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Abstract
People with severe mental illness (SMI), schizophrenia in particular, show considerable functional impairment in emotional recognition and social perception, which negatively affects interpersonal relationships and social functioning. Owing to its ecological validity, virtual reality (VR) has been observed to improve both assessment and training of emotional recognition skills of people with SMI. This article includes two studies: (a) a descriptive study on the Virtual Reality program for Facial Emotion Recognition (VR-FER) and (b) an empirical study that presents the results of the application of the VR-FER’s first module. For the second study, data were collected using two samples: a group of 12 people with schizophrenia and a reference group of 12 people who were mentally healthy. Data analysis comprised descriptive (mean, standard deviation) and inferential statistics (Mann–Whitney U test). Results showed that the first group presented a lower number of correct answers and a higher number of incorrect answers compared with the second group regarding facial emotion recognition (FER), thereby confirming the need to develop strategies to improve emotional recognition and social perception in people with schizophrenia. VR-FER is regarded a strategic training program for FER, using latest technology and following rehabilitation guidelines for SMI.
References
|
American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Google Scholar | Crossref | |
|
American Psychological Association . (2016). Revision of ethical standard 3.04 of the “ethical principles of psychologists and code of conduct” (2002, as amended 2010). American Psychologist, 71, Article 900. doi:10.1037/amp0000102 Google Scholar | Crossref | |
|
Anthony, W. A., Mizock, L. (2014). Evidence-based processes in an era of recovery: Implications for rehabilitation counseling and research. Rehabilitation Counseling Bulletin, 57, 219–227. doi:10.1177/0034355213507979 Google Scholar | SAGE Journals | ISI | |
|
Barello, S., Triberti, S., Graffigna, G., Libreri, C., Serino, S., Hibbard, J., Riva, G. (2016). eHealth for patient engagement: A systematic review. Frontiers in Psychology, 6, Article 2013. doi:10.3389/fpsyg.2015.02013 Google Scholar | Crossref | Medline | |
|
Barkhof, E., de Sonneville, L., Meijer, C., de Haan, L. (2015). Specificity of facial emotion recognition impairments in patients with multi-episode schizophrenia. Schizophrenia Research: Cognition, 2, 12–19. doi:10.1016/j.scog.2015.01.001 Google Scholar | Crossref | Medline | |
|
Bediou, B., Krolak-Salmon, P., Saoud, M., Henaff, M. A., Burt, M., Dalery, M., D’Amato, T. (2005). Facial expression and sex recognition in schizophrenia and depression. Canadian Journal of Psychiatry, 50, 525–533. doi:10.1177/070674370505000905 Google Scholar | SAGE Journals | ISI | |
|
Behere, R. V. (2015). Facial emotion recognition deficits: The new face of schizophrenia. Indian Journal of Psychiatry, 57, 229–235. doi:10.4103/0019-5545.166641 Google Scholar | Crossref | Medline | |
|
Bekele, E., Crittendon, J., Zheng, Z., Swanson, A., Weitlauf, A., Warren, Z., Sarkar, N. (2014). Assessing the utility of a virtual environment for enhancing facial affect recognition in adolescents with autism. Journal of Autism and Developmental Disorders, 44, 1641–1650. Google Scholar | Crossref | Medline | |
|
Bellack, A., Mueser, K., Gingerich, S., Agresta, J. (2004). Social skills training for schizophrenia: A step by step guide (2nd ed.). New York, NY: Guilford Press. Google Scholar | |
|
Borrego, A., Latorre, J., Llorens, R., Alcañiz, M., Noé, E. (2016). Feasibility of a walking virtual reality system for rehabilitation: Objective and subjective parameters. Journal of NeuroEngineering and Rehabilitation, 13, 68–77. doi:10.1186/s12984-016-0174-1 Google Scholar | Crossref | Medline | |
|
