title: A Randomized, Head-to-Head Study of Virtual Reality Exposure Therapy for Posttraumatic Stress Disorder.
abstract: Virtual reality exposure therapy (VRET) is one of the few interventions supported by randomized controlled trials for the treatment of combat-related posttraumatic stress disorder (PTSD) in active duty service members. A comparative effectiveness study was conducted to determine if virtual reality technology itself improved outcomes, or if similar results could be achieved with a control exposure therapy (CET) condition. Service members with combat-related PTSD were randomly selected to receive nine weeks of VRET or CET. Assessors, but not therapists, were blinded. PTSD symptom improvