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BackgroundAlcohol use disorder (AUD) has been associated with diverse physical and mental morbidities. Among the main consequences of chronic and excessive alcohol use are cognitive and executive deficits. Some of these deficits may be reversed in specific cognitive and executive domains with behavioral approaches consisting of cognitive training. The advent of computer-based interventions may leverage these improvements, but randomized controlled trials (RCTs) of digital interactive-based interventions are still scarce. ObjectiveThe aim of this study is to explore whether a cognitive training approach using VR exercises based on activities of daily living is feasible for improving the cognitive function of patients with AUD undergoing residential treatment, as well as to estimate the effect size for this intervention to power future definitive RCTs. MethodsThis study consisted of a two-arm pilot RCT with a sample of 36 individuals recovering from AUD in a therapeutic community; experimental group participants received a therapist-guided, VR-based cognitive training intervention combined with treatment as usual, and control group participants received treatment as usual without cognitive training. A comprehensive neuropsychological battery of tests was used both at pre- and postassessments, including measurement of global cognition, executive functions, attention, visual memory, and cognitive flexibility. ResultsIn order to control for potential effects of global cognition and executive functions at baseline, these domains were controlled for in the statistical analysis for each individual outcome. Results indicate intervention effects on attention in two out of five outcomes and on cognitive flexibility in two out of six outcomes, with effect sizes in significant comparisons being larger for attention than for cognitive flexibility. Patient retention in cognitive training was high, in line with previous studies. ConclusionsOverall, the data suggest that VR-based cognitive training results in specific contributions to improving attention ability and cognitive flexibility of patients recovering from AUD. Trial RegistrationClinicalTrials.gov NCT04505345; https://clinicaltrials.gov/show/NCT04505345

BackgroundMemory and attention are two cognitive domains pivotal for the performance of instrumental activities of daily living (IADLs). The assessment of these functions is still widely carried out with pencil-and-paper tests, which lack ecological validity. The evaluation of cognitive and memory functions while the patients are performing IADLs should contribute to the ecological validity of the evaluation process. ObjectiveThe objective of this study is to establish normative data from virtual reality (VR) IADLs designed to activate memory and attention functions. MethodsA total of 243 non-clinical participants carried out a paper-and-pencil Mini-Mental State Examination (MMSE) and performed 3 VR activities: art gallery visual matching task, supermarket shopping task, and memory fruit matching game. The data (execution time and errors, and money spent in the case of the supermarket activity) was automatically generated from the app. ResultsOutcomes were computed using non-parametric statistics, due to non-normality of distributions. Age, academic qualifications, and computer experience all had significant effects on most measures. Normative values for different levels of these measures were defined. ConclusionsAge, academic qualifications, and computer experience should be taken into account while using our VR-based platform for cognitive assessment purposes.

BackgroundThe consequences of alcohol dependence are severe and may range from physical disease to neuropsychological deficits in several cognitive domains. Alcohol abuse has also been related to brain dysfunction specifically in the prefrontal cortex. Conventional neuropsychological interventions (paper-and-pencil cognitive stimulation training) have a positive effect but are time-consuming, costly, and not motivating for patients. ObjectiveOur goal was to test the cognitive effects of a novel approach to neuropsychological intervention, using mobile technology and serious games, on patients with alcohol dependence. MethodsThe trial design consisted of a two-arm study assessing the cognitive outcomes of neuropsychological intervention with mobile serious games (mHealth) versus control (treatment-as-usual with no neuropsychological intervention) in patients undergoing treatment for alcohol dependence syndrome. Sixty-eight patients were recruited from an alcohol-rehab clinic and randomly assigned to the mHealth (n=33) or control condition (n=35). The intervention on the experimental group consisted of a therapist-assisted cognitive stimulation therapy for 4 weeks on a 2-3 days/week basis. ResultsFourteen patients dropped out of the study. The results of the neuropsychological assessments with the remaining 54 patients showed an overall increase (P

