Efficacy of Virtual Reality in Treating Post-traumatic Stress Disorder in U.S. Warfighters Returning from Iraq and Afghanistan Combat Theaters

摘要

This randomized, controlled clinical trial examined the usefulness of brief cognitive behavioral therapy augmented with graded virtual reality exposure (VRE) to treat combat-related PTSD in returning OIF and OEF warfighters. A mixed within-between Group by Time experimental design was utilized. The virtual combat environment of a Middle Eastern town was developed with a clinical interface to allow the therapist to titrate visual, auditory, and kinesthetic VR stimuli with patient arousal responses. Treatment consisted of 10 sessions (2x/week) for 5 weeks, and a control group received structured minimal attention (i.e., periodic phone contact), for 5 weeks. Outcome measures included a PTSD clinical interview (CAPS), and self-report questionnaires for depression, trauma guilt, quality of life, and PTSD symptoms. They were administered to all subjects pre- and post-treatment or control periods. The VRE group received follow-up assessments at 3 and 6 months after treatment completion. Group x Time interaction for the CAPS was not significant (p=.284). However, Cluster C (avoidance and numbing) did reveal a Group x Time interaction (p=.008), and Guilt was also improved (Group x Time interaction, p=.039). No other significant results were obtained, possibly due to a small number of treatment completers. Only 10 of 29 treatment group subjects completed all 10 sessions. No adverse reactions were reported. Brief CBT with VR exposure may be useful in treating combat PTSD in selected warfighters; however, more research is needed to determine the efficacy of this novel treatment approach.