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Inclusion of Virtual Reality: A Rationale for the Use of VR in the Treatment of PTSD

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Book cover Future Directions in Post-Traumatic Stress Disorder

Abstract

In this chapter we examine the potential for using virtual reality, a form of Information and Communication Technology (ICT), with the aim of treating Posttraumatic Stress Disorder (PTSD). We review and discuss the use of exposure therapy for this disorder, considered the first-line treatment for PTSD, as well as its limitations. We then briefly examine some emerging psychological treatments for PTSD and analyze the use of virtual reality as a tool to deliver exposure therapy in the treatment of PTSD in more detail.

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References

  • American Psychiatric Association (APA). (1980). Diagnostic and statistical manual of mental disorders (DSM-III) (3rd ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Baños, R. M., Guillén, V., Quero, S., García-Palacios, A., Alcañiz, M., & Botella, C. (2011). A virtual reality system for the treatment of stress-related disorders: A preliminary analysis of efficacy compared to a standard cognitive behavioral program. International Journal of Human-Computer Studies, 69, 602–613.

    Article  Google Scholar 

  • Beck, J. G., Palyo, S. A., Winer, E. H., Schwagler, B. E., & Ang, E. J. (2007). Virtual reality exposure therapy for PTSD symptoms after a road accident: An uncontrolled case series. Behavior Therapy, 38(1), 39–48.

    Article  PubMed  Google Scholar 

  • Becker, C. B., Darius, E., & Schaumberg, K. (2007). An analog study of patient preferences for exposure versus alternative treatments for posttraumatic stress disorder. Behaviour Research and Therapy, 45, 2861–2873.

    Article  PubMed  Google Scholar 

  • Becker, C. B., Zayfert, C., & Anderson, E. (2004). A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD. Behaviour Research and Therapy, 42, 277–292.

    Article  PubMed  Google Scholar 

  • Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional metaanalysis of psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214–227.

    Article  PubMed  Google Scholar 

  • Cukor, J., Spitalnick, J., Difede, J., Rizzo, A., & Rothbaum, B. O. (2009). Emerging treatments for PTSD. Clinical Psychology Review, 29(8), 715–726.

    Article  PubMed  Google Scholar 

  • Difede, J., Cukor, J., Jayasinghe, N., Patt, I., Jedel, S., Spielman, L., et al. (2007). Virtual reality exposure therapy for the treatment of posttraumatic stress disorder following September 11, 2001. Journal of Clinical Psychiatry, 68(11), 1639–1647.

    Article  PubMed  Google Scholar 

  • Difede, J., & Hoffman, H. G. (2002). Virtual reality exposure therapy for world trade center post-traumatic stress disorder: A case report. Cyberpsychology and Behavior, 5, 529–535.

    Article  PubMed  Google Scholar 

  • Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear. Exposure to corrective information. Psychological Bulletin, 99, 20–35.

    Article  PubMed  Google Scholar 

  • Foa, E. B., & McNally, R. (1996). Mechanisms of change in exposure therapy. In R. M. Rapee (Ed.), Current controversies in anxiety disorders (pp. 329–343). New York: Guilford.

    Google Scholar 

  • Foa, E. B., & Rothbaum, B. O. (1998). Treating the trauma of rape. Cognitive-behavioral therapy for PTSD. New York: Guilford Press.

    Google Scholar 

  • Foa, E. B., Rothbaum, B. O., & Furr, J. M. (2003). Augmenting exposure therapy with other CBT procedures. Psychiatric Annals, 33(1), 47–53.

    Article  Google Scholar 

  • Foa, E. B., Zoellner, L. A., Feeny, N. C., Hembree, E. A., & Alvarez-Conrad, J. (2002). Does imaginal exposure exacerbate PTSD symptoms? Journal of Consulting and Clinical Psychology, 70, 1022–1028.

    Article  PubMed  Google Scholar 

  • Freedman, S. A., Hoffman, H. G., Garcia-Palacios, A., Weiss, P. L., Avitzour, S., & Josman, N. (2010). Prolonged exposure and virtual reality–enhanced imaginal exposure for PTSD following a terrorist bulldozer attack: A case study. Cyberpsychology, Behavior and Social Networking, 13, 95–101.

    Article  PubMed  Google Scholar 

  • Garcia-Palacios, A., Botella, C., Hoffman, H., & Fabregat, S. (2007). Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias. Cyberpsychology and Behavior, 10, 722–724.

    Article  PubMed  Google Scholar 

  • Hembree, E. A., Foa, E. B., Dorfan, N. M., Street, G. P., Kowalski, J., & Tu, X. (2003). Do patients drop out prematurely from exposure therapy for PTSD? Journal of Traumatic Stress, 16, 555–562.

    Article  PubMed  Google Scholar 

  • Herbert, J. D., & Sageman, M. (2004). “First do not harm:” Emerging guidelines for the treatment of posttraumatic reactions. In G. M. Rosen (Ed.), Posttraumatic stress disorder. Issues and controversies. New York: Wiley.

    Google Scholar 

  • Hoffman, H. G., Doctor, J. N., Patterson, D. R., Carrougher, G. J., & Furness, T. A. (2000). Use of virtual reality for adjunctive treatment of adolescent burn pain during wound care: A case report. Pain, 85, 305–309.