First responders (FRs) are continuously exposed to critical incidents, considered traumatic events (TEs). This cumulative exposure increases the risk for post-traumatic stress disorder (PTSD). However, there is no evidence about the relationship between PTSD symptoms and emergency decision-making (EDM). The objective of this study was to examine the EDM of FRs during a virtual reality through the simulation of two emergency scenarios to collect data on the reaction time and the number of incorrect decisions. We also assessed PTSD symptoms, TE, and sociodemographics. The sample included 368 Portuguese FRs, were 295 (80.20%) males and 73 (19.80%) females, with a mean age of 33.96 (SD = 9.38). Considering the probable PTSD diagnosis according to the DSM-5, 85 (23.10%) of the FRs met the criteria. These individuals who meet the criteria exhibited higher EDM scores (M = 19.60, SD = 5.99) compared to those without probable PTSD (M = 17.87, SD =.5.66) (F(1, 360) = 5.32, p =.02, partial η2 =.015). We found that TEs had a direct effect on EDM, β = −.16, Z = −3.74, p <.001), and the pathway of trauma-PTSD symptoms-decision-making an indirect effect, β =.02, Z = 3.10, p =.002). Individuals exposed to more TEs demonstrated faster and more accurate decision-making in the context of EDM. However, when these individuals developed PTSD symptoms, their decision-making became slower and less accurate. The inclusion of a trauma-informed approach for FRs to prevent individual and job-related consequences is discussed. [ABSTRACT FROM AUTHOR]

(1) Background: To mitigate COVID-19 transmission, global public health interventions were swiftly implemented. However, a comprehensive understanding of individual variations in adhering to these recommendations remains elusive. Addressing this gap is crucial for effectively managing future epidemic and pandemic scenarios. This study aims to explore individual differences in attachment, emotion regulation, and risk for COVID-19 infection using virtual reality (VR). (2) Methods: The sample included 73 (88%) university students and 10 (12%) university staff. Participants completed questionnaires on sociodemographic information, the Difficulties in Emotion Regulation Scale, the Experiences in Close Relationships—Relationship Structures Questionnaire, and the fear of COVID-19 Scale. Additionally, each participant engaged in five daily situations using a VR simulator to assess the risk of COVID-19 infection. (3) Results: Our study revealed that high levels of attachment anxiety, difficulties controlling impulsive behaviors, and limited access to emotion regulation strategies were strong predictors of elevated risk of COVID-19 infection. Conversely, high levels of fear of COVID-19 and attachment avoidance were associated with lower risk of COVID-19 infection. (4) Conclusions: We discuss the importance of policymakers and health professionals being aware of some psychological characteristics that make it difficult for some individuals to adhere to public health measures involving social distancing. [ABSTRACT FROM AUTHOR]

The acquired brain injuries (ABI) have consequences that affect the patients' autonomy, particularly regarding activities of daily living (ADL). To reduce the impact that these changes will have on the patient's life, it is important to develop diversified tasks with which individuals can train and improve their impaired abilities and strengthen those that are preserved. Therefore, this study aimed to validate a virtual ATM (Automated Teller Machine) task to be used to train patients with cognitive impairments. The sample consisted of 34 participants with ABI and 66 healthy controls. These participants performed the task either virtually or with a real ATM. Beyond revealing that the type of environment did not influence task performance, the results showed a relationship between the results of cognitive screening measures and the time to complete the task, in which participants with the lowest results had worse performance in the task. Also, the virtual ATM was more sensitive in discriminating the clinical group than the real task. [ABSTRACT FROM AUTHOR]

Recent studies argue that the use of virtual reality tasks depicting activities daily living may be effective means for cognitive rehabilitation. The aim of this study was to test an ecologically oriented approach in virtual reality resembling the demands of everyday life activities for cognitive rehabilitation following stroke. The sample comprised 30 sub-acute stroke patients recovering from stroke in a rehabilitation hospital. They were assessed in a single-arm pre-post intervention study on global cognition, executive functions, memory and attention abilities. The intervention consisted of virtual reality in a multidomain cognitive training approach depicting everyday life tasks (preparing food, choosing clothes, shopping, etc.). Improvements were found in the assessed cognitive domains at 6 to 10 post-treatment sessions. In-depth analysis through reliable change scores has suggested larger treatment effects on global cognition. Overall results suggest that the use of virtual reality-based exercises on everyday life activities may be a useful cognitive rehabilitation approach to provide short-term gains in cognition following stroke. Virtual reality-based cognitive rehabilitation resembling everyday life activities may provide short-term gains in cognition of stroke patients; Consistent improvements in executive functions may require higher treatment dosage than for improvements in global cognition. [ABSTRACT FROM AUTHOR]