ارزیابی واکنش پذیری به نشانه های مجازی مبتنی بر واقعیت الکل

Abstract The use of virtual reality (VR) programs in behavioral science research has been gaining prominence over the past several years. In the field of substance abuse, VR cue reactivity programs have been successfully tested for feasibility in nicotine and cocaine dependent samples. Seeking to expand VR applications in alcohol cue research, a novel VR alcohol cue reactivity assessment system incorporating visual, auditory, and olfactory stimuli was developed and tested. In a controlled trial, 40 non-treatment-seeking drinkers with alcohol use disorders were exposed to VR alcohol cue environments. Subjective craving, attention to alcohol cues, and level of presence (realism of experience) in VR were assessed across the environments. Overall, subjective craving for alcohol increased across the VR alcohol-related cue environments versus VR neutral cue environments. Participants reported high levels of presence in VR, indicating that the environments were perceived as realistic and compelling. These initial findings support the use of VR based cue reactivity environments for use in alcohol cue-based treatment and research.

Results 3.1. Craving A significant main effect of VR cue rooms (neutral 1, kitchen, bar, argument, party, neutral 2) on subjective craving was found (F(4, 146) = 71.31, p < .001). Because the assumption for sphericity was not met, a Huynh–Feldt correction was used. After the significant main effect, pairwise comparisons lindicated that alcohol craving ratings for the VR party, bar, kitchen, and argument rooms were significantly higher than neutral 1 and neutral 2 VR rooms. As depicted in Fig. 2, mean (SD) craving ratings for the kitchen, bar, and party alcohol cue rooms were not significantly different from each other, showing similar reactivity. Craving ratings in the argument room were significantly lower compared to the other alcohol cue rooms (p < .005). Craving ratings in neutral rooms 1 and 2 were not significantly different from each other. Average alcohol craving ratings across VR cue rooms. Fig. 2. Average alcohol craving ratings across VR cue rooms. Figure options Because VR is a relatively new cue presentation method, craving effect sizes were calculated using d, which is the difference between craving means divided by their pooled standard deviation Cohen (1988). This estimation of effect size is, therefore, in terms of standard deviation units. Cohen (1988) has described effect sizes of 2, .5, and .8 as small, medium and large effect sizes. The craving effect sizes found in this study (comparing alcohol cue rooms to neutral rooms) ranged from 1.70 to 2.45. The average effect size, combining craving scores across all three alcohol rooms and both neutral rooms (and excluding the argument room) was 2.19. 3.2. Attention to cues Three separate repeated measures ANOVA were conducted for each of the alcohol attention scale items. For all three ANOVAs, the sphericity assumptions were not met, so Huynh–Feldt corrections were used. Significant main effects for VR cue rooms were found on sight (F(4,142) = 184.00, p < .001), smell (F(4, 168) = 74.8, p < .001), and thought (F(4,145) = 94.5, p < .001) items. Overall pairwise comparisons for each of the three separate alcohol attention scale items (sight, smell, thoughts) indicated that scores were greater in the bar, kitchen, party, and argument rooms compared to the neutral rooms (p < .05). For the sight and smell attention items, no significant differences were found between alcohol cue rooms. Attention to thoughts about drinking in the argument room were significantly lower compared to the other alcohol cue rooms (p < .001). Attention items were not significantly different between the neutral rooms 1 and 2. Average scores for each of the AAS across the VR rooms are presented in Table 1. Table 1. Mean alcohol attention scale ratings for each item across VR cue rooms AAS Item Neutral 1 Kitchen Bar Argument Party Neutral 2 M (SD) M (SD) M (SD) M (SD) M (SD) M (SD) Sight of alcohol 0.20 (0.46)a 9.0 (1.9)b 8.4 (2.3)b 5.6 (3.1)b 7.5 (2.3)b 0.73 (2.1)a Smell of alcohol 0.73 (1.7)a 6.9 (3.1)b 6.9 (3.1)b 5.3 (3.5)b 7.1 (3.1)b 1.4 (2.5)a Thoughts about drinking 1.3 (1.9)a 7.9 (2.5)b 8.0 (2.6)b 4.7 (3.4)c 7.9 (2.3)b 2.1 (2.8)a Note: Scores on the AAS items for sight and smell range from 0 (didn't notice at all) to 10 (completely paid attention), and for thoughts from 0 (didn't think about drinking at all) to 10 (thought about drinking all the time). VR rooms in each row that do not share the same subscript letter differ at p < .05. Table options No significant differences were found on craving in the VR cue rooms based on level of drinking, smoking status, or gender. 3.3. Presence/realism To assess the degree of presence of the VR-ACRAS environments, average scores for participants on the seven PQ items and overall total scores were calculated. The overall total mean score on the PQ was 81.7 (SD = 11.3). Average presence ratings for individual items related to realism and involvement in VR are depicted in Fig. 3. Average rating on PQ items. Fig. 3. Average rating on PQ items.