David Mal, M.Sc.

Abstract: A negative body image can have an impact on developing and maintaining obesity. Using virtual reality (VR) to conduct cognitive behavioral therapy (CBT) is an innovative approach to treat people with obesity. This multicenter non-randomized pilot study examined the feasibility and the effect on eating behavior and body perception of a newly developed VR system to conduct body image exercises.

Abstract: Virtual humans play a pivotal role in social virtual environments, shaping users’ VR experiences. The diversity in available options and users’ individual preferences can result in a heterogeneous mix of appearances among a group of virtual humans. The resulting variety in higher-order anthropomorphic and realistic cues introduces multiple (in)congruencies, eventually impacting the plausibility of the experience. However, related work investigating the effects of being co-located with multiple virtual humans of different appearances remains limited. In this work, we consider the impact of (in)congruencies in the realism of a group of virtual humans, including co-located others (agents) and one’s self-representation (self-avatar), on users’ individual VR experiences. In a 2 × 3 mixed design, participants embodied either (1) a personalized realistic or (2) a customized stylized self-avatar across three consecutive VR exposures in which they were accompanied by a group of virtual others being either (1) all realistic, (2) all stylized, or (3) mixed between stylized and realistic. Our results indicate groups of virtual others of higher realism, i.e., potentially more congruent with participants’ real-world experiences and expectations, were considered more human-like, increasing the feeling of co-presence and the impression of interaction possibilities. (In)congruencies concerning the homogeneity of the group did not cause considerable effects. Furthermore, our results indicate that a self-avatar’s congruence with the participant’s real-world experiences concerning their own physical body yielded notable benefits for virtual body ownership and self-identification for realistic personalized avatars. Notably, the incongruence between a stylized self-avatar and a group of realistic virtual others resulted in diminished ratings of self-location and self-identification. This suggests that higher-order (in)congruent visual cues that are not within the ego-central referential frame of one’s (virtual) body, can have an (adverse) effect on the relationship between one’s self and body. We conclude on the implications of our findings and discuss our results within current theories of VR experiences, considering (in)congruent visual cues and their impact on the perception of virtual others, self-representation, and spatial presence

Abstract: Virtual humans significantly contribute to users' plausible XR experiences. However, it may be not only the congruent rendering of the virtual human but also the intermediary display technology having a significant impact on virtual humans' plausibility. In a low-immersive desktop-based and a high-immersive VR condition, participants rated realistic and abstract animated virtual humans regarding plausibility, affective appraisal, and social judgments. First, our results confirmed the factor structure of a preliminary virtual human plausibility questionnaire in VR. Further, the appearance and behavior of realistic virtual humans were overall perceived as more plausible compared to abstract virtual humans, an effect that increased with high immersion. Moreover, only for high immersion, realistic virtual humans were rated as more trustworthy and sympathetic than abstract virtual humans. Interestingly, we observed a potential uncanny valley effect for low but not for high immersion. We discuss the impact of a natural perception of anthropomorphic and realistic cues in VR and highlight the potential of immersive technology to elicit distinct effects in virtual humans.

Abstract: Our work investigates the influence of self-related cues in the design of virtual humans on body perception in virtual reality. In a 2x2 mixed design, 64 participants faced photorealistic virtual humans either as a motion-synchronized embodied avatar or as an autonomous moving agent, appearing subsequently with a personalized and generic texture. Our results unveil that self-related cues through embodiment and personalization yield an individual and complemented increase in participants' sense of embodiment and self-identification towards the virtual human. Different body weight modification and estimation tasks further showed an impact of both factors on participants' body weight perception. Additional analyses revealed that the participant's body mass index predicted body weight estimations in all conditions and that participants' self-esteem and body shape concerns correlated with different body weight perception results. Hence, we have demonstrated the occurrence of double standards through induced self-related cues in virtual human perception, especially through embodiment.

Abstract: Virtual reality (VR) offers various opportunities for innovative therapeutic approaches, especially regarding self-related mind-body interventions. We introduce a VR body swap system enabling multiple users to swap their perspectives and appearances and evaluate its effects on virtual sense of embodiment (SoE) and perception- and cognition-based self-related processes. In a self-compassion-framed scenario, twenty participants embodied their personalized, photorealistic avatar, swapped bodies with an unfamiliar peer, and reported their SoE, interoceptive awareness (perception), and self-compassion (cognition). Participants' experiences differed between bottom-up and top-down processes. Regarding SoE, their agency and self-location shifted to the swap avatar, while their top-down self-identification remained with their personalized avatar. Further, the experience positively affected interoceptive awareness but not self-compassion. Our outcomes offer novel insights into the SoE in a multiple-embodiment scenario and highlight the need to differentiate between the different processes in intervention design. They raise concerns and requirements for future research on avatar-based mind-body interventions.

