Improve your skills with virtual reality: Enhancing and understanding treatment effects for aggressive behavior problems in children

Abstract

Aggressive behavior problems in school-aged children are of high concern, given the high prevalence and risk for adverse outcomes later in life. Intervention programs therefore target these problems as they arise in childhood, however, treatment effects are modest and do not benefit all children. The overall aim of this dissertation was to enhance and better understand treatment effects for children with aggressive behavior problems. The first part of this dissertation focuses on whether treatment effects for children with aggressive behavior problems can be enhanced using interactive virtual reality. The new cognitive behavioral therapy ‘YourSkills’ was developed, in which children actively practice new skills. Findings indicate that virtual reality can be an effective method to enhance treatment outcomes. Practicing in an emotionally emerging and immersive real-life environment yielded not only improvements in effectiveness but also higher levels of children’s treatment appreciation. In the second part of this dissertation, we aimed to increase our understanding of potential treatment mechanisms. Findings provided within-person evidence for anger regulation and hostile intent attribution as treatment mechanisms to reduce aggressive behavior problems. In conclusion, this dissertation showed that a new treatment using active practice is effective for children with aggressive behavior problems. In addition, virtual reality enabled children to enjoy practicing their new skills within the intervention.