreational and entertaining interventions are recommended. The tested interventions have, however, shown varying effects and demand a high degree of planning and staff involvement while being difficult to adapt to individual needs. Virtual reality (VR) may help overcome these challenges.

The study is a mixed-methods clinical trial with a target sample of 124 patients hospitalised at a closed psychiatric ward in the capital region of Denmark. Outcomes (eg, coercion, need-based medication and perceived stress) for a 12-month period where all patients are offered VR-based recreational experiences during their hospitalisation will be compared with outcomes for a 12-month period where VR is not offered. Feasibility and acceptability will be explored with qualitative interviews supplemented with non-participant observations and focus groups. The study began on 1 January 2023, and we expect to complete data collection by 31 December 2024.

The study is registered at Danish Data Protection Agency (j.no P-2022-466) and is approved by the Committee on Health Research Ethics of the capital region of Denmark (j.no 22013313). All patients will be required to provide informed consent. Results from this study will be disseminated via peer-reviewed journals and congress/consortium presentations.

NCT05654740.

The development of negative behavioral and psychosocial factors (depression, anxiety, apathy, etc) is associated with poor well-being, which can contribute to health issues in ageing, especially in the context of COVID-19. Despite its relative novelty, fully immersive virtual reality (VR) interventions through 360° immersive videos are becoming more accessible and flexible and constitute an emerging method to potentially enhance well-being. The aim of this scoping review is to assess the effectiveness of 360° interventions on well-being in older adults with or without cognitive impairment, as well as cybersickness and attitudes toward this technology.

Scoping review.

Older adults with or without cognitive impairment.

The PRISMA-SR guideline was followed. Four databases were used, and we selected articles published until April 2022. We have analyzed the effect of 360° videos on the well-being of older adults with respect to the study design, the population, the contents, the duration of intervention, and the outcomes.

A total of 2262 articles were screened, of which 10 articles were finally included in this review. Most of them are pilot studies and used mixed methods including scales and interviews. The material and content of VR are diversified. Many behavioral and psychological outcomes were assessed, including anxiety, apathy, loneliness, depression, social engagement, quality of life, and emotions. The results were positive or mixed, according to the outcomes. We recorded few adverse events, and the interviews show contrasting results concerning the participants' feelings (ie, degree of immersion, familiarity with technology, and VR content).

The use of VR 360° videos seems feasible in community-dwelling older adults or residential aged care facilities, as they are safe and provide enjoyment. It constitutes an emerging and promising therapeutic tool to manage psychosocial disorders. This review provides key considerations for the design and implementation of interventions using VR 360° video in clinical practice.

With the increasing number of travelling people, the behavior of tourists is having an increasing impact on the environment. Situational environmental education will influence the tourists' responsible environmental behavior, which positively or negatively affects the environment. The purpose of this study is to explore the impact of situational environmental education on tourists' responsible environmental behavior through a field study of Changchun Water Culture Ecological Park, combined with a survey and Zaltman metaphor elicitation technique (ZMET) interview method. There are 527 questionnaires, 89 pre-questionnaires, and 15 interview records collected. The results showed that: (1) All interviewees were impressed with the situational environmental education in the park. It can be concluded that the situational environmental education is easily accepted. The reason may be that, among the theme park users, 42.69% were aged 21-30 year's old, and 62.8% of the population have a college degree or above. (2) The standardized path coefficient of situational environmental education in tourist destinations for tourists' behavioral intention is 0.74, and the standardized path coefficient for responsible environmental behavior is 0.78, which is much higher than the standard value of 0.4. Therefore, situational environmental education has positive influences on the tourists' behavioral intention and responsible environmental behavior. (3) The sensitive analysis the tourists' behavioral intention has a positive relationship with attitudes toward environmental behaviors (0.66), subjective norm (0.53), and perceptual behavior control (0.52). The results of this study can provide a scientific basis for the planning and design of urban parks.