虚拟现实辅助认知行为疗法改善精神分裂症患者的心理理论并减少偏执：一项随机对照试验

IF 2.2 4区医学 Q3 PSYCHIATRY

Journal of Behavior Therapy and Experimental Psychiatry Pub Date : 2025-08-23 DOI:10.1016/j.jbtep.2025.102055

Elham Monaghesh , Sara Farhang , Taha Samad-Soltani

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引用次数: 0

摘要

精神分裂症患者存在社会认知和社会功能缺陷。虚拟现实是由计算机创造的三维真实世界模拟。基于虚拟现实的认知行为疗法可能会提高这些患者治疗的有效性和可接受性。本研究调查了VR-CBT与传统CBT在改善新近发作的精神分裂症患者这些结果方面的疗效。方法在这项开放标签、随机对照试验中，60名精神分裂症患者（36名男性，24名女性）在药物治疗的基础上随机接受4次VR-CBT或传统CBT治疗。这个虚拟现实环境用11个无表情的虚拟人物模拟了一次巴士旅行。在基线和治疗后使用阳性和阴性症状量表（PANSS；阳性症状子量表）、绿色偏执思维量表（GPTS）和眼睛读心术测试（Eyes Test）评估结果。数据分析采用重复测量方差分析。结果两组患者各项指标均有显著改善（p < 0.05）。然而，与CBT组相比，VR-CBT组在PANSS （p < 0.001）和GPTS评分（p < 0.001）方面表现出显著更大的下降，在眼睛测试评分方面表现出显著更大的增加（p < 0.002）。无不良反应报告。结论vr -CBT似乎是一种有希望的辅助治疗新发精神分裂症的标准治疗方法，与传统CBT相比，在阳性症状、偏执和ToM方面提供了更好的改善。有必要进一步研究VR-CBT在这一人群中的长期影响和潜在机制。

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Virtual reality assisted cognitive behavioral therapy improves theory of mind and decreases paranoia in patients with schizophrenia: a randomized controlled trial

Introduction

patients with schizophrenia have deficits in social cognition and functioning. Virtual reality is a 3D real-world simulation created by a computer. Virtual reality-based cognitive behavioral therapy might increase effectiveness and acceptability of treatment for these patients. This study investigated the efficacy of VR-CBT compared to traditional CBT in improving these outcomes in patients with recent-onset schizophrenia.

Methods

In this open-label, randomized controlled trial, 60 patients with schizophrenia (36 men, 24 women) were randomized to receive either four sessions of VR-CBT or traditional CBT, in addition to pharmacological treatment. The VR environment simulated a bus trip with 11 neutral-faced avatars. Outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS; positive symptom subscale), the Green Paranoid Thoughts Scale (GPTS), and the Reading the Mind in the Eyes Test (Eyes Test) at baseline and post-treatment. Data were analyzed using repeated measures ANOVA.

Results

Both groups showed significant improvements in all measures (p < 0.05). However, the VR-CBT group demonstrated significantly greater reductions in PANSS (p < 0.001) and GPTS scores (p < 0.001), and a significantly greater increase in Eyes Test scores (p < 0.002) compared to the CBT group. No adverse effects were reported.

Conclusion

VR-CBT appears to be a promising adjunct to standard treatment for recent-onset schizophrenia, offering superior improvements in positive symptoms, paranoia, and ToM compared to traditional CBT. Further research is warranted to examine the long-term effects and underlying mechanisms of VR-CBT in this population.

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来源期刊

Journal of Behavior Therapy and Experimental Psychiatry Multiple-

CiteScore

3.60

自引率

5.60%

发文量

期刊介绍： The publication of the book Psychotherapy by Reciprocal Inhibition (1958) by the co-founding editor of this Journal, Joseph Wolpe, marked a major change in the understanding and treatment of mental disorders. The book used principles from empirical behavioral science to explain psychopathological phenomena and the resulting explanations were critically tested and used to derive effective treatments. The second half of the 20th century saw this rigorous scientific approach come to fruition. Experimental approaches to psychopathology, in particular those used to test conditioning theories and cognitive theories, have steadily expanded, and experimental analysis of processes characterising and maintaining mental disorders have become an established research area.