Enhancing Prospection with Virtual Reality in Alcohol Use Disorder Recovery

通过虚拟现实增强酒精使用障碍康复的前景

基本信息

批准号：
10687816
负责人：
Brandon Oberlin
金额：
$ 63.5万
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：
2022-08-20 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10687816
关键词：
Abstinence Address Aftercare Age Alcohol abuse Alcohol consumption Alcohols Attention Behavior Behavioral Biometry Brain Clinical Trials Costs and Benefits Data Decision Making Development Disease Dose Drug usage Effectiveness Emotional Event Functional Magnetic Resonance Imaging Future Goals Impairment Impulsivity Individual Intervention Investments Laboratories Longitudinal Studies Measures Motivation Outcome Participant Patients Persons Pharmacotherapy Placebos Quality of life Randomized Recovery Recovery Support Relapse Rest Rewards Sampling Self Efficacy Signal Transduction Substance Use Disorder Testing Thinking Time Travel Treatment Efficacy Treatment outcome Validation Visualization Work addiction aged alcohol abstinence alcohol use disorder behavioral economics behavioral outcome cingulate cortex comparative efficacy comparison group craving design digital discounting drinking early alcohol use effectiveness testing endophenotype experience feasibility testing follow-up hedonic improved intervention effect long term recovery male men multidisciplinary neurobehavioral neuroimaging neurotransmission novel novel therapeutics open label optimism pilot test predictive marker preference prolonged abstinence randomized placebo controlled trial relapse patients relapse prevention response safety and feasibility success sustained recovery theories treatment as usual treatment duration 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 increase abstinence, enhance future orientation and delayed reward preference, quantify brain responses, and improve recovery outcomes in early recovering alcohol use disorder (AUD) persons. We also intend to demonstrate that aged future selves representing alternate futures are the ‘active ingredient’ of the intervention. Impaired future orientation and discounted future outcomes appear to be a behavioral endophenotype for AUD and other addictions. With recovery attempts usually failing within 6 months of treatment, there is considerable room for improved efficacy for long-term recovery. Converging evidence indicates that a hallmark of AUD is preference for immediate hedonic rewards and impaired visualizing and planning for the future. To enhance visualization of the future, we extend prior work on episodic future thinking through virtually experiencing plausible alternate futures. Our intervention increases connectedness with one’s future by immersing subjects in a realistic interaction with their Future Selves in divergent futures that rely on present decisions. 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 AUD persons enter a compelling virtual world, are introduced to a time travel narrative, and interact with two digitally age-progressed Future Selves; one after 15 years of ongoing alcohol 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 problem drinking, 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 promising preliminary data showing increased prosocial behavioral change and brain target engagement. Interacting with Future Selves in virtual reality significantly increased abstinence rates compared to a treatment-as-usual comparison group, increased identification with the future, increased behavioral delay-of-reward, and enhanced brain activation and connectivity in executive and introspection networks. The current proposal will test this paradigm in a larger sample with an expansion of Recovery Future Self interactions (30 daily experiences) to show efficacy compared to a virtual reality control. Aim 1 will test the effectiveness of the virtual reality intervention on abstinence and alcohol use outcomes at 1 and 6 months, future self-similarity, and behavioral delay-of-reward. Aim 2 will demonstrate brain target engagement by showing stronger executive and introspective network function during decision-making and at rest, and executive network connectivity that correlates with increased delayed reward preference. Further, brain activation will provide a neural signal that could be used as a predictive marker for intervention responders. The ultimate goal is to deliver a potent recovery support intervention that is readily implemented in the context of promoting long-term recovery.

项目概要/摘要我们提出了一种新颖的虚拟现实干预措施，以增加节欲、增强未来导向和延迟奖励偏好、量化大脑反应并改善早期恢复饮酒的恢复结果我们还打算证明老年的未来自我代表着另一种未来。是干预措施的“活性成分”。似乎是 AUD 和其他成瘾的行为内表型，康复尝试通常会失败。治疗6个月内，长期康复疗效还有相当大的提升空间。一致的证据表明，澳元的一个特点是偏好即时的享乐奖励和未来的可视化和规划受损为了增强对未来的可视化，我们扩展了之前的工作。通过虚拟体验可能的替代未来，我们的干预会增加。通过让受试者沉浸在与未来的自我的现实互动中，与未来建立联系我们整合自我差异理论，关注差距。区分“是什么”和“可能是什么”来提高动力，我们通过最大限度地提高参与度来促进参与体验的新颖性和情感的突出性使早期康复的 AUD 人进入了一个引人注目的虚拟环境。世界，被引入时间旅行叙事，并与两个数字时代的未来自我互动；一个是在持续酗酒 15 年之后，另一个是在 15 年的康复之后。与参与者谈论他们的恢复奖励或因重新酗酒而造成的损失，以及旅途中的个人斗争非常强调代理、乐观和决策。经过迭代开发以及可行性和安全性测试，该范式产生了有希望的初步数据显示出亲社会行为变化和大脑目标参与度的增加。与常规治疗对照组相比，虚拟现实显着提高了戒断率，增加对未来的认同，增加行为延迟奖励，并增强大脑激活当前的提案将在执行网络和内省网络中测试这种范式。更大的样本，扩展“恢复未来自我”互动（30 次日常体验）以显示功效与虚拟现实控制相比，目标 1 将测试虚拟现实干预的有效性。 1 个月和 6 个月时的禁欲和饮酒结果、未来的自相似性和行为延迟奖励。目标 2 将通过展示更强大的执行和内省网络来展示大脑目标参与度决策和休息期间的功能，以及与增加相关的执行网络连接此外，大脑激活将提供可用作延迟奖励偏好的神经信号。干预响应者的预测标记最终目标是提供有效的恢复支持。在促进长期恢复的背景下易于实施的干预措施。