Brave New Worlds: Virtual Reality Experiments Linking Psychosis and Social Environment

Epidemiological studies, my own included, have conclusively shown high rates of
psychotic disorders in densely populated urban environments and among ethnic
minorities, likely reflecting the causal influence of environmental exposures.
The common denominator underlying these environmental risks may be repeated
experience of social adversity, leading to sensitization in individuals with
prior psychosis liability and culminating in progressively greater expression
of psychotic responses to cumulative social adversity over time. To date, these
hypotheses remain essentially untested, as it is difficult to accurately
measure the social environment, and individuals* psychological and
physiological responses to it. Recently, however, Virtual Reality (VR)
techniques have been developed, that provide the opportunity for controlled
experimental exposure to different social environments.

In this project, I wish to take a novel step in understanding the influence of
environmental exposures in the aetiology of psychotic disorders, by studying
occurrence of (minor) psychotic symptoms and the (correlates of) physiological
indicators of stress following controlled exposure to virtual social risk
environments.

Key objectives are to investigate:

A. how exposure to the following virtual environments is associated with
development
of physiological stress, paranoid ideations and other (minor) psychotic
symptoms:
1. High population density, 2. Low ethnic density, and 3. Social defeat
B. if the stress / psychotic response is greater in those with:
1. Higher degree of liability to psychosis, 2. Greater cumulative lifetime
experience of
social adversity, 3. Cognitive biases
C. if the stress / psychotic response is associated with (expression of) gene
variants that have previously been related to psychosis

Four groups of individuals (N=50 in each group), with different levels of
liability to psychosis, will be exposed to virtual social risk environments
that have been (hypothesized to be) associated with increased risk for
psychotic disorders in earlier studies, i.e. high population density, low
ethnic density and social defeat. In three experiments with a cross-over
design, I will investigate how exposure to these environments is associated
with development of (minor) psychotic symptoms and physiological stress, and
whether these responses increase with higher level of prior psychosis
liability, higher level of (sensitizing) cumulative lifetime social adversity,
and (expression of) genes that have been related to psychosis in previous
research.

The study concerns one visit to the research centre.

Burden:
- Completing questionnaires
- Three virtual experiments, total time 45 minutes
- Blood draw, twice, in total 40 ml

Risks:
- Emotional burden of completing questionnaires
- Nausea or dizziness as a result of virtual environment
- Potential complications blood draw