Using a virtual reality 'social situation' task to assess associations between paranoid ideation and social performance

Objectives: Paranoid ideation and social performance impairments overlap significantly. Virtual reality (VR) can enable psychological assessment in ecologically valid social environments. This project, in two linked studies,... [ view full abstract ]

Objectives: Paranoid ideation and social performance impairments overlap significantly. Virtual reality (VR) can enable psychological assessment in ecologically valid social environments. This project, in two linked studies, aimed to recruit a general population sample; test for paranoid ideation and its correlates with cognitive, affective, and behavioural components of social performance; then piloted a new VR ‘social situation’ paradigm in non-clinical participants with high and low paranoid ideation; and to investigate whether these components of social performance and mood were associated with increased paranoid ideation in a VR ‘social situation’ task. Design: Study 1 was a cross-sectional cohort study. Study 2 was a cross-sectional comparison study. Method: In Study 1, a general population online survey (N=609) investigated how trait paranoia related to components of social performance and mood. In Study 2, two groups were formed from Study 1: participants who scored high and low in trait paranoia (N=89) entered a VR ‘social situation’ task to evaluate the acceptability of the VR task and the relationship between paranoid ideation and social performance. Results: As hypothesised, in Study 1, trait paranoia was associated with components of social performance; in Study 2, participants found the VR environment acceptable and immersive; exposure to the VR environment elicited a range of cognitive, affective, and behavioural components of social performance; and high trait paranoia participants reported higher state paranoia and greater negative components of social performance. Conclusions: The VR task has assessment and treatment applications for people with psychosis, who can experience paranoia in social situations.