Virtual Reality Pain Distraction in Feminine-Specific Surgical Procedures

Partnering with researchers Jose Luis Mosso Vasquez from Panamerican University School of Medicine and Veronica Lara Vaca of Hospital de Ginecología y Obstetricia Número 4 in Mexico City, Mexico, Interactive Media Institute and Virtual Reality Medical Center studied virtual reality (VR) pain distraction during gynecological surgery. Gynecological surgeries are often sources of stress for women, causing higher pain both during and after the surgery. As a supplement to traditional anesthesia, VR helps to distract patients from pain by showing them immersive and interactive virtual environments, taking their mind off of the surgical procedure and the pain associated with it.


Of the 44 participants in this study, half received VR pain distraction, while the other half received no pain distraction method. The results indicated statistically significant differences in pain perception between the groups, but physiological measurements were less determinable. Overall, this study highlights the need for interventions to reduce stress and pain during feminine-specific medical procedures. To inquire about this study, please contact Dr. Brenda K. Wiederhold at the Virtual Reality Medical Center (



To access the full text:


Vasquez JM, Vaca VL, Wiederhold BK, Miller I, Wiederhold MD. Virtual reality pain distraction during gynecological surgery—A report of 44 cases. Surgical Research Updates. 2017.

European Medical Journal – Innovations

Interactive Media Institute, Virtual Reality Medical Center, and the Panamerican University School of Medicine in Mexico City recently published findings on the use of virtual reality (VR) surgical pain distraction in the January 2017 issue of the European Medical Journal – Innovations. In a study of 115 participants, researchers found people who viewed immersive VR environments reported less pain during and after their gastrointestinal surgical procedure than those who did not. The researchers call for further investigation into whether VR can be used to supplement or replace traditional pharmacological anesthesia.


This research adds on to studies already examining the use of VR in pain attenuation, but is one of the first to use VR during surgical procedures. Not only did the patients report lower pain scores, but the success of the treatment suggests the potential of VR to help lower the need for medications like anesthesia. Additionally, the surgeon rated his stress lower and completed surgeries faster when patients were in VR. The reduction of pain without pharmacological substances can 1) help lower costs for public health institutions, 2) reduce the risk of complications, and 3) decrease patient recovery time.


Contact author:

Dr. Brenda K. Wiederhold

Virtual Reality Medical Center

Access full text:

Vázquez JL, Wiederhold BK, Miller I, Wiederhold MD. Virtual reality assisted anaesthesia during upper gastrointestinal endoscopy: report of 115 cases. EMJ Innov. 2017;1[1]:75-82.

Checking email less frequently reduces stress


Checking email less frequently reduces stress, according to psychologists at the University of British Columbia.

They instructed half of the study’s 124 adults, including students, financial analysts and medical professionals, to limit checking their email to three times daily for a week, while telling the other half to check email as often as they did before the study. Then the researchers reversed the instructions for the two groups during a subsequent week. The researchers found that during the limited email use week, participants experienced significantly lower daily stress than during the unlimited email use week. Lower stress, in turn, predicted higher well-being on a diverse range of well-being outcomes. These findings highlight the benefits of checking email less frequently for reducing psychological stress.

You can read the full research on Computer in Human Behavior book.

Teens who have been prescribed anti-anxiety medications may be more likely to abuse those drugs

stressed teen

Teens who have been prescribed anti-anxiety or sleep medications may be 12 times more likely to abuse those drugs than teens who have never received a prescription, finds a research conducted at the University of Michigan.

Looking at data over three years from more than 2,700 high school and middle school students, researchers found that almost 9 percent of the students had been prescribed a potentially addictive benzodiazepine for treating anxiety or sleep problems at some time in their lives.

Just over 3 percent of students had a current prescription during the study, and those students were 10 times more likely than students who never had a prescription to obtain anti-anxiety or sleep medications for nonmedical reasons, such as experimenting or getting high.

Students who were prescribed anti-anxiety medications before the three-year study but no longer had a prescription were 12 times more likely to use someone else’s anti-anxiety medication than students who had never received a prescription.

