490 research outputs found

    RC2S: A Cognitive Remediation Program to Improve Social Cognition in Schizophrenia and Related Disorders

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    In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind (ToM), attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (cognitive remediation of social cognition) in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients’ functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual reality techniques. In the RC2S program, the patient’s goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters’ mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with psychiatric disorders

    Virtual faces as a tool to study emotion recognition deficits in schizophrenia

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    Studies investigating emotion recognition in patients with schizophrenia predominantly presented photographs of facial expressions. Better control and higher flexibility of emotion displays could be afforded by virtual reality (VR). VR allows the manipulation of facial expression and can simulate social interactions in a controlled and yet more naturalistic environment. However, to our knowledge, there is no study that systematically investigated whether patients with schizophrenia show the same emotion recognition deficits when emotions are expressed by virtual as compared to natural faces. Twenty schizophrenia patients and 20 controls rated pictures of natural and virtual faces with respect to the basic emotion expressed (happiness, sadness, anger, fear, disgust, and neutrality). Consistent with our hypothesis, the results revealed that emotion recognition impairments also emerged for emotions expressed by virtual characters. As virtual in contrast to natural expressions only contain major emotional features, schizophrenia patients already seem to be impaired in the recognition of basic emotional features. This finding has practical implication as it supports the use of virtual emotional expressions for psychiatric research: the ease of changing facial features, animating avatar faces, and creating therapeutic simulations makes validated artificial expressions perfectly suited to study and treat emotion recognition deficits in schizophrenia

    Efficacité et processus thérapeutiques de la Thérapie basée sur la réalité virtuelle pour le traitement de la schizophrénie réfractaire aux traitements

