Preliminary Findings From an Augmented Reality (AR) App Delivering Recovery-Oriented Cognitive Therapy for Negative Symptoms in Schizophrenia

Abstract

Background: NST-SPARK is a novel digital therapeutic targeting negative symptoms in schizophrenia spectrum disorders (SSD). It is a smartphone application delivering recovery-oriented cognitive therapy (CT-R), via gamified augmented reality (AR) experiences. The primary objective was to determine the acceptability and feasibility of a single-session prototype. Secondary objectives were to generate descriptive findings for changes in defeatist beliefs, self-esteem and attitudes toward goal-oriented activities. Methods: Twenty participants with schizophrenia or schizoaffective disorder enrolled. Participants completed self-reports on the acceptability and feasibility of NST-SPARK v.1.5 and provided open-ended feedback. Self-report scales on defeatist beliefs, self-esteem and attitudes toward goal-oriented activities were completed before and after participants were introduced to NST-SPARK, and at 1-week follow-up. Results: Participants found NST-SPARK to be feasible and acceptable, with an average response of ‘Agree’, indicating that the intervention met with the participants' approval and seemed implementable. Almost all participants (19 of 20) used the app on their own prior to the 1-week follow up despite not being incentivised. We also observed changes in defeatist beliefs, self-esteem and attitudes toward goal attainment consistent with intended improvements in these targeted areas. Participants made substantive progress toward identified goals in 90% of cases. The most common positive feedback was appreciation that the app got them going, and the most common negative feedback pointed out technical aspects that did not function properly. Conclusions: This preliminary, single-arm, unblinded study of a single-module prototype for NST-SPARK found that the approach is generally acceptable and feasible for people with SSD and negative symptoms.