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The primary outcome was Kikuchi's Social Skills Scale\u201318 (KiSS\u201018); secondary outcomes were social adaptation, social anxiety, and depressive symptoms (self\u2010report). A linear mixed\u2010effects model tested the effects of Time (pre vs post), baseline Autism\u2010Spectrum Quotient (AQ; mean\u2010centered), and their interaction. Feasibility was assessed via attendance and attrition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Attendance was 94.2% with no attrition. KiSS\u201018 increased from 49.7\u2009\u00b1\u200910.6 to 53.5\u2009\u00b1\u200912.4 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028;\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.56). The model showed significant effects of Time (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2(1)\u2009=\u20098.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and Time\u2009\u00d7\u2009AQ (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      \u00b2(1)\u2009=\u20094.46,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035), suggesting smaller gains at higher AQ (exploratory; restricted AQ range). Emotional processing and stress management subscales improved; secondary outcomes showed no significant change. Bootstrap analyses were consistent with the mixed\u2010model findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SST\u2010VR was feasible. Because the single\u2010arm add\u2010on design cannot isolate SST\u2010VR\u2013specific effects from concurrent care and nonspecific influences, the KiSS\u201018 change is hypothesis\u2010generating. Controlled comparisons with Re\u2010Work alone in larger, more diverse samples should test efficacy, include objective behavioral and vocational outcomes, and prospectively evaluate moderation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pcn5.70289","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T11:24:56Z","timestamp":1770031496000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Embedding virtual reality social skills training into return\u2010to\u2010work care for depression: A single\u2010arm feasibility pilot with exploratory autistic\u2010trait moderation"],"prefix":"10.1002","volume":"5","author":[{"given":"Yutaro","family":"Akaki","sequence":"first","affiliation":[{"name":"Seishinkai Medical Corporation Fujita Mental Care Satellite Tokushige\u2010Kita Re\u2010Work Center Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8486-022X","authenticated-orcid":false,"given":"Yasuhisa","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Faculty of Health Sciences Nihon Fukushi University Handa Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Seishinkai Medical Corporation Fujita Mental Care Satellite Tokushige\u2010Kita Re\u2010Work Center Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Okuyama","sequence":"additional","affiliation":[{"name":"Seishinkai Medical Corporation Fujita Mental Care Satellite Tokushige\u2010Kita Re\u2010Work Center Nagoya Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoshi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Okehazama Hospital Fujita Kokoro Care Center Toyoake Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-62381-9"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.07.054"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000028845"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.608496"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.06.035"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.07.002"},{"key":"e_1_2_13_8_1","first-page":"361","article-title":"Interpersonal theory and the treatment of depression","volume":"15","author":"Hilsenroth MJ","year":"2019","journal-title":"Annu Rev Clin Psychol"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(98)00104-4"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.944472"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-33703-0"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-3588.00051"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/014544558044008"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/6564098"},{"key":"e_1_2_13_15_1","doi-asserted-by":"crossref","unstructured":"SagaT TanakaH IwasakaH MatsudaY MorimotoT UrataniM et al. 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