Virtual reality (VR) integrates real-time computer graphics, body tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer-generated virtual environment that changes in a natural way with head and body motion. VR exposure (VRE) is proposed as an alternative to typical imaginal exposure treatment for Vietnam combat veterans with posttraumatic stress disorder (PTSD). This report presents the results of the first Vietnam combat veteran with PTSD to have been treated with VRE. The patient was exposed to two virtual environments, a virtual Huey helicopter flying over a virtual Vietnam and a clearing surrounded by jungle. The patient experienced a 34% decrease on clinician-rated PTSD and a 45% decrease on self-rated PTSD. Treatment gains were maintained at 6-month follow-up.

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Post Traumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experience including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that at least 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) delivered exposure therapy for PTSD has been used with reports of positive outcomes. The aim of the current paper is to present the rationale and brief description of a Virtual Iraq PTSD VR therapy application and present initial findings from two successfully treated patients. The VR treatment environment was created via the recycling of virtual graphic assets that were initially built for the U.S. Army-funded combat tactical simulation scenario and commercially successful X-Box game, Full Spectrum Warrior, in addition to other available and newly created assets. Thus far, Virtual Iraq consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback needed to iteratively evolve the system was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Clinical trials are currently underway at Camp Pendleton and at the San Diego Naval Medical Center and the results from two successfully treated patients are presented along with a delineation of our future plans for research and clinical care using this application.

Virtual reality (VR) technology offers new options for the creation of sophisticated tools that could be applied in the areas of assessment and rehabilitation of cognitive and functional processes. VR systems allow for the precise presentation and control of dynamic, multisensory, three-dimensional (3-D) stimulus environments, as well as the recording of all behavioral responses that occur within them. Assessment and rehabilitation scenarios that would be difficult if not impossible to deliver using conventional neuropsychological methods are now being developed that take advantage of these VR assets. If empirical studies demonstrate effectiveness, virtual environments (VEs) could be of considerable value for better understanding, measuring, and treating persons with impairments due to traumatic brain injury, neurological disorders, and learning disabilities. This article describes the progress of a VR research program at the USC Integrated Media Systems Center and Information Sciences Institute that has developed and investigated the use of a series of VEs designed to target (i) molecular visuospatial skills using a 3-D, projection-based ImmersaDesk system, and (ii) attention (and soon memory and executive functioning) processes within ecologically valid functional scenarios utilizing a head-mounted display (HMD). Results from completed research, rationales and methodology of works in progress, and our plan for future work is presented. Our primary vision has been to develop VR systems that target cognitive processes and functional skills that are of relevance to a wide range of patient populations with central nervous system (CNS) dysfunction, as well as for the assessment of unimpaired performance. We have also sought to select cognitive/functional targets that intuitively appear well matched to the specific assets available with currently available VR technology.