Improving social cognition in people with a psychotic disorder:preliminary results of a pilot study on Dynamic interactive Social Cognition training in Virtual Reality (DiSCoVR)

Aim: Dysfunctions in emotion recognition, reading others’ mental states and assessing social situations are common in individuals with a psychotic disorder. Social cognitive deficits such as these strongly predict problems in social functioning. Meta-analyses show that social cognition can be improved by social cognition training (SCT); however, it is unclear whether these effects persist over time. The stimuli and techniques that are typically used in SCT may not adequately mimic real-life social interactions. Several key characteristics of real-world interactions are also absent from conventional training materials, particularly interaction. We have therefore developed a SCT which is provided using Virtual Reality (VR). VR is highly realistic and interactive, eliciting genuine psychological responses, and the environment and the virtual people (‘avatars’) in it, react to the actions of the participant. VR also allows for control of several parameters, facilitating structured and individualized training. Methods: A novel form of SCT using VR (called ‘DiSCoVR’) has been developed. DiSCoVR consists of 16 sessions, provided over the course of eight weeks, targeting the following social-cognitive domains: 1) Emotion perception; 2) Social perception and Theory of Mind (i.e., understanding the social context and interdependence of emotions, thoughts and behavior); and 3) Social interaction training (i.e., selecting and practicing adequate responses in social situations). These domains are trained in VR, supplemented by coaching from a therapist and homework assignments. A pilot study of DiSCoVR is currently conducted amongst 25 mental health service clients in the northern Netherlands. In this pilot study, our primary outcome of interest is the acceptability and feasibility of the intervention. Our secondary outcome measure is the efficacy of DiSCoVR on several domains of social cognition: emotion perception, social perception and theory of mind. These domains are measured using conventional tests of social cognition, as well as performance on Virtual Reality tasks. The mental health service client group is compared on these measures to a healthy control group (n=25), to determine ‘normal’ performance on these measures and in VR. Results & Conclusion: We will demonstrate the intervention and provide preliminary results of the ongoing pilot study