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    La schizophrĂ©nie est considĂ©rĂ©e comme l'un des troubles psychiatriques les plus invalidants. L'une des principales raisons de ce fardeau Ă©levĂ© est qu'une grande partie des patients atteints de schizophrĂ©nie ne rĂ©pondent pas adĂ©quatement aux traitements pharmacologiques de premiĂšre ligne et continueront de souffrir d’hallucinations auditives. La prĂ©sence de celles-ci peut avoir un effet dĂ©vastateur sur le bien-ĂȘtre Ă©motionnel des patients ainsi que sur leur qualitĂ© de vie. Les alternatives non-pharmacologiques (ex., ThĂ©rapie cognitivo-comportementale (TCC)) demeurent aussi limitĂ©es. Ainsi, pour plusieurs patients, les traitements actuellement recommandĂ©s ne sont pas suffisants. À cet Ă©gard, le traitement de la schizophrĂ©nie peut ĂȘtre perfectionnĂ© si, en plus du traitement des symptĂŽmes, l'accent thĂ©rapeutique est mis sur d’autres sphĂšres importantes pour les patients (ex., amĂ©liorer l’estime de soi, rĂ©guler les Ă©motions). Les efforts visant Ă  accroĂźtre l'efficacitĂ© et les bĂ©nĂ©fices des psychothĂ©rapies fondĂ©es sur des preuves ont menĂ© Ă  l'Ă©mergence d'interventions basĂ©es sur la rĂ©alitĂ© virtuelle (RV). Avec ces progrĂšs technologiques, AVATAR Therapy et l’adaptation faite par notre Ă©quipe, la ThĂ©rapie assistĂ©e par la RĂ©alitĂ© Virtuelle (TRV) (ou communĂ©ment nommĂ© la ThĂ©rapie Avatar (TA)), permettent aux patients d’entrer en dialogue en temps rĂ©el avec un avatar, animĂ© entiĂšrement par le thĂ©rapeute, qui reprĂ©sente leur voix la plus persĂ©cutrice. Cette approche, Ă  la fois relationnelle et expĂ©rientielle, offre une occasion unique d’aider les patients Ă  prendre le contrĂŽle de leur voix. Cette thĂšse a pour objectif principal d’évaluer l’efficacitĂ© de cette psychothĂ©rapie basĂ©e sur la RV ainsi que les thĂšmes abordĂ©s durant et aprĂšs la thĂ©rapie. Pour arriver Ă  cette fin, divers objectifs ont Ă©tĂ© mis Ă  l’avant : (i) rĂ©sumer l'Ă©tat des preuves sur l'efficacitĂ© des interventions basĂ©es sur la RV pour les troubles psychiatriques, (ii) Ă©valuer l'efficacitĂ© de la TA/TRV par rapport Ă  la TCC, (iii) illustrer l’efficacitĂ© de la thĂ©rapie Ă  travers la perspective de patients ayant montrĂ© des effets bĂ©nĂ©fiques, et (iv) explorer les thĂšmes Ă©mergeants ainsi que les processus thĂ©rapeutiques de la TA/TRV. Dans la premiĂšre section, deux recensions des Ă©critsdans diverses bases de donnĂ©es ont Ă©tĂ© effectuĂ©es pour examiner l’efficacitĂ© des psychothĂ©rapies basĂ©es sur la RV. Notre mĂ©ta-revue (c’est-Ă -dire revue de mĂ©ta-analyse) incluant 11 mĂ©ta-analyses et 41 tailles d'effet a montrĂ© des rĂ©sultats positifs de la RV dans le traitement des troubles psychiatriques, principalement des troubles anxieux. Les interventions basĂ©es sur la RV sont meilleures que le traitement usuel et montrent gĂ©nĂ©ralement des effets similaires par rapport aux approches fondĂ©es sur des preuves. Les rĂ©sultats prĂ©liminaires suggĂšrent Ă©galement que les effets de la RV se maintiennent dans le temps. Par contre, de nombreux symptĂŽmes et troubles psychiatriques qui peuvent ĂȘtre traitĂ©s par des interventions utilisant RV n'ont pu ĂȘtre examinĂ©s par une analyse mĂ©ta-analytique, en particulier les symptĂŽmes psychotiques (ex., hallucinations auditives) et les comportements liĂ©s Ă  l'agressivitĂ© (ex., rĂ©gulation Ă©motionnelle). Ainsi, notre seconde revue a montrĂ© qu’il existe un nombre limitĂ© de paradigmes basĂ©s sur la RV pour traiter les individus atteints de troubles psychotiques et autres troubles mentaux Ă  risque de comportements agressifs. Les Ă©tudes prĂ©liminaires dans des populations autres que la schizophrĂ©nie ont montrĂ© des rĂ©ductions de la colĂšre et de l'impulsivitĂ©, des amĂ©liorations des capacitĂ©s de rĂ©solution des conflits ainsi que des niveaux d'empathie et des diminutions de l'agressivitĂ©. En ce qui a trait aux interventions basĂ©es sur la RV pour la schizophrĂ©nie, des rĂ©ductions par rapport aux dĂ©lires et aux hallucinations auditives ont Ă©tĂ© trouvĂ©es. Dans la seconde section, deux essais cliniques ont Ă©tĂ© menĂ©s pour Ă©valuer l’efficacitĂ© de la TA/TRV seule en comparaison avec la TCC et en combinaison avec la TCC (TCC+TA/TRV). Notre essai randomisĂ© comparant la TA/TRV Ă  la TCC a compris 37 participants de plus de 18 ans entendant des voix persĂ©cutives et souffrant de schizophrĂ©nie rĂ©sistante aux traitements dans chacun des groupes. Les rĂ©sultats principaux ont montrĂ© que les deux interventions ont produit des amĂ©liorations significatives sur la sĂ©vĂ©ritĂ© des symptĂŽmes hallucinatoires avec des effets plus prononcĂ©s pour la TA/TRV. De plus, les rĂ©sultats suggĂšrent une supĂ©rioritĂ© de la TA/TRV par rapport Ă  la TCC sur les symptĂŽmes affectifs. La TA/TRV a Ă©galement montrĂ© des effets positifs sur la qualitĂ© de vie. Les effets ont Ă©tĂ© maintenus Ă  long terme, soit jusqu'Ă  un an de suivi. Notre preuve de concept sur 10 patients ayant suivi la TCC de notre essai clinique comparatif qui souhaitaient