Reading the mind of the avatar: Dynamic interactive social cognition virtual reality training (discovr) for people with a psychotic disorder

Background: Individuals who have a psychotic disorder often fnd it dif-fcult to recognize emotions, read others' mental states, and assess social situations. These social cognitive defcits are highly predictive of problems in daily life functioning. Meta-analyses show that social cognition can be improved by social cognition training (SCT) approaches; however, long-term effects appear to be limited. Given that training of cognitive functions is best executed in a manner that resembles and is integrated with participants' daily lives as much as possible, a plausible explanation is that the stimuli and techniques that are typically used in SCT do not suffciently resemble real-life social interactions. Several key characteristics of real-world interactions are absent from these stimuli, most notably interaction with the material. Methods: To improve transference of SCT to daily life functioning and interaction, we have therefore developed a SCT which utilizes Virtual Reality (VR). VR is highly realistic, eliciting genuine psychological reac-tions, and highly interactive: the environment and the virtual people (“avatars”) in it react to the actions of the participant. At the same time, VR is customizable and controllable, allowing for training that is tailored to the individual. Results: A new form of SCT, utilizing VR (called “DiSCoVR”), has been developed. DiSCoVR consists of 16 sessions, provided over the course of 8 weeks, in which the following social cognitive domains are trained: (1) Emotion perception; (2) Social perception and Theory of Mind (ie, understanding the context and interdependence of emotions, thoughts and behavior); and (3) Social interaction training (ie, understanding the other person and choosing an adequate response). These domains are trained in VR, supplemented by coaching from a therapist, and homework assignments. DiSCoVR is currently being piloted amongst 25 mental health service clients and 25 healthy controls in the northern Netherlands. In this pilot, we primarily test the acceptability and feasibility of the intervention. Furthermore, effects of the intervention on several domains of social cognition are investigated. Moreover, social behavior in VR is studied using heart rate and eye tracking data, comparing healthy controls and clients. Conclusion: We will present a theoretical framework for DiSCoVR. Moreover, we will demonstrate the intervention and provide preliminary results of the ongoing pilot study.