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

摘要 品行障碍(CD)仍然是最常见、损害和代价最高的精神障碍之一 青春年华。患有CD的青少年往往面临终身调整、心理健康、法律、社会、职业和身体方面的问题。 健康问题。一部分患有CD的年轻人表现出冷酷无情(CU)的特征。有CD和CU特征的年轻人 更有可能从事慢性犯罪行为，并在成年后发展成精神病 与只有CD的年轻人相比。尽管CD和CU的特征都与糟糕的结果密不可分地联系在一起，但 仍然缺乏针对CD和CU特征的有针对性的干预措施。最重大的挑战之一是 治疗是，患有CD的青年通常被认为是治疗抵抗者和治疗破坏者。这条线索 导致治疗保留率低和进一步与治疗机会隔绝。在很大程度上存在的干预措施 注重减少反社会行为，而不是破坏Cd和CU特征的发育机制。 总部位于弗吉尼亚州的小企业Arche VR，LLC旨在通过提供一种文化上的 针对CD和CU特征的适当、尖端的虚拟现实(VR)干预称为Impact VR。Impact VR 为情绪调节和情绪识别训练提供简短的心理教育方案 身临其境的游戏玩法和故事情节，吸引并与年轻人相关。Impact VR的核心是 个性化培训计划，教年轻人有效地识别他人的情感表达。影响 VR使用尖端技术，包括集成的眼睛跟踪和实时自适应编程，以 根据青少年的表现调整教学。这确保了年轻人得到量身定做的、个性化的 无地板和天花板影响的治疗风险。该提案的总体目标是完善Impact VR 成为CD青少年想要参与的、与主题相关的干预活动，并确定 跨治疗环境(即，在家庭、学校， 和心理健康环境)。最后，这项研究包括一个随机对照试验(RCT)来评估初步的 Impact VR对减少CD、CU特征和行为问题(CP)和改善情绪识别的有效性 和监管。在我们与心理健康专业人员和教育工作者组成的早期焦点小组中，我们 发现了Impact VR对讲西班牙语的年轻人的迫切需求。为了解决这个意料之外的问题 为满足需要，本行政补编(PA-20-272)要求提供资金，将讲西班牙语的青年包括在内。 也将增加我们为该项目招聘的机会。该附录将支持翻译Impact VR 西班牙语以及将讲西班牙语的青年纳入发展进程(SA1和SA2)以及 冲击性虚拟现实评估(SA3)。研究表明，讲西班牙语的年轻人的心理健康状况 近年来情况恶化，这在很大程度上是由于西班牙语精神健康服务的减少。 这一补编将通过增加征聘机会来加强现有研究，并提供 为讲西班牙语的青年提供公平的研究和治疗机会。

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. 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. 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. The overall objective of the 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. During our early-stage focus groups with mental health professionals and educators, we discovered a critical need for Impact VR to be available to Spanish-speaking youth. To address this unanticipated need, this administrative supplement (PA-20-272) is requesting funds to include Spanish-speaking youth, which will also bolster our recruitment opportunities for the project. The supplement will support translating Impact VR to Spanish, as well as including Spanish-speaking youth in the development process (SA1 and SA2) and evaluation of Impact VR (SA3). Research has shown that mental health among Spanish-speaking youth has worsened in recent years, and this is largely due to the reduction in Spanish-language mental health services. This supplement will strengthen the existing study by increasing recruitment opportunities, as well as provide equitable research and treatment opportunities to Spanish-speaking youth.