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Virtual Reality and Psychotic Disorders

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Part of the Virtual Reality Technologies for Health and Clinical Applications book series (VRTHCA)

Abstract

In the early years of virtual reality in mental healthcare several reviews were published (Gregg and Tarrier 2007; G. Riva 2002; 2003; 2005). None of them mentions work done on virtual reality with psychotic disorders yet, though some early work was starting to get published around the same time. There are different psychotic disorders with each their own specified combination of symptom domains, symptom intensity and duration. Wood et al. (2011) suggest a dimensional staging of psychosis, ranging from psychotic-like experiences to severe persistent psychotic episodes. A large body of research is accumulating showing psychotic symptoms can be seen as a transdiagnostic and extended phenotype found in the general population (J. van Os and Reininghaus 2016). When psychotic experiences persist, transition to a psychotic disorder becomes a possibility. The main recognizable symptom domains of psychotic disorders are hallucinations and delusions. Hallucinations are perceptions a person experiences without a corresponding external stimulus. Hallucinations can occur for all five senses. Patients with a psychotic disorder for example often experience auditory hallucinations such as hearing voices. These voices can be commentary, give orders to the patient or call them names. Delusions are beliefs people have about the external reality which are strongly maintained despite strong evidence to the contrary or despite what almost everybody else (of a person’s culture or subculture) believes. The most common delusion found in psychotic disorders is the persecutory delusion (paranoia). People with a persecutory delusion feel others (known or unknown) spy on them, pursue them and threaten their safety (van der Gaag et al. 2012; Beck et al. 2009). Hallucinations and delusions often cause anxiety and make the patient avoid (social) situations, which can be treated with exposure therapy. Other symptom domains of psychotic disorders are negative symptoms and impaired cognition. Patients with negative symptoms experience an diminished emotional expression and avolition. Impaired cognition is about learning deficiencies, whether insufficiently thought or thwarted by deficits. For both negative symptoms and impaired cognition training can help patients learn to master new skills. There are some additional symptom domains in psychotic disorders, but these don’t play a part in virtual reality (yet). See Box 13.1 for an overview.

Keywords

Schizophrenia Psychotic disorders Delusions Treatment 

References

  1. Achim, A. M., Maziade, M., Raymond, E., Olivier, D., Merette, C., & Roy, M. A. (2011). How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association. Schizophrenia Bulletin, 37(4), 811–821.  https://doi.org/10.1093/schbul/sbp148.CrossRefPubMedGoogle Scholar
  2. Alvarez-Jimenez, M., Alcazar-Corcoles, M. A., González-Blanch, C., Bendall, S., McGorry, P. D., & Gleeson, J. F. (2014). Online, social media and mobile technologies for psychosis treatment: A systematic review on novel user-led interventions. Schizophrenia Research, 156(1), 96–106.  https://doi.org/10.1016/j.schres.2014.03.021.CrossRefPubMedGoogle Scholar
  3. Atherton, S., Antley, A., Evans, N., Cernis, E., Lister, R., Dunn, G., et al. (2016). Self-confidence and paranoia: An experimental study using an immersive virtual reality social situation. Behavioural and Cognitive Psychotherapy, 44(1), 56–64.  https://doi.org/10.1017/S1352465814000496.CrossRefPubMedGoogle Scholar
  4. Baker, E. K., Kurtz, M. M., & Astur, R. S. (2006). Virtual reality assessment of medication compliance in patients with schizophrenia. Cyberpsychology & Behavior, 9(2), 224–229.CrossRefGoogle Scholar