continuer Ă  obtenir des amĂ©liorations avec la TA/TRV a montrĂ© que les effets de la TCC+TA/TRV sur les symptĂŽmes dĂ©pressifs et les symptĂŽmes de la schizophrĂ©nie Ă©taient plus larges que ceux trouvĂ©s pour l'une ou l'autre des interventions uniques. La troisiĂšme section a pour but de dĂ©tailler les cas de 2 patients ayant suivi la TA/TRV. D’abord, nous avons dĂ©crit un partenariat entre un utilisateur de services en santĂ© mentale et des chercheurs cliniciens en mettant en vedette M. X, le premier patient Ă  suivre la thĂ©rapie. Nous avons ainsi montrĂ© l’apport de monsieur X quant Ă  ses suggestions d’amĂ©lioration de la thĂ©rapie et ensuite en tant que notre pair aidant pour les futurs patients, dans son cheminement vers le rĂ©tablissement. Ensuite, nous avions rapportĂ© le cas d'un patient atteint d’une schizophrĂ©nie ultra-rĂ©sistante, soit M. Smith, qui n'a pas rĂ©pondu Ă  plusieurs traitements antipsychotiques, Ă  la stimulation magnĂ©tique transcrĂąnienne rĂ©pĂ©titive et Ă  la thĂ©rapie par Ă©lectrochocs avant de participer Ă  notre essai. De plus, le patient a terminĂ© notre TCC avant de se voir proposer notre TA/TRV. Cette derniĂšre intervention a montrĂ© les effets les plus positifs. Or, ces deux cas ont montrĂ© que la thĂ©rapie a aidĂ© non seulement Ă  diminuer leurs symptĂŽmes, mais aussi Ă  amĂ©liorer leur qualitĂ© de vie. La quatriĂšme section a pour objectif d’explorer les thĂšmes Ă©mergents de la TA/TRV suite Ă  des analyses de contenu. Ainsi, suite Ă  une analyse qualitative dĂ©coulant du discours spontanĂ© de 10 patients ayant bien rĂ©pondu Ă  la TA/TRV, quatre thĂšmes gĂ©nĂ©raux ont Ă©mergĂ© : impact de la thĂ©rapie sur les voix, relations interpersonnelles, bien-ĂȘtre psychologique et mode de vie. Cette analyse de contenu a permis d’identifier plusieurs sphĂšres de vie qui sont davantage amĂ©liorĂ©es chez les patients ayant une schizophrĂ©nie rĂ©sistante aux traitements Ă  l’aide de la TA/TRV. Deux autres analyses qualitatives ont Ă©tĂ© conduites pour approfondir nos connaissances sur les processus thĂ©rapeutiques de la TA/TRV. Celles-ci ont permis de montrer que les patients rĂ©pondent au propos de l’avatar en utilisant des mĂ©canismes d'adaptation ou en exprimant des Ă©motions, des croyances, des perceptions de soi ou des aspirations. Le discours de l'avatar a pu ĂȘtre catĂ©gorisĂ© en techniques de confrontation (ex., provocation) et en techniques positives (ex., renforcement). GrĂące Ă  l'identification de changements mutuels dans l'interaction entre le patient et son avatar, un changement a Ă©tĂ© observĂ© au fil des sĂ©ances de la confrontation vers un dialogue constructif. L'affirmation de soi, les rĂ©ponses Ă©motionnelles et les stratĂ©gies de prĂ©vention semblaient ĂȘtre au cƓur du processus thĂ©rapeutique, et celles-ci se produisent gĂ©nĂ©ralement en rĂ©ponse Ă  des techniques positives. Cette thĂšse contribue Ă  la validation d’une nouvelle approche thĂ©rapeutique rĂ©pondant Ă  un besoin clinique fondamental. Ainsi, la TA/TRV met en lumiĂšre l'avenir des approches adaptĂ©es aux patients qui peuvent prĂ©senter des avantages par rapport aux traitements conventionnels. Ces types d’interventions holistiques utilisant la RV pourraient aussi prĂ©senter des avenues prometteuses dans plusieurs autres troubles psychiatriques.Schizophrenia is considered one of the most debilitating psychiatric disorders. One of the main reasons for this high burden is that a large proportion of patients with schizophrenia do not respond adequately to first-line pharmacological treatments and will continue to suffer from auditory hallucinations. The presence of these symptoms can have a devastating effect on the emotional well-being of patients as well as their quality of life. Non-pharmacological alternatives (e.g., Cognitive Behavioral Therapy (CBT)) also remain limited. Thus, for many patients, the treatments currently recommended are not sufficient. In this regard, the treatment of schizophrenia may be improved if, in addition to the treatment of symptoms, therapeutic emphasis is placed on other areas of importance to patients (e.g., improving self-esteem, emotion regulation). Efforts to increase the effectiveness and benefits of evidence-based psychotherapies have led to the emergence of virtual reality (VR)-based interventions. With these technological advances, AVATAR Therapy and its related innovative form from our team, Virtual Reality Assisted Therapy (VRT) (or commonly Avatar Therapy (AT)), allow patients to enter a real-time dialogue with an avatar, animated entirely by the therapist, who represents their most persecutory voice. This approach, both relational and experiential, offers a unique opportunity to help patients take control of their voice. The main objective of this thesis is to evaluate the effectiveness of this psychotherapy based on VR as well as the themes addressed during and after the therapy. To achieve this end, various objectives have been put forward: (i) summarize the state of the evidence on the effectiveness