Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) for People With a Psychotic Disorder: Single-Group Feasibility and Acceptability Study

Saskia Anne Nijman; Wim Veling; Kirstin Greaves-Lord; Maarten Vos; Catharina Elizabeth Regina Zandee; Marije Aan Het Rot; Chris Neeltje Wil Geraets; Gerdina Hendrika Maria Pijnenborg

doi:10.2196/17808

Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) for People With a Psychotic Disorder: Single-Group Feasibility and Acceptability Study

JMIR Ment Health. 2020 Aug 7;7(8):e17808. doi: 10.2196/17808.

Authors

Affiliations

¹ Department of Psychotic Disorders, GGZ Drenthe, Assen, Netherlands.
² University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
³ Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands.
⁴ Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Rotterdam, Netherlands.
⁵ Autism Team Northern-Netherlands of Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands.
⁶ Department of Yulius Autism, Yulius, Dordrecht, Netherlands.
⁷ Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands.
⁸ Flexible Assertive Community Treatment Team, Outpatient treatment center, GGZ Delfland, Delft, Netherlands.

PMID: 32763880
PMCID: PMC7442939
DOI: 10.2196/17808

Abstract

Background: People with a psychotic disorder commonly experience problems in social cognition and functioning. Social cognition training (SCT) improves social cognition, but may inadequately simulate real-life social interactions. Virtual reality (VR) provides a realistic, interactive, customizable, and controllable training environment, which could facilitate the application of skills in daily life.

Objective: We developed a 16-session immersive VR SCT (Dynamic Interactive Social Cognition Training in Virtual Reality [DiSCoVR]) and conducted a single-group feasibility pilot study.

Methods: A total of 22 people with a psychotic disorder and reported problems in social cognition participated. Feasibility and acceptability were assessed using a survey for participants and therapists, and by examining relevant parameters (eg, dropouts). We analyzed preliminary treatment effects on social cognition, neurocognition, and psychiatric symptoms.

Results: A total of 17 participants completed the study. Participants enjoyed DiSCoVR (mean 7.25, SD 2.05; range 3-10), thought it was useful for daily social activities (mean 7.00, SD 2.05; range 3-10), and enjoyed the combination of VR and a therapist (mean 7.85, SD 2.11; range 3-10). The most frequently mentioned strength of DiSCoVR was the opportunity to practice with personalized social situations (14/20, 70%). A significant improvement of emotion perception was observed (Ekman 60 Faces; t₁₆=-4.79, P<.001, d=-0.67), but no significant change was found in other measures of social cognition, neurocognition, psychiatric symptoms, or self-esteem.

Conclusions: DiSCoVR was feasible and acceptable to participants and therapists, and may improve emotion perception.

Keywords: cognitive remediation therapy; emotion perception; psychotic disorder; social cognition; social cognition training; theory of mind; virtual reality.

©Saskia Anne Nijman, Wim Veling, Kirstin Greaves-Lord, Maarten Vos, Catharina Elizabeth Regina Zandee, Marije Aan het Rot, Chris Neeltje Wil Geraets, Gerdina Hendrika Maria Pijnenborg. Originally published in JMIR Mental Health (http://mental.jmir.org), 07.08.2020.