4 - (SYM 85) Virtual Reality for Suicidal Behavior

  

Background: Evidence for the effectiveness of virtual reality (VR) exposure treatment for various forms of psychopathology (e.g., obsessive-compulsive disorders) associated with risky or maladaptive safety behaviors is mounting. Recently, VR was implemented as a training tool for suicide risk assesment and VR suicidal behavior (SB) scenarios been shown to be a valid and safe proxy for SB in research; however, it’s potential as a therapeutic tool has received little attention. VR offers a novel platform for the extension of exposure-based interventions for suicide risk.

  

Methods: Participants (n = 48) were young adults (Mage = 25.3; 78% female) with recent suicidal ideation (SI) or SB recruited from a larger study examining the effects of social exclusion on decision-making, physiological arousal, and risk for SB assessed in-lab using VR SB decision scenarios. These scenarios involve the explicit choice between engaging in a VR SB (jumping, shooting oneself) and a non-SB. Suicide risk and related factors were assessed via subjective ratings, psychophysiology, and electroencephalography (EEG) data obtained in lab, self-report, and suicide risk interviews at baseline and 4-month follow-up. Data collection is ongoing and analyses will be updated with a larger sample. 

  

Results: Exposure to VR SB decision scenarios were associated with reduced hopelessness, wish to die, and fearlessness about death, and increased wish to live. Most participants reported minimal distress and none reported exposure to VR SB scenarios increased their likelihood of a suicide attempt. The vast majority of participants reported the VR SB scenarios decreased their likelihood of a suicide attempt immediately (57%) and at 4-month follow-up (71%). Reduction in rates and severity of SI and SB were observed at 4-month follow-up. These findings were observed in both participants who chose to engaged (n = 8) and did not engage in a VR suicide attempt. Psychophysiology and EEG data were feasible to collect with high quality in this context.
  

Conclusions: A moderately powered pilot trial observed that exposure to VR SB decision scenarios, were associated with short-term reductions in suicide risk factors and strengthening of protective factors, as well as decreased self-reported likelihood of a suicide attempt. Adverse incidents were minimal and fewer than most therapeutic trials. These data suggest that VR SB scenarios should be considered as a potential adjunctive therapeutic tool that warrants further investigation, which is amenable to contemporary neuroscience methods.