of VR-based interventions for psychiatric disorders, (ii) assess the effectiveness of AT/VRT versus CBT, (iii) obtain the perspective of patients who have undergone AT/TRV, (iv) explore the therapeutic processes of AT/VRT. In the first section, two literature reviews in various databases were performed to examine the effectiveness of VR-based psychotherapies. Our meta-review including 11 meta-analyzes and 41 effect sizes showed positive results of VR in the treatment of psychiatric disorders, mainly anxiety disorders. VR-based interventions appear better than inactive controls and generally show similar effects compared to evidence-based approaches. Preliminary results also suggest that the effects of VR are sustained over time. On the other hand, many psychiatric symptoms and disorders that can be treated with interventions using VR have not been examined by a meta-analytical analysis, including psychotic symptoms (e.g., auditory hallucinations) and related behaviors. aggression (e.g., emotional regulation). Thus, our second review showed that there are a limited number of VR-based paradigms for treating individuals with psychotic disorders and other mental disorders at risk for aggressive behavior. Preliminary studies in populations other than schizophrenia have shown reductions in anger and impulsivity, improvements in conflict resolution skills as well as levels of empathy and decreases in aggression. Particularly related to VR interventions for schizophrenia, reductions in delusions and auditory hallucinations were found. In the second section, two clinical trials were conducted to evaluate the efficacy of AT/VRT alone in comparison with CBT and in combination with CBT (CBT+TA/VRT). Our randomized trial comparing AT/VRT to CBT included 37 participants over 18 years of age hearing persecutory voices and suffering from treatment-resistant schizophrenia in each group. The main results showed that the two interventions produced significant improvements in the severity of hallucinatory symptoms with more pronounced effects for AT/VRT. In addition, the results suggest that AT/VRT is superior to CBT on affective symptoms. AT/VRT has also shown positive effects on quality of life. The effects were maintained for up to one year of follow-up. Our proof of concept on 10 patients having followed CBT from our comparative clinical trial who wanted to continue to achieve improvements with AT/VRT showed that the effects of CBT+AT/VRT on depressive symptoms and symptoms of schizophrenia were broader than those found for either intervention alone. The third section details the cases of 2 patients who had followed AT/VRT. First, we described a partnership between a mental health service user and clinical researchers by featuring Mr. X, the first to follow therapy for his suggestions and our peer helper for future patients, on his journey to the recovery. Next, we reported the case of a patient with ultra-resistant schizophrenia, Mr. Smith, who failed to respond to multiple antipsychotic treatments, repetitive transcranial magnetic stimulation, and electroconvulsive therapy before participating in our trial. In addition, this patient completed our CBT before being offered AT/VRT. The latter intervention showed the most positive effects. These two cases showed that AT/VRT not only helped to decrease their symptoms, but also to improve their quality of life. The fourth section aimed to explore emerging themes of AT/VRT following content analyses. Thus, following a qualitative analysis resulting from the spontaneous speech of 10 patients who responded well to AT/VRT, four general themes emerged: impact of therapy on voices, interpersonal relationships, psychological well-being and lifestyle. This content analysis identified several areas of life that are further improved in patients with treatment resistant schizophrenia after having followed AT/VRT. Two other qualitative analyses were carried out to deepen our knowledge of the therapeutic processes of AT/VRT. These have shown that patients respond to the avatar's words by using a coping mechanism or by expressing emotions, beliefs, self-perceptions or aspirations. The avatar's discourse could be categorized into confrontational techniques (e.g., provocation) and positive techniques (e.g., reinforcement). With the identification of mutual changes in the interaction between the patient and their avatar, a shift was observed over therapy sessions from confrontation towards a constructive dialogue. Assertiveness, emotional responses, and prevention strategies seemed to be central to the therapeutic process, and these usually occurred in response to positive techniques. This thesis contributes to the validation of a new therapeutic approach responding to a fundamental clinical need. Thus, AT/VRT shines a light on the future of patient-oriented approaches that may have advantages over conventional treatments. These types of holistic interventions using VR may have notable applications in several other psychiatric disorders

