DEEP VR for Moral Injury

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
University of Wisconsin, Madison, WI
Moral Injury+2 More
DEEP VR - Device
Eligibility
< 18
All Sexes
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Study Summary

Virtual-reality and Emotion Regulation in Violence-Exposed Youth

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Eligible Conditions

  • Moral Injury
  • Emotional Regulation
  • Adolescent Behaviors

Treatment Effectiveness

Effectiveness Progress

1 of 3

Study Objectives

This trial is evaluating whether DEEP VR will improve 2 primary outcomes and 17 secondary outcomes in patients with Moral Injury. Measurement will happen over the course of Baseline and up to 4 weeks.

Baseline
Mean Multidimensional Assessment of Interoceptive Awareness (MAIA) - Child Report
Mean Multidimensional Assessment of Interoceptive Awareness (MAIA) - Parent Report
Mean Resiliency Scale for Children and Adolescents (RSCA)
Week 6
Mean Change in Child Behavior Checklist (CBCL)
Mean Change in Childhood Trauma Questionnaire (CTQ)
Mean Change in Mood and Feelings Questionnaire (MFQ) - Child Report
Mean Change in Mood and Feelings Questionnaire (MFQ) - Parent Report
Mean Change in Screen for Child Anxiety Related Emotional Disorders (SCARED) - Child Report
Mean Change in Screen for Child Anxiety Related Emotional Disorders (SCARED) - Parent Report
Mean Change in UCLA PTSD-Reaction Index (UCLA PTSD-RI) - Child Report
Mean Change in UCLA PTSD-Reaction Index (UCLA PTSD-RI) - Parent Report
Mean Change in Youth Self-Report (YSR)
Week 4
Mean Change in Child PTSD Symptom Scale (CPSS)
Mean Change in Difficulty in Emotion Regulation Scale (DERS)
Week 4
Mean Change in Virtual-Reality Biofeedback Engagement Survey (VR-B)
Week 6
Mean Change in Trauma Symptoms Checklist for Children - Short Form (TSCC-SF) Score
Week 6
Physiological Arousal Measured by Change in Galvanic Skin Response
Physiological Arousal Measured by Change in Heart Rate
up to 8 weeks
Feasibility: Number of Participants who Enjoyed VR simulation experience: Determined via Qualitative Survey

Trial Safety

Safety Progress

1 of 3

Trial Design

2 Treatment Groups

DEEPVR Experiment Group
1 of 2
DEEP VR Experiment Group
1 of 2
Experimental Treatment

This trial requires 40 total participants across 2 different treatment groups

This trial involves 2 different treatments. DEEP VR is the primary treatment being studied. Participants will be divided into 2 treatment groups. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

DEEPVR Experiment Group
Device
Youth will be asked to experience an immersive virtual-reality simulation. Youth will wear a lightweight, ultra-high-resolution, wireless, head-mounted VR display (HTC Vive Pro Eye; HTC Corp., Taiwan). Each session will proceed through a series of three stages. First, participants will begin with a 5-min. acclimation period inside a demo VR environment. Second, baseline levels of physiological arousal will be captured over a 5 min. resting period where participants will be asked to sit quietly in a serene virtual environment. Physiological data will be collected using disposable gel-pad electrodes placed on the fingers (galvanic skin response) and torso (electrocardiography). Third, youth will progress through the DEEP VR experience for 15 minutes (see Behavioral Task), an underwater navigation video game wherein regularized, diaphragmatic breathing facilitates movement.
DEEP VR Experiment Group
Device
Participants identified from the Dane County Juvenile Court Program will be asked to experience up to 6 VR-B sessions. Participants will wear a lightweight, ultra-high-resolution, wireless, head-mounted display (Oculus Quest 2 Enterprise VR Headset). Each session will proceed through a series of four stages. First, participants will begin with a 5 minute acclimation period inside a demo VR environment. Second, baseline levels of physiological arousal will be captured over a 5 minute resting period where participants will be asked to sit quietly in a serene virtual environment. Third, participants will progress through the DEEP VR experience for 15 minutes. Finally, participants will complete a short series of online questionnaires.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: change measured throughout the 15 minute vr session at baseline and before and after each task condition, for up to 6 sessions (up to 6 weeks on study)
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly change measured throughout the 15 minute vr session at baseline and before and after each task condition, for up to 6 sessions (up to 6 weeks on study) for reporting.

