Improving Emotion Regulation, Internalizing Symptoms and Cognitive Functions in Adolescents at Risk of Executive Dysfunction—A Controlled Pilot VR Study

Abstract

Executive functions (EFs) are essential cognitive processes involved in concentration, planning, decision-making, and impulse control during adolescence. Executive Dysfunction (ED) can lead to significant academic and socio-emotional difficulties, particularly with impairments in emotion regulation (ER). This study aims to assess a virtual reality (VR) cognitive training intervention on EFs, ER, and internalizing symptoms in adolescents at risk for ED. Thirty-eight adolescents aged 12–14 years, identified as being at moderate to high risk for ED, were randomly assigned to two groups. The experimental group (n = 22) received gamified VR cognitive training, while the control group (n = 16) received VR nature-based relaxation training. Both interventions lasted five weeks, twice a week for 30 min each. Pre- and post-assessments included ER skills, internalizing symptoms, and cognitive performance measures. Two-way mixed ANOVAs showed significant group × time interactions (p < 0.05) in measures of depression and internalizing symptoms. The experimental group showed significant reductions in these symptoms compared with the control group. Significant main effects of time (p < 0.05) were also found on some measures. Both groups experienced reduced anxiety, improved emotional control and cognitive functioning, and VR cognitive training was particularly effective in reducing internalizing symptoms, while both interventions showed promising results in improving some ER skills and cognitive performance. The findings demonstrate the preliminary effects of VR-based cognitive training in improving the psychological and cognitive well-being of adolescents at risk for ED and suggest that integrating VR technologies into educational settings can effectively address the cognitive and emotional challenges faced by these students.