Distraction of attention with the use of virtual reality. Influence of the level of game complexity on the level of experienced pain

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: Research done in recent years shows that Virtual Reality (VR) can be an effective tool for distracting attention from pain. The purpose of this study was to test how the complexity of Virtual Environment (VE) influences the experienced intensity of thermal pain stimuli.

A within-subjects design experiment was conducted, using cold pressor test for pain stimulation. Research was done on 31 students of Wroclaw Universities. Participants played games created for the purpose of the study, using head mounted displays and movement sensors. Two Virtual Environments differing in the level of complexity and non-VR control condition were used. The order of all conditions was counterbalanced.

Participants reported significantly lower pain intensity (Visual Analogue Scale) after playing the high complexity game, compared to the low complexity game. There were also significant differences between non-VR control condition and high complexity game, but not between non-VR and low complexity game. The pain tolerance (measured by time of keeping the hand in cold water) was significantly higher in both VR conditions comparing to non-VR conditions. However, no significant differences between VE’s were found in pain tolerance ratings. Results of this study provide preliminary evidence that game complexity can be related to pain experience during VR interventions.

Birnie, K. A., Petter, M., Boerner, K. E., Noel, M., & Chambers, C. T. (2012). Contemporary use of the cold pressor task in pediatric pain research: a systematic review of methods. The Journal of Pain, 13, 9, 817-826.

Botella, C., Garcia-Palacios, A., Banos, R., Quero, S., Breton-Lopez, J. (2008). Virtual Reality in the Treatment of Pain. Journal of CyberTherapy & Rehabilitation, 1, 1, 93-100.

Cohen, J (1992). A power primer. Psychological Bulletin, 112, 1, 155-159.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences. 2nd edition. Hillsdale, N.J.: L. Erlbaum Associates Czub, M., & Piskorz, J. How body movement influences Virtual Reality analgesia? Unpublished.

Czub, M., & Piskorz, J. (2012). The Effectiveness of Different Virtual Reality Environments for Thermal Pain Distraction. How Does the Level of Stimulation Influence the Amount of Experienced Pain? Polish Journal of Applied Psychology, 10, 2, 7-19.

Czub, M., Piskorz, J. Misiewicz, M., Hodowaniec, P., Mrula, M., Urbańska, K. Influence of memory engagement on the level of experienced pain during Virtual Reality analgesia. Polish Journal of Applied Psychology. (in press).

Dahlquist, L. M., Weiss, K. E., Clendaniel, L. D., Law, E. F., Ackerman, C. S., & McKenna, K. D. (2009). Effects of videogame distraction using a virtual reality type head-mounted display helmet on cold pressor pain in children. Journal of Pediatric Psychology, 34, 5, 574-584.

Dahlquist, L.M., Herbert, L.J., Weiss, K.E., Jimeno, M. (2010a). Virtual - reality distraction and cold - pressor pain tolerance: does avatar point of view matter? Cyberpsychology, Behavior and Social Networking, 13, 5, 587-91

Dahlquist, L. M., Weiss, K. E., Law, E. F., Sil, S., Herbert, L. J., Horn, S.B., Wohlheiter K, & Ackerman, C. S. (2010b). Effects of videogame distraction and a virtual reality type head-mounted display helmet on cold pressor pain in young elementary school-aged children. Journal of pediatric psychology, 35, 6, 617-625.

Dahlquist, L.M, McKenna, K.D, Jones, K.K, Dilliger, L., Weiss, K.E., Ackerman, C.S. (2007). Active and passive distraction using a headmounted display helmet: effects on cold pressor pain in children.Health psychology: official journal of the Division of Health Psychology. American Psychological Association, 26, 6, 794 - 801.

Das, D. A., Grimmer, K. A., Sparnon, A. L., McRae, S. E., Thomas B. H. (2005). The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial. BMC Pediatrics, 5, 1, doi: 10.1186/1471-2431-5-1.

Ferreira-Valente, M. A., Pais-Ribeiro, J. L., & Jensen, M. P. (2011).Validity of four pain intensity rating scales. Pain, 152, 10, 2399-2404.

Forys, K.L, & Dahlquist, L.M (2007). The influence of preferred coping style and cognitive strategy on laboratory-induced pain. Health psychology, 26, 1, 22-29.

Geisser, M.E., Robinson, M. E., Pickren, W. E. (1992). Differences in cognitive coping strategies among pain-sensitive and pain-tolerant individuals on the cold-pressor test. Behavior Therapy, 23, 1, 31-41.

Gershon, J., Zimand, E., Pickering, M., Rothbaum, B. O., Hodges, L. (2004). A pilot and feasibility study of virtual reality as a distraction for children with cancer. Journal of the American Academy of Child Adolescent Psychiatry, 43, 10, 1243-1249.

Gold, J. I., Belmont, K. A., Thomas, D.A. (2007). The Neurobiology of Virtual Reality Pain Attenuation. CyberPsychology & Behavior, 10, 4, 536-544.

