Virtual Reality Exposure Therapy of Combat-Related PTSD: A Case Study Using Psychophysiological Indicators of Outcome

This article describes the treatment by exposure therapy of a Vietnam veteran for PTSD related to his war experiences. There are several unique features of this particular treatment and case report. One, the exposure treatment was delivered in conjunction with virtual reality. The patient was exposed to two virtual Vietnam environments, a virtual Huey helicopter and a virtual landing zone, while engaging in exposure to his most traumatic Vietnam memories. Two, the nature of several of these traumatic memories included guilt over acts that the patient committed in Vietnam, which is often times not considered a good candidate for exposure therapy. Three, psychophysiological monitoring occurred throughout the treatment as well as at pretreatment and posttreatment. His responses to treatment, in terms of guilt, anger, and anxiety, standardized symptom measures at pretreatment and post-treatment and follow-ups of 3 months and 6 months, and psychophysiological responding, are discussed.

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

[2]  Kathryn L. Taylor,et al.  Clinical evaluation of a measure to assess combat exposure. , 1989 .

[3]  N. Schneiderman,et al.  Piecewise latent growth curve modeling of systolic blood pressure reactivity and recovery from the cold pressor test. , 2001, Psychophysiology.

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

[5]  D. Charney,et al.  The development of a Clinician-Administered PTSD Scale , 1995, Journal of traumatic stress.

[6]  D. King,et al.  Partners' Ratings of Combat Veterans' PTSD Symptomatology , 1999, Journal of traumatic stress.

[7]  D. Weiss,et al.  The prevalence of lifetime and partial post-traumatic stress disorder in vietnam theater veterans , 1992 .

[8]  P W Lavori,et al.  Utility of psychophysiological measurement in the diagnosis of posttraumatic stress disorder: results from a Department of Veterans Affairs Cooperative Study. , 1998, Journal of consulting and clinical psychology.

[9]  H. S. Davis,et al.  A Controlled Study , 1966 .

[10]  D. Weiss,et al.  The prevalence of lifetime and partial post-traumatic stress disorder in Vietnam theater veterans , 1992 .

[11]  Charles R. Marmar,et al.  Trauma and the Vietnam War generation: Report of findings from the National Vietnam Veterans Readjus , 1990 .

[12]  Patrick A. Boudewyns,et al.  Physiological response to combat memories and preliminary treatment outcome in Vietnam veteran PTSD patients treated with direct therapeutic exposure. , 1990 .

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

[14]  L. Derogatis,et al.  Brief Symptom Inventory Bsi Administration Scoring And Procedures Manual >>>CLICK HERE<<< , 1993 .

[15]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[16]  P. Venables,et al.  Direct measurement of skin conductance: a proposal for standardization. , 1971, Psychophysiology.

[17]  J. Fairbank,et al.  Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans. , 1989 .

[18]  B. Jacobs,et al.  Serotonin and behavior: emphasis on motor control. , 1991, The Journal of clinical psychiatry.

[19]  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.

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

[21]  P. Resick,et al.  Schematic integration of traumatic events. , 2002, Clinical psychology review.

[22]  E. Kubany,et al.  Application of cognitive therapy for trauma-related guilt (CT-TRG) with a Vietnam veteran troubled by multiple sources of guilt , 1997 .

[23]  B. Rothbaum,et al.  A controlled study of virtual reality exposure therapy for the fear of flying. , 2000, Journal of consulting and clinical psychology.

[24]  T. Keane,et al.  Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: three studies in reliability and validity. , 1988, Journal of consulting and clinical psychology.