Training Reward Responsiveness Through Virtual Reality

Change in reported anhedonia (score range: 14-70), with higher scores indicating greater anhedonic symptom severity

Change in reward anticipation, motivation, and consumption for rewards such as rewards such as food, physical touch, positive feedback, social interactions, hobbies and goals (score range: 21-105). Higher scores (e.g. 105) indicate higher reward responsiveness.

Reported symptoms of depression (score range: 0-21), anxiety (score range: 0-21), and stress (score range: 0-21), higher scores indicate higher severity and frequency.

Change in reported positive affect and negative affect (score range for each scale: 10-50, higher scores indicate higher levels of positive affect or negative affect) and will be measured weekly.

The PANAS-X is a comprehensive measure comprised of 60 items assessing positive affect and negative affect. The PANAS-X will be administered at each assessment point

Change in rumination and dampening (Score range: 17-68). Higher scores indicate greater rumination and dampening.

The WSAS is used to assess the degree of impairment of a) work activities b) social life and leisure activities, and c) family life and home responsibilities. The scale discriminates depressed or anxious individuals in primary care who differ in impairment. Participants must score a 10 or above as their total, overall score to be included in the study.

The IPQ is a measure of 14 items assessing the sense of present in a virtual environment. The IPQ will be administered at each assessment point besides baseline.

Change in accuracy in recalling neutral memories. Participants verbally recall a neutral distant memory (i.e., a memory that occurred longer than 2 weeks ago but closer than 3 months ago) and neutral recent (i.e., within past week) memory, then provide a word and sentence cue for each, to be used in future assessment sessions. At post-treatment and follow-up, the participants will be reminded of their word and sentence cue and recall both memories again verbally.

Change in heart rate variability (HRV). Data will be collected through actigraphy during session 1, 7, and 14. These data will be collected via a polar heartbeat monitor and actigraphy watch pairing. Actigraphy will be collected while the participant watches both VR scenes, the VR recall, and either the personal memory recall (eVR-RT) or the short story recall (VR-MT).

A Visual Analogue Scale for Affect will be completed throughout the VR session, which assesses state affect before and after VR scenes and recountings. Higher scores (score range: 1-9) indicate higher affect.

In a subset of 8 reward participants, the neural measure of reward-relevant neural reactivity including the ventral striatum and the medial orbitofrontal cortex (measured by fMRI) to assess change in reward processing from week 0 assessment to post-treatment. First-level voxel-wise z-statistics will be generated, contrasting reward anticipation (i.e., Win $0.50, Win $5.00) vs nonreward (i.e., Win $0.00), loss anticipation (i.e., Lose $0.50, Lose $5.00) vs non-loss (i.e., Lose $0.00), outcome of gain vs no-gain, and outcome of loss vs no-loss129.

A small blood sample (approximately 1/8th teaspoon) will be collected at baseline, mid-treatment, post-treatment, and follow-up to measure peripheral inflammatory markers at these time points.

Change in a composite score of depressive symptoms including anhedonia (Measured by MASQ-AD), Depression (Measured by DASS-D), and low positive affect (Measured by PANAS).