Effects of Social Presence and Perception in Virtual Reality on Pain (SPP) (SPP2)

Effects of Social Presence and Perception on Pain: Comparing Close Others to Strangers and VR to Video Conferencing

This experiment aims to examine the effects of social interaction with close others or strangers in virtual reality or through a video-conferencing call, on pain threshold in healthy volunteers in an induced pain task.

In a within-subjects study, participants will complete a series of induced-pain heat ramps in four conditions. These conditions are 1. alone in virtual reality 2. with a close friend or family member in virtual reality 3. with a stranger in virtual reality 4. with the same close friend or family member in a video call.

Study Overview

• Status: Completed
• Conditions: Pain Threshold
• Intervention / Treatment: Behavioral: VR Close Other; Behavioral: VR Alone; Behavioral: VR Stranger; Behavioral: Video Close Other

Detailed Description

Some of the earliest clinical uses of virtual reality were as a distractor for patients experiencing pain. However, virtual worlds also allow for social interaction, which has the potential to strongly affect both pain and the sensation of presence in an environment. While social support has been linked to pain reduction, in a recent study, participants who texted with a stranger while undergoing surgery were less likely to require analgesia than those who texted with companions or played a distracting game on their phone. While the authors propose that the context of the chat may have affected participants' pain levels, another additive possibility is that these patients were experiencing social presence with the strangers, who were conversing from a location outside the hospital, and were thus feeling less present in the hospital environment. This might explain why participants received greater benefit from these text conversations than from conversations with loved ones, who were conversing from the hospital environment where their pain occurred. In a previous study, we found that participants in an induced pain task demonstrated higher pain thresholds when they were interacting socially with a stranger compared to when they were alone (Won, Pandita and Kruzan, 2020).

In this study, we follow up on these results. First, we aim to replicate the previous finding of social interactions, overall, increasing pain tolerance. Second, we aim to compare the potential effects of interacting with a stranger compared to a "close other," defined as a friend or family member. Third, we compare social interactions in virtual reality compared to video. Fourth, we examine whether cortisol is linked with pain threshold.

METHODS AND RESEARCH STRATEGY: Our previous study used 75 participants, and since this is the closest study to our current research design, we will retain this number as our target. We will work with a student sample of convenience.

Each participant will experience four conditions in a random order: 1. alone in virtual reality 2. with a close friend or family member in virtual reality 3. with a stranger in virtual reality 4. with the same close friend or family member in a video call. Each condition will take place in a different virtual environment.

Participants will be stably seated, and observed by a research assistant, as they experience each condition. During each condition, participants will complete an induced pain task using a Medoc TSA-2001/Model Q-Sense thermode. Prior to experiencing the four experimental conditions, participants will complete a "practice" induced pain task while viewing a different virtual environment. This will allow them to orient themselves to both the virtual environment and the pain task, since based on the pilot experiment, order effects are predicted to be most notable for the first pain task administered. In this and all subsequent induced pain tasks, participants will place their non-dominant hand on the thermode and will be instructed to remove their hand as soon as they feel the temperature has become "painful". The beginning and end of each trial (when the heat ramp begins, and when participants remove their hands) will be noted, and that time duration, and thus the degree of temperature to which it corresponds, will serve as the measure of pain threshold for that trial. In addition to this outcome measure, after each pain trial participants will also fill out a brief self-report survey. These measures will include their self-reported feelings of presence in the virtual environment, and social presence with the other conversational partners. All conditions will be presented in a randomized order to control for order effects. The time to complete these surveys will be approximately 7-10 minutes, which will also allow participants time between each trial to reorient themselves to the real environment, and for any lingering effects of heat on their hands to dissipate. After each survey, 15 minutes after each pain task, a saliva sample for cortisol will be taken.

• Study Type: Interventional
• Enrollment (Actual): 71
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • Ithaca, New York, United States, 14853
      • Cornell Virtual Embodiment Lab

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Consenting Adult

Exclusion Criteria:

1. History of cardiovascular disorder
2. History of fainting or seizures
3. Open cut or sore on hand to be thermally tested
4. Burn or sunburn on hand to be thermally tested.
5. Pregnancy
6. Prone to motion sickness, or have balance or dizziness conditions
7. Recent concussion
8. Seizure disorders
9. History of fainting or seizures
10. Visual impairment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Time 1; Participant will be randomly assigned to one of the four interventions; either Near Non-Social, Near Social, Far Non-Social, or Far Social	Behavioral: VR Close Other; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments while chatting with the friend or family member who accompanied them to the lab; Behavioral: VR Alone; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments alone; Behavioral: VR Stranger; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments while chatting with a stranger; Behavioral: Video Close Other; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they chat with the friend or family member who accompanied them to the lab using a video-conferencing tool
Active Comparator: Time 2; Participant will be randomly assigned to one of the remaining three interventions; either Near Non-Social, Near Social, Far Non-Social, or Far Social	Behavioral: VR Close Other; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments while chatting with the friend or family member who accompanied them to the lab; Behavioral: VR Alone; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments alone; Behavioral: VR Stranger; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments while chatting with a stranger; Behavioral: Video Close Other; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they chat with the friend or family member who accompanied them to the lab using a video-conferencing tool
Active Comparator: Time 3; Participant will be randomly assigned to one of the remaining two interventions; either Near Non-Social, Near Social, Far Non-Social, or Far Social	Behavioral: VR Close Other; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments while chatting with the friend or family member who accompanied them to the lab; Behavioral: VR Alone; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments alone; Behavioral: VR Stranger; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments while chatting with a stranger; Behavioral: Video Close Other; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they chat with the friend or family member who accompanied them to the lab using a video-conferencing tool
Experimental: Time 4; Participant will be randomly assigned to the remainingintervention; either Near Non-Social, Near Social, Far Non-Social, or Far Social	Behavioral: VR Close Other; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments while chatting with the friend or family member who accompanied them to the lab; Behavioral: VR Alone; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments alone; Behavioral: VR Stranger; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they experience one of four randomly assigned virtual environments while chatting with a stranger; Behavioral: Video Close Other; Participants will be stably seated, and observed by a research assistant, as they complete an induced pain threshold task while they chat with the friend or family member who accompanied them to the lab using a video-conferencing tool

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain threshold in degrees tolerated at end of trial	Change in temperature from the beginning to the end of each trial (when the heat ramp begins, and when participants remove their hands) will be noted in milliseconds.	The beginning and end of each trial < 90 seconds

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cortisol levels	Cortisol levels derived from saliva samples	15 minutes between samples
Self-reported Social Presence	Questionnaire of self-reported feelings of social presence with the conversational partner (1-5 Likert scale, higher means greater)	Experience and subsequent survey time 5-15 minutes
Self-reported Environmental Presence	Questionnaire of self-reported feelings of environmental presence with the conversational partner (1-5 Likert scale, higher means greater)	Experience and subsequent survey time 5-15 minutes

Collaborators and Investigators

• Sponsor: Cornell University

Study record dates

Study Major Dates

• Study Start (Actual): October 22, 2021
• Primary Completion (Actual): May 5, 2023
• Study Completion (Actual): May 5, 2023

Study Registration Dates

• First Submitted: April 12, 2022
• First Submitted That Met QC Criteria: April 12, 2022
• First Posted (Actual): April 19, 2022

Study Record Updates

• Last Update Posted (Actual): August 23, 2024
• Last Update Submitted That Met QC Criteria: August 21, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Keywords: virtual reality
• Other Study ID Numbers: 1701006910-2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data and code will be posted through the Cornell Center for Social Sciences and Cornell Restricted Access Data Center repositories after publication and made available to researchers who present a valid IRB protocol and promise to destroy data after use.
• IPD Sharing Time Frame: The SAP is already posted to Open Science Framework. Once published the data will be available on the CCSS/CRADC archives indefinitely.
• IPD Sharing Access Criteria: Anonymized data will be available to any who request it. The full data set will be available upon submission of a valid IRB protocol and promise to destroy data after use.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No