Gutierrez-Martinez, O., Gutierrez-Maldonado, J., Cabas-Hoyos, K., & Loreto, D. (2010). The illusion of presence influences VR distraction: effects on cold-pressor pain. Annual Review of Cybertherapy and Telemedicine 2010: Advanced Technologies in the Behavioral, Social and Neurosciences, 155, 154 - 159.

Hoffman, H. G., Doctor, J. N., Patterson, D. R., Carrougher, G. J., & Furness III, T. A. (2000). Virtual reality as an adjunctive pain control during burn wound care in adolescent patients. Pain, 85, 1, 305-309.

Hoffman, H. G., Garcia-Palacios, A.., Patterson, D. R., Jensen, M., Furness, T. A., III, & Ammons, W. F., Jr. (2001). The effectiveness of virtual reality for dental pain control: A case study. Cyberpsychological Behavior, 4, 527-535.

Hoffman, H. G., Patterson, D. R., Carrougher, G. J., Nakamura, D., Moore, M., Garcia-Palacios, A., & Furness Iii, T. A. (2001). The effectiveness of virtual reality pain control with multiple treatments of longer durations: A case study. International Journal of Human-Computer Interaction, 13, 1, 1-12.

Hoffman, H. G., Seibel, E. J., Richards, T. L., Furness, T. A., Patterson, D. R., & Sharar, S. R. (2006). Virtual reality helmet display quality influences the magnitude of virtual reality analgesia. The Journal of Pain, 7, 11, 843-850.

Hoffman, H.G., Sharar, S.R., Coda, B., Everett, J.J., Ciol, M., Richards, T. Patterson, D.R. (2004). Manipulating presence influences the magnitude of virtual reality analgesia. Pain, 111, 1-2, 162-168.

Labus, J. S., Keefe, F. J., & Jensen, M. P. (2003). Self-reports of pain intensity and direct observations of pain behavior: when are they correlated?. Pain, 102, 1, 109-124.

Li, A., Montaño, Z., Chen, V. J., & Gold, J. I. (2011). Virtual reality and pain management: current trends and future directions. Pain management, 1, 2, 147-157.

Malloy, K.M., Milling, L. S. (2010). The effectiveness of virtual reality distraction for pain reduction: A systematic review. Clinical Psychology Review, 30, 8, 1011-1018.

Mitchell, L. A., MacDonald, R. A., & Brodie, E. E. (2004). Temperature and the cold pressor test. The Journal of Pain, 5, 4, 233-237.

Mühlberger, A., Wieser, M. J., Kenntner-Mabiala, R., Pauli, P. Wiederhold, B. K. (2007). Pain modulation during drives through cold and hot virtual environments. CyberPsychology & Behavior, 10, 4, 516-522.

Rutter, C. E., Dahlquist, L. M., & Weiss, K. E. (2009). Sustained efficacy of virtual reality distraction. The Journal of Pain, 10, 4, 391-397.

Sanchez-Vives, M. V., & Slater, M. (2005). From presence to consciousness through virtual reality. Nature Reviews Neuroscience, 6, 4, 332-339.

Schmitt, Y. S., Hoffman, H. G., Blough, D. K., Patterson, D. R., Jensen, M.P., Soltani, M., ... & Sharar, S. R. (2011). A randomized, controlled trial of immersive virtual reality analgesia, during physical therapy for pediatric burns. Burns, 37, 1, 61-68.

Schubert, T. (2003). The sense of presence in virtual environments: a three-component scale measuring spatial presence, involvement, and realness. Zeitschrift fuer Medienpsychologie, 15, 69-71.

Shahrbanian, S., Simmonds, M. J. (2008). Effects of different virtual reality environments on experimental pain rating in post-stroke individuals with and without pain in comparison to pain free healthy individuals.Annual Review Of Cybertherapy And Telemedicine, 653-659.

Slater, M. (2004). How colorful was your day? Why questionnaires cannot assess presence in virtual environments. Presence: Teleoperators and Virtual Environments, 13(4), 484-493.

Slater, M., Usoh, M., & Steed, A. (1994). Depth of presence in virtual environments. Presence, 3, 2, 130-144.

Van Twillert, B., Bremer, M., Faber, A.W. (2007). Computer-generated virtual reality to control pain and anxiety in pediatric and adult burn patients during wound dressing changes. Journal of Burn Care and Research, 28, 5, 694-702.

Wender, R., Hoffman, H. G., Hunner, H. H., Seibel, E. J., Patterson, D.R., & Sharar, S. R. (2009). Interactivity influences the magnitude of virtual reality analgesia. Journal of cyber therapy and rehabilitation, 2,1, 27-33.

Wiech, K., Tracey, I. (2009). The influence of negative emotions on pain: behavioral effects and neural mechanisms. Neuroimage, 47, 3, 987-994.

Wiederhold, M. D., Wiederhold, B. K. (2007). Virtual reality and interactive simulation for pain distraction. Pain Medicine, 8, 3, 182 - 188.

Polish Psychological Bulletin

The Journal of Committee for Psychological Sciences of Polish Academy of Sciences

Journal Information

CiteScore 2016: 0.33

SCImago Journal Rank (SJR) 2016: 0.185
Source Normalized Impact per Paper (SNIP) 2016: 0.258

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