Researchers also found that white students were twice as likely as black students to use the medications without a prescription.

In VRMI, we use an alternative to method to help people to clam down their anxiety, find out more here.

2012 Summer Editorial

Journal of CyberTherapy & Rehabilitation

Summer 2012, Volume 5, Issue 2



Welcome to the Summer 2012 issue of the Journal of CyberTher- apy & Rehabilitation (JCR). As you know, JCR is one of the two official journals of the International Association of CyberPsychology, Training & Rehabilitation (iACToR). Now in its 17th year, the annual international CyberPsychology & CyberTherapy Conference (CYBER 17) is the official conference of iACToR. The CyberPsychology, Behavior, & Social Networking Journal (CYBER), CyberTherapy & Rehabilitation (C&R) Magazine, and JCR, form to create our Combined Communications Platform. The journals, conference, magazine, and association combine into one powerful platform to address previous information deficits in the utilization of advanced technologies in healthcare which strives to speak with a united voice to inform and educate stakeholders about the uses of technologies in healthcare, as well as how tech- nologies are impacting behavior and society.

This year the Interactive Media Institute, in collaboration with the Virtual Reality Medical Institute, is organizing the International Association of CyberPsychology, Training, & Rehabilitation’s (iACToR) 17th Annual CyberPsychology & CyberTherapy Con- ference (CYBER17), scheduled for September 25-28, 2012 at the European Parlimanet in Brussels.

The Annual CyberPsychology & CyberTherapy Conference began as a symposium that featured presentations dealing mostly with conceptual matters and future possibilities at the Medicine Meets Virtual Reality Conference. CYBER17 has now grown to a full- scale conference with presentations that demonstrate controlled clinical trials with unique applications of cutting edge technologies that improve the access and increase the quality of healthcare.

CYBER17’s focus areas include:
1. The Impact of Technologies as Tools
CYBER17 will continue its examination of the exciting applications of advanced technologies being used in training, therapy, rehabilitation, and education for the improvement of the quality and availability of healthcare for people around the globe.

2. The Influence of New Technologies
CYBER17 will further its investigation into how new technologies are influencing behavior and society through the use of positive technology, healthy ageing and well-being.

3. The Imprint of Social Networking
CYBER17 will embrace, as it did in 2011, the exploration of social networking tools on individual behavior and societal relations.

4. The Introduction of New Technologies and New Terms
CYBER17 will study the psychological aspects of new areas in- fluenced by technology such as cyberfashion, cyberadvertising and cyberstalking.


I would like to take this opportunity to thank all those who are helping to make this year’s conference possible through their tireless energy and drive this year’s Scientific Chairs, Professors Rosa Marie Baños, Willem-Paul Brinkman and Giuseppe Riva; Exhibit Chairs Professors Evangelos Bekiaris and Luciano Gamberini; Workshop Chair Professor Stéphane Bouchard; Cyberarium Chairs Professors Mariano Alcañiz and Andrea Gaggioli; and Website Chair Professor Sun Kim. Many thanks to the Scientific Committee, made up of prominent researchers from around the world, as well as all of the presenters and attendees. Finally, my gratitude to James Cullen, Emily Butcher, Tanisha Croad and Pierre Schifflers for overseeing the Conference Coordination, to Chelsie Boyd for editing related materials, and to the teams at Interactive Media Institute, Virtual Reality Medical Center, and Virtual Realty Medical Institute for their time and contributions to all facets of the conference.

To our sponsors and supporters, who continue to support our vi- sion and help make it a reality, a warm and heartfelt thank you – Brussels Capital Region, Engineering Systems Technologies GmbH & Co. KG, the European Commission, Hanyang Univer- sity, International Association of CyberPsychology, Training, & Rehabilitation (iACToR), Interactive Media Institute (IMI), INTERSTRESS, ISfTeH, Istituto Auxologico Italiano, Mary Ann Liebert, Inc. Publishers, National Institute on Drug Abuse (NIDA), Université du Québec en Outaouais (UQO), the Virtual Reality Medical Center (VRMC), the Virtual Reality Medical Institute (VRMI) and Visit Brussels. As integral parts of our Combined Communications Platform, the CyberPsychology & CyberTher- apy Conference Conference series will continue to work together with iACToR, JCR, and C&R to inform and educate industry, ac- ademia, and government officials and the general public on the explosive growth of advanced technologies for therapy, training, education, prevention and rehabilitation.

