Introduced in 1986 by Jaron Lanier, virtual reality is experiencing an exponential interest in psychological researches. Recently, applications as a clinical therapeutic tool in psychopathology and in the field of cognitive and behavioral therapy have been developed. Then, new applications emerged to evaluate and remedy cognitive difficulties in the field of cognitive psychopathology and neuropsychology. Virtual reality offers a rich, dynamic, and flexible environment that allows the creation of an ecological evaluation context in contrast to most traditional paper and pencil or computerized evaluation tools.
The scientific challenges associated with the study of attentional and executive functions reflect their key role in the individual autonomy and daily activities. These cognitive functions are essential to ensure good mental and physical health, academic and professional success, good cognitive, social and psychological development. Their implication in many psychopathological disorders and neurological diseases, and their interaction with most cognitive processes, have been widely demonstrated. Neuropsychological evaluation constitutes one of the decisive elements for an adapted treatment of these functions in a pathological context. The evaluation steps must be the most exhaustive as possible and sensitive to all the difficulties encountered by the individual in his daily life. In this context, many tests are used to measure these functions but have limitations, particularly in terms of ecological validity. In this sense, virtual reality is a tool that seems to offer precise, multiple (according to the sensory modalities involved) and standardized measurements in an environment close to daily situations.
The general aim of the present study was to explore the relevance of virtual reality for the evaluation of executive and attentional functions, in comparison with traditional paper-and-pencil evaluation tools. More precisely, the aim was to validate the French version of Nesplora aquarium, initially designed to examine attentional and executive capacities in adult people. Our specific goal was to obtain data to assure its psychometric validity (convergent, divergent and criterion validity), and its sensitivity for the evaluation of executive and attentional functions. The utility of this research was to propose an ecological tool for research and clinical examination of executive and attentional functions adapted to the French population. By using the virtual reality technology, Nesplora Aquarium allows to recreate a virtual museum/aquarium with a central room overlooking different art paintings and aquariums.
With reference to our hypotheses, we expected an age effect which is classically translated by a decrease in attentional and executive capacities. We therefore expected to find lower scores in Nesplora aquarium for middle-aged adults (41-60 years) compared to young adults (16-40 years). In addition, we expected that men perform better than women on all indices.
To test the convergent validity of Nesplora Aquarium, we made correlational analyzes between the Trail Making Test B (TMT-B), the digit code symbol test, and all the scores from Nesplora Aquarium. Similar to the Nesplora Aquarium validation study, we compared participants scores on the Nesplora Aquarium tests (visual response speed, visual inhibitory control, visual sustained attention, visual selective attention, mental flexibility, and divided attention) with the reaction time of the TMT-B and the number of items completed on the digit code symbol test.
In accordance with the original Nesplora study, we examined the effects of state-trait anxiety using the STAI on all test scores. Even though anxiety has not been found to be a disruptive factor in Nesplora performance in previous studies, it seemed essential to us to control this variable in our participants in order to examine these potential effects on the Nesplora Aquarium performance.
Our results indicate that Nesplora Aquarium has very good psychometric properties regarding the convergent validity between digit code symbol test and the TMT B. Our results support precisely with the data from the Nesplora Aquarium validation study. However, we found a weak effect of age on performances and no differences in performance between women and men. Nesplora Aquarium is a test that does not seem to be sensitive to anxiety, especially on the anxiety traits (STAI YB). It is therefore a promising test for diagnosing attentional and executive disorders.
MARONGIU Zaccaria