Abstract: Einleitung Die multimodale Adipositastherapie besteht aus Elementen der Ernährung, der Bewegung und des Verhaltens bzw. des Körperbildes. Anwendungen der virtuellen Realität (VR) können das Methodenspektrum der Körperbildtherapie erweitern. Im vorliegenden Projekt wurde ein VR-System (bestehend aus einem Avatar und einem virtuellen Spiegel) zur Verbesserung von Körperwahrnehmung und Körperbild bei Personen mit Adipositas entwickelt. Methoden Im Rahmen der multizentrischen kontrollierten ViTraS-Pilotstudie (Registrierungsnummer: DRKS00027906) wurden bei Personen mit Adipositas virtuelle bzw. traditionelle Körperbildübungen angewendet. Es fanden drei Sitzungen im Abstand von ca. zwei Wochen statt. Über die Zeit wurden anthropometrische Daten sowie Daten zum Ernährungsverhalten (Dutch Eating Behavior Questionnaire (DEBQ) und eine Auswahl von Fragen des The Eating Motivation Survey (TEMS)) erfasst. In zwei Sitzungen wurden Körperbildübungen virtuell (VR-Gruppe) oder nicht-virtuell (Kontrollgruppe) durchgeführt. Eine online Follow-Up-Datenerhebung fand 6 Wochen nach der letzten Sitzung statt. Ergebnisse Insgesamt wurden 66 Personen (VR-Gruppe: 31, Kontrollgruppe: 35) in die Studie eingeschlossen. Die Personen waren zu 79% (52/66) weiblich, 45±13 Jahre alt und der mittlere BMI lag bei 37±4 kg/m2. Die Auswertung des DEBQ Fragebogens hat ergeben, dass in der VR-Gruppe gezügeltes Essverhalten von Anfang bis Ende der Studie signifikant (p<0,05) zugenommen hat. Die Ergebnisse der Auswahl von Fragen des TEMS hat keine signifikanten (p≥0,05) Unterschiede innerhalb oder zwischen den Gruppen ergeben. Schlussfolgerung Die Studie hat ergeben, dass die Durchführung von virtuellen Körperbildübungen eine Auswirkung auf das Ernährungsverhalten von Personen mit Adipositas haben kann.

Abstract: Many studies show the significance of the Proteus effect for serious virtual reality applications. The present study extends the existing knowledge by considering the relationship (congruence) between the self-embodiment (avatar) and the virtual environment. We investigated the impact of avatar and environment types and their congruence on avatar plausibility, sense of embodiment, spatial presence, and the Proteus effect. In a 2 × 2 between-subjects design, participants embodied either an avatar in sports- or business wear in a semantic congruent or incongruent environment while performing lightweight exercises in virtual reality. The avatar-environment congruence significantly affected the avatar’s plausibility but not the sense of embodiment or spatial presence. However, a significant Proteus effect emerged only for participants who reported a high feeling of (virtual) body ownership, indicating that a strong sense of having and owning a virtual body is key to facilitating the Proteus effect. We discuss the results assuming current theories of bottom-up and top-down determinants of the Proteus effect and thus contribute to understanding its underlying mechanisms and determinants.

Abstract: Body awareness is relevant for the efficacy of psychotherapy. However, previous work on virtual reality (VR) and avatar-assisted therapy has often overlooked it. We investigated the effect of avatar individualization on body awareness in the context of VR-specific user experience, including sense of embodiment (SoE), plausibility, and sense of presence (SoP). In a between-subject design, 86 participants embodied three avatar types and engaged in VR movement exercises. The avatars were (1) generic and gender-matched, (2) customized from a set of pre-existing options, or (3) personalized photorealistic scans. Compared to the other conditions, participants with personalized avatars reported increased SoE, yet higher eeriness and reduced body awareness. Further, SoE and SoP positively correlated with body awareness across conditions. Our results indicate that VR user experience and body awareness do not always dovetail and do not necessarily predict each other. Future research should work towards a balance between body awareness and SoE.

Abstract: Mirror exposure is an important method in the treatment of body image disturbances. Eye tracking can support the unaffected assessment of attention biases during mirror exposure. However, the analysis of eye tracking data in mirror exposure comes with various difficulties and is associated with a high manual workload during data processing. We present an automated data processing framework that enables us to determine any body part as an area of interest without placing markers on the bodies of participants. A short, formative user study proved the quality compared to the gold standard. The automatic processing and openness for different systems allow a broad range of applications.

