Virtual Environments for Childhood Social Phobia

描述(申请人提供)：焦虑症是年轻人中最常见的精神障碍，终生患病率在普通人群中从18%到20%不等。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、学习成绩有限、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，作为整体治疗战略的一部分，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，与没有这些组成部分的干预措施相比，显示出更高的疗效--后两个因素旨在加强技能推广。有两个关键的治疗要素(同伴推广、家庭作业)很难在传统的临床环境中实施，限制了对不同环境(例如，学校、门诊或社区设施)需要这些服务的青年的最佳传播。为响应PA-07-423《神经科学、行为科学和心理健康研究的计算工具》而编写的这一第一阶段STTR将开发和验证一套交互式虚拟环境，以解决对对技能推广至关重要的密集行为练习机会的需求，从而加强传播并为未来的努力提供一个模型。虚拟环境使儿童用户能够在任何标准计算机上与虚拟学校角色互动，允许日常密集的社交技能练习，而不需要正式的同龄人小组活动(诊所解决方案)或密集的父母参与(在家解决方案)。虚拟角色反应将被预先确定和预先编程，但似乎对用户的交互做出响应，创建了模拟的生活场景。这种新颖的、商业上可行的干预措施，包括诊所内和家庭部分，将通过在模拟的社会虚拟环境中反复练习，促进通过传统社交技能培训获得的社交技能转移到儿童的现实生活中，从而优化临床服务。一旦开发和验证，这一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，并提供易于适应其他疾病的技术。 公共卫生相关性：在儿童中，社交焦虑是一种常见的、严重的慢性疾病。儿童社会有效性治疗(SET-C)是一种有经验支持的治疗方法，具有显著的潜力，可以影响患有这种严重和慢性疾病的儿童的生活。拟议的基于SET-C的基于学校的虚拟环境将大大增加经验支持治疗的传播，将解决目前以儿童为基础的干预措施所固有的许多治疗障碍，并且可以容易和负担得起地调整，以用于其他需要基于技能的行为干预的人群。

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. PUBLIC HEALTH RELEVANCE: Among children, social anxiety is a common, severe and chronic disorder. Social Effectiveness Therapy for Children (SET-C) is an empirically supported treatment with significant potential to impact the lives of children with this severe and chronic disorder. The proposed school-based Virtual Environment, based on SET-C, will significantly increase dissemination of an empirically supported treatment, will address many of the current treatment barriers inherent in child-based interventions, and could be easily and affordably adapted for use with other populations in need of skills-based behavioral interventions.