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Cited by 33Schizophrenia research and treatmentVirtual Reality Applications and ImpactsAutism Spectrum Disorder Research

Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) versus Virtual Reality Relaxation (VRelax) for People With a Psychotic Disorder: A Single-Blind Multicenter Randomized Controlled Trial

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Nijman, S A, Pijnenborg, G H M, Vermeer, R R, Zandee, C E R, Zandstra, D C, van der Vorm, D, de Wit - de Visser, A C, Meins, I A +2 more·2023·Schizophrenia Bulletin
DOI 10.1093/schbul/sbac166PMC PMC10016415
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Abstract

Background and Hypothesis: Social cognition training (SCT), an intervention for social cognition and social functioning, might be improved by using virtual reality (VR), because VR may offer better opportunities to practice in a potentially more realistic environment. To date, no controlled studies have investigated VR-SCT. This study investigated a VR-SCT, “DiSCoVR”. We hypothesized that DiSCoVR would improve social cognition and social functioning. Study Design: Participants were randomized to DiSCoVR (n = 41) or VR relaxation (‘VRelax’, n = 40), an active control condition, and completed 16 twice-weekly sessions. Three assessments (baseline, posttreatment, and 3-month follow-up) were performed by blinded assessors. The primary outcome was social cognition (emotion perception and theory of mind). Secondary outcomes included social functioning (measured with an interview and experience sampling), psychiatric symptoms, information processing, and self-esteem. Data were analyzed using mixed-models regression analysis. Treatment effects were evaluated by the time by condition interaction terms. Study Results: No significant time by condition interactions were found for any of the outcome variables, indicating an absence of treatment effects. Between-group effect sizes ranged from negligible to moderate (Cohen’s d < |0.53|). Main effects of time were found for several outcomes. Conclusions: These results suggest that DiSCoVR was not effective, possibly because of inadequate simulation of emotional expressions in VR. This lack of efficacy may indicate that current SCT protocols are relatively unsuitable for improving social functioning. Previous studies showed small to moderate effects on higher order social cognition, but the SCT approach may need critical reevaluation, as it may not sufficiently lead to functional improvement.

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  • Virtual reality interventions improved social functioning in schizophrenia and clinical high risk compared to treatment-as-usual.

    “Five studies found statistically significant improvements in social functioning in SZ/CHR compared to TAU (Alvarez‐Jimenez et al. 2018; Hoşgelen et al. 2023; Nijman et al. 2023; Rus‐Calafell et al. 2014; Shen et al. 2022).”

    From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Nijman et al. 2023

    The Results (Treatment Effects; page unavailable) report no significant time-by-condition interactions, so this trial did not find a statistically significant social-functioning benefit of DiSCoVR over its comparator. Although social-functioning scores improved over time across both groups, the comparator was VR relaxation, not treatment as usual; the paper also does not establish the claim for a clinical-high-risk group. (LLM, conf=0.92)

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Authors
Nijman, S. A., Pijnenborg, G. H. M., Vermeer, R. R., Zandee, C. E. R., Zandstra, D. C., van der Vorm, D., de Wit - de Visser, A. C., Meins, I. A., Geraets, C. N. W., & Veling, W.
Affiliations
  • University Medical Center Groningen (NL)
  • University of Groningen (NL)
  • GGZ Delfland (NL)
  • Zeeuwse Gronden , Axelsestraat 8/A, 4537 AJ, Terneuzen , The Netherlands
  • GGZ Westelijk Noord-Brabant , Hoofdlaan 8, PO Box 371, 4600AJ, Bergen op Zoom , The Netherlands
Corresponding author
Nijman, S A
ORCID
Venue
Schizophrenia Bulletin
Publisher
Oxford University Press (OUP)
Published
2022-11-22
Volume
49
Issue
2
Pages
518-530
ISSN
  • 0586-7614 (ISSN-L)
  • 1745-1701
DOI
10.1093/schbul/sbac166
PMC
PMC10016415
OpenAlex
W4309649670
Cited by
33
References
4
Citations by year
2026: 8 · 2025: 12 · 2024: 5 · 2023: 8
FWCI
4.07
Type
journal article
Language
en
Open access
Licence
Locations
  • Schizophrenia Bulletin (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
Funders
Nederlandse Organisatie voor Wetenschappelijk Onderzoek (628.005.007)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
social cognition training, virtual reality
MeSH terms
Virtual Reality, Social Cognition, Cognition, Humans, Psychotic Disorders, Single-Blind Method, Treatment Outcome

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