Abstract: Virtual reality applications employing avatar embodiment typically use virtual mirrors to allow users to perceive their digital selves not only from a first-person perspective but also from a holistic third-person view. However, due to distance-related biases such as the distance compression effect or a reduced relative rendering resolution, the self-observation distance (SOD) between the user and the virtual mirror might influence how users perceive their embodied avatar. Our article systematically investigates the effects of a short (1 meter), middle (2.5 meter), and far (4 meter) SOD between user and mirror on the perception of personalized and self-embodied avatars. The avatars were photorealistic reconstructed using state-of-the-art photogrammetric methods. Thirty participants were repeatedly exposed to their real-time animated self-embodied avatars in each of the three SOD conditions. In each condition, the personalized avatars were repeatedly altered in their body weight, and participants were asked to judge the (1) sense of embodiment, (2) body weight perception, and (3) affective appraisal towards their avatar. We found that the different SODs are unlikely to influence any of our measures except for the perceived body weight estimation difficulty. Here, the participants judged the difficulty significantly higher for the farthest SOD. We further found that the participants' self-esteem significantly impacted their ability to modify their avatar's body weight to their current body weight and that it positively correlated with the perceived attractiveness of the avatar. Additionally, the participants' concerns about their body shape affected how eerie they perceived their avatars. Both measures influenced the perceived body weight estimation difficulty. For practical application, we conclude that the virtual mirror in embodiment scenarios can be freely placed and varied at a distance of one to four meters from the user without expecting major effects on the perception of the avatar.

Abstract: This article investigates the effects of different XR displays on the perception and plausibility of personalized virtual humans. We compared immersive virtual reality (VR), video see-through augmented reality (VST AR), and optical see-through AR (OST AR). The personalized virtual alter egos were generated by state-of-the-art photogrammetry methods. 42 participants were repeatedly exposed to animated versions of their 3D-reconstructed virtual alter egos in each of the three XR display conditions. The reconstructed virtual alter egos were additionally modified in body weight for each repetition. We show that the display types lead to different degrees of incongruence between the renderings of the virtual humans and the presentation of the respective environmental backgrounds, leading to significant effects of perceived mismatches as part of a plausibility measurement. The device-related effects were further partly confirmed by subjective misestimations of the modified body weight and the measured spatial presence. Here, the exceedingly incongruent OST AR condition leads to the significantly highest weight misestimations as well as to the lowest perceived spatial presence. However, similar effects could not be confirmed for the affective appraisal (i.e., humanness, eeriness, or attractiveness) of the virtual humans, giving rise to the assumption that these factors might be unrelated to each other.

Abstract: Obesity is a serious disease that can affect both physical and psychological well-being. Due to weight stigmatization, many affected individuals suffer from body image disturbances whereby they perceive their body in a distorted way, evaluate it negatively, or neglect it. Beyond established interventions such as mirror exposure, recent advancements aim to complement body image treatments by the embodiment of visually altered virtual bodies in virtual reality (VR). We present a high-fidelity prototype of an advanced VR system that allows users to embody a rapidly generated personalized, photorealistic avatar and to realistically modulate its body weight in real-time within a carefully designed virtual environment. In a formative multi-method approach, a total of 12 participants rated the general user experience (UX) of our system during body scan and VR experience using semi-structured qualitative interviews and multiple quantitative UX measures. Using body weight modification tasks, we further compared three different interaction methods for real-time body weight modification and measured our system’s impact on the body image relevant measures body awareness and body weight perception. From the feedback received, demonstrating an already solid UX of our overall system and providing constructive input for further improvement, we derived a set of design guidelines to guide future development and evaluation processes of systems supporting body image interventions.

Abstract: Virtual humans contribute to users’ state of plausibility in various XR applications. We present the development and preliminary evaluation of a self-assessment questionnaire to quantify virtual human’s plausibility in virtual environments based on eleven concise items. A principal component analysis of 650 appraisals collected in an online survey revealed two highly reliable components within the items. We interpret the components as possible factors, i.e., appearance and behavior plausibility and match to the virtual environment, and propose future work aiming towards a standardized virtual human plausibility scale by validating the structure and sensitivity of both sub-components in XR environments.