As in previous conferences, this year’s conference will be hosting an interactive exhibit area, the Cyberarium, which allows conference attendees and members of the press to try new technologies firsthand. To recognize outstanding achievements by students and new researchers, as well as lifetime achievement for a senior researcher, we will also be hosting awards during the conference and announcing the 2012-2013 iACToR officers during the General Assembly. Pre-conference workshops will focus on advanced topics including Brain Computer Interfaces, VR for cognitive assessment and rehabilitation and finally VR treatment manuals for clinical applications.
As we approach CYBER17 with excitement, we begin too to look toward next year’s conference, CyberPsychology & CyberTherapy 18, to be held in June 2013. Thank you again for your commitment to the evolution of healthcare!



Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

2012 Spring Editorial

Journal of CyberTherapy & Rehabilitation

Spring 2012, Volume 5, Issue 1



As defined by the European Commission, ambient assisted living (AAL) “refers to intelligent systems of assistance for a better, healthier, and safer life in the preferred living environment and covers concepts, products, and services that interlink and improve new technologies and the social environment. It aims at enhancing the quality of life (the physical, mental, and social well-being) for everyone (with a focus on elder persons) in all stages of their life. AAL can help elder individuals to improve their quality of life, to stay healthier and to live longer, thus extending one’s active and creative participation in the community.” AAL relies on Ambient Intelligence (AmI) to ensure that devices are noninvasive or in- visible, personalized to the user’s needs, adaptive to the user and the environment, and anticipatory of the user’s wishes. Its roots are in assistive technologies for people with disabilities, and in accessibility requirements for interactive technologies (e.g., Section 508 Web site requirements in the U.S.).

The impetus for accelerated AAL research and implementation is our elders, who live longer and can remain in their homes longer with the assistance of technology, thereby preventing costly hospitalizations and nursing home admissions. The number of older people worldwide has tripled in the last 50 years, and will more than triple again in the next 50 years.

A recent literature review categorizes AAL into services that handle adverse conditions, assess health state, consult and educate, motivate and provide feedback, facilitate ordering of service, and promote social inclusion. AAL devices use sensors and actuators in the home environment to, for example, detect falls in elders or spikes in blood sugar of people with diabetes, and fuse data to trigger caregiver alerts. Other systems of interest to our readers include those designed to help people who have mild cognitive impairments with activities of daily living. Most challenging to develop are pattern recognition applications that can, for example, sense an elder’s behavior change and prevent depression by motivating the elder to socialize.

Both Virtual Reality and mixed reality (augmented reality and aug- mented virtuality) environments for AAL have been proposed. For example, in an extension of the current boundaries of telemedicine, the physician could view the whole body of the at-home patient, and the patient could more easily understand(s) he was undergoing a physical examination. At least one paper reports elders’ positive reactions to AAL, so this scenario may not be far in the future.

However, a recent issue of ERCIM News highlighted the fundamental research challenges that remain in AAL and AmI:

  • “Knowledge of user requirements. Age-related factors are crucial, and the current understanding of the interaction requirements of older users in complex technological environments is limited.
  • Ready-to-use accessibility solutions supporting alternative interaction techniques. Most available assistive technologies are limited to specific devices, and cannot be easily made compatible with complex environments including a variety of devices.
  • Architectural frameworks supporting the integration and management accessibility solutions.
  • Tools supporting the development lifecycle of accessible AAL environments (e.g., requirements analysis, design and prototyping, evaluation).”
  • We applaud the clinicians and researchers who are working to solve AAL and AmI research problems, and look forward to the day when smart homes for our elders are the norm.



Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

2011 Winter Editorial

Journal of CyberTherapy & Rehabilitation

Winter 2011, Volume 4, Issue 4


How Can we Help preserve Mental Capital?

First, let me define what I mean by the concept of mental wealth or mental capital. The Foresight Project on Mental Health and Well-being says that it “encompasses a person’s cognitive and emotional resources. It includes their cognitive ability, how flexible and efficient they are at learning, and their ‘emotional intelligence,’ such as their social skills and resilience in the face of stress. It therefore conditions how well an individual is able to contribute effectively to society, and also to experience a high personal quality of life.” The study focused on the U.K., but the 20-year trends cited as affecting the mental wealth of that country are relevant to the rest of the EU, the U.S., and other parts of the world. Trends include the aging of the population (increasing dementia), changes in the global economy (rise of China and India, need for more training and work-life balance), the changing nature and expectations of society and public services (balance of responsibility), and new science and technology (equal access to their benefits).

These same themes emerge in the resulting study article, “The mental wealth of nations,” by Beddington et al., which reported on the group’s evaluation of the scientific evidence to produce this independent assessment involving 450 experts from 16 countries. The authors of this paper urged development of initiatives to support early diagnosis and treatment of childhood learning problems, workplace environments that promote mental health and programs that advance learning among elders to slow cognitive decline. They noted, “How a nation develops and uses its mental capital not only has a significant effect on its economic competitiveness and prosperity but is also important for mental health and well- being and social cohesion and inclusion.”

Pointing to a disproportionate share of investment in mental health relative to its disease burden, the U.S. National Institute of Mental Health (NIMH) created the Grand Challenges in Global Mental Health, identifying research priorities for the next 10 years that will make a difference in people’s mental health. These 25 specific challenges are grouped into broad goals that seek to:

  • Identify root causes, risk and protective factors
  • Advance prevention and implementation of early interventions
  • Improve treatments and expand access to care
  • Raise awareness of the global burden
  • Build human resource capacity
  • Transform health-system and policy responses

NIMH lists guiding principles for funding such research:

  • Use a life-course approach to study
  • Use system-wide approaches to address suffering
  • Use evidence-based interventions
  • Understand environmental influences

So how can we, as clinical and research professionals with spe- cialties in, for example, psychology, physical medicine and rehabilitation, or autism, help our clients boost their mental capital?


  1.  Improved access to education can help: “The [Foresight] Project has identified a number of technologies … ubiquitous and mobile technologies; artificial intelligence; assessment technologies; and tools to support teachers in designing and exchanging learning activities.” A virtual environment to help children with autism learn to cross the street is one example of how we can use the technolo- gies we espouse for early intervention, the most cost-effective way to prevent mental ill health.
  2.  Although the mechanisms are not yet understood, a growing number of studies show that physical exercise may prevent or mitigate the effects of depression, and a Stanford University study showed that a virtual representation of one’s self gaining or losing weight in proportion to the exercise completed motivated volunteers to complete more exercise.
  3.  While we are just beginning to debate the legal and ethical im- plications of using pharmacological (smart drugs) means of improving mental wealth, use of these drugs in controlled clinical trials and publication of results that show minimal side effects from long-term use will pave the way for their mainstreaming.
  4. Neurocognitive activation via cognitive training is a promising area of investigation, as I reported in my recent article co-authored with Dr. Mark Wiederhold. With the aid of fMRI-safe Virtual Reality goggles, we can study the brain while a patient interacts with a virtual environment, and learn how to tailor treatments to pro- duce the desired activations in that individual’s brain.
  5.  Finally, I would encourage you to continue to advocate for mental health funding by governments. As the Foresight study authors noted, “… a cross-governmental approach is needed to realize the full benefits … Interventions may have long timescales before they see any returns. Implementing these recommendations will require significant changes in the nature of governance, placing mental capital and well-being at the heart of policy-making.”



Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute

Citizen Scientists Generate Benefits for Researchers, Educators, Society, and Themselves

What, exactly, is a ‘‘citizen scientist’’? ‘‘The term ‘citizen scientists’ refers to volunteers who participate as    field    assistants    in    scientific    studies.    Citizen    scientists . are not paid for their assistance, nor are they necessarily even scientists.’’1 Two hundred years ago, everyone was a citizen scientist and made their living in another profession. Ben Franklin, who invented the lightning rod and bifocals, made his living as a printer, diplomat, and politician. Contrast that with today’s call from the National Oceanic and Atmospheric Administration National Weather Service to ‘‘Be a Citizen Scientist’’ ( .pdf) and join its network of 230,000 trained severe-weather spotters.

In September 2011, you may have heard that an amazing event occurred: citizen scientists formulated a structure for a key enzyme related to the development of the AIDS virus by using FoldIt,2 an online game in which volunteers can shake, wiggle, or pull apart different pieces of a protein molecule ( It took these gamers a mere 2 years to crack a code that had eluded scientists. What you may not know is that this breakthrough was just the latest contribu- tion by citizen scientists, who are increasingly moving into the life sciences, and that FoldIt was created because of a project called Rosetta@home.3

Rosetta@home, like the more famous SETI@home that sorts through radio signals in the Search for Extraterrestrial Intelligence (SETI), harnessed volunteers’ unused computer power to research complex issues through so-called grid computing. When the volunteers noted to the researchers that they could do a better job of manipulating the molecule than the computer, the researchers developed the FoldIt program, and the rest, as they say, is history.

It is interesting to note that most of the gamers didn’t have sophisticated knowledge of biology, but instead had good spatial reasoning skills—something that is difficult to emulate in a computer program. We don’t know yet whether these successful gamers have increased their knowledge of and improved their attitude toward science, but an earlier study may provide some clues.

Environmental science was one of the first fields to so- licit volunteers in projects such as the National Audubon Society’s Christmas Bird Count, which began in 1900. The Birdhouse Network (TBN) is a more complex citizen scientist project involving the creation of nesting boxes and reporting on the behaviors of cavity-nesting birds such as swallows; interaction with TBN staff is encouraged. In a standardized evaluation of this project, the researchers determined that participants’ knowledge of bird biology increased, but they were unable to detect a significant increase in attitude toward science or the environment, or increased knowledge of the scientific process. As a result, the authors suggested, ‘‘Citizen-science projects that hope to increase understanding of the scientific process should be framed in a way that makes participants particularly aware of the scientific process in which they are becoming involved.’’4

How can we encourage more individuals to become citizen scientists? As we wrote in our last editorial about engaging the public in scientific discourse, how we frame the issue is key. Also important are the software and other tools that make participation easy. Most citizen scientists, such as those now becoming involved in genomic research, derive satis- faction from knowing that researchers will use the data they contribute. Science grant recipients will increasingly find public outreach requirements as a condition of funding, and should welcome the opportunity to engage citizens in a way that encourages participation.

As National Academies of Science researchers put it, ‘‘Citizen science has a number of benefits for four separate communities. For scientific researchers, it allows projects that were previously impossible to be done quickly and easily. For volunteers, it can provide fun, a sense of community, and the ability to contribute to science. For STEM (science, technology, engineering, and mathematics) educators, it can offer the opportunity for in- creased learning, a window into the process of science, and a chance to promote the idea that ‘I can do science.’ For society at large, it can build a closer connection between scientists and the public, and can result in a public with increased knowledge about science and scientific habits of mind.’’5

Given that anyone with Internet access has the potential to serve as a citizen scientist, we think that cybertherapy projects and citizen scientists are a good fit. We hope that you, our CYBER reader, will consider the benefits of engaging citizen scientists to the fullest extent possible in your work as you test and validate new virtual environ- ments and related technologies.

1. Cohn JP. Citizen science: Can volunteers do real research? BioScience 2008; 58:192–7.
2. Gamers succeed where AIDS researchers could not. Inter- national Business News, Sep. 20, 2011. art/services/print.php?articleid = 216916 (accessed Sep. 25, 2011).
3. Bonetta L. New citizens for the life sciences. Cell 2009; 138:1043–5.