    Article  PubMed  Google Scholar 

  • Hoffman, H. G., Patterson, D. R., & Carrougher, G. J. (2000). Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: A controlled study. The Clinical Journal of Pain, 16(3), 244–250.

    Article  PubMed  Google Scholar 

  • Hoffman, H. G., Prothero, J., Wells, M. J., & Groen, J. (1998). Virtual chess: Meaning enhances users’ sense of presence in virtual environments. International Journal of Human-Computer Interaction, 10, 251–263.

    Article  Google Scholar 

  • Jaycox, L. H., Foa, E. B., & Morral, A. R. (1998). Influence of emotional engagement and habituation on exposure therapy for PTSD. Journal of Consulting and Clinical Psychology, 66(1), 185–192.

    Article  PubMed  Google Scholar 

  • Josman, N., Somer, E., Reisberg, A., Weiss, P. L. T., Garcia-Palacios, A., & Hoffman, H. (2006). BusWorld: Designing a virtual environment for post-traumatic stress disorder in Israel: A protocol. Cyberpsychology & Behavior, 9(2), 241–244.

    Article  Google Scholar 

  • Keefe, F. J., Huling, D. A., Coggins, M. J., Keefe, D. F., Rosenthal, M. Z., Herr, N. R., et al. (2012). Virtual reality for persistent pain: A new direction for behavioural pain management. Pain, 153, 2163–2166.

    Article  PubMed Central  PubMed  Google Scholar 

  • Marks, I. M. (1987). Fears, phobias and rituals. Nueva York: Oxford University.

    Google Scholar 

  • McLay, R. N., Wood, D. P., Webb-Murphy, J. A., Spira, J. L., Wiederhold, M. D., Pyne, J. M., et al. (2011). A randomized, controlled trial of virtual reality-graded exposure therapy for post-traumatic stress disorder in active duty service members with combat-related post-traumatic stress disorder. Cyberpsychology, Behavior and Social Networking, 14, 223–229.

    Article  PubMed  Google Scholar 

  • Opris, D., Pintea, S., García-Palacios, A., Botella, C., Szamosközi, S., & David, D. (2012). Virtual reality exposure therapy in anxiety disorders: A quantitative meta-analysis. Depression and Anxiety, 29, 85–93.

    Google Scholar 

  • Parsons, T. D., & Rizzo, A. A. (2008). Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: A meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 39(3), 250–261.

    Article  PubMed  Google Scholar 

  • Powers, M. B., & Emmelkamp, P. M. G. (2008). Virtual reality exposure therapy for anxiety disorders: A meta-analysis. Journal of Anxiety Disorders, 22(3), 561–569.

    Article  PubMed  Google Scholar 

  • Reger, G. M., Holloway, K. M., Candy, C., Rothbaum, B. O., Difede, J., Rizzo, A. A., et al. (2011). Effectiveness of virtual reality exposure therapy for active duty soldiers in a military mental health clinic. Journal of Traumatic Stress, 24(1), 93–96.

    Article  PubMed  Google Scholar 

  • Richard, D. C. S., & Gloster, A. T. (2007). Exposure therapy has a public relations problem: A dearth of litigation amid a wealth of concern. In D. C. S. Richard & D. Lauterbach (Eds.), Handbook of exposure therapies (pp. 409–425). New York: Academic Press/Elsevier.

    Chapter  Google Scholar 

  • Rizzo, A., Difede, J., Rothbaum, B. O., Reger, G., Spitalnick, J., Cukor, J., et al. (2010). Development and early evaluation of the virtual Iraq/Afghanistan exposure therapy system for combat-related PTSD. Annals of the New York Academy of Sciences, 1208, 114–125.

    Article  PubMed  Google Scholar 

  • Rothbaum, B. O., Hodges, L., Alarcon, R. D., Ready, D., Shahar, F., Graap, K., et al. (1999). Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 12, 263–271.

    Article  PubMed  Google Scholar 

  • Rothbaum, B., Hodges, L., Opdyke, D., Willifor, M., & North, M. (1995). Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. American Journal of Psychiatry, 152, 626–628.

    Article  PubMed  Google Scholar 

  • Rothbaum, B. O., Hodges, L., Ready, D., Graap, K., & Alarcon, R. D. (2001). Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. Journal of Clinical Psychiatry, 62, 617–622.

    Article  PubMed  Google Scholar 

  • Zayfert, C., DeViva, J. C., Becker, C. B., Pike, J. L., Gillock, K. L., & Hayes, S. A. (2005). Exposure utilization and completion of cognitive behavioral therapy for PTSD in a “real world” clinical practice. Journal of Traumatic Stress, 18(6), 637–645.

    Article  PubMed  Google Scholar 

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Correspondence to Azucena García-Palacios Ph.D. .

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García-Palacios, A., Botella, C., Baños, R., Guillén, V., Navarro, M.V. (2015). Inclusion of Virtual Reality: A Rationale for the Use of VR in the Treatment of PTSD. In: Safir, M., Wallach, H., Rizzo, A. (eds) Future Directions in Post-Traumatic Stress Disorder. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7522-5_14

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