Abstract: Mind-body therapies aim to improve health by combining physical and mental exercises. Recent developments tend to incorporate virtual reality (VR) into their design and execution, but there is a lack of research concerning the inclusion of virtual bodies and their effect on body awareness in these designs. In this study, 24 participants performed in-VR body awareness movement tasks in front of a virtual mirror while embodying a photorealistic, personalized avatar. Subsequently, they performed a heartbeat counting task and rated their perceived body awareness and sense of embodiment towards the avatar. We found a significant relationship between sense of embodiment and self-reported body awareness but not between sense of embodiment and heartbeat counting. Future work can build on these findings and further explore the relationship between avatar embodiment and body awareness.

Abstract: Embodiment and body perception have become important research topics in the field of virtual reality (VR). VR is considered a particularly promising tool to support research and therapy in regard to distorted body weight perception. However, the influence of embodiment on body weight perception has yet to be clarified. To address this gap, we compared body weight perception of 56 female participants of normal weight using a VR application. They either (a) self-embodied a photorealistic, non-personalized virtual human and performed body movements in front of a virtual mirror or (b) only observed the virtual human as other's avatar (or agent) performing the same movements in front of them. Afterward, participants had to estimate the virtual human's body weight. Additionally, we considered the influence of the participants' body mass index (BMI) on the estimations and captured the participants' feelings of presence and embodiment. Participants estimated the body weight of the virtual human as their embodied self-avatars significantly lower compared to participants rating the virtual human as other's avatar. Furthermore, the estimations of body weight were significantly predicted by the participant's BMI with embodiment, but not without. Our results clearly highlight embodiment as an important factor influencing the perception of virtual humans' body weights in VR.

Abstract: The appearance of avatars can potentially alter changes in their users' perception and behavior. Based on this finding, approaches to support the therapy of body perception disturbances in eating or body weight disorders by mixed reality (MR) systems gain in importance. However, the methodological heterogeneity of previous research has made it difficult to assess the suitability of different MR systems for therapeutic use in these areas. The effects of MR system properties and related psychometric factors on body-related perceptions have so far remained unclear. We developed an interactive virtual mirror embodiment application to investigate the differences between an augmented reality see-through head-mounted-display (HMD) and a virtual reality HMD on the before-mentioned factors. Additionally, we considered the influence of the participant's body-mass-index (BMI) and the BMI difference between participants and their avatars on the estimations. The 54 normal-weight female participants significantly underestimated the weight of their photorealistic, generic avatar in both conditions. Body weight estimations were significantly predicted by the participants' BMI and the BMI difference. We also observed partially significant differences in presence and tendencies for differences in virtual body ownership between the systems. Our results offer new insights into the relationships of body weight perception in different MR environments and provide new perspectives for the development of therapeutic applications.

Abstract: In shared immersive virtual reality, users can interact with other participants and experience them as being present in the environment. Thereby different aspects of the respective interaction partners can have an impact on the perceived quality of the communication and possibly also the self-perception of an embodied user. This paper describes various factors the author aims to investigate during his doctoral studies. As the research area of embodied social interactions is broad, relevant factors and concrete research questions have been identified to investigate how social contact with one or multiple other persons may affect one’s self-perception, behavior and her or his relationship with the others while being embodied in a virtual environment.

Abstract: Technologies for Virtual, Mixed, and Augmented Reality (VR, MR, and AR) allow to artificially augment social interactions and thus to go beyond what is possible in real life. Motivations for the use of social augmentations are manifold, for example, to synthesize behavior when sensory input is missing, to provide additional affordances in shared environments, or to support inclusion and training of individuals with social communication disorders. We review and categorize augmentation approaches and propose a software architecture based on four data layers. Three components further handle the status analysis, the modification, and the blending of behaviors. We present a prototype (injectX) that supports behavior tracking (body motion, eye gaze, and facial expressions from the lower face), status analysis, decision-making, augmentation, and behavior blending in immersive interactions. Along with a critical reflection, we consider further technical and ethical aspects.

Abstract: Humans communicate to a large degree through nonverbal behavior. Nonverbal mimicry, i.e., the imitation of another’s behavior can positively affect the social interactions. In virtual environments, user behavior can be replicated to avatars, and agent behaviors can be artificially constructed. By combining both, hybrid avatar-agent technologies aim at actively mediating virtual communication to foster interpersonal understanding and rapport.We present a naïve prototype, the “Mimicry Injector”, that injects artificial mimicry in real-time virtual interactions. In an evaluation study, two participants were embodied in a Virtual Reality (VR) simulation, and had to perform a negotiation task. Their virtual characters either a) replicated only the original behavior or b) displayed the original behavior plus induced mimicry. We found that most participants did not detect the modification. However, the modification did not have a significant impact on the perception of the communication.