  5. Bekele, E., Bian, D., Peterman, J., Park, S., & Sarkar, N. (2017). Design of a virtual reality system for affect analysis in facial expressions (VR-SAAFE); application to schizophrenia. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 25(6), 739–749.  https://doi.org/10.1109/TNSRE.2016.2591556.CrossRefPubMedGoogle Scholar
  6. Bell, M. D., & Weinstein, A. (2011). Simulated job interview skill training for people with psychiatric disability: Feasibility and tolerability of virtual reality training. Schizophrenia Bulletin, 37(suppl 2), S91–S97.  https://doi.org/10.1093/schbul/sbr061.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Ben-Zeev, D. (2014). Technology-based interventions for psychiatric illnesses: Improving care, one patient at a time. Epidemiology and Psychiatric Sciences, 23(04), 317–321.  https://doi.org/10.1017/s2045796014000432.CrossRefPubMedGoogle Scholar
  8. Broome, M. R., Zányi, E., Hamborg, T., Selmanovic, E., Czanner, S., Birchwood, M., et al. (2013). A high-fidelity virtual environment for the study of paranoia. Schizophrenia Research and Treatment, 2013, 1–7.  https://doi.org/10.1155/2013/538185.CrossRefGoogle Scholar
  9. Chan, C. L. F., Ngai, E. K. Y., Leung, P. K. H., & Wong, S. (2010). Effect of the adapted virtual reality cognitive training program among Chinese older adults with chronic schizophrenia: A pilot study. International Journal of Geriatric Psychiatry, 25(6), 643–649.  https://doi.org/10.1002/gps.2403.CrossRefPubMedGoogle Scholar
  10. Craig, T., Garety, P., Ward, T., Rus-Calafell, M., Williams, G., Huckvale, M., & Leff, J. (2014). Computer assisted therapy for auditory hallucinations: The avatar clinical trial. Schizophrenia Research, 153(S1), S74.  https://doi.org/10.1016/s0920-9964(14)70240-3.CrossRefGoogle Scholar
  11. Dyck, M., Winbeck, M., Leiberg, S., Chen, Y., & Mathiak, K. (2010). Virtual faces as a tool to study emotion recognition deficits in schizophrenia. Psychiatry Research, 179(3), 247–252.  https://doi.org/10.1016/j.psychres.2009.11.004.CrossRefPubMedGoogle Scholar
  12. Ellett, L., Freeman, D., & Garety, P. A. (2008). The psychological effect of an urban environment on individuals with persecutory delusions: The Camberwell walk study. Schizophrenia Research, 99(1–3), 77–84.  https://doi.org/10.1016/j.schres.2007.10.027.CrossRefPubMedGoogle Scholar
  13. Fornells-Ambrojo, M., Barker, C., Swapp, D., Slater, M., Antley, A., & Freeman, D. (2008). Virtual reality and persecutory delusions: Safety and feasibility. Schizophrenia Research, 104(1–3), 228–236.  https://doi.org/10.1016/j.schres.2008.05.013.CrossRefPubMedGoogle Scholar
  14. Fornells-Ambrojo, M., Freeman, D., Slater, M., Swapp, D., Antley, A., & Barker, C. (2013). How do people with persecutory delusions evaluate threat in a controlled social environment? A qualitative study using virtual reality. Behavioural and Cognitive Psychotherapy, 43(01), 89–107.  https://doi.org/10.1017/s1352465813000830.CrossRefPubMedGoogle Scholar
  15. Freeman, D. (2008). Studying and treating schizophrenia using virtual reality: A new paradigm. Schizophrenia Bulletin, 34(4), 605–610.  https://doi.org/10.1093/schbul/sbn020.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Freeman, D., Gittins, M., Pugh, K., Antley, A., Slater, M., & Dunn, G. (2008a). What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation. Psychological Medicine, 38(8), 1121–1132.  https://doi.org/10.1017/s0033291708003589.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Freeman, D., Pugh, K., Antley, A., Slater, M., Bebbington, P., Gittins, M., et al. (2008b). Virtual reality study of paranoid thinking in the general population. The British Journal of Psychiatry, 192(4), 258–263.  https://doi.org/10.1192/bjp.bp.107.044677.CrossRefPubMedGoogle Scholar