Campos, C., Santos, S., Gagen, E., Machado, S., Rocha, S., Kurtz, M., Rocha, N. (2016). Neuroplastic changes following social cognition training in schizophrenia: A systematic review. Neuropsychology Review, 26, 310–328. doi:10.1007/s11065-016-9326-0 Google Scholar | Crossref | Medline | |
|
Chan, F., Leahy, M. J., Saunders, J. L., Tarvydas, V. M., Ferrin, J. M., Lee, G. (2003). Training needs of certified rehabilitation counselors for contemporary practice. Rehabilitation Counseling Bulletin, 46, 82–91. doi:10.1177/00343552030460020201 Google Scholar | SAGE Journals | ISI | |
|
Chung, Y., Barch, D. (2011). The effect of emotional context on facial emotion ratings in schizophrenia. Schizophrenia Research, 13, 235–241. doi:10.1016/j.schres.2011.05.028 Google Scholar | Crossref | |
|
Cipresso, P., Riva, G. (2016). Personality assessment in ecological settings by means of virtual reality. In Kumar, U. (Ed.), The Wiley handbook of personality assessment (pp. 240–248). New York, NY: John Wiley. Google Scholar | Crossref | |
|
Coan, J. A., Allen, J. B. (2007). Handbook of emotion elicitation and assessment. Oxford, UK: Oxford University Press. Google Scholar | |
|
Couture, S., Penn, D., Roberts, D. (2006). The functional significance of social cognition in schizophrenia: A review. Schizophrenia Bulletin, 23, S44–S63. doi:10.1093/schbul/sbl029 Google Scholar | Crossref | |
|
Danilina, O., Cox, A. L., Fonseca, A., Johnson, S. (2017). Serious video games as psychosocial interventions for psychosis. CHI 2017, Denver, CO, USA. Google Scholar | |
|
Didehbani, N., Allen, T., Kandalaft, M., Krawczyk, D., Chapman, S. (2016). Virtual reality social cognition training for children with high functioning autism. Computers in Human Behavior, 62, 703–711. doi:10.1016/j.chb.2016.04.033 Google Scholar | Crossref | |
|
Ekman, P., Friesen, W. (1978). The facial action coding system: A technique for the measurement of facial movement. San Francisco, CA: Consulting Psychologists Press. Google Scholar | |
|
Feingold, D., Hasson-Ohayon, I., Laukka, P., Vishne, T., Dembinsky, Y., Kravets, S. (2016). Emotion recognition deficits among persons with schizophrenia: Beyond stimulus complexity level and presentation modality. Psychiatry Research, 240, 60–65. doi:10.1016/j.psychres.2016.04.015 Google Scholar | Crossref | Medline | |
|
Fisher, M., Nahum, M., Howard, E., Rowlands, A., Brandrett, B., Kermott, A., . . . Vinogradov, S. (2017). Supplementing intensive targeted computerized cognitive training with social cognitive exercises for people with schizophrenia: An interim report. Psychiatric Rehabilitation Journal, 40, 21–32. doi:10.1037/prj0000244 Google Scholar | Crossref | Medline | |
|
Folstein, M. F., Folstein, S. E., McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. doi:10.1016/0022-3956(75)90026-6 Google Scholar | Crossref | Medline | ISI | |
|
Freeman, D., Reeve, S., Robinson, A., Ehlers, A., Clark, D., Spanlang, B., Slater, M. (2017). Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychological Medicine, 47, 2393–2400. doi:10.1017/S003329171700040X Google Scholar | Crossref | Medline | |
|
Gayer-Anderson, C. (2016). The application of virtual reality technology to understanding psychosis. Social Psychiatry and Psychiatric Epidemiology, 51, 937–939. doi:10.1007/s00127-016-1245-0 Google Scholar | Crossref | Medline | |
|
Giggins, O. M., Persson, U. M., Caulfield, B. (2013). Biofeedback in rehabilitation. Journal of NeuroEngineering and Rehabilitation, 10(1), Article 60. doi:10.1186/1743-0003-10-60 Google Scholar | Crossref | Medline | |
|
Golan, O., Baron-Cohen, S., Ashwin, E., Day, K., McClintock, S., Leggett, V. (2008). Facilitating emotional understanding and face-processing in young children with autism spectrum conditions using animations of vehicles with faces. In British Psychological Society Annual Conference. University of Bath. Google Scholar | |
|
