Symptom assessment using virtual reality (Freeman, 2008)

What does difficulties with diagnosing schizophrenia lead to?

* Difficulties with diagnosing schizophrenia and related disorders can relate to interpretation of the individual’s experiences in the social world.
* Social interaction may involve misinterpretation of other people’s behavior and can lead to distrust, paranoia and withdrawal.

What is virtual reality used for?

* Freeman (2008) explored the potential use of virtual reality to eliminate such challenges when checking symptoms and developing treatment for schizophrenia.
* Virtual reality (VR) involves using the technology for presenting different social environments to the user, and has been applied successfully in the treatment of other disorders, such as social phobias.

Describe the problems associated with traditional symptom assessment

* Symptom assessment has relied on an interviewer and patient sitting in a clinical room and discussing behavior over the previous week or month.
* One problem with this approach is that it relies on the individual answering truthfully.


* Using VR, the assessment can be novel and standardized while assessing actual behavior.
* It also can ensure that paranoid thoughts and behavior are genuine, as the social situation is totally artificial.

Describe the technique used for VR in Freeman’s study

The patients had to walk through a specifically designed library or underground train scene, in the presences of other neutral avatars, wearing VR headgear.

Describe the sample used

* Trialed on non-clinical population of 200 students.
* Prior to the study, multiple validated measurement tools (such as the 16 item Green Et al. Paranoid Thoughts Scale (GPTS) Part B) were used to assess user’s paranoid thinking, emotional distress and other social and cognitive traits.
* After the test, persecutory thinking, visual analogue rating scale (used to measure frequency of symptoms) and degree of immersion in virtual environment was taken.

Describe the results of this study

* High score on paranoia assessment questionnaire had high levels of persecutory ideation.
* Individuals who experience auditory hallucinations in real world experienced them in VR too.

What does persecutory ideation mean?

The process of forming an idea that one is at risk of being ill-treated or harmed by others.

Evaluate the study

* Large %%sample%% but no clinical population.
* VR used a %%standardized%% approach to assessing symptoms, hence increasing %%reliability%% of measurement.
* Low %%ecological validity%% as the environment is simulated.
* It also continues to rely on %%self-report%% in that users of VR are asked to make comments about their experiences, which may lead to %%response bias.%%

Describe the relevance to everyday life in this study

* This study has good %%relevance to everyday life%% as it can be used to identify symptoms, %%causal factors%% and treatment strategies.
* Not used extensively in clinical populations, so it is yet to be determined whether it can replace clinical %%interviews%% and %%questionnaires%% in diagnosis.

Describe the cultural bias of this study

* %%Cultural bias%% relies on culturally based expectations of what determines normal social behavior.
* Different cultures have different interpretation of normal behavior, so these factors need to be considered when diagnosing symptoms and behavior to avoid %%biased%% results.