  18. Freeman, D., McManus, S., Brugha, T., Meltzer, H., Jenkins, R., & Bebbington, P. (2010a). Concomitants of paranoia in the general population. Psychological Medicine, 41(05), 923–936.  https://doi.org/10.1017/s0033291710001546.CrossRefPubMedGoogle Scholar
  19. Freeman, D., Pugh, K., Vorontsova, N., Antley, A., & Slater, M. (2010b). Testing the continuum of delusional beliefs: An experimental study using virtual reality. Journal of Abnormal Psychology, 119(1), 83–92.  https://doi.org/10.1037/a0017514.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Freeman, D., Evans, N., Lister, R., Antley, A., Dunn, G., & Slater, M. (2014). Height, social comparison, and paranoia: An immersive virtual reality experimental study. Psychiatry Research, 218(3), 348–352.  https://doi.org/10.1016/j.psychres.2013.12.014.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Freeman, D., Bradley, J., Antley, A., Bourke, E., DeWeever, N., Evans, N., et al. (2016). Virtual reality in the treatment of persecutory delusions: Randomised controlled experimental study testing how to reduce delusional conviction. The British Journal of Psychiatry, 209(1), 62–67.  https://doi.org/10.1192/bjp.bp.115.176438.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Galderisi, S., Mucci, A., Bitter, I., Libiger, J., Bucci, P., Wolfgang Fleischhacker, W., & Kahn, R. S. (2013). Persistent negative symptoms in first episode patients with schizophrenia: Results from the European first episode schizophrenia trial. European Neuropsychopharmacology, 23(3), 196–204.  https://doi.org/10.1016/j.euroneuro.2012.04.019.CrossRefPubMedGoogle Scholar
  23. García-Montes, J. M., Noguera, C., Álvarez, D., Ruiz, M., & Cimadevilla Redondo, J. M. (2014). High and low schizotypal female subjects do not differ in spatial memory abilities in a virtual reality task. Cognitive Neuropsychiatry, 19(5), 427–438.  https://doi.org/10.1080/13546805.2014.896786.CrossRefPubMedGoogle Scholar
  24. Gega, L., White, R., Clarke, T., Turner, R., & Fowler, D. (2013). Virtual environments using video capture for social phobia with psychosis. Cyberpsychology, Behavior and Social Networking, 16(6), 473–479.  https://doi.org/10.1089/cyber.2013.1510.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Greenwood, K. E., Morris, R., Smith, V., Jones, A. M., Pearman, D., & Wykes, T. (2016). Virtual shopping: A viable alternative to direct assessment of real life function? Schizophrenia Research, 172(1–3), 206–210.  https://doi.org/10.1016/j.schres.2016.02.029.CrossRefPubMedGoogle Scholar
  26. Gregg, L., & Tarrier, N. (2007). Virtual reality in mental health. Social Psychiatry and Psychiatric Epidemiology, 42(5), 343–354.  https://doi.org/10.1007/s00127-007-0173-4.CrossRefPubMedGoogle Scholar
  27. Han, K., Young Kim, I., & Kim, J.-J. (2012). Assessment of cognitive flexibility in real life using virtual reality: A comparison of healthy individuals and schizophrenia patients. Computers in Biology and Medicine, 42(8), 841–847.  https://doi.org/10.1016/j.compbiomed.2012.06.007.CrossRefPubMedGoogle Scholar
  28. Han, K., Shin, J., Yoon, S. Y., Jang, D.-P., & Kim, J.-J. (2014). Deficient gaze pattern during virtual multiparty conversation in patients with schizophrenia. Computers in Biology and Medicine, 49, 60–66.  https://doi.org/10.1016/j.compbiomed.2014.03.012.CrossRefPubMedGoogle Scholar
  29. Heckers, S., Barch, D. M., Bustillo, J., Gaebel, W., Gur, R., Malaspina, D., et al. (2013). Structure of the psychotic disorders classification in DSM-5. Schizophrenia Research, 150(1), 11–14.  https://doi.org/10.1016/j.schres.2013.04.039.CrossRefPubMedGoogle Scholar
  30. Isnanda, R. G., Brinkman, W. P., Veling, W., van der Gaag, M., & Neerincx, M. A. (2013). Priming to induce paranoid thought in a non clinical population. Studies in Health Technology and Informatics, 191, 95–99.  https://doi.org/10.3233/978-1-61499-282-0-95.CrossRefPubMedGoogle Scholar
