Physiology-based virtual reality training for social skills in schizophrenia

 描述（由申请人提供）：社交障碍是精神分裂症的核心特征，导致预后不良。社交技能和能力提高生活质量，防止与压力相关的症状恶化，同时支持弹性，人际交往和社会关系。为了改善结果，我们必须弥补社会赤字。现有的心理社会干预措施是适度有效的，但努力密集型的性质（高负担），低坚持性，以及日常生活中的技能转移薄弱，对恢复提出了重大障碍。因此，迫切需要为精神分裂症患者制定有效，参与和低负担的社会干预措施，以提高依从率和功能结果。 我们将测试一种新的自适应虚拟现实（VR）干预在改善精神分裂症患者的目标社会认知功能（以眼球扫描模式为指标的社会注意力）方面的有效性。VR技术为传统疗法提供了一种灵活的替代方案，具有几个优点，包括简化和 低压力的社会互动环境，有针对性的机会，以模拟，锻炼和加强社会技能的基本要素在一个非常广泛的现实场景，并从多个角度重复暴露于自然的情况。我们的桌面VR“游戏”被设计成一个“智能”系统，它可以根据参与者的生理、眼球跟踪和真实的表现数据，自适应地调整社交训练任务的难度。这种基于动态反馈的“闭环”VR支持和增强训练，因为它为每个参与者真实的时间调整和个性化学习环境，使他/她始终以最佳唤醒和注意力状态学习。此外，VR环境可以模拟任何社交场景，这允许参与者在各种情况下练习社交技能。这种模拟练习有助于将学到的技能推广到日常生活中。 R21阶段旨在实施社会干预VR任务，测试其在改善精神分裂症患者社会注意力（目标）方面的功效，并确定最佳“剂量”。我们假设VR训练会吸引社会注意力，提高社会注意力会带来更好的社会结果。R33阶段将在试点随机对照试验中测试自适应社交VR游戏对主动控制条件的影响，以评估社交VR在增强社交注意力和相关神经回路方面的相对功效。我们还将研究社会结果。如果这项初步工作取得成功，我们的长期目标是开发个性化、可访问和便携式的VR社交技能培训模块，使社交补救成为人们日常生活中不可或缺的一部分。

 DESCRIPTION (provided by applicant): Social impairments are core features of schizophrenia that lead to poor outcome. Social skills and competence improve quality of life and protect against stress-related exacerbation of symptoms, while supporting resilience, interpersonal interactions, and social affiliation. To improve outcome, we must remediate social deficits. Existing psychosocial interventions are moderately effective but the effort-intensive nature (high burden), low adherence, and weak transfer of skills to everyday life present significant hurdles toward recovery. Thus, there is a dire need to develop effective, engaging and low-burden social interventions for people with schizophrenia that will result in better compliance rates and functional outcome. We will test the effectiveness of a novel adaptive virtual reality (VR) intervention in improving targeted social cognitive function (social attention as indexed by eye scanning patterns) in individuals with schizophrenia. VR technology offers a flexible alternative to conventional therapies, with several advantages, including a simplified and low-stress social interaction environment with targeted opportunities to simulate, exercise and reinforce basic elements of social skills in a very wide range of realistic scenarios, and to repea exposure to naturalistic situations from multiple angles. Our desktop VR `game' is designed as an `intelligent' system that adaptively adjusts the difficulty of social training tasks based on participant's physiological, eye tracking and performance data in real time. Such dynamic feedback-based, `closed-loop' VR supports and enhances training because it adjusts and personalizes the learning environment in real time for each participant so that he/she always learns at an optimal arousal and attentional state. Furthermore, the VR environment can potentially simulate any social scenarios, which allows the participants to exercise social skills n a wide variety of situations. Such simulation exercises can help generalize learned skills to everyday life. The R21 phase will aim to implement the social intervention VR task, test its efficacy on improving social attention (target) in schizophrenia, and determine an optimal `dose'. We hypothesize that the VR training will engage social attention and improving social attention will lead to better social outcome. The R33 phase will test the adaptive social VR game against an active control condition in a pilot randomized controlled trial to evaluate the relative efficac of the social VR on enhancing social attention and associated neural circuitry. We will also examine social outcome. If this initial work is successful, our long-term goals are to develop VR social skills training modules that are personalized, accessible, and portable so that social remediation can become an integral part of one's daily life.