Virtual Iraq: Initial Results from a VR Exposure Therapy Application for Combat-Related Post Traumatic Stress Disorder

Rizzo,A., Pair,J., Graap,K., Rothbaum,B.O., Difede,J., Reger,G., Parsons,T., Mclay,R.N., Perlman,K.

Abstract:
The 'Virtual Iraq' VR environment is designed to be an immersive tool foruse as an Exposure Therapy treatment tool for combat related PTSD. The application consists of a series of virtual scenarios designed to represent relevant contexts for VR exposure therapy, including city and desert road environments. In addition to the visual stimuli presented in the VR HMD, directional 3D audio, vibrotactile and olfactory stimuli of relevance can be delivered. Stimulus presentation is controlled by the clinician via a separate 'wizard of oz'; interface, with the clinician in full audio contact with the patient. The presentation at the conference will detail the results of our research and clinical treatment protocols as they stand at that time. Presently, an open clinical trial to evaluate our system’s efficacy for PTSD treatment with military personnel is being conducted at the Naval Medical Center San Diego and at Ft. Lewis, Washington, and a randomized controlled trial comparing VR alone and VR+D-cycloserine is in progress at Emory University. Ten other test sites are now on line between now and the conference addressing a variety of research questions involving assessment of PTSD, psychophysiological markers of the disorder, impact of multiple trauma events, and an fMRI study. Thus far, eight male and female treatment completers (out of 11) at two of the treatment sites have shown clinically significant improvements at post-treatment, with these patients now no longer meeting PTSD criteria. Due to the challenges for treatment of this disorder, we are encouraged by these early results.