Validation of an Upgraded Virtual Reality Platform Designed for Real-Time Dialogical Psychotherapies

Background: The advent of virtual reality in psychiatry presents a wealth of opportunities for a variety of psychopathologies. Avatar Interventions are dialogic and experiential treatments integrating personalized medicine with virtual reality (VR), which have shown promising results by enhancing the emotional regulation of their participants. Notably, Avatar Therapy for the treatment of auditory hallucinations (i.e., voices) allows patients to engage in dialogue with an avatar representing their most persecutory voice. In addition, Avatar Intervention for cannabis use disorder involves an avatar representing a significant person in the patient’s consumption. In both cases, the main goal is to modify the problematic relationship and allow patients to regain control over their symptoms. While results are promising, its potential to be applied to other psychopathologies, such as major depression, is an exciting area for further exploration. In an era where VR interventions are gaining popularity, the present study aims to investigate whether technological advancements could overcome current limitations, such as avatar realism, and foster a deeper immersion into virtual environments, thereby enhancing participants’ sense of presence within the virtual world. A newly developed virtual reality platform was compared to the current platform used by our research team in past and ongoing studies. Methods: This study involved 43 subjects: 20 healthy subjects and 23 subjects diagnosed with severe mental disorders. Each participant interacted with an avatar using both platforms. After each immersive session, questionnaires were administered by a graduate student in a double-blind manner to evaluate technological advancements and user experiences. Results: The findings indicate that the new technological improvements allow the new platform to significantly surpass the current platform as per multiple subjective parameters. Notably, the new platform was associated with superior realism of the avatar (d = 0.574; p < 0.001) and the voice (d = 1.035; p < 0.001), as well as enhanced lip synchronization (d = 0.693; p < 0.001). Participants reported a significantly heightened sense of presence (d = 0.520; p = 0.002) and an overall better immersive experience (d = 0.756; p < 0.001) with the new VR platform. These observations were true in both healthy subjects and participants with severe mental disorders. Conclusions: The technological improvements generated a heightened sense of presence among participants, thus improving their immersive experience. These two parameters could be associated with the effectiveness of VR interventions and future studies should be undertaken to evaluate their impact on outcomes.