Physiology-based virtual reality training for social skills in schizophrenia

 描述(由申请人提供)：社会障碍是精神分裂症的核心特征，导致不良结局。社交技能和能力可以提高生活质量，防止与压力相关的症状恶化，同时支持复原力、人际互动和社会联系。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，但努力密集的性质(高负担)、低依从性以及将技能转移到日常生活中的薄弱构成了康复的重大障碍。因此，迫切需要为精神分裂症患者开发有效、参与性和低负担的社会干预措施，以产生更好的依从率和功能结果。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(由眼睛扫描模式指示的社会注意力)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，具有几个优势，包括简化和 低压力的社交环境，有针对性的机会在非常广泛的现实场景中模拟、练习和强化社交技能的基本要素，并从多个角度重复暴露于自然情况。我们的桌面VR游戏被设计为一个智能系统，它根据参与者的生理、眼球跟踪和表现数据实时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式虚拟现实支持和加强培训，因为它实时调整和个性化每个参与者的学习环境，使他/她始终在最佳唤醒和注意力状态下学习。此外，VR环境可以潜在地模拟任何社交场景，允许参与者在各种情况下练习社交技能。这样的模拟练习可以帮助将学到的技能推广到日常生活中。R21阶段将旨在实施社会干预虚拟现实任务，测试其在提高精神分裂症患者社会注意力(目标)方面的有效性，并确定最佳剂量。我们假设VR培训将引起社会关注，提高社会关注将带来更好的社会结果。R33阶段将在试点随机对照试验中，针对主动控制条件测试自适应社交VR游戏，以评估社交VR在增强社会注意力和相关神经回路方面的相对效果。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、可访问和便携的VR社交技能培训模块，使社交补救可以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.