Guerreiro, M., Silva, A. P., Botelho, M. A., Leitão, O., Castro-Caldas, A., Garcia, C. (1994). Adaptação à população portuguesa da tradução do Mini Mental State Examination (MMSE) [Adaptation to the Portuguese population of the translation of the Mini Mental State Examination (MMSE)]. Revista Portuguesa De Neurologia, 1(9), 9–10. Google Scholar | |
|
Gutiérrez-Maldonado, J., Rus-Calafell, M., González-Conde, J. (2014). Creation of a new set of dynamic virtual reality faces for the assessment and training of facial emotion recognition ability. Virtual Reality, 18, 61–71. doi:10.1007/s10055-013-0236-7 Google Scholar | Crossref | |
|
Horan, W. P., Kern, R. S., Green, M. F., Penn, D. L. (2008). Social cognition training for individuals with schizophrenia: Emerging evidence. American Journal of Psychiatric Rehabilitation, 11, 205–252. doi:10.1080/15487760801963652 Google Scholar | Crossref | |
|
Isleyen, F., Gulkesen, K. H., Cinemre, B., Samur, M. K., Zayim, N., Sen Kaya, S. (2014). Evaluation of the usability of a serious game aiming to teach facial expressions to schizophrenic patients. Studies in Health Technology and Informatics, 205, 662–666. doi:10.3233/978-1-61499-432-9-662 Google Scholar | Crossref | Medline | |
|
Johnston, P., Devir, H., Karayanidis, F. (2006). Facial emotion processing in schizophrenia: No evidence for a deficit specific to negative emotions in a differential deficit design. Psychiatry Research, 143, 51–61. doi:10.1016/j.psychres.2005.08.006 Google Scholar | Crossref | Medline | ISI | |
|
Johnston, P., McCabe, K., Schall, U. (2003). Differential susceptibility to performance degradation across categories of facial emotion—A model confirmation. Biological Psychology, 63, 45–58. doi:10.1016/S0301-0511(03)00026-7 Google Scholar | Crossref | Medline | ISI | |
|
Kee, K., Qreen, M., Mintz, J., Brekke, J. (2003). Is emotion processing a predictor of functional outcome in schizophrenia? Schizophrenia Bulletin, 29, 487–497. doi:10.1093/oxfordjournals.schbul.a007021 Google Scholar | Crossref | Medline | ISI | |
|
Kim, K., Kim, J. J., Kim, J., Park, D. E., Jang, H. J., Ku, J., . . . Kim, S. I. (2007). Characteristics of social perception assessed in schizophrenia using virtual reality. Cyberpsychology & Behavior, 10, 215–219. doi:10.1089/cpb.2006.9966 Google Scholar | Crossref | Medline | |
|
Kohler, C., Walker, J., Martin, E., Healey, K., Moberg, P. (2010). Facial emotion perception in schizophrenia: A meta-analytic review. Schizophrenia Bulletin, 36, 1009–1019. doi:10.1093/schbul/sbn192 Google Scholar | Crossref | Medline | ISI | |
|
Kring, A. M., Elis, O. (2013). Emotion deficits in people with schizophrenia. Annual Review of Clinical Psychology, 9, 409–433. doi:10.1146/annurev-clinpsy-050212-185538 Google Scholar | Crossref | Medline | ISI | |
|
Kring, A. M., Germans Gard, M., Gard, D. E. (2011). Emotion deficits in schizophrenia: Timing matters. Journal of Abnormal Psychology, 120, 79–87. doi:10.1037/a0021402 Google Scholar | Crossref | Medline | |
|
Langner, O., Dotsch, R., Bijlstra, G., Wigboldus, D. J., Hawk, S. T., van Knippenberg, A. (2010). Presentation and validation of the Radboud faces database. Cognition and Emotion, 24, 1377–1388. doi:10.1080/02699930903485076 Google Scholar | Crossref | ISI | |
|
Marques-Teixeira, J., Pereira, A., Silva, A., Marieiro, A., Humberto, J., Guerreiro, M. (2005). Caracterização de doentes portugueses com esquizofrenia: Resultados da avaliação do estudo observacional SOHO no início do estudo [Characterization of Portuguese patients with schizophrenia: Results from the evaluation of the SOHO observational study at baseline]. Saúde Mental, 7(4), 13–21. Google Scholar | |
|
McGloin, R., Nowak, K. L., Watt, J. (2014). Avatars and expectations: Influencing perceptions of trustworthiness in an online consumer setting. PsychNology Journal, 1(1–2), 7–28. Google Scholar | |
|
Mental Illness Policy Organization . (2019). What is “serious mental illness” and what is not? Retrieved from https://mentalillnesspolicy.org/serious-mental-illness-not/ Google Scholar | |