    Social environments and mental health:Exploring new worlds with virtual reality

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    With virtual reality (VR) glasses, you can enter a completely different world within seconds. Computer-generated VR simulations of real-like environments can trigger psychological and physical reactions, such as anxiety, sweating or joy, similar to the reactions in real life. This characteristic of VR simulations - feeling real- makes VR a powerful tool for assessment, therapies and research in mental healthcare. With this thesis, we experimentally investigated how people behave in VR environments. We found that people with and without a vulnerability for psychosis maintain similar interpersonal distance to other visitors in a virtual cafĂ©. Further, we found that emotion recognition in faces of VR simulated people and real people is very similar. This finding supports that virtual emotional stimuli – i.e., emotions on virtual faces - are suitable for research and training of emotion recognition skills.Next, the effects of a novel VR cognitive behavioral therapy (VR-CBT) were investigated in patients with a psychotic disorder and patients with a generalized anxiety disorder. During VR-CBT patients practice within virtual environments which they tend to avoid in the real world. They could practice in a VR bar, streets, bus and supermarket environment. VR environments were personalized by the therapist to fit the specific needs of the patient. The VR-CBT intervention was effective in reducing paranoia as well as social anxiety in everyday life. Currently, several mental health care institutes in the Netherlands are offering VR-CBT as a treatment

    Reducing risk and improving maternal perspective-taking and empathy using virtual embodiment

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    The ability to perspective-take (cognitive awareness of another's state) and empathise (emotional/affective response) are important characteristics for sensitive, co-operative and constructive parenting, which assists in developing adaptive functioning for children. For the first time, immersive virtual reality was used to place parents in the position of a child in order to assess impact on perspective-taking and empathy. This novel study was conducted with 20 non-high risk Spanish mothers (a pilot study with 12 mothers is reported in supplementary files). Mothers were virtually embodied as a 4-year-old child, experienced from the first-person perspective and with virtual and real body movements synchronised. They interacted with a 'mother avatar', which responded either in a Positive or Negative way. Participants reported a strong body ownership illusion for the child body that led to cognitive, emotional and physical reactions. Experiencing negative maternal behavior increased levels of empathy. In addition, the Negative mother led to increased feelings of fear of violence. Physiological data indicated greater stress in the Negative than Positive condition. Although further research is required to assess the effectiveness of such methods, any improvement in empathy that leads to a change in parenting behavior has the potential to impact on developmental outcomes for children

    Investigating the Influence of Intergroup Contact in Virtual Reality on Empathy : An Exploratory Study Using AltspaceVR

