Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT03927612 |
| Other study ID # |
1902596251 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
January 7, 2020 |
| Est. completion date |
March 30, 2022 |
Study information
| Verified date |
June 2023 |
| Source |
Indiana University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
This project will examine how virtual reality treatment that provides users with the
alternate perspective of a virtual interpersonal interaction impacts psychological and
neurobiological markers of social perspective taking in children with a disruptive behavior
disorder. The investigators anticipate that experiencing a virtual encounter from a
counterpart's point-of-view improves a child's perspective taking and alters brain function
related to imagining another person's pain.
Description:
Oppositional defiant disorder (ODD) and conduct disorder (CD), collectively known as
disruptive behavior disorders (DBDs), involve persistent physical or verbal confrontations,
antisocial behavior, and emotional outbursts. Despite a range of biological and environmental
risk factors for DBD, social-cognitive impairments are a common link, and improving these
deficits should be beneficial for all patients with DBD.
Children and adolescents with DBD have deficits in social perspective taking that contribute
significantly to these behavior problems. Perspective taking is the ability to perceive the
world from another person's point of view, including making inferences about the
capabilities, feelings, and expectations of others. Perspective taking requires substantial
motivation and cognitive resources and can be difficult to achieve, particularly for
children. A failure to understand or value another person's perspective inhibits helping
behavior without clear direct benefits. Perspective taking skills are related to empathic
concern, which encompasses feelings of sympathy and concern for unfortunate others, and
theory of mind, the ability to accurately infer others' mental states, such as intentions.
Negative attribution biases are more likely in individuals with poor theory of mind. Thus,
improving children's perspective-taking skills should allow them to better understand a
counterpart's thinking and intentions, increasing empathic concern, and reducing hostile
attribution biases-and therefore improving the likelihood that prosocial behavior occurs.
In the brain, perspective taking engages circuitry underlying empathic concern and theory of
mind. In fMRI studies, imagining pain to the self or other, often in conjunction with images
depicting painful scenarios, engages the brain's salience network. Dorsal ACC and bilateral
anterior insula, the regions most commonly activated in response to other's pain, also show
strong responses to self-perspective pain. However, in youth with DBD, there is a decreased
response to other-perspective pain in dACC and anterior insula, despite no change or a
heightened response to self-perspective pain.
Software interventions have shown some promise to improve perspective taking. In particular,
VR has exciting therapeutic potential to address perspective-taking deficits because it
provides naturalistic yet controlled environments in which users can experience interactions
from multiple viewpoints. VR interventions typically provide better generalization to
real-world behavioral changes compared to traditional methods. VR has an advantage over
traditional interventions because it provides an embodied experience that is a middle ground
between therapy room settings and the real world (e.g., school, home) where problematic
behaviors occur.
In this investigation, the investigators will build upon a current VR design using an Oculus
Quest virtual reality headset. After experiencing virtual interpersonal conflicts in a school
cafeteria setting, participants will re-experience scenarios in one of two manners: an
enriched perspective from the virtual counterpart's point-of-view, with internal dialogue and
background information; or a control perspective, which replays the original point-of-view.
During this proof-of-concept phase, the primary target is social perspective taking. The
investigators will assess functional engagement of this target by quantifying (1) the ability
to recognize and understand the virtual counterpart's perspective; and (2) the neural
response (in pain circuitry) to pain experienced by the virtual counterpart, a common marker
for perspective taking that is abnormal in DBD.
