Virtual Reality-Augmented Future Orientation in Stimulant Use Disorder Recovery

虚拟现实增强兴奋剂使用障碍康复的未来方向

基本信息

批准号：
10455193
负责人：
Brandon Oberlin
金额：
$ 23.78万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-05-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10455193
关键词：
Abstinence Address Aftercare Age Attention Behavior Behavior Therapy Behavioral Behavioral Mechanisms Biometry Brain Clinical Psychology Clinical Trials Communities Data Decision Making Development Drug usage Effectiveness Emotional Event Evidence based intervention Exhibits Frequencies Future Goals Immersion Impairment Individual Intervention Interview Intoxication Investments Italy Laboratories Methods Motivation Neuropsychological Tests Outcome Participant Patient Self-Report Patients Persons Pharmacotherapy Preparation Randomized Clinical Trials Randomized Controlled Trials Recovery Relapse Resistance Rewards Sampling Sensory Signal Transduction Stimulant Substance Use Disorder Substance abuse problem Testing Thinking Time Travel Treatment outcome Validation Virtual and Augmented reality Work behavior change behavior test behavioral economics craving design digital discounting disorder later incidence prevention drug abstinence drug efficacy drug testing efficacy testing efficacy trial endophenotype experience feasibility testing follow-up hedonic improved male medication-assisted treatment multidisciplinary neglect non-drug novel open label optimism personalized medicine precision medicine preference recruit relapse risk response safety and feasibility stimulant abuse stimulant use stimulant use disorder success successful intervention theories treatment as usual virtual virtual reality virtual reality environment virtual reality intervention virtual world

项目摘要

PROJECT SUMMARY / ABSTRACT We propose a novel virtual reality intervention to test for efficacy on reducing stimulant use and increasing abstinence, with concomitant increases in future self-identification, future time perspective, and delay-of- reward, in early recovering stimulant use disorder (StUD) persons. Impaired future orientation and delay-of- reward appear to be behavioral endophenotypes for substance use disorders. With recovery attempts usually failing within 6 months of treatment, there is considerable room for improved efficacy. Converging evidence indicates that a hallmark of StUD is impaired visualizing and planning for the future, which corresponds to greater devaluation of delayed rewards. Our preliminary tests of the intervention were promising, with n=14 out of n=18 participants remaining abstinent 30 days later; importantly, 10 of the 14 abstainers showed a positive response to the intervention, suggesting an efficacy marker. The intervention increases future self-identification and delay-of-reward in people recovering from substance use disorder, and engages brain networks governing prospection; further, the VR effect on delay-of-reward correlated with introspective-executive brain connectivity. Extending prior work on episodic future thinking, we employed a precision medicine approach in designing a personalized immersive virtual experience that integrates personal details and maximizes sensory engagement. Our intervention increases connectedness with one’s future by immersing subjects in a realistic portrayal of interacting with their Future Selves in divergent futures. Importantly, we integrate self-discrepancy theory, focusing on the gap between “what is” and “what could be” to heighten motivation, and we promote engagement by maximizing the novelty and emotional salience of the experience. Early-recovering StUD persons enter a realistic virtual world, are introduced to a time travel narrative, and interact with two digitally age-progressed Future Selves; one after 15 years of ongoing stimulant abuse, and the other after 15 years of recovery. Both Future Selves speak to the participant about their recovery rewards, or losses from returning to habitual drug use, and personal struggles during the journey. Strong emphasis is placed on agency, optimism, and decision-making. After iterative development and tests of feasibility and safety, the paradigm yielded a promising efficacy signal, behavioral change, and brain target engagement. The current proposal will validate this paradigm in an expanded sample to show efficacy and behavioral mechanisms using the same VR paradigm. Aim 1 will test for efficacy on stimulant and drug use outcomes (amount, frequency, type, relapse, and abstinence) with longitudinal assessments at 1 and 6 months. Aim 2 will determine mechanisms by testing for changes in future self-identification, future time perspective, and behavioral delay discounting. The long- term goal of the project is to validate a potent adjunctive intervention with long-term recovery benefits that is readily implemented during post-treatment aftercare or in a treatment setting.

项目摘要 /摘要我们提出了一种新颖的虚拟现实干预措施，以测试减少兴奋剂使用和增加的效率禁欲，随着未来的自我认同，未来的时间观点和延迟 - 奖励，在早期康复的兴奋剂障碍（螺柱）中。损害未来的定向和延迟奖励外观是用于物质使用障碍的行为内表型。通常尝试恢复尝试在治疗后6个月内失败，有相当大的效率空间。融合证据表明Stud的标志是可视化和计划的未来计划，这与延迟奖励的更大定义。答应了我们对干预的初步测试，n = 14 30天后，n = 18名参与者仍保留；重要的是，14个弃权者中有10个表现为阳性对干预的反应，提示效率标记。干预增加了未来的自我认同并延迟从药物使用障碍中恢复过来的人，并参与脑网络网络假面；此外，VR对奖励延迟的影响与内省 - 执行脑连接性相关。扩展了关于情节未来思维的先前工作，我们在设计一个方面采用了精确的医学方法个性化的沉浸式虚拟体验，可以整合个人细节并最大化感官订婚。我们的干预措施通过将主题融入现实的主题来增加与未来的联系在不同的未来中与未来自我互动的刻画。重要的是，我们整合了自我裁员理论，专注于“什么”和“可能是什么”之间的差距，以增强动力，我们促进通过最大化体验的新颖性和情感显着性来参与。早期恢复螺柱人们进入现实的虚拟世界，被介绍给时间旅行叙事，并在数字上与两个互动年龄增长的未来自我；一个经过15年的持续刺激性滥用，另一个是15年后恢复。未来的自我都与参与有关他们的恢复奖励或从返回到习惯性毒品使用和旅途中的个人斗争。强烈重视代理，乐观，和决策。在迭代发展和可行性和安全性测试之后，范式产生了有希望的效率信号，行为改变和大脑目标参与。当前的提议将验证扩展样本中的范例，以使用相同的VR显示效率和行为机制范例。 AIM 1将测试刺激和药物使用结果的效率（数量，频率，类型，退休，和禁欲）在1和6个月时进行纵向评估。 AIM 2将通过测试确定机制为了改变未来的自我认同，未来的时间观点和行为延迟折现。长期该项目的任期目标是验证具有长期恢复福利的潜在辅助干预措施在治疗后或治疗环境中很容易实施。