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Virtual Reality-Augmented Future Orientation in Stimulant Use Disorder Recovery

虚拟现实增强兴奋剂使用障碍康复的未来方向

基本信息

批准号：
10611503
负责人：
Brandon Oberlin
金额：
$ 23.78万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-05-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10611503
关键词：
Abstinence Address Aftercare Age Attention Behavior Behavior Therapy Behavioral Behavioral Mechanisms Biometry Brain Clinical Psychology Clinical Trials Communities Data Decision Making Development Drug usage Effectiveness Emotional Event Evidence based intervention Exhibits Frequencies Future Goals Impairment Individual Intervention Interview Intoxication Investments Laboratories Methods Motivation Neuropsychological Tests Outcome Participant Patient Self-Report Patients Persons Pharmacotherapy Preparation Randomized, Controlled Trials Recovery Relapse Resistance Rewards Sampling Sensory Signal Transduction Stimulant Substance Use Disorder Substance abuse problem Testing Thinking Time Travel Treatment outcome Validation Virtual and Augmented reality Visualization Work behavior change behavior test behavioral economics comparison control craving design digital discounting drug abstinence drug efficacy drug testing efficacy evaluation efficacy testing efficacy trial endophenotype experience feasibility testing follow-up hedonic improved long term recovery male medication-assisted treatment multidisciplinary neglect non-drug novel open label optimism personalized medicine precision medicine preference randomized, clinical trials recruit relapse prevention relapse risk response safety and feasibility stimulant abuse stimulant use stimulant use disorder success successful intervention sustained recovery theories treatment as usual virtual virtual reality virtual reality environment virtual reality intervention virtual world

项目摘要

PROJECT SUMMARY / ABSTRACT We propose a novel virtual reality intervention to test for efficacy on reducing stimulant use and increasing abstinence, with concomitant increases in future self-identification, future time perspective, and delay-of- reward, in early recovering stimulant use disorder (StUD) persons. Impaired future orientation and delay-of- reward appear to be behavioral endophenotypes for substance use disorders. With recovery attempts usually failing within 6 months of treatment, there is considerable room for improved efficacy. Converging evidence indicates that a hallmark of StUD is impaired visualizing and planning for the future, which corresponds to greater devaluation of delayed rewards. Our preliminary tests of the intervention were promising, with n=14 out of n=18 participants remaining abstinent 30 days later; importantly, 10 of the 14 abstainers showed a positive response to the intervention, suggesting an efficacy marker. The intervention increases future self-identification and delay-of-reward in people recovering from substance use disorder, and engages brain networks governing prospection; further, the VR effect on delay-of-reward correlated with introspective-executive brain connectivity. Extending prior work on episodic future thinking, we employed a precision medicine approach in designing a personalized immersive virtual experience that integrates personal details and maximizes sensory engagement. Our intervention increases connectedness with one’s future by immersing subjects in a realistic portrayal of interacting with their Future Selves in divergent futures. Importantly, we integrate self-discrepancy theory, focusing on the gap between “what is” and “what could be” to heighten motivation, and we promote engagement by maximizing the novelty and emotional salience of the experience. Early-recovering StUD persons enter a realistic virtual world, are introduced to a time travel narrative, and interact with two digitally age-progressed Future Selves; one after 15 years of ongoing stimulant abuse, and the other after 15 years of recovery. Both Future Selves speak to the participant about their recovery rewards, or losses from returning to habitual drug use, and personal struggles during the journey. Strong emphasis is placed on agency, optimism, and decision-making. After iterative development and tests of feasibility and safety, the paradigm yielded a promising efficacy signal, behavioral change, and brain target engagement. The current proposal will validate this paradigm in an expanded sample to show efficacy and behavioral mechanisms using the same VR paradigm. Aim 1 will test for efficacy on stimulant and drug use outcomes (amount, frequency, type, relapse, and abstinence) with longitudinal assessments at 1 and 6 months. Aim 2 will determine mechanisms by testing for changes in future self-identification, future time perspective, and behavioral delay discounting. The long- term goal of the project is to validate a potent adjunctive intervention with long-term recovery benefits that is readily implemented during post-treatment aftercare or in a treatment setting.

项目摘要/摘要