Virtual-reality-based social cognition and interaction training for patients with schizophrenia: A preliminary efficacy study

Abstract

BackgroundSocial cognition and interaction training (SCIT) is a psychosocial intervention program for patients with psychosis, designed to improve their social functioning by improving social cognition. Although the feasibility and efficacy of SCIT have been verified, patients with schizophrenia tend to suffer from motivational deficits and low treatment adherence. It has been suggested that using virtual reality (VR) technology might be effective in addressing these issues. In this study, we aimed to develop a VR-based SCIT and compare its efficacy with that of traditional SCIT.Materials and methodsWe developed a novel VR-based social cognition and interaction training (VR-SCIT) that combines traditional SCIT (TR-SCIT) intervention with VR technology. Participants were randomly assigned in a 1:1:1 ratio to the VR-SCIT (n = 28), TR-SCIT (n = 30), or waiting-list groups (n = 29). All treatments were combined with treatment-as-usual. Assessments of social cognition (i.e., Chinese version of Face-Affective Identification Task, Chinese version of Social Cognition Screening Questionnaire) and social functioning (i.e., Chinese version of Personal and Social Performance Scale) were administered from baseline to post-intervention.ResultsPatients receiving VR-SCIT and TR-SCIT showed a significantly greater improvement on the assessments of emotion perception (Cohen’s d was 1.66, 0.55, and 0.10 for VR-SCIT, TR-SCIT, and Waiting-list, respectively), hostile attributional bias (Cohen’s d was 0.48, 0.44, and 0.05 for VR-SCIT, TR-SCIT, and Waiting-list, respectively), metacognition (Cohen’s d was 1.66, 0.76, and 0.06 for VR-SCIT, TR-SCIT, and waiting-list, respectively), and social functioning (Cohen’s d was 1.09, 0.90, and 0.20 for VR-SCIT, TR-SCIT, and waiting-list, respectively) from baseline to post-intervention, compared to those in waiting-list group. Additionally, VR-SCIT showed an advantage over TR-SCIT in improving emotion perception and metacognition with higher treatment compliance.ConclusionThese preliminary findings indicate that VR-SCIT is a feasible and promising method for improving social cognition and social functioning in patients with schizophrenia.

Application of Immersive VR Serious Games in the Treatment of Schizophrenia Negative Symptoms

“…And, finally, in all studies except [4,19,20], feedback was successfully integrated, underscoring the effort to integrate mechanisms within the game that can enhance the player's experience and performance.…”

“…Among the studies, several noteworthy immersive VR programs have emerged to address the unique challenges faced by schizophrenia patients in social settings. These include GameChange [3], soskitrain [4], Multimodal Adaptive Social Intervention in Virtual Reality (MASI-VR) [9], Social Skills Training VR (SST-VR) [13], Virtual Reality Virtual Training System (VRVTS) [18], Fruit Pioneer [19] and VR Social Cognition and Interaction Training (VR-SCIT) [20] each with its distinct approach and objectives.…”

“…In VR-SCIT [20], a game about office stories, players completed activities to enhance emotion recognition, by judging what kind of emotion was being presented to them, to avoid jumping to conclusions, by trying to understand the context of a situation, and to practice social strategies, by practicing the learned skills in real-life scenarios. Participants were randomly assigned to one of three groups: VR group, standard treatment group, or waiting-list.…”

“…It is noteworthy that, aside from our research, only one other study [3] acknowledged the importance of treatment portability. [20] also used a standalone device, the Pico Goblin2 All-In-One, which opens up better opportunities for treatment portability, yet did not acknowledge that possibility.…”

Biosensor-Integrated Virtual Reality (VR) System Assisted CBT and the Alteration of Delusional Perceptions in Psychosis

“…A cognitive flexibility virtual environment is a virtual reality (VR) environment that challenges and improves the ability to adapt to changing situations and generate novel solutions. Patients can retrain their cognitive flexibility through repetition without consequences [14][15][16].…”