Two case studies from a virtual reality intervention for delusions: feasibility and preliminary evidence

Abstract

The use of virtual reality (VR) interventions for psychosis is on the rise. As information-processing biases such as overconfidence in memory are likely to be involved in the formation and maintenance of delusions, VR could also be used to correct cognitive distortions and in turn ameliorate delusions. The present study illustrates two case studies in which a VR intervention was employed to reduce delusions by means of correcting experiences. Participants navigated four virtual environments via a head-mounted display (HMD) and computer and were asked to recollect previously seen faces and objects and to rate their response confidence. The scenarios were created to elicit false memories. Immediately after each response, they received feedback to correct possible overconfidence in false memories. We present two case studies to illustrate individual differences. Both participants benefited from the intervention: delusions were reduced from pre- to post-assessment (after 3 weeks) as measured with the Positive and Negative Syndrome Scale and Psychotic Symptom Scale. This was corroborated by results on the Paranoia Checklist and the Community Assessment of Psychic Experiences collected immediately after the session. Immediate effects also showed a reduction in delusion conviction rate. The present study provides preliminary evidence that delusions may be ameliorated by a VR paradigm designed to correct memory overconfidence. Cybersickness emerged as a problem in one of the patients.

Akzeptanz und Nebenwirkungen einer Virtuellen-Realitäts-Intervention bei Menschen mit Psychose und gesunden Kontrollprobanden

“…Die Rückmeldung v.a. hochkonfidenter (d.h. mit übermäßiger Urteilssicherheit) Fehlerinnerungen mit der Aufforderung, vorsichtiger Schlüsse ziehen, soll in der Folge wahnhafte Überzeugungen und Überkonfidenz reduzieren [Moritz et al, 2014;Dietrichkeit et al, 2018Dietrichkeit et al, , 2020. In der Pilotstudie [Moritz et al, 2014] konnte eine Reduktion paranoider Symptomatik mit mittlerer Effektstärke erzielt werden.…”

“…Stanney et al, 2020] und Angst [z.B. Bouchard et al, 2011] [Dietrichkeit et al, 2018[Dietrichkeit et al, , 2020. Diese Forschungsarbeit soll die Akzeptanz und etwaige Nebenwirkungen der VR-Intervention untersuchen.…”