{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:46:47Z","timestamp":1790704007854,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T00:00:00Z","timestamp":1594857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["432-13-802"],"award-info":[{"award-number":["432-13-802"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Many forensic psychiatric inpatients have difficulties regulating aggressive behavior. Evidence of effective aggression treatments is limited. We designed and investigated the effectiveness of a transdiagnostic application of a virtual reality aggression prevention training (VRAPT). In this randomized controlled trial at four Dutch forensic psychiatric centers, 128 inpatients with aggressive behavior were randomly assigned to VRAPT (N = 64) or waiting list control group (N = 64). VRAPT consisted of 16 one-hour individual treatment sessions twice a week. Assessments were done at baseline, post-treatment and at 3-month follow-up. Primary outcome measures were aggressive behavior observed by staff and self-reported aggressive behavior. Analysis was by intention to treat. This trial was registered in the Dutch Trial Register (NTR, TC = 6340). Participants were included between 1 March 2017, and 31 December 2018. Compared to waiting list, VRAPT did not significantly decrease in self-reported or observed aggressive behavior (primary outcomes). Hostility, anger control, and non-planning impulsiveness improved significantly in the VRAPT group compared to the control group at post-treatment. Improvements were not maintained at 3-month follow-up. Results suggest that VRAPT does not decrease aggressive behavior in forensic inpatients. However, there are indications that VRAPT temporarily influences anger control skills, impulsivity and hostility.<\/jats:p>","DOI":"10.3390\/jcm9072258","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T03:23:16Z","timestamp":1595388196000},"page":"2258","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Virtual Reality Aggression Prevention Therapy (VRAPT) versus Waiting List Control for Forensic Psychiatric Inpatients: A Multicenter Randomized Controlled Trial"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4964-593X","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Klein Tuente","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands"},{"name":"Forensic Psychiatric Center (FPC) Dr. S. van Mesdag, Helperlinie 2, 9722 AZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3776-3792","authenticated-orcid":false,"given":"Stefan","family":"Bogaerts","sequence":"additional","affiliation":[{"name":"Department of Developmental Psychology, Tilburg University, Prof Cobbenhagenlaan 225, P.O. Box 90153, 5000 LE Tilburg, The Netherlands"},{"name":"Fivoor, Fivoor Science &amp; Treatment Innovation, Kijvelandsekade 1, 3172 AB Poortugaal, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Bulten","sequence":"additional","affiliation":[{"name":"Division Diagnostics Research and Education, Forensic Psychiatric Hospital Pompefoundation, Weg door Jonkerbos 55, 6532 CN Nijmegen, The Netherlands"},{"name":"Behavioral Science Institute (BSI) of Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4819-1152","authenticated-orcid":false,"given":"Marije","family":"Keulen-de Vos","sequence":"additional","affiliation":[{"name":"Forensic Psychiatric Center (FPC) de Rooyse Wissel, P.O. Box 433, 5800AK Venray, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-7573","authenticated-orcid":false,"given":"Hein","family":"Bokern","sequence":"additional","affiliation":[{"name":"Forensic Psychiatric Center (FPC) Dr. S. van Mesdag, Helperlinie 2, 9722 AZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah van","family":"IJzendoorn","sequence":"additional","affiliation":[{"name":"Fivoor, Fivoor Science &amp; Treatment Innovation, Kijvelandsekade 1, 3172 AB Poortugaal, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6401-2073","authenticated-orcid":false,"given":"Chris N. W.","family":"Geraets","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Veling","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Broderick, C., Azizian, A., Kornbluh, R., and Warburton, K. (2015). Prevalence of physical violence in a forensic psychiatric hospital system during 2011\u20132013: Patient assaults, staff assaults, and repeatedly violent patients. 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