物质使用障碍作为一种慢性高复发性脑疾病,是复杂的生物、心理、社会多元因素相互作用的结果.应对这一难以治愈的脑疾病,需要在整合生物-社会-心理医学模式指导下,运用多种不同的干预手段进行综合治疗.目前该领域正在探索一种新的治疗技术,利用虚拟现实的沉浸式、交互式、构想式技术优势获得增强的线索反应模式,提供成瘾相关的多因素交互的虚拟环境,在现有线索暴露疗法及行为干预治疗技术及疗效方面可能获得新的突破.本文总结近10年来这一领域的研究进展,内容包括:利用虚拟现实技术获得增强的线索反应模式提高渴求评估的生态效度,利用虚拟现实技术改进线索暴露疗法的效用,以及利用虚拟环境呈现高危复吸情境的应对技能训练. 更多还原

Substance use disorder（SUD） is a chronic brain disease with a high rate of relapse that results from the complex interaction amongst physical, psychological, and social factors. To deal with this intractable brain disease, it is necessary to utilize a variety of treatment methods for comprehensive intervention under the guidance of integrative physical-social-psychological treatment model. Currently, the virtual reality（VR） technologies has been successfully used to investigate the effects of specific and context cue on the emotional, cognitive and behavioral response and craving in the persons with SUD, and new treatment methods on SUD with VR have been well developing. This technique synthesizes the immersive, interactive, and constructive technological advantages of VR to provide a complex changeable multi-factor interactive virtual environment. With the aid of VR technique, it is hoped that the quality and effects of cue-exposure therapy and behavioral therapy will make a new breakthrough. This article summarizes the research advances in this field within the last decade. It includes： To improve the validity of craving assessment by providing the drug-related cues and contexts more similar with the real life environments, combined with multiple levels of craving assessment methods like subjective report, eye movement tracking, heart rate, galvanic skin response and electroencephalograph; To improve the ecological validity of cue exposure therapy by extinguishing the cue response with multiple drug-related cues and contexts, and the trans-context extinction training will reduce the spontaneous recovery, which is the big challenge in regular cue exposure therapy; To improve the coping skill on how to deal with high relapse risk environments by training the coping skills in the virtual environments with social pressure context associated with drug-related cues; To improve the therapeutic effect of regular psychological and behavioral therapy, like cognitive behavioral therapy. In sum, the virtual reality procedures have some advantages in the subjective and objective assessment of craving, and improvement of therapeutic effect by providing a flexible and controllable platform to integrate different psychological and behavioral therapies under the virtual environments with specific complex drug-related cues, contexts and social interaction. The specificity created by virtual reality techniques holds the great promise to the development of individualized care and treatment in SUD. The future researches will focus on how to increase the sense of presence and reduce the sensations of nausea, and then to elevate the individual involvement to the virtual environments.