|
Ministry of Health . (2004). National health plan 2004 to 2010. Vol. I. Priorities. Lisbon, Portugal: Author. Google Scholar | |
|
Naslund, J. A., Aschbrenner, K. A., Bartels, S. J. (2016). How people with serious mental illness use smartphones, mobile apps, and social media. Psychiatric Rehabilitation Journal, 39, 364–367. doi:10.1037/prj0000207 Google Scholar | Crossref | Medline | |
|
National Institute of Mental Health . (2019). Mental illness. Retrieved from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml Google Scholar | |
|
Nicolaou, M., Gunes, H., Pantic, M. (2011). Output-associative RVM regression for dimensional and continuous emotion prediction. Retrieved from http://ibug.doc.ic.ac.uk/people/mnicolaou Google Scholar | |
|
Pallesen, H., Andersen, M. B., Hansen, G. M., Lundquist, C. B., Brunner, I. (2018). Patients’ and health professionals’ experiences of using virtual reality technology for upper limb training after stroke: A qualitative substudy. Rehabilitation Research and Practice. Advance online publication. doi:10.1155/2018/4318678 Google Scholar | Crossref | |
|
Parsons, T. D., Riva, G., Parsons, S. J., Mantovani, F., Newbutt, N., Lin, L., . . . Hall, T. (2017). Virtual reality in pediatric psychology. Pediatrics, 140, S86–S91. doi:10.1542/peds.2016-1758I Google Scholar | Crossref | Medline | |
|
Penn, D., Roberts, D., Combs, D., Sterne, A. (2007). The development of social cognition and interaction training program for schizophrenia spectrum disorders. Psychiatric Services, 58, 449–451. doi:10.1176/ps.2007.58.4.449 Google Scholar | Crossref | Medline | ISI | |
|
Phillips, B. N., Deiches, J., Morrison, B., Kaseroff, A. A. (2016). Social effectiveness: A 30-year review of the rehabilitation counseling literature. Rehabilitation Counseling Bulletin, 60, 16–26. doi:10.1177/0034355215601073 Google Scholar | SAGE Journals | ISI | |
|
Raffard, S., Bortolon, C., Khoramshahi, M., Salesse, R. N., Burca, M., Marin, L., . . . Capdevielle, D. (2016). Humanoid robots versus humans: How is emotional valence of facial expressions recognized by individuals with schizophrenia? An exploratory study. Schizophrenia Research, 176, 506–513. doi:10.1016/j.schres.2016.06.001 Google Scholar | Crossref | Medline | |
|
Ravyse, W. S., Seugnet Blignaut, A., Leendertz, V., Woolner, A. (2017). Success factors for serious games to enhance learning: A systematic review. Virtual Reality, 21, 31–58. doi:10.1007/s10055-016-0298-4 Google Scholar | Crossref | |
|
Reeve, J. (2009). Understanding motivation and emotion. Hoboken, NJ: John Wiley. Google Scholar | |
|
Rice, L. M., Wall, C. A., Fogel, A., Shic, F. (2015). Computer-assisted face processing instruction improves emotion recognition, mentalizing, and social skills in students with ASD. Journal of Autism and Developmental Disorders, 45, 2176–2186. doi:10.1007/s10803-015-2380-2 Google Scholar | Crossref | Medline | |
|
Richard, D. A., More, W., Joy, S. P. (2015). Recognizing emotions: Testing an intervention for children with autism spectrum disorders. Art Therapy, 32, 13–19. doi:10.1080/07421656.2014.994163 Google Scholar | Crossref | |
|
Riva, G. (2015). Embodied medicine: What human-computer confluence can offer to health care. In Gaggioli, A., Ferscha, A., Riva, G., Dunne, S., Viaud-Delmon, I. (Eds.), Human computer confluence: Transforming human experience through symbiotic technologies (pp. 55–79). Warsaw, Poland: De Gruyter Open. Google Scholar | Crossref | |
|
Rizzo, A. S., Kim, G. J. (2005). A SWOT analysis of the field of virtual reality rehabilitation and therapy. Presence: Teleoperators & Virtual Environments, 14, 119–146. doi:10.1162/1054746053967094 Google Scholar | Crossref | ISI | |
|
Roesch, E. B., Tamarit, L., Reveret, L., Grandjean, D., Sander, D., Scherer, K. R. (2011). FACSGen: A tool to synthesize emotional facial expressions through systematic manipulation of facial action units. Journal of Nonverbal Behavior, 35, 116. doi:10.1007/s10919-010-0095-9 Google Scholar | Crossref | |
