Investigating The Acceptability and Validity of a Novel VR Paradigm that Simulates Audio-verbal Hallucinations
Donagh Seaver O'Leary, Pat Mulvaney, Laura Moore, Lera O’Connor, Brendan Rooney, Keith Gaynor
Study at a glance
AI-extracted from the abstract| Characteristics | Experimental trial with qualitative interviews |
|---|---|
| Sample size | 67 |
| Population | Non-clinical participants |
| Measures | Subjective Units of Distress, heart rate variability, semi-structured interviews guided by the Theoretical Framework of Acceptability |
| Key findings | The VR-sAH was judged a valid and acceptable simulation: heart rate variability reductions supported self-reported embodied immersion, and all participants described it as an acceptable experimental paradigm. Participants reported affective experiences from mildly unpleasant to unnerving, aligned with clinical accounts, though the authors note it lacks the spontaneous, self-referential, and emotionally intense qualities of real auditory hallucinations. |
Abstract
There is a growing use of Virtual Reality (VR) technologies in psychosis research and intervention. Validated VR simulations of psychotic-like experience have the potential to allow controlled manipulation of stimuli, reproducibility, and to isolate mechanisms of change in an ethical research framework. Although initial developments appear to be safe, qualitative reporting of participants’ experiences of VR simulated psychotic-like experiences is lacking. This study investigated the acceptability and validity of an immersive VR experience that simulates auditory hallucinations (VR-sAH) based upon the prototypical content of auditory hallucinations described by people with lived experience. Sixty-seven non-clinical participants undertook an experimental trial involving VR-sAH. Validity of the VR-sAH was assessed by combined assessment of qualitative reports and psychophysiological responses. Non-acceptability was operationalised as drop-outs, indications of distress during the experiment, and self-reported Subjective Units of Distress post-experiment. Following the experiment, a subset of participants (n = 29) undertook semi-structured interviews guided by the Theoretical Framework of Acceptability. Results indicated that the VR-sAH was a valid simulation of auditory hallucinatory experiences. Statistically significant reductions in heart rate variability validated participants’ self-reported embodied immersion in the VR-sAH. Semi-structured interviews and quantitative acceptability criteria indicated that the VR-sAH was an acceptable research tool. All participants contended that the VR-sAH was an acceptable experimental paradigm. Participants described a range of affective experiences - from mildly unpleasant to unnerving - with qualitative descriptions aligned with those with clinical auditory hallucinations from the literature. VR-sAHs do not replicate the phenomenology of real auditory hallucinations; they lack the spontaneous, self-referential, and emotionally intense qualities of true psychotic experiences but may act as models of potential perceptual and cognitive processes to be further tested in clinical populations.