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Two case studies from a virtual reality intervention for delusions: feasibility and preliminary evidence

Published online by Cambridge University Press:  01 August 2018

Mona Dietrichkeit ,
Kristina Flint ,
Eva Krieger ,
Karsten Grzella ,
Matthias Nagel  and
Steffen Moritz
Mona Dietrichkeit*
Affiliation:
Department of Psychiatry and Psychotherapy, Asklepios Clinic North, Hamburg, Germany
Kristina Flint
Affiliation:
Department of Psychiatry and Psychotherapy, Asklepios Clinic North, Hamburg, Germany
Eva Krieger
Affiliation:
Department of Psychiatry and Psychotherapy, Asklepios Clinic North, Hamburg, Germany
Karsten Grzella
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Matthias Nagel
Affiliation:
Department of Psychiatry and Psychotherapy, Asklepios Clinic North, Hamburg, Germany
Steffen Moritz
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
*
*Author for correspondence: Mona Dietrichkeit, Asklepios Klinik Nord – Wandsbek, Jüthornstraße 71, 22043 Hamburg, Germany (email: m.dietrichkeit@uke.de).
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Abstract

The use of virtual reality (VR) interventions for psychosis is on the rise. As information-processing biases such as overconfidence in memory are likely to be involved in the formation and maintenance of delusions, VR could also be used to correct cognitive distortions and in turn ameliorate delusions. The present study illustrates two case studies in which a VR intervention was employed to reduce delusions by means of correcting experiences. Participants navigated four virtual environments via a head-mounted display (HMD) and computer and were asked to recollect previously seen faces and objects and to rate their response confidence. The scenarios were created to elicit false memories. Immediately after each response, they received feedback to correct possible overconfidence in false memories. We present two case studies to illustrate individual differences. Both participants benefited from the intervention: delusions were reduced from pre- to post-assessment (after 3 weeks) as measured with the Positive and Negative Syndrome Scale and Psychotic Symptom Scale. This was corroborated by results on the Paranoia Checklist and the Community Assessment of Psychic Experiences collected immediately after the session. Immediate effects also showed a reduction in delusion conviction rate. The present study provides preliminary evidence that delusions may be ameliorated by a VR paradigm designed to correct memory overconfidence. Cybersickness emerged as a problem in one of the patients.

Keywords

psychosisdelusionsvirtual realitycognitive biasoverconfidence in memory
Type
Case Study
Information
the Cognitive Behaviour Therapist , Volume 11 , 2018 , e10
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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References

Recommended follow-up reading

Valmaggia, LR, Latif, L, Kempton, MJ, Rus-Calafell, M (2016). Virtual reality in the psychological treatment for mental health problems: a systematic review of recent evidence. Psychiatry Research 236, 189–195. https://doi.org/10.1016/j.psychres.2016.01.015Google Scholar
Veling, W, Moritz, S, van Der Gaag, M (2014). Brave new worlds – review and update on virtual reality assessment and treatment in psychosis. Schizophrenia Bulletin 40, 1194–1197. https://doi.org/10.1093/schbul/sbu125Google Scholar

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