Virtual reality-based assessment and treatment of social functioning impairments in psychosis: a systematic review

Abstract

People with psychosis can experience social functioning impairments. Virtual reality (VR) has been used to assess and treat these difficulties. This systematic review (Prospero CRD42015026288) provides an evaluation of these VR applications. PsycINFO, MEDLINE, Embase, Web of Science, Cochrane Library, and Scopus were searched until May 2020. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess studies. Database searching identified 3810 titles. Fifty-eight studies (published 2005-2020; N ¼ 2,853), comprising twenty-six head-mounted display studies (20 assessment, 6 treatment) and thirtytwo immersive 2D screen studies (23 assessment, 9 treatment), were included. There were fortyeight observational studies and ten randomised controlled trials, with 1570 participants (of which, 185 were at ultra-high risk of psychosis) in VR test groups. Nearly half the studies were published since 2016. Assessments targeted cognitive and behavioural indicators of social functioning, e.g. paranoia, eye gaze, or interpersonal distance. Treatments promoted cognitivebehavioural social skills or job interview training. Studies indicate feasibility, acceptability, and effectiveness of VR for social functioning impairments in psychosis. Limitations of studies include the narrow scope of social functioning, small sample sizes, and limited randomised controlled trials and standardised interventions. Findings suggest VR has potential to be integrated with existing psychological approaches.

Virtual reality-assisted cognitive behavioural therapy for outpatients with alcohol use disorder (CRAVR): a protocol for a randomised controlled trial

“…VR has been used therapeutically in various ways, and promising results have been found for treating anxiety disorders, post-traumatic stress disorder, psychosis and eating and addictive disorders. [13][14][15][16][17] Nevertheless, the research remains at an early stage.…”

“…The presence is generally achieved by stimulating the auditory and visual senses, allowing a high degree of interaction with the environment. VR has been used therapeutically in various ways, and promising results have been found for treating anxiety disorders, post-traumatic stress disorder, psychosis and eating and addictive disorders 13–17. Nevertheless, the research remains at an early stage.…”

Social Skills Acquisition in Virtual Reality-Based Interventions for People with Mental Health and Substance Use Disorders: A Qualitative Exploration (Preprint)

“…Virtual reality-based interventions (VRIs) for cognitive training and recovery are a rapidly growing field in mental health treatment. Recent research on VRIs shows a promising trans-diagnostic potential in improving social functioning and quality of life, across the spectrum of neuropsychiatric disorders [2,[9][10][11][12][13][14][15]. The concept of VRIs for mental health is to be understood as all kinds of interventions using VR technology (VRT) to promote psychological and/or behavioral change in order to achieve symptom reduction or improved psychosocial functioning.…”

“…It is also vital to understand the target group's digital literacy and their perception of the use of digital interventions as these are key uptake factors for all types of digital interventions [26]. Further challenges when developing efficient VRIs are human limitations of transferring skills from virtual to real environments and long-term maintenance of VRI learned skills in real-world environments [10,12,[27][28][29][30][31].…”

Application of Immersive Virtual Reality for Assessment and Intervention in Psychosis: A Systematic Review

“…In this systematic review, we mainly focus on the use of semi- and fully-immersive VR, as it is proven that the feeling of presence is a crucial element in enhancing user engagement [ 14 ]; this is in contrast to previous systematic reviews on virtual reality in psychosis, which included both non-immersive/3D computer-screen-based as well as immersive VR [ 6 , 15 , 16 ]. Moreover, these previous reviews had slightly different patient groups of interest that also included mood disorders [ 15 ] or examined the validity of VR-based assessment only in the domain of social functioning [ 16 ]. We conducted a systematic review on the studies that applied immersive VR technology in patients with psychotic disorders.…”