4. Brossard D, Lewenstein B, Bonney R. Scientific knowledge and attitude change: The impact of a citizen science pro- ject. International Journal of Science Education 2005; 27: 1099–21.
5. Riddick MJ, Bracey G, Carney K, et al. Citizen science: Status and research directions for the coming decade. AGB Stars and Related Phenomenastro2010: The Astronomy and Astrophysics Decadal Survey, Vol. 2010, p.46P. 2010/DetailFileDisplay.aspx?id = 454 (accessed Sep. 26, 2011).


Brenda K. Wiederhold


What Would Happen If We Treated Scientists Like Rock Stars?

These days, it seems like everybody knows Lady Gaga, but how many know Noam Chomsky who reshaped the field of psychology? A 2010 Research!America survey revealed that 72% of the public can’t name a living scientist. Would it make a difference if we treated scientists like rock stars? Recently, the Geoffrey Beene Foundation and GQ magazine set out to find out.

The December 2010 edition of GQ carried a six-page spread of rockers and scientists designed to help bridge the gap between science and the public. The Rock Stars of Science Web site ( honors 28 ‘‘Roc Docs’’ of 2009–2010. One of the featured physicians, Susan J. Blumenthal, M.D., M.P.A., former U.S. Assistant Surgeon General, has this to say about what scientists and rock stars have in common: ‘‘Rock stars and scientists share passion, creativity, and the thrill of discovery. Where musicians use their minds, instruments, and voices to create new rhythms, researchers use science and technology to make the music of medicine: new discoveries that improve health and eradicate disease.’’

A critic of the Rock Stars of Science campaign1 says that while the goal is connecting science to people and the idea is to see scientists, like rock stars, as ‘‘one of us,’’ the premise is flawed. Rock stars are ‘‘the other,’’ representing a world of fast cars and glamour that may be aspired to but is seldom achieved.

One Rock Stars of Science campaign goal was to increase funding for scientific research and, for a number of reasons, that goal may be realized. President Obama’s FY 2012 budget contains a 6% increase for federal research and development, which is in line with the support this President has shown for basic and applied science throughout his presidency.

Another campaign goal, to inspire young people to pursue scientific careers, may be more elusive. A November 2010 column2 reported the reaction of Sofya Low, a public high school math and science teacher: ‘‘They’re asking kids to go to this website, process that they like Timbaland and then that he’s standing with scientists, read that the scientists study Alzheimer’s, figure out what that is, and then see how that’s exciting. I just don’t see it happening with teenagers and their 20-second attention spans.’’ Her students don’t per- ceive science as glamorous and well-paying, so science needs to be interesting in a fundamental way to attract their attention.

Although some scientists, such as Stephen Hawking, have a knack for making science interesting to the public and generating media interest, many scientists may be uncom- fortable in the spotlight. Communicating with the public is now considered a scientist’s responsibility. For scientists un- accustomed to speaking before lay audiences, programs such as the Aldo Leopold Leadership Program at Oregon State University exist. They train scientists on how to talk to the media, testify before Congress, and communicate effectively with business leaders.

A recent paper acknowledges that scientists have ‘‘a growing recognition that effective communication requires initiatives that sponsor dialogue, trust, relationships, and public participation across a diversity of social settings and media platforms.’’3 The authors concluded that if people feel they are being marketed to, trust erodes, and recommended that scientists find ways to engage the public that respect ‘‘differences in knowledge, values, perspectives, and goals.’’



1. McGannS.RockStarsofScience.RefractiveIndex2011(Feb14). of-rock-stars-of-science (accessed June 25, 2011).

2. Maxmen A. Scientists as rock stars? They pose with famous musicians to excite the public about science, but not everyone thinks it’s working. The Scientist 2010 (Nov 17). http://classic (accessed June 25, 2011).

3. Nisbet MC, Scheufele DA. What’s next for science commu- nication? Promising directions and lingering distractions. American Journal of Botany 2009; 96:1767–1778.


Brenda K. Wiederhold