Virtual Reality Aggression Prevention Training in forensic clinics

Besides being perpetrators, forensic inpatients are also more likely to become victims of aggression. Reactive aggression is an impulsive and uncontrolled outburst of anger as a reaction on a perceived provocation, often involving problems with Social Information Processing (SIP). The SIP-model is used as a framework for Virtual Reality Aggression Prevention Training (VRAPT). VRAPT is an interactive three-dimensional virtual environment in which inpatients have the opportunity to practice with aggressive behavior of virtual characters. In an iterative process, software engineers, VR experts, clinicians and researchers developed the VRAPT protocol.
VRAPT consists of 16-biweekly individual treatment sessions. Different interactive provocative social scenarios were designed with the main focus on controlling behavior, emotions and impulses. During these interactive scenarios participants wear earphones and a head-mounted display while arguing with a virtual character that is controlled by the therapist. Therapists deliver the dialogue and control speech, emotions and actions of the virtual character. Besides, VRAPT measures real-time galvanic skin response and heart rate as feedback for participants on their physical arousal.
All participants are monitored with the Social Dysfunction and Aggression Scale by staff for aggression on a weekly basis. Additionally, pre- and after treatment; and at three months follow-up self-report questionnaires will be completed. The development of the VRAPT protocol and the pilot was successful. Following the evaluation after the pilot a few adaptations in the VRAPT protocol and software were made. The multicenter randomized controlled trial is still ongoing.

Besides being perpetrators, forensic inpatients are also more likely to become victims of aggression. Reactive aggression is an impulsive and uncontrolled outburst of anger as a reaction on a perceived provocation, often involving problems with Social Information Processing (SIP). The SIP-model is used as a framework for Virtual Reality Aggression Prevention Training (VRAPT). VRAPT is an interactive three-dimensional virtual environment in which inpatients have the opportunity to practice with aggressive behavior of virtual characters.

Data will be collected at baseline (T0), pre-treatment (T1), after treatment (T2) and at three-month follow-up (T3).

In both arms treatment as usual (with the exception of specific aggression therapy or training) will be provided for the forensic psychiatric patients. In the first experimental arm there will be a maximum of 16-biweekly individual treatment sessions Virtual Reality Aggression Prevention Training (VRAPT). Treatment duration is about two months and patients will be followed-up at 3 months. The second arm entails a waiting list and after the study, these participants will also get VRAPT.