Impact VR: An Emotion Recognition and Regulation Training Program for Youth with Conduct Disorder

摘要 行为障碍（CD）仍然是最常见的，损害，和最昂贵的精神疾病之一， 青年患有CD的青少年经常面临终身适应，心理健康，法律的，社会，职业和身体 健康问题CD青少年的一个子集表现出冷酷无情（CU）的特征（称为“有限的亲社会 情绪”）。具有CD和CU特征的青少年更有可能从事慢性犯罪行为， 精神病理学进入成年时相比，青年与CD只有。虽然CD和CU特征都是 与不良结果有着千丝万缕的联系，仍然缺乏针对CD和CU特征的有针对性的干预措施。一 治疗面临的最重大挑战之一是，青年CD患者通常被视为治疗抵抗者 和治疗干扰物。这导致治疗保留不佳和进一步与治疗隔离 机会现有的干预措施主要集中在减少反社会行为，而不是扰乱社会秩序。 CD和CU性状的发育机制。Arche VR，LLC是一家总部位于哥伦比亚的小企业，旨在提供 通过提供文化上合适的，尖端的虚拟现实（VR）干预来解决这个问题， CD和CU特性称为Impact VR。Impact VR为情感提供了简短的心理教育编程 使用沉浸式游戏和故事情节进行调节和情感识别培训， 与青年有关。Impact VR是使用基于证据的策略开发的，以改善情绪调节。在 Impact VR的中心是一个个性化的培训计划，教导青少年有效地识别情感 别人的表情。Impact VR使用了尖端技术，包括集成的眼动跟踪和真实的- 根据青少年的表现调整教学的时间适应性编程。这意味着，青年 接受量身定制的个性化治疗，而没有下限和上限效应的风险。此外，Impact VR提供 用于系统的资源有效和标准化处理方法（例如，学校，医院），以帮助改善 通过针对CD的机制，为患有CD的青少年提供循证心理健康治疗， CU特征。本提案的总体目标是将Impact VR改进为一个引人入胜且与主题相关的 参与干预，并确定 Impact VR在治疗环境中的部署（即，在家庭、学校和心理健康环境中）。最后， 这项研究包括一项随机对照试验（RCT），以评估Impact VR在减少 CD，CU特征和行为问题（CP），并改善情绪识别和调节。的成果 第一阶段的研究包括对Impact VR的全面改进，使其成为一种部署就绪、有效和吸引人的 治疗策略的青年与CD和CU性状。

ABSTRACT Conduct disorder (CD) remains one of the most common, impairing, and costliest psychiatric disorders among youth. Youth with CD often face lifelong adjustment, mental health, legal, social, occupational, and physical health problems. A subset of youth with CD display callous-unemotional (CU) traits (termed “limited prosocial emotions”). Youth with CD and CU traits are more likely to engage in chronic criminal behaviors and develop psychopathology into adulthood when compared to youth with CD only. Although both CD and CU traits are inextricably linked to poor outcomes, there remains a scarcity of targeted interventions for CD and CU traits. One of the most significant challenges for treatment is that youth with CD are often perceived as treatment-resistant and treatment disrupters. This leads to poor treatment retention and further isolation from treatment opportunities. Interventions that do exist largely focus on reducing antisocial behavior rather than disrupting the developmental mechanisms of CD and CU traits. Arche VR, LLC, a Virginia-based small business, aims to offer a solution to this problem by providing a culturally appropriate, cutting-edge virtual reality (VR) intervention for CD and CU traits called Impact VR. Impact VR provides brief psychoeducational programming for emotion regulation and emotion recognition training using immersive gameplay and storylines that are engaging and relevant to youth. Impact VR is developed using evidence-based strategies to improve emotion regulation. At the center of Impact VR is an individualized training program that teaches youth to effectively identify emotional expressions in others. Impact VR uses cutting-edge technologies, including integrated eye-tracking and real- time adaptive programming to adjust instruction based on the youths' performance. This ensures that youth receive tailored, individualized treatment without the risk of floor and ceiling effects. Further, Impact VR provides a resource-efficient and standardized treatment approach for systems (e.g., schools, hospitals) to help improve access to evidence-based mental health treatment for youth with CD by targeting the mechanisms of CD and CU traits. The overall objective of this proposal is to refine Impact VR to be an engaging and topic-relevant intervention that youth with CD will want to participate in, and to determine the feasibility and usability of the deployment of Impact VR across treatment settings (i.e., in the home, school, and mental health settings). Lastly, this study includes a randomized control trial (RCT) to assess the preliminary efficacy of Impact VR for reducing CD, CU traits, and conduct problems (CP) and improving emotion recognition and regulation. Outcomes from this Phase I study include overall improvements in Impact VR as a deployment-ready, effective, and engaging treatment strategy for youth with CD and CU traits.