A new Virtual Reality-intervention to train social cognition (‘Dynamic Interactive Social Cognition Training in Virtual Reality’) for people with a psychotic disorder: a pilot study

Background Social Cognition Training (SCT) is aimed at ameliorating deficits in social cognition, which are commonly experienced by people with a psychotic disorder. Since research shows that cognitive remediation is most effective when it is integrated into a variety of daily-life situations, virtual reality (VR) could be an effective tool for SCT. VR is a realistic and interactive method to simulate daily life social situations. VR is also controllable, which facilitates structured practice and personalization. In a pilot study, we studied the feasibility and acceptance of a VR SCT.
Method Twenty-two people with a psychotic disorder participated. They took part in DiSCoVR, a VR SCT aimed at: 1) facial affect recognition (recognizing emotions of virtual characters in a shopping street); 2) social perception and theory of mind (understanding social situations and the thoughts, emotions and behavior of virtual characters); and 3) practicing social interaction in role-play with a virtual character. Acceptance and feasibility were assessed using a survey. Preliminary effects on social cognition and psychiatric symptoms were also evaluated.
Results Seventeen participants completed the study. Participants gave positive ratings to the enjoyability (M=7.3 out of 10), and difficulty level of DiSCoVR (M=7.2), the combination of VR and a therapist (M=7.85) and the utility for daily social contact (M=7). 70% of participants indicated that the opportunity to practice with social situations was the most important strength of the intervention. A significant improvement of emotion perception was observed (MD=-4.35, t=-4.80, p<.001).
Discussion DiSCoVR is well accepted by participants and seems to be useful for simulating social contact in a way that complements participants’ skills. The results indicate that DiSCoVR could improve emotion perception. However, these findings concern a small, uncontrolled pilot study. We are therefore currently studying the effect of DiSCoVR in a Randomized Controlled Trial.