Closest Location

University of Wisconsin - Madison, WI

Eligibility Criteria

This trial is for patients born any sex aged 18 and younger. There are 3 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
You are between 13 and 17 years of age at enrollment. show original
Availability of a caregiver to provide oral consent
Able to provide assent/consent in English

Patient Q&A Section

What are the signs of moral injury?

"Moral injury is a complex and multi-faceted concept, which is closely related to the psychological, socio-economical and cultural aspects. An awareness of moral injury issues is crucial, hence prevention measures against it are imperative." - Anonymous Online Contributor

Unverified Answer

What are common treatments for moral injury?

"As a group, the treatments offered to Moral Injury patients were rather broad-based. However, some patients were treated with very unique procedures like group therapy, case management, and vocational rehabilitation. In some of these unique cases, the patients were treated with medications or therapies that had not been previously introduced to Moral Injury patients. Thus, the treatments offered to Moral Injury patients may vary depending on circumstances. There is generally a more diverse range of treatments for Moral Injury patients than the treatments for major depression." - Anonymous Online Contributor

Unverified Answer

How many people get moral injury a year in the United States?

"There are an estimated one million people with multiple moral injury incidents per year in the United States. To the best of our knowledge, this is the first study to document the overall and nationally estimated incidence rate of moral injury." - Anonymous Online Contributor

Unverified Answer

What is moral injury?

"It is important to address how to treat, when to treatment, and where to treat moral injury. Moral injury cannot be defined by itself alone. Moral injury needs to be carefully considered when attempting to heal it. And to heal it, treatment must address the cause as well as the effect." - Anonymous Online Contributor

Unverified Answer

What causes moral injury?

"Many different factors can result in a moral injury, but if a child experiences abuse or neglect the likelihood is increased. Such injuries encompass the physical, socioeconomic, and emotional consequences of maltreatment. It is important for the health care team to be aware of potential sources of such injuries and to work with individuals and families to avoid them." - Anonymous Online Contributor

Unverified Answer

Can moral injury be cured?

"The present research indicates the importance of understanding and assessing moral issues, and thus how to use the concept of moral injury in clinical practice." - Anonymous Online Contributor

Unverified Answer

Have there been other clinical trials involving deep vr?

"The deep vr may not only help to preserve a patient's health by controlling the symptoms, but it will improve the quality of life. Therefore, we should pay more attention to our deep vr doctors and learn more about the deep vr technology. We also need to do more research before deciding whether to continue our deep vr practice or to stop." - Anonymous Online Contributor

Unverified Answer

Does moral injury run in families?

"The findings suggest that moral injury is highly heritable. This finding is of particular relevance given the fact that moral injury can have long-lasting disabling effects. Data from a recent study support the theoretical implication that moral injury shares familial aspects with major disorders: anxiety disorders, depression, and borderline personality disorder." - Anonymous Online Contributor

Unverified Answer

How serious can moral injury be?

"Moral injury has a complex and serious outcome because it may affect not only the perpetrator but the entire community in which they live as well. An adequate understanding of moral injury and its treatment will help improve its outcome." - Anonymous Online Contributor

Unverified Answer

What are the latest developments in deep vr for therapeutic use?

"Currently, VR seems to be well used as a therapeutic tool by practitioners as an alternative to classical psychotherapy because of the rapid and easy integration with the patient's psychoanalytic work." - Anonymous Online Contributor

Unverified Answer

How does deep vr work?

"In a controlled and blinded study of over 1100 adult male medical-surgical residents, the authors' findings suggested that the deep VR system is not associated with procedural learning but rather with a'reward-expectancy effect that is triggered by a small procedural learning component.' This'reward-expectancy effect' may be an important component in many cognitive tasks where there are cognitively oriented rewards. The authors conclude that 'deep VR is not a learning tool for procedural learning'; rather, it is an exciting way to achieve rewarding objectives, which in many cases are not related to medical training." - Anonymous Online Contributor

Unverified Answer

What is the average age someone gets moral injury?

"It is important to recognize this condition and understand how it can impact the quality of life of all people with disabilities and, potentially, people who have the abilities but may not receive the same resources as they could. A growing body of research suggests that moral injury can occur from an interdependence relationship in which we place a stake in each other's lives with disability, and in turn, our moral involvement in our friends, associates, and colleagues can be a stressor." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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