Distance-delivered interventions for PTSD: A systematic review and meta-analysis

Olthuis, Janine V.; Wozney, Lori; Asmundson, Gordon J.G.; Cramm, Heidi; Lingley-Pottie, Patricia; McGrath, Patrick J.

doi:10.1016/j.janxdis.2016.09.010

Cited by 60 publications

(55 citation statements)

References 83 publications

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“…This barrier has served to drive recent efforts at using PE teletherapy (Tuerk, Yoder, Ruggiero, Gros, & Acierno, 2010) or online self-help CBT programming (Olthuis et al, 2016). The similar use of VR as a tool for pushing trauma-relevant care outside of the clinic is still somewhat limited by cost and complexity issues, as well as by ethical concerns.…”

Section: Discussionmentioning

confidence: 99%

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

Rizzo

Shilling

2017

European Journal of Psychotraumatology

155

107

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Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) military personnel has created a significant behavioural healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. The current article presents the use of Virtual Reality (VR) as a clinical tool to address the assessment, prevention, and treatment of PTSD, based on the VR projects that were evolved at the University of Southern California Institute for Creative Technologies since 2004. A brief discussion of the definition and rationale for the clinical use of VR is followed by a description of a VR application designed for the delivery of prolonged exposure (PE) for treating Service Members (SMs) and Veterans with combat- and sexual assault-related PTSD. The expansion of the virtual treatment simulations of Iraq and Afghanistan for PTSD assessment and prevention is then presented. This is followed by a forward-looking discussion that details early efforts to develop virtual human agent systems that serve the role of virtual patients for training the next generation of clinical providers, as healthcare guides that can be used to support anonymous access to trauma-relevant behavioural healthcare information, and as clinical interviewers capable of automated behaviour analysis of users to infer psychological state. The paper will conclude with a discussion of VR as a tool for breaking down barriers to care in addition to its direct application in assessment and intervention.

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Section: Discussionmentioning

confidence: 99%

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

Rizzo

Shilling

2017

European Journal of Psychotraumatology

155

107

View full text Add to dashboard Cite

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“…Electronic health (eHealth) applications have been found to be helpful in treating many psychological conditions. They have been extensively studied for common disorders (eg, depression or anxiety disorders) [1,2] and a broad spectrum of less frequent conditions, such as eating disorders [3,4] or posttraumatic stress disorder [5]. However, only a few studies have so far investigated eHealth applications in relation to people with borderline personality disorder (BPD).…”

Section: Introductionmentioning

confidence: 99%

A Schema Therapy–Based eHealth Program for Patients with Borderline Personality Disorder (priovi): Naturalistic Single-Arm Observational Study

et al. 2018

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BackgroundElectronic health (eHealth) programs have been found to be effective in treating many psychological conditions. However, regarding borderline personality disorder (BPD), only a few eHealth programs have been tested, involving small interventions based on the dialectical behavior therapy treatment approach. We investigated priovi, a program based on the schema therapy (ST) approach. priovi is considerably more comprehensive than prior programs, offering broad psychoeducation content and many therapeutic exercises.ObjectiveWe tested the acceptability and feasibility of priovi in 14 patients with BPD as an add-on to individual face-to-face ST.MethodsPatients received weekly individual ST and used priovi over a period of 12 months. We assessed BPD symptom severity using self-reported and interview-based measures. Qualitative interviews were conducted with both patients and therapists to assess their experiences with priovi.ResultsBPD symptoms improved significantly (Cohen d=1.0). Overall, qualitative data showed that priovi was positively received by both patients and therapists. Some exercises provoked mild anxiety; however, no serious threat to safety was detected.Conclusionspriovi is a potentially helpful and safe tool that could support individual ST. It needs to be further tested in a randomized controlled study.Trial RegistrationGerman Clinical Trials Register DRKS00011538; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00011538 (Archived by WebCite at http://www.webcitation.org/74jb0AgV8)

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“…prolonged exposure therapy) and pharmacotherapy (e.g. SSRIs) are known to reduce symptoms of PTSD (Forbes et al, 2010), but technology-based and assisted interventions have been recently promoted as ways to improve treatment access for patients with PTSD (Foa et al, 2013; Olthuis et al, 2016; Rosen et al, 2017). Further, no existing treatments are fully effective for all patients with PTSD, and thus new treatments that target perturbed brain function in PTSD are direly needed.…”

Section: Introductionmentioning

confidence: 99%

Attention training modulates resting-state neurophysiological abnormalities in posttraumatic stress disorder

Badura-Brack

McDermott

Becker

et al. 2018

Psychiatry Research: Neuroimaging

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Recent research indicates the relative benefits of computerized attention control treatment (ACT) and attention bias modification treatment (ABMT) for posttraumatic stress disorder (PTSD); however, neural changes underlying these therapeutic effects remain unknown. This study examines how these two types of attention training modulate neurological dysfunction in veterans with PTSD. A community sample of 46 combat veterans with PTSD participated in a randomized double-blinded clinical trial of ACT versus ABMT and 32 of those veterans also agreed to undergo resting-state magnetoencephalography (MEG) recordings. Twenty-four veterans completed psychological and MEG assessments at pre- and post-training to evaluate treatment effects. MEG data were imaged using an advanced Bayesian reconstruction method and examined using statistical parametric mapping. In this report, we focus on the neural correlates and the differential treatment effects observed using MEG; the results of the full clinical trial have been described elsewhere. Our results indicated that ACT modulated occipital and ABMT modulated medial temporal activity more strongly than the comparative treatment. PTSD symptoms decreased significantly from pre- to post-test. These initial neurophysiological outcome data suggest that ACT modulates visual pathways, while ABMT modulates threat-processing regions, but that both are associated with normalizing aberrant neural activity in veterans with PTSD.

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Distance-delivered interventions for PTSD: A systematic review and meta-analysis

Cited by 60 publications

References 83 publications

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

A Schema Therapy–Based eHealth Program for Patients with Borderline Personality Disorder (priovi): Naturalistic Single-Arm Observational Study

Attention training modulates resting-state neurophysiological abnormalities in posttraumatic stress disorder

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