Virtual Reality Exposure Therapy for World Trade Center Post-traumatic Stress Disorder: A Case Report

Done properly by experienced therapists, re-exposure to memories of traumatic events via imaginal exposure therapy can lead to a reduction of Post-traumatic Stress Disorder (PTSD) symptoms. Exposure helps the patient process and habituate to memories and strong emotions associated with the traumatic event: memories and emotions they have been carefully avoiding. But many patients are unwilling or unable to self-generate and re-experience painful emotional images. The present case study describes the treatment of a survivor of the World Trade Center (WTC) attack of 9-11-01 who had developed acute PTSD. After she failed to improve with traditional imaginal exposure therapy, we sought to increase emotional engagement and treatment success using virtual reality (VR) exposure therapy. Over the course of six 1-h VR exposure therapy sessions, we gradually and systematically exposed the PTSD patient to virtual planes flying over the World Trade Center, jets crashing into the World Trade Center with animated explosions and sound effects, virtual people jumping to their deaths from the burning buildings, towers collapsing, and dust clouds. VR graded exposure therapy was successful for reducing acute PTSD symptoms. Depression and PTSD symptoms as measured by the Beck Depression Inventory and the Clinician Administered PTSD Scale indicated a large (83%) reduction in depression, and large (90%) reduction in PTSD symptoms after completing VR exposure therapy. Although case reports are scientifically inconclusive by nature, these strong preliminary results suggest that VR exposure therapy is a promising new medium for treating acute PTSD. This study may be examined in more detail at www.vrpain.com.

[1]  Robert J. Ursano,et al.  Effective Treatments for PTSD , 2002 .

[2]  B. Rothbaum,et al.  Exposure therapy for posttraumatic stress disorder. , 2002, American journal of psychotherapy.

[3]  Grigore C. Burdea,et al.  Treating Psychological and Physical Disorders with VR , 2022 .

[4]  M. Kozak,et al.  Emotional processing of fear: exposure to corrective information. , 1986, Psychological bulletin.

[5]  S. Weghorst,et al.  Virtual reality and tactile augmentation in the treatment of spider phobia: a case report. , 1997, Behaviour research and therapy.

[6]  A. Rizzo,et al.  Basic issues in the use of virtual environments for mental health applications. , 1998, Studies in health technology and informatics.

[7]  R. Baños,et al.  Virtual reality: a new clinical setting lab. , 1998, Studies in health technology and informatics.

[8]  Dong Pyo Jang,et al.  Physiological Monitoring as an Objective Tool in Virtual Reality Therapy , 2002, Cyberpsychology Behav. Soc. Netw..

[9]  Thomas C. Meyer,et al.  Presence as the Defining Factor in a VR Application , 1994 .

[10]  Cristina Botella,et al.  Interfaces That Heal: Coupling Real and Virtual Objects to Treat Spider Phobia , 2003, Int. J. Hum. Comput. Interact..

[11]  B. Rothbaum,et al.  Twelve-month follow-up of virtual reality and standard exposure therapies for the fear of flying. , 2002, Journal of consulting and clinical psychology.

[12]  Hunter G. Hoffman,et al.  The Illusion of Presence in Immersive Virtual Reality during an fMRI Brain Scan , 2003, Cyberpsychology Behav. Soc. Netw..

[13]  B. Rothbaum,et al.  Virtual Reality Exposure Therapy for PTSD Vietnam Veterans: A Case Study , 1999, Journal of traumatic stress.

[14]  B. Rothbaum,et al.  Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. , 2001, The Journal of clinical psychiatry.

[15]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[16]  G. Riva,et al.  Virtual Environments in Clinical Psychology and Neuroscience: Methods and Techniques in Advanced Patient-Therapist Interaction , 1998 .

[17]  Benjamin Watson,et al.  A virtual airplane for fear of flying therapy , 1996, Proceedings of the IEEE 1996 Virtual Reality Annual International Symposium.

[18]  Cristina Botella,et al.  Virtual reality in the treatment of claustrophobic fear: A controlled, multiple-baseline design , 2000 .

[19]  J. Rabe-Jabłońska,et al.  [Affective disorders in the fourth edition of the classification of mental disorders prepared by the American Psychiatric Association -- diagnostic and statistical manual of mental disorders]. , 1993, Psychiatria polska.

[20]  M. Krijn,et al.  Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia. , 2002, Behaviour research and therapy.

[21]  Cristina Botella,et al.  Redefining Therapeutic Success with Virtual Reality Exposure Therapy , 2001, Cyberpsychology Behav. Soc. Netw..

[22]  D. Campbell,et al.  EXPERIMENTAL AND QUASI-EXPERIMENT Al DESIGNS FOR RESEARCH , 2012 .

[23]  B. Rothbaum,et al.  Behavioral/cognitive conceptualizations of post-traumatic stress disorder , 1989 .

[24]  Francesco Vincelli,et al.  From Imagination to Virtual Reality: The Future of Clinical Psychology , 1999, Cyberpsychology Behav. Soc. Netw..

[25]  C. Botella,et al.  Virtual reality in the treatment of spider phobia: a controlled study. , 2002, Behaviour research and therapy.

[26]  A. Morral,et al.  Influence of emotional engagement and habituation on exposure therapy for PTSD. , 1998, Journal of consulting and clinical psychology.

[27]  R. Baños,et al.  Virtual reality treatment of claustrophobia: a case report. , 1998, Behaviour research and therapy.

[28]  Marion F Zabinski,et al.  Computer and Internet applications for psychological treatment: update for clinicians. , 2004, Journal of clinical psychology.

[29]  Joseph Wolpe,et al.  The practice of behavior therapy , 1969 .