|
Rus-Calafell, M., Garety, P., Sason, E., Craig, T. J. K., Valmaggia, L. R. (2018). Virtual reality in the assessment and treatment of psychosis: A systematic review of its utility, acceptability and effectiveness. Psychological Medicine, 48, 362–391. doi:10.1017/S0033291717001945 Google Scholar | Crossref | Medline | |
|
Schueller, S. M. (2018). Mental health and eHealth technology. In van Gemert-Pijnen, L., Kelders, S. M., Kip, H., Sanderman, R. (Eds.), eHealth research, theory and development (pp. 111–130). New York, NY: Routledge. Google Scholar | Crossref | |
|
Sloan, R., Cook, M., Robinson, B. (2009). Considerations for believable emotional facial expression animation. 2nd International Conference on Visualization, Barcelona, Spain. Google Scholar | Crossref | |
|
Strohmer, D. C., Chan, F. (2015). Introduction to the special issue on international rehabilitation counseling research. Rehabilitation Counseling Bulletin, 58, 67–69. doi:10.1177/0034355214561208 Google Scholar | SAGE Journals | ISI | |
|
Tcherkassof, A., Bollon, T., Dubois, M., Pansu, P., Adam, J. M. (2007). Facial expressions of emotions: A methodological contribution to the study of spontaneous and dynamic emotional faces. European Journal of Social Psychology, 37, 1325–1345. doi:10.1002/ejsp.427 Google Scholar | Crossref | ISI | |
|
Tieri, G., Morone, G., Paolucci, S., Iosa, M. (2018). Virtual reality in cognitive and motor rehabilitation: Facts, fiction and fallacies. Expert Review of Medical Devices, 15, 107–117. doi:10.1080/17434440.2018.1425613 Google Scholar | Crossref | Medline | |
|
Tortella-Feliu, M., Baños, R. M., Barrantes, N., Botella, C., Fernández-Aranda, F., García-Campayo, J., . . . Soler, J. (2016). Retos de la investigación psicológica en salud mental [Challenges of psychological research in mental health]. Clínica Y Salud, 27, 37–43. doi:10.1016/j.clysa.2016.02.001 Google Scholar | Crossref | |
|
Tsoi, D., Lee, K., Khokhar, W., Mir, N., Swalli, J., Gee, K., . . . Woodruff, P. (2008). Is facial emotion recognition impairment in schizophrenia identical for different emotions? A signal detection analysis. Schizophrenia Research, 99, 263–269. doi:10.1016/j.schres.2007.11.006 Google Scholar | Crossref | Medline | ISI | |
|
Uvais, N. A. (2015). Virtual reality applications in Schizophrenia. Industrial Psychiatry Journal, 24(2), Article 210. doi:10.4103/0972-6748.181755 Google Scholar | Crossref | Medline | |
|
Valmaggia, L. R., Day, F., Rus-Calafell, M. (2016). Using virtual reality to investigate psychological processes and mechanisms associated with the onset and maintenance of psychosis: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 51, 921–936. doi:10.1007/s00127-016-1245-0 Google Scholar | Crossref | Medline | |
|
Van’t Wout, M., Aleman, A., Kessels, R. P. C., Cahn, W., de Haan, E., Kahn, R. S. (2007). Exploring the nature of facial affect processing deficits in schizophrenia. Psychiatry Research, 150, 227–235. doi:10.1016/j.psychres.2006.03.010 Google Scholar | Crossref | Medline | ISI | |
|
Vauth, R., Rusch, N., Wirtz, M., Corrigan, P. (2004). Does social cognition influence the relation between neurocognitive deficits and vocational functioning in schizophrenia? Psychiatry Research, 128, 155–165. doi:10.1016/j.psychres.2004.05.018 Google Scholar | Crossref | Medline | ISI | |
|
World Health Organization . (2014). Global reference list of 100 core health indicators. Retrieved from http://www.who.int/healthinfo/indicators/2015/en/ Google Scholar | |
|
Wrzesien, M., Rodriguez Ortega, A., Rey, B., Alcañiz Raya, M. L., Banos, R., Vara, M. (2015). How the physical similarity of avatars can influence the learning of emotion regulation strategies in teenagers. Computers in Human Behavior, 43, 101–111. doi:10.1016/j.chb.2014.09.024 Google Scholar | Crossref |
