Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose Patients with schizophrenia, defined as a cognitive & emotional disorder, in face emotional situations, commonly show improper response because of their lack of ability to cope with emotional situations. Because they are vulnerable to negative stimulus that induces anxiety, they generally use repression to restrain their emotion causing symptom aggravation or relapse. Therefore, it is important to treat their emotions in an effective way. The ability to express emotion has been measured by self-reporting, therapist's subjective evaluation and also, evaluation based on imagined situations for patients by role-play. But this can involve too much subjective opinion based on only imagined situations. Virtual Reality (VR), recently being used for treating psychosis, is helpful in designing virtual space for participants to interact based on their own experiences. Moreover, it allows the setting of criteria for objective measurement from the parameters gained by experiences and responses in virtual space. In this study, we tried to verify the usefulness of this VR system for measuring patients' ability to express emotion.

Methods Participants were 20 patients with schizophrenia and 19 normal controls. The situations in VR are made up of positive & negative situations that are built on various circumstances such as home, café, bakery, street and etc. Various avatars representing families, friends, colleagues were designed to trigger participants to start expressing their emotions. “The point to react”, “The duration to express emotion”, “The ratio for eye gaze to avatars” were measured as the VR parameters. In order to decide if VR system worked as a tool for inducing and measuring participants' emotion, valence and arousal of emotion were measured after experiencing each situation. Presence scale was used to assess how close the participants felt VR system to reality.

Results Patients showed significantly faster reaction to negative situation, shorter duration to express their emotion and remarkably lower ratio for eye gaze to avatars than normal. Patient group showed significantly faster reaction against negative situations than positive ones. Since no differences were found in the measurements of valence, arousal and presence scale between patients and normal groups, VR system seems to work properly to induce emotion for both patients and non-patients.

Implication for Practice For patients who have cognitive and emotional disorder, it is clinically important to train patients to effectively express their emotions in order to prevent relapse. Accurate and objective measurements are necessary to design these trainings.

VR system has the following merits that can be practically utilized.

1. VR system can actualize more similar situation to reality based on patients' experiences in their past, present and future. 2. Patients' emotions can be more easily induced by representing a more realistic situation and this can guarantee more accurate and objective assessment. 3. VR system would provide patients more interests in participating in the training and more opportunities for education for treating repeated situation. 4. VR system can measure degrees of patients' change more objectively.