Posttraumatic Stress Disorder (PTSD) Treatment
Our mission is to develop, test, validate and deliver posttraumatic stress disorder (PTSD) hardware, software, and clinical protocols for combat troops throughout the world. For those personnel who require PTSD treatment post-deployment, we use a virtual reality graded exposure therapy protocol that allows the patient to authentically and reliably bring up situationally accessed memories (SAMs) in a way that facilitates new learning. Our PTSD treatment works by allowing the therapist to gradually expose the patient to distressing stimuli in the virtual scenarios while teaching skills to regulate breathing and psychophysiological arousal. After a number of sessions, the patient’s hyperaroused (“fight or flight”) response to distressing stimuli is extinguished.
ONR Treatment for PTSD
This study is exploring whether exposure therapy for PTSD-diagnosed service members using a cognitive behavioral therapy (CBT) approach is more effective when facilitated by virtual reality (VR) tools. Participants include US Navy active duty personnel who have acute PTSD stemming from combat exposure.
Outcome measures focus on the general symptom categories targeted by exposure therapy, such as re-experiencing, avoidance, and arousal. Should VR facilitated psychotherapy prove statistically superior, then a cost-effectiveness analysis will be performed to estimate the relative value of the additional clinical benefit of adjunctive VR therapy.
On April 27, 2006, a VRMC interactive display was part of an exhibit (“Taking Care of Marines”) at Naval Medical Center San Diego’s (NMCSD) Health Fair that won the 1st Place People’s Choice Award. On September 28, 2006, this project was selected for a 30-second pitch in a chance to compete for investor attention at the Tech Coast Venture Network Survivor II event in Irvine, CA. Subsequently, VRMC was chosen to exhibit its PTSD product at the Welcoming Arms Festival on October 21, 2006 and May 12, 2007, and at the Comprehensive Combat Casualty Care Center Summiton December 8, 2006 at NMCSD.
On November 7, 2006, VRMC was awarded a prestigious Director’s Award for its Association of Medical Service Corps Officers of the Navy (AMSCON) poster presentation. This event was held in conjunction with the Association of Military Surgeons of the United States (AMSUS) annual meeting in San Antonio. The presentation was titled, “Combat-Related Posttraumatic Stress Disorder: A Case Report Using Virtual Reality Exposure Therapy with Physiological Monitoring.” The same presentation was made March 2, 2007 at the American Psychological Association Division 21, Division 19 (Society for Military Psychology), and Human Factors and Ergonomics Society Potomac Chapter Annual Symposium on Applied Experimental Research in Fairfax, VA. The poster won 1st Place, Interesting Case Studies at the 2007 NMCSD Academic Research Competition, and was requested to be on display at the May 18 Navy-Wide Academic Research Competition.
The ONR-VRMC VR PTSD program was featured in an article, “Virtual Fallujah Offers Hope for Military PTSD,” published in the April–May 2007 edition of Primary Issues, a newsletter that reaches 90,000 clinicians.
TATRC Polish PTSD
TATRC Iraq Scenario-Based Virtual Reality to Treat Posttraumatic Stress Disorder in Polish Troops
Former Prime Minister Leszek Miller with Polish troops
At this writing, Poland has the second largest number of troops in Iraq of all of the strategic allies. Instead of being scattered across the country, Polish military personnel with posttraumatic stress disorder (PTSD) will be sent to Warsaw, thus providing an ideal clinical research environment. The current rate of PTSD among Army and Marine Corps combatants returning from duty in Iraq is about 19 percent, and research suggests that the rate of PTSD among Poles returning from duty may be even higher than among American troops.
The Interactive Media Institute proposes to explore the feasibility (Phase 1) and effectiveness (Phase 2) of utilizing virtual reality graded exposure therapy (VRGET) in a Polish military setting for soldiers who have combat-related PTSD.
Phase 1 (including a pilot test with 10 Polish military patients with combat-related PTSD) will be determined to be successful if a) the technology can be set up and work appropriately in a Polish military mental health setting, b) therapists can be trained to use the technology appropriately, and c) patients believe they would continue with this type of treatment and might benefit from it. Phase 2 (30 patients) will be a single group design intended to examine whether Polish military combat veterans with PTSD will improve their PTSD diagnosis and symptoms following 10 weeks of VRGET.
This treatment follows a protocol in which patients use biofeedback to learn how to relax their bodies and cognitively attend more fully in the moment. After this is achieved (usually within the first 2 sessions), patients are placed in the Virtual Fallujah virtual environment. First neutral, and then progressively combative scenarios are presented, as the patients are able to handle them. As long as patients can control their physiological and subjective arousal, increasingly combative scenarios are played. If at any time patients become overly aroused, the scenario is simplified, and patients are instructed to use their skills to relax physiologically and attend to the moment at hand.
As TATRC develops broadband systems in Africa and in other parts of the world for deployment via Internet2, the U.S.–Polish PTSD VR system can be easily adapted to treat people with PTSD in other countries.
TATRC VR Therapy in Iraq
TATRC VR Therapy for PTSD Treatment in Iraq
This contract brought the VRMC virtual reality (VR) posttraumatic stress disorder (PTSD) treatment tool to Iraq. The PTSD treatment tool was developed by VRMC under the Office of Naval Research (ONR) Contract No. N00014-05-C-0136.
The tool is being used by psychiatrists and psychologists deployed to Iraq, where mental health professionals are now far forward. In-country clinicians appreciate use of the VR PTSD tool as part of an early intervention protocol, and provide VRMC clinicians with valuable feedback on ways to improve the tool.