Chris N W Geraets1, Marije van Beilen2, Roos Pot-Kolder3, Jacqueline Counotte4, Mark van der Gaag3, Wim Veling5. 1. University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30 001, 9700 RB Groningen, The Netherlands. Electronic address: c.n.w.geraets@umcg.nl. 2. University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30 001, 9700 RB Groningen, The Netherlands. 3. Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands; VU University, Department of Clinical Psychology, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands. 4. Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands. 5. University of Groningen, University Medical Center Groningen, Department of Psychiatry, PO Box 30 001, 9700 RB Groningen, The Netherlands; Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands; Maastricht University, Department of Psychiatry and Neuropsychology, PO Box 616, 6200 MD Maastricht, The Netherlands.
Abstract
BACKGROUND: Experimentally studying the influence of social environments on mental health and behavior is challenging, as social context is difficult to standardize in laboratory settings. Virtual Reality (VR) enables studying social interaction in terms of interpersonal distance in a more ecologically valid manner. Regulation of interpersonal distance may be abnormal in patients with psychotic disorders and influenced by environmental stress, symptoms or distress. AIMS: To investigate interpersonal distance in people with a psychotic disorder and at ultrahigh risk for psychosis (UHR) compared to siblings and controls in virtual social environments, and explore the relationship between clinical characteristics and interpersonal distance. METHODS: Nineteen UHR patients, 52 patients with psychotic disorders, 40 siblings of patients with a psychotic disorder and 47 controls were exposed to virtual cafés. In five virtual café visits, participants were exposed to different levels of social stress, in terms of crowdedness, ethnicity and hostility. Measures on interpersonal distance, distress and state paranoia were obtained. Baseline measures included trait paranoia, social anxiety, depressive, positive and negative symptoms. RESULTS: Interpersonal distance increased when social stressors were present in the environment. No difference in interpersonal distance regulation was found between the groups. Social anxiety and distress were positively associated with interpersonal distance in the total sample. CONCLUSION: This VR paradigm indicates that interpersonal distance regulation in response to environmental social stressors is unaltered in people with psychosis or UHR. Environmental stress, social anxiety and distress trigger both people with and without psychosis to maintain larger interpersonal distances in social situations.
BACKGROUND: Experimentally studying the influence of social environments on mental health and behavior is challenging, as social context is difficult to standardize in laboratory settings. Virtual Reality (VR) enables studying social interaction in terms of interpersonal distance in a more ecologically valid manner. Regulation of interpersonal distance may be abnormal in patients with psychotic disorders and influenced by environmental stress, symptoms or distress. AIMS: To investigate interpersonal distance in people with a psychotic disorder and at ultrahigh risk for psychosis (UHR) compared to siblings and controls in virtual social environments, and explore the relationship between clinical characteristics and interpersonal distance. METHODS: Nineteen UHR patients, 52 patients with psychotic disorders, 40 siblings of patients with a psychotic disorder and 47 controls were exposed to virtual cafés. In five virtual café visits, participants were exposed to different levels of social stress, in terms of crowdedness, ethnicity and hostility. Measures on interpersonal distance, distress and state paranoia were obtained. Baseline measures included trait paranoia, social anxiety, depressive, positive and negative symptoms. RESULTS: Interpersonal distance increased when social stressors were present in the environment. No difference in interpersonal distance regulation was found between the groups. Social anxiety and distress were positively associated with interpersonal distance in the total sample. CONCLUSION: This VR paradigm indicates that interpersonal distance regulation in response to environmental social stressors is unaltered in people with psychosis or UHR. Environmental stress, social anxiety and distress trigger both people with and without psychosis to maintain larger interpersonal distances in social situations.