Is virtual reality exposure therapy effective for service members and veterans experiencing combat-related PTSD?

Abstract

Purpose: Exposure therapy has been identified as an effective treatment for anxiety disorders, including posttraumatic stress disorder (PTSD). The use of virtual reality exposure therapy (VRET) in the past decade has increased due to improvements in virtual reality technology. VRET has been used to treat active duty service members and veterans experiencing posttraumatic stress symptoms by exposing them to a virtual environment patterned after the real-world environment in which the trauma occurred. This article is a systematic review of the effectiveness of using VRET with these two populations. Method: A search of 14 databases yielded 6 studies with experimental or quasi-experimental designs where VRET was used with active duty service members or veterans diagnosed with combat-related PTSD. Results: Studies show positive results for the use of VRET in treating combat-related PTSD, though more trials are needed with both active duty service members and veterans. Conclusions: VRET is an effective treatment, however more studies including random assignment are needed in order to show whether it is more effective than other treatments. There are still many barriers that the use of VRET with military populations would need to overcome in order to be widely used, including helping veterans become accustomed to the technology; assisting veterans who have spent a longer period of time avoiding anxiety-inducing stimuli in accepting an initial increase in anxiety; clinician concerns about the technology interfering with the therapeutic alliance, and clinician biases against the use of exposure therapy in general; and high treatment dropout rates.

The Use of Virtual Reality in Psychology: A Case Study in Visual Perception

“…For example, exposure therapy is a common method employed in the treatment of anxiety disorders which, in the case of PTSD, may be difficult to implement for logistical or safety reasons. To overcome these issues, multimodal VR has been employed to create a virtual replica of a warzone, complete with audio and haptic feedback, to treat PTSD in war veterans [ 21 , 22 ]. Where phenomena are known to occur due to a confluence of sensory data (e.g., audio and visual), multimodal VR enables the researcher to manipulate each input separately to gain a more accurate understanding of the relative contribution of each.…”

Virtual Reality Exposure Therapy for the Treatment of Posttraumatic Stress Disorder: A Methodological Review Using CONSORT Guidelines

“…In the past decade, numerous studies have been conducted to investigate the processes and outcomes of VRET. Although researchers have begun to synthesize existing literature (Gonçalves, Pedrozo, Coutinho, Figueira, & Ventura, 2012;Nelson, 2012), no prior review has evaluated the methodological quality of the VRET literature based on the Consolidating Standards of Reporting Trials (CONSORT) statement, which is an internationally recognized method of assessing the reporting quality of studies. Moreover, the current review identified studies not included in previous reviews.…”

Physiological reactivity to nonideographic virtual reality stimuli in veterans with and without PTSD

“…Most agree that more treatment studies with VR are needed to assess its effectiveness compared to other treatment methods (Goncalves et al. ; Nelson ). Although additional research is needed, VR appears to be a promising method for treatment of PTSD.…”

“…A recent review found that most treatment studies utilizing VR demonstrated improvement relative to wait list conditions, but that there was no difference between VR and traditional exposure therapies (Goncalves et al 2012). Most agree that more treatment studies with VR are needed to assess its effectiveness compared to other treatment methods (Goncalves et al 2012;Nelson 2012). Although additional research is needed, VR appears to be a promising method for treatment of PTSD.…”