Virtual Environments for Childhood Social Phobia

描述（由申请人提供）：焦虑症是青少年中最常见的精神疾病，其终生患病率在总人口的18-20%之间。在焦虑症中，社交恐惧症（SP）影响了8%的青少年，导致严重的短期和长期损害，包括药物滥用的可能性增加、学业成就有限、职业功能减弱以及社会关系受损或缺失。新出现的数据表明，包括社交技能培训、正式的同伴推广会议和家庭作业在内的干预措施作为整体治疗策略的一部分，与没有这些组成部分的干预措施相比，效果更好——后两个要素旨在提高技能推广。两个关键的治疗要素（同伴推广、家庭作业）在传统的临床环境中难以实施，限制了在不同环境中（例如，在学校、门诊或社区设施）向需要这些服务的青少年进行最佳传播。根据PA-07-423《神经科学、行为科学和心理健康研究的计算工具》，第一阶段STTR将开发并验证一套交互式虚拟环境，以解决对技能推广至关重要的强化行为练习机会的需求，从而加强传播并为未来的努力提供模型。虚拟环境使儿童用户能够与任何标准计算机上的虚拟学校角色进行互动，允许日常密集的社交技能练习，而无需正式的同伴小组活动（诊所解决方案）或密集的父母参与（家庭解决方案）。虚拟角色的反应将是预先确定和预先编程的，但似乎对用户的互动有反应，创造一个模拟的现场场景。通过在模拟的虚拟社会环境中反复练习，促进儿童将通过传统社交技能训练获得的社交技能转移到现实生活中，这种新颖的、商业上可行的干预措施将在诊所和家庭中都有，从而优化临床服务。一旦开发和验证，这种可销售的资源将加强以证据为基础的行为干预在各种治疗环境中的治疗传播，并提供易于适用于其他疾病的技术。

DESCRIPTION (provided by applicant): Anxiety disorders are the most common psychiatric disorders among youth, with lifetime prevalence ranging between 18-20% of the general population. Among anxiety disorders, social phobia (SP) affects 8% of all youth, resulting in significant short and long-term impairment, including increased likelihood of substance abuse, limited academic achievement, attenuated occupational functioning, and impaired or missing social relationships. Emerging data suggest that interventions that include social skills training, formal peer generalization sessions, and homework assignments as part of an overall treatment strategy show enhanced efficacy when compared to interventions without these components - the latter two elements which are designed to enhance skill generalization. Two critical treatment elements (peer generalization, homework assignments) are difficult to implement in traditional clinical settings, limiting optimal dissemination to youth in need of these services in different settings (e.g., at school, outpatient, or community facilities). This Phase I STTR, written in response to PA-07-423 Computational Tools for Research in Neuroscience, Behavioral Science and Mental Health, will develop and validate an interactive set of virtual environments to solve the need for intensive behavioral practice opportunities that are critical for skill generalization, thereby enhancing dissemination and providing a model for future efforts. Virtual environments enable the child user to interact with virtual school characters on any standard computer, allowing daily intensive practice of social skills without the need for formal peer group activities (in-clinic solution) or intensive parental involvement (at-home solution).The virtual character responses will be predetermined and preprogrammed yet appear to be responsive to the users interactions, creating a simulated live scenario. This novel and commercially viable intervention with both in-clinic and at-home components will optimize clinical services by promoting the transfer of social skills acquired through traditional social skills training into real-life situations for children through repeated practice in a simulated social virtual environment. Once developed and validated, this marketable resource will enhance treatment dissemination of an evidence-based behavioral intervention to various treatment settings and provide technology readily adaptable for other disorders.