  31. Isnanda, R. G., Brinkman, W. P., Veling, W., van der Gaag, M., & Neerincx, M. (2014). Controlling a stream of paranoia evoking events in a virtual reality environment. Studies in Health Technology and Informatics, (199), 55–60.Google Scholar
  32. Leff, J., Williams, G., Huckvale, M. A., Arbuthnot, M., & Leff, A. P. (2013). Computer-assisted therapy for medication-resistant auditory hallucinations: Proof-of-concept study. The British Journal of Psychiatry, 202(6), 428–433.  https://doi.org/10.1192/bjp.bp.112.124883.CrossRefPubMedGoogle Scholar
  33. Man, D. W. K., Ganesan, B., Yip, C. C. K., Lee, C. O. P., Tsang, S. Y. L., Yu, P. W. P., et al. (2016). Validation of the virtual-reality prospective memory test (Hong Kong Chinese version) for individuals with first-episode schizophrenia. Neuropsychological Rehabilitation, 28, 1–14.  https://doi.org/10.1080/09602011.2016.1251949.CrossRefGoogle Scholar
  34. Meyerbröker, K., & Emmelkamp, P. M. G. (2010). Virtual reality exposure therapy in anxiety disorders: A systematic review of process-and-outcome studies. Depression and Anxiety, 27(10), 933–944.  https://doi.org/10.1002/da.20734.CrossRefPubMedGoogle Scholar
  35. Moritz, S., Voigt, M., Köther, U., Leighton, L., Kjahili, B., Babur, Z., et al. (2014). Can virtual reality reduce reality distortion? Impact of performance feedback on symptom change in schizophrenia patients. Journal of Behavior Therapy and Experimental Psychiatry, 45(2), 267–271.  https://doi.org/10.1016/j.jbtep.2013.11.005.CrossRefPubMedGoogle Scholar
  36. Opriş, D., Pintea, S., García-Palacios, A., Botella, C., Szamosközi, Ş., & David, D. (2012). Virtual reality exposure therapy in anxiety disorders: A quantitative meta-analysis. Depression and Anxiety, 29(2), 85–93.  https://doi.org/10.1002/da.20910.CrossRefGoogle Scholar
  37. Park, I. H., Kim, J. J., Ku, J., Jang, H. J., Park, S. H., Kim, C. H., … Kim, S. I. (2009a). Characteristics of social anxiety from virtual interpersonal interactions in patients with schizophrenia. Psychiatry, 72(1), 79–93.CrossRefGoogle Scholar
  38. Park, K.-M., Ku, J., Park, I.-H., Park, J.-Y., Kim, S. I., & Kim, J.-J. (2009b). Improvement in social competence in patients with schizophrenia: A pilot study using a performance-based measure using virtual reality. Human Psychopharmacology: Clinical and Experimental, 24(8), 619–627.  https://doi.org/10.1002/hup.1071.CrossRefGoogle Scholar
  39. Park, K.-M., Ku, J., Choi, S.-H., Jang, H.-J., Park, J.-Y., Kim, S. I., & Kim, J.-J. (2011). A virtual reality application in role-plays of social skills training for schizophrenia: A randomized, controlled trial. Psychiatry Research, 189(2), 166–172.  https://doi.org/10.1016/j.psychres.2011.04.003.CrossRefPubMedGoogle Scholar
  40. Riva, G. (2002). Virtual reality for health care: The status of research. Cyberpsychology & Behavior, 5(3), 219–225.CrossRefGoogle Scholar
  41. Riva, G. (2003). Virtual environments in clinical psychology. Psychotherapy: Theory, Research, Practice, Training, 40(1/2), 68–76.  https://doi.org/10.1037/0033-3204.40.1/2.68.CrossRefGoogle Scholar
  42. Riva, G. (2005). Virtual reality in psychotherapy: Review. Cyberpsychology & Behavior, 8(3), 220–230.CrossRefGoogle Scholar
  43. Rus-Calafell, M., Gutiérrez-Maldonado, J., & Ribas-Sabaté, J. (2014). A virtual reality-integrated program for improving social skills in patients with schizophrenia: A pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 45(1), 81–89.  https://doi.org/10.1016/j.jbtep.2013.09.002.CrossRefPubMedGoogle Scholar
  44. Rus-Calafell, M., Garety, P., Sason, E., Craig, T. J. K., & Valmaggia, L. R. (2017). Virtual reality in the assessment and treatment of psychosis: A systematic review of its utility, acceptability and effectiveness. Psychological Medicine, 1–30.  https://doi.org/10.1017/S0033291717001945.CrossRefGoogle Scholar
