Virtually social: research on social cognition and virtual reality in people with a psychotic disorder

Many people who are susceptible to psychosis have problems understanding what is going on in other people’s minds. Problems in these mental skills called ‘social cognition’ have been linked to difficulties in social functioning, such as finding paid work and making new friends. In a network meta-analysis, we found that problems in social cognition can be treated with ‘Social Cognition Training’ (SCT). SCT targeting multiple domains of social cognition was particularly effective. Therefore, we have developed a virtual reality (VR) SCT, ‘DiSCoVR’, because VR makes it possible to practice accessibly in a realistic, interactive environment. DiSCoVR consisted of sixteen sessions, in which participants practiced with emotion recognition, understanding others, and social interaction in VR. These sessions were guided by a psychologist, who helped participants set social goals and determine an appropriate approach for social situations. DiSCoVR was evaluated by comparing it to a VR-relaxation training (‘VRelax’). In VRelax, participants explored relaxing virtual environments. We found no effect of DiSCoVR social cognition or social functioning, neither directly after training, nor three months later. To understand why, we examined data that were logged as participants practiced emotion recognition in VR. This showed that participants did improve their accuracy and speed of emotion recognition in VR, but this did not translate to improvement outside of VR. DiSCoVR might therefore be too abstract, not realistic enough, or too different from real, daily social situations. A solution could be to use more technologically advanced VR programs that are more focused on concrete social problems