VR-Reward Training for Depression

(VR-RT Trial)

Overseen By Courtney Forbes, Ph.D

Age: 18+

Sex: Any

Trial Phase: Phase 1

Sponsor: University of California, Los Angeles

Must not be taking: Psychotropic medications

Disqualifiers: Bipolar, Psychosis, Substance use, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

Duration: 7 weeks

59 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

Yes, you will need to stop taking any current psychotropic medications (medications that affect your mind, emotions, or behavior) to participate in this trial.

What data supports the effectiveness of the treatment Virtual Reality-Reward Training (VR-RT) for depression?

A pilot study showed that using virtual reality to view positive scenes helped reduce symptoms of depression, anxiety, and anhedonia (loss of interest or pleasure) in participants. This suggests that VR-RT could be a promising new way to treat depression by increasing positive feelings. ^{1 2 3 4 5}

Is VR-Reward Training safe for humans?

Research on virtual reality (VR) treatments for depression and other conditions suggests that they are generally safe for humans. Studies have shown high levels of patient satisfaction and acceptance, with no significant safety concerns reported. ^{6 7 8 9 10}

How is Virtual Reality-Reward Training (VR-RT) different from other treatments for depression?

Virtual Reality-Reward Training (VR-RT) is unique because it uses virtual reality to enhance behavioral activation, a therapy that encourages engaging in enjoyable activities, by allowing patients to visualize and anticipate these activities in a highly immersive environment. This approach aims to increase motivation and activity levels in a novel way compared to traditional therapies. ^{6 9 11 12 13}

What is the purpose of this trial?

This trial tests a new virtual reality therapy to help adults with depression enjoy positive experiences more. It targets those who struggle with feeling pleasure and aims to improve their mood by using happy virtual reality scenarios.

Research Team

Michelle G Craske, Ph.D

Principal Investigator

University of California, Los Angeles

Eligibility Criteria

This trial is for adults who feel very little pleasure or interest in activities (anhedonia), may be experiencing depression, and have trouble functioning daily. They must speak English fluently, not be on psychotropic drugs, and agree not to start other psychological treatments during the study. People with bipolar disorder, psychosis, substance use issues in the last six months, or those prone to motion sickness can't join.

Inclusion Criteria

Willingness to refrain from initiating other psychosocial treatments throughout the duration of the study

Your score on the SDS is 6 or higher.

Your depression score is 11 or higher, your PANAS-P score is 24 or lower, and your SDS score is 6 or higher.

Exclusion Criteria

I have had seizures or been diagnosed with epilepsy in the past year.

Lifetime history of bipolar disorder, psychosis, mental retardation, or organic brain damage

You have had a problem with using drugs or alcohol in the past 6 months.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo 7 weeks of either Virtual Reality-Reward Training (VR-RT) or Virtual Reality-Memory Training (VR-MT), with weekly sessions

7 weeks

7 visits (in-person)

Follow-up

Participants are monitored for changes in clinical symptoms and target measures

5 weeks

1 visit (in-person)

Treatment Details

Interventions

• Virtual Reality-Memory Training (VR-MT)
• Virtual Reality-Reward Training (VR-RT)

Trial Overview The study tests if Virtual Reality-Reward Training (VR-RT), which uses VR to help people enjoy positive experiences more deeply, is better than a control activity called Virtual Reality-Memory Training (VR-MT) at improving mood and reducing symptoms of depression over seven weeks.

Participant Groups

Group I: Virtual Reality-Reward Training (VR-RT) Experimental Treatment 1 Intervention

7 sessions of positive VR immersion and positive memory specificity training exercises designed to savor rewarding features of immersion followed by memory specificity training exercises to savor rewarding features of autobiographical memory.

Group II: Virtual Reality-Memory Training (VR-MT) Active Control 1 Intervention

7 sessions of neutral VR immersion and neutral memory specificity training exercises, designed to train memory of objective non-emotional stimuli followed by memory exercises to neutral autobiographical memories.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Findings from Research

Integrating virtual reality (VR) with existing evidence-based treatments for eating disorders, like cue exposure therapy, shows promise in improving treatment outcomes and reducing dropout rates, which currently affect about 24% of patients.

The paper emphasizes the need for a structured clinical protocol to support the implementation of VR-based interventions, aiming to enhance their acceptance and effectiveness in real-world settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bringing Virtual Reality From Clinical Trials to Clinical Practice for the Treatment of Eating Disorders: An Example Using Virtual Reality Cue Exposure Therapy. Brown, T., Nauman Vogel, E., Adler, S., et al.[2020]

The automated VR therapy (gameChange) significantly reduced avoidance and distress in everyday situations for patients with psychosis compared to usual care alone, with notable improvements observed at 6 weeks after treatment.

The therapy was particularly effective for patients with severe agoraphobic avoidance, and it worked by reducing anxious thoughts and protective behaviors, showing promise for increasing access to psychological therapy for those struggling to leave their homes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses. Freeman, D., Lambe, S., Kabir, T., et al.[2022]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Virtual Reality Reward Training for Anhedonia: A Pilot Study. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Dopamine modulating agents alter individual subdomains of motivation-related behavior assessed by touchscreen procedures. [2022]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Measurement of reinforcement in depression: a pilot study. [2019]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Effects of depression on reward-based decision making and variability of action in probabilistic learning. [2019]

5. England pubmed.ncbi.nlm.nih.gov

From laboratory to life: associating brain reward processing with real-life motivated behaviour and symptoms of depression in non-help-seeking young adults. [2020]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Behavioral Activation through Virtual Reality for Depression: A Single Case Experimental Design with Multiple Baselines. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Feasibility of a Virtual Reality-Based Psychoeducational Tool (VRight) for Depressive Patients. [2020]

8. Canada pubmed.ncbi.nlm.nih.gov

Bringing Virtual Reality From Clinical Trials to Clinical Practice for the Treatment of Eating Disorders: An Example Using Virtual Reality Cue Exposure Therapy. [2020]

9. Switzerland pubmed.ncbi.nlm.nih.gov

How to Treat Depression With Low-Intensity Virtual Reality Interventions: Perspectives on Translating Cognitive Behavioral Techniques Into the Virtual Reality Modality and How to Make Anti-Depressive Use of Virtual Reality-Unique Experiences. [2023]

10. England pubmed.ncbi.nlm.nih.gov

Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Virtual reality: a powerful technology to provide novel insight into treatment mechanisms of addiction. [2023]

12. Switzerland pubmed.ncbi.nlm.nih.gov

Clinical Relevance of Immersive Virtual Reality in the Assessment and Treatment of Addictive Disorders: A Systematic Review and Future Perspective. [2023]

13. England pubmed.ncbi.nlm.nih.gov

Reliability assessment of temporal discounting measures in virtual reality environments. [2023]