Training Reward Responsiveness Through Virtual Reality

University of California, Los Angeles (UCLA)

Status and phase: Enrolling; Phase 2

Conditions: Depression; Positive Affect

Treatments: Behavioral: Enhanced Virtual Reality-Reward Training (eVR-RT); Behavioral: Virtual Reality-Memory Training (VR-MT)

Study type: Interventional

Funder types: Other

Identifiers

NCT07219875

IRB-22-0269

Details and patient eligibility

About

The purpose of this study is to compare the effects of enhanced Virtual Reality-Reward Training (eVR-RT) with an active control condition, Virtual Reality-Memory Training (VR-MT), on positive affect and other clinical symptoms.

Enhanced VR-Reward Training is a novel intervention aimed at enhancing savoring of positive experiences among individuals with depression and low positive affect through guided imaginal recounting following immersion in positive VR experiences. The current study tests an enhanced version of this training using improved virtual reality technology.

Target enrollment is 80 participants with low positive affect, depression, and impaired functioning, who are at least 18 years old, who will be randomly assigned to 7 weeks of either enhanced Virtual Reality-Reward Training (VR-RT) or Virtual Reality-Memory Training (VR-MT). Participants will complete in-person VR sessions, laboratory assessments, self-report questionnaires as part of the study. A subset of 8 participants randomly assigned to VR-RT will complete fMRI scans and EMA surveys.

The total length of participation is around 3 months.

Full description

Anhedonia, or loss of interest and pleasure in usual activities, has been relatively resistant to pharmacological and psychological treatments in the context of anxiety and depression. Newer treatments that focus upon positivity or reward sensitivity have shown promising results.

The purpose of the current randomized controlled trial is to compare the effects of Enhanced Virtual Reality-Reward Training (eVR-RT) with an active control condition, Virtual Reality-Memory Training (VR-MT), on positive affect and other clinical symptoms. Enhanced Virtual Reality-Reward Training is designed to augment reward sensitivity in individuals with depression and low positive affect. Targets include reward anticipation and initial response to reward. Specificity of target engagement is assessed by comparison with Virtual Reality-Memory Training, designed to improve memory.

Targets and clinical outcomes are assessed at Week 0 Assessment (Week 0) and either weekly or at mid-treatment (Week 7), post-treatment (1 week after Session 14), and follow-up (Week 12). Statistical models evaluate whether change in outcomes and change in target measures are greater as a result of enhanced Virtual Reality-Reward Training compared to Virtual-Reality-Memory Training and whether changes in target measures correlate with changes in outcome measures.

Target enrollment is 80 participants with low positive affect, depression, and impaired functioning, who are at least 18 years old, who will be randomized to enhanced Virtual Reality-Reward Training or Virtual-Reality Memory Training, each comprising 13 individual virtual reality training sessions over the course of 7 weeks.

Participants will complete laboratory tests and self-report questionnaires as part of the study. Total length of participation is around 3 months.

Enrollment: 80 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. At least 18 years old

2. Fluent in written and spoken English

3. Meet all of the following dimensional score cutoffs:

   1. Score on the DASS-21 depression subscale must be ≥ 8
   2. Score on the PANAS-P of 27 or lower
   3. Score on the WSAS of ≥ 11

Exclusion criteria

1. Lifetime history of bipolar disorder, psychosis, mental retardation, or organic brain damage
2. Substance use disorder in the past 6 months
3. Current use of psychotropic medications
4. Currently pregnant or planning to become pregnant
5. Self-reported frequent motion sickness
6. Self-reported seizures within the last year and/or a diagnosis of epilepsy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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80 participants in 2 patient groups

Enhanced Virtual Reality-Reward Training (eVR-RT)

Experimental group

Description:

13 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

Treatment:

Behavioral: Enhanced Virtual Reality-Reward Training (eVR-RT)

Virtual Reality-Memory Training (VR-MT)

Active Comparator group

Description:

13 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 non-personal stories

Treatment:

Behavioral: Virtual Reality-Memory Training (VR-MT)