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    Virtual Reality (VR) has often been referred to as an “empathy machine.” This is mostly because it can induce empathy through embodiment experiences in outgroup membership. However, the potential of intergroup contact with an outgroup avatar in VR to increase empathy is less studied. Even though intergroup contact literature suggests that less threatening and more prosocial emotions are the key to understanding why intergroup contact is a powerful mean to decrease prejudice, few studies have investigated the effect of intergroup contact on empathy in VR. In this study, we developed a between-participants design to investigate how VR can be used to create a positive intergroup contact with a member of a stigmatized outgroup (ethnic minority) and present the results of the effect of intergroup contact in VR on empathy. Sixty four participants experienced either positive contact (i.e., equal intergroup status, collaborative) with a black (experimenter-controlled) avatar (experimental condition) or no intergroup contact (i.e., ingroup contact with a white avatar; control condition), with situational empathy (personal distress and empathic interest) being measured through a self-report questionnaire up to a week before and right after the VR contact experience. The experiment showed that satisfying degrees of body ownership of participants’ own avatar and co-presence with the contacted avatar can be achieved in simple and universally accessible virtual environments such as AltspaceVR. The results indicated that while VR intergroup contact had no significant direct effect on empathy, exploratory analyses indicated that post-intervention empathic interest increased with stronger feelings of co-presence in the intergroup contact condition.Peer reviewe

    The influence of gender and body dissatisfaction on body‐related attentional bias: An eye‐tracking and virtual reality study

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    Objective In the attentional bias (AB) phenomenon, eating disorder (ED) patients show a tendency to pay more attention to self‐attributed unattractive body parts than to other body parts. However, little research has focused on gender differences in body‐related attention, controlling for body dissatisfaction (BD). This study aimed to assess gender differences in AB toward specific weight‐ or nonweight‐related body parts using a virtual reality (VR)‐based embodiment technique and an eye‐tracking AB assessment. Method Forty‐five women (23 with high BD and 22 with low BD) and 40 men (20 with high BD and 20 with low BD) were subsequently embodied in three virtual avatars, the first based on the participant's actual measurements, the second being larger than the participant, and the third being the same as the first avatar. The number of fixations and complete fixation time on weight‐related areas of interest (W‐AOIs) and nonweight‐related areas of interest (NW‐AOIs) were recorded for the three assessment time/avatars. Results The results showed a statistically significant interaction between gender and time for total fixation time and number of fixations (p < .05). BD levels did not significantly affect the results. Overall, women paid more attention to the W‐AOIs than men, who in turn paid more attention to the NW‐AOIs. Furthermore, preliminary evidence was found for an AB toward muscular‐related AOIs among men. Conclusions This study provides new information about gender differences and BD in gaze pattern behaviors. Future psychological ED assessments and treatments could take advantage of the possibilities of VR while real‐time AB is objectively measured

    Mental Health Practitioners Perceptions’ of Presence in a Virtual Reality Therapy Environment for Use for Children Diagnosed with Autism Spectrum Disorder

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    Children with autism spectrum disorder (ASD) think and understand social contexts primarily from a visual stand point. Feelings of being present in their social environment are a key component to their development (Strickland, Marcus, Mesibov, & Hogan, 1996). A virtual reality environment (VRE) can provide a therapeutic setting for children with ASD to learn social skills (Ehrlich & Munger, 2012). In the present research, a pilot study was used to assess the validity of a Second Life VRE developed by the researcher (Markopoulos, 2016b) by comparing the VRE to a real life film by The National Autistic Society (2016) in the United Kingdom. Feedback from the pilot study was used to make revisions to the VRE. The validated virtual reality therapy environment (VRTE) was used in the main research study. Twenty-eight Louisiana mental health practitioners’ perceptions of the VRTE were assessed using two random order conditions. Condition A required participation in the VRTE twice, first using a laptop computer only and then using the laptop with the new 2016 Oculus Rift head-mounted display (HMD, Oculus VR, LLC, 2016). Condition B required participation in the VRTE twice, first using a laptop with the new 2016 Oculus Rift HMD and then using a Laptop alone. Four out of eight subscales from the Temple Presence Inventory (TPI) (Lombard, Weinstein, & Ditton, 2011) were used to assess practitioners’ perceptions of presence in the VRTE. Results of a repeated-measures MANOVA showed that the order of the conditions were not significantly different. Additionally, participants’ TPI total and subscales scores were significantly higher when using the HMD than when using the Laptop, as well as their likelihood of using the HMD with children diagnosed with ASD than using the Laptop. All of the correlations for participants’ age and experience with technology were insignificant except for the subscale III, engagement was significant for participants’ age. Keywords: Autism spectrum disorder, therapy, virtual reality environment, head-mounted display, temple presence inventory, presenc
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