  45. Smith, M. J., Fleming, M. F., Wright, M. A., Roberts, A. G., Humm, L. B., Olsen, D., & Bell, M. D. (2015). Virtual reality job interview training and 6-month employment outcomes for individuals with schizophrenia seeking employment. Schizophrenia Research, 166(1–3), 86–91.  https://doi.org/10.1016/j.schres.2015.05.022.CrossRefPubMedPubMedCentralGoogle Scholar
  46. Sohn, B. K., Hwang, J. Y., Park, S. M., Choi, J. S., Lee, J. Y., Lee, J. Y., & Jung, H. Y. (2016). Developing a virtual reality-based vocational rehabilitation training program for patients with schizophrenia. Cyberpsychology, Behavior and Social Networking, 19(11), 686–691.  https://doi.org/10.1089/cyber.2016.0215.CrossRefPubMedGoogle Scholar
  47. Sorkin, A., Peled, A., & Weinshall, D. (2005). Virtual reality testing of multi-modal integration in schizophrenic patients. Studies in Health Technology and Informatics, 111, 508–514.PubMedGoogle Scholar
  48. Sorkin, A., Weinshall, D., Modai, I., & Peled, A. (2006). Improving the accuracy of the diagnosis of schizophrenia by means of virtual reality. The American Journal of Psychiatry, 163(3), 512–520.CrossRefGoogle Scholar
  49. Sorkin, A., Weinshall, D., & Peled, A. (2008). The distortion of reality perception in schizophrenia patients, as measured in virtual reality. in Proc: 16th Annual Medicine Meets Virtual Reality (MMVR). http://icnc.huji.ac.il/files/SorkinMMVR2008.pdf.
  50. Souto, T., Baptista, A., Tavares, D., Queiros, C., & Marques, A. (2013). Facial emotional recognition in schizophrenia: Preliminary results of the virtual reality program for facial emotional recognition. Revista De Psiquiatria Clinica, 40(4), 129–134.CrossRefGoogle Scholar
  51. Spieker, E. A., Astur, R. S., West, J. T., Griego, J. A., & Rowland, L. M. (2012). Spatial memory deficits in a virtual reality eight-arm radial maze in schizophrenia. Schizophrenia Research, 135(1–3), 84–89.  https://doi.org/10.1016/j.schres.2011.11.014.CrossRefPubMedGoogle Scholar
  52. Thirioux, B., Tandonnet, L., Jaafari, N., & Berthoz, A. (2014). Disturbances of spontaneous empathic processing relate with the severity of the negative symptoms in patients with schizophrenia: A behavioural pilot-study using virtual reality technology. Brain and Cognition, 90, 87–99.  https://doi.org/10.1016/j.bandc.2014.06.006.CrossRefPubMedGoogle Scholar
  53. Tsang, M. M. Y., & Man, D. W. K. (2013). A virtual reality-based vocational training system (VRVTS) for people with schizophrenia in vocational rehabilitation. Schizophrenia Research, 144(1–3), 51–62.  https://doi.org/10.1016/j.schres.2012.12.024.CrossRefPubMedGoogle Scholar
  54. Üçok, A., & Ergül, C. (2014). Persistent negative symptoms after first episode schizophrenia: A 2-year follow-up study. Schizophrenia Research, 158(1–3), 241–246.  https://doi.org/10.1016/j.schres.2014.07.021.CrossRefPubMedGoogle Scholar
  55. Valmaggia, L. R., Freeman, D., Green, C., Garety, P., Swapp, D., Antley, A., et al. (2007). Virtual reality andparanoidideations in peoplewith an ‘at-risk mental state’ for psychosis. British Journal of Psychiatry, 191(S1), S63–S68.CrossRefGoogle Scholar
  56. Valmaggia, L. R., Day, F., & Rus-Calafell, M. (2016). Using virtual reality to investigate psychological processes and mechanisms associated with the onset and maintenance of psychosis: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 51(7), 921–936.  https://doi.org/10.1007/s00127-016-1245-0.CrossRefPubMedGoogle Scholar
  57. van Bennekom, M. J., de Koning, P. P., & Denys, D. (2017). Virtual reality objectifies the diagnosis of psychiatric disorders: A literature review. Frontiers in Psychiatry, 8.  https://doi.org/10.3389/fpsyt.2017.00163.
  58. Van Der Gaag, M. (2012). Cognitive-behavioral therapy. In J.D. Blom and I.E. Sommer (Eds). Hallucinations. Research and Practice (pp. 361–374). New York: Springer.Google Scholar
  59. van Os, J., & Reininghaus, U. (2016). Psychosis as a transdiagnostic and extended phenotype in the general population. World Psychiatry, 15(2), 118–124.  https://doi.org/10.1002/wps.20310.CrossRefPubMedPubMedCentralGoogle Scholar
  60. van Os, J., Kenis, G., & Rutten, B. P. F. (2010). The environment and schizophrenia. Nature, 468(7321), 203–212.  https://doi.org/10.1038/nature09563.CrossRefPubMedGoogle Scholar
  61. Veling, W., Selten, J.-P., Veen, N., Laan, W., Blom, J. D., & Hoek, H. W. (2006). Incidence of schizophrenia among ethnic minorities in the Netherlands: A four-year first-contact study. Schizophrenia Research, 86(1–3), 189–193.  https://doi.org/10.1016/j.schres.2006.06.010.CrossRefPubMedGoogle Scholar
  62. Veling, W., Moritz, S., & van der Gaag, M. (2014). Brave new worlds--review and update on virtual reality assessment and treatment in psychosis. Schizophrenia Bulletin, 40(6), 1194–1197.  https://doi.org/10.1093/schbul/sbu125.CrossRefPubMedPubMedCentralGoogle Scholar
  63. Veling, W., Pot-Kolder, R., Counotte, J., van Os, J., & van der Gaag, M. (2016). Environmental social stress, paranoia and psychosis liability: A virtual reality study. Schizophrenia Bulletin, 42(6), 1363–1371.  https://doi.org/10.1093/schbul/sbw031.CrossRefPubMedPubMedCentralGoogle Scholar
  64. Weniger, G., & Irle, E. (2008). Allocentric memory impaired and egocentric memory intact as assessed by virtual reality in recent-onset schizophrenia. Schizophrenia Research, 101(1–3), 201–209.  https://doi.org/10.1016/j.schres.2008.01.011.CrossRefPubMedGoogle Scholar
  65. Wilkins, L. K., Girard, T. A., King, J., King, M. J., Herdman, K. A., Christensen, B. K., & King, J. (2013a). Spatial-memory deficit in schizophrenia spectrum disorders under viewpoint-independent demands in the virtual courtyard task. Journal of Clinical and Experimental Neuropsychology, 35(10), 1082–1093.  https://doi.org/10.1080/13803395.2013.857389.CrossRefPubMedGoogle Scholar
  66. Wilkins, L. K., Girard, T. A., Konishi, K., King, M., Herdman, K. A., King, J., et al. (2013b). Selective deficit in spatial memory strategies contrast to intact response strategies in patients with schizophrenia spectrum disorders tested in a virtual navigation task. Hippocampus, 23(11), 1015–1024.  https://doi.org/10.1002/hipo.22189.CrossRefPubMedGoogle Scholar
  67. Wood, S. J., Yung, A. R., McGorry, P. D., & Pantelis, C. (2011). Neuroimaging and treatment evidence for clinical staging in psychotic disorders: From the at-risk mental state to chronic schizophrenia. Biological Psychiatry, 70(7), 619–625.  https://doi.org/10.1016/j.biopsych.2011.05.034.CrossRefPubMedGoogle Scholar
  68. Zawadzki, J. A., Girard, T. A., Foussias, G., Rodrigues, A., Siddiqui, I., Lerch, J. P., et al. (2013). Simulating real world functioning in schizophrenia using a naturalistic city environment and single-trial, goal-directed navigation. Frontiers in Behavioral Neuroscience, 7.  https://doi.org/10.3389/fnbeh.2013.00180.
  69. Zimmermann, G., Favrod, J., Trieu, V. H., & Pomini, V. (2005). The effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: A meta-analysis. Schizophrenia Research, 77(1), 1–9.  https://doi.org/10.1016/j.schres.2005.02.018.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Arkin BasisGGZ, Amsterdam, The Netherlands & VU UniversityAmsterdamThe Netherlands
  2. 2.Department of PsychiatryUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
  3. 3.Interactive Intelligence GroupDelft University of TechnologyDelftThe Netherlands
  4. 4.Parnassia Psychiatric InstituteThe HagueThe Netherlands

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