Simulating real world functioning in schizophrenia using a naturalistic city environment and single-trial, goal-directed navigation

Abstract

Objective: To develop a virtual reality platform that would serve as a functionally meaningful measure of cognition in schizophrenia and that would also complement standard batteries of cognitive tests during clinical trials for cognitive treatments in schizophrenia, be amenable to human neuroimaging research, yet lend itself to neurobiological comparison with rodent analogs.Method: Thirty-three patients with schizophrenia and 33 healthy controls matched for age, sex, video gaming experience, and education completed eight rapid, single-trial virtual navigation tasks within a naturalistic virtual city. Four trials tested their ability to find different targets seen during the passive viewing of a closed path that led them around different city blocks. Four subsequent trials tested their ability to return to four different starting points after viewing a path that took them several blocks away from the starting position.Results: Individuals with schizophrenia had difficulties in way-finding, measured as distance travelled to find targets previously encountered within the virtual city. They were also more likely not to notice the target during passive viewing, less likely to find novel shortcuts to targets, and more likely to become lost and fail completely in finding the target. Total travel distances across all eight trials strongly correlated (negatively) with neurocognitive measures and, for 49 participants who completed the Quality of Life Scale, psychosocial functioning.Conclusion: Single-trial, goal-directed navigation in a naturalistic virtual environment is a functionally meaningful measure of cognitive functioning in schizophrenia.

Virtual Reality Job Interview Training for Individuals With Psychiatric Disabilities

“…Our results were also consistent with recent studies demonstrating that VR training using animated avatars can be used to improve vocational and social skills for individuals with psychiatric disabilities (Park et al, 2011; Rus-Calafell et al, 2014; Tsang et al, 2013; Zawadzki et al, 2013). Moreover, VR-JIT provided in-the-moment feedback, was rewarding, and was designed using behavioral learning principles with repetitive practice that allowed participants to build mastery as the simulated interviews progressively increased in difficulty.…”

“…In conclusion, VR training is a strategy that the field is developing to improve social cognition and assess community-based outcomes (Rus-Calafell et al, 2014; Zawadzki et al, 2013). This study demonstrated preliminary evidence that a VR approach to training job interview skills might be a feasible and efficacious tool to improve job interview performances and self-confidence in job interviewing for individuals with psychiatric disabilities.…”

Virtual reality job interview training for veterans with posttraumatic stress disorder

“…Effect sizes of the within-group changes in the VR-JIT and wait-list TAU groups were consistent with the effects observed among individuals with SMI or ASD who used VR-JIT training (Smith et al, 2014a, 2014b) and that of other studies that used animated avatars to improve social skills for individuals with psychiatric disabilities (Park et al, 2011; Rus-Calafell et al, 2014; Tsang & Man, 2013; Zawadzki et al, 2013). …”

Brave New Worlds--Review and Update on Virtual Reality Assessment and Treatment in Psychosis

“…16 Cognitive problems in goal-directed navigation were also found in naturalistic virtual environments such as finding targets in a city. 17 Compared to healthy controls, schizophrenia patients were less flexible in changing strategies for finding the best bus route, 18 were slower and less successful in a shopping task 19 and had poorer medication management skills in a virtual apartment. 20 VR enables to investigate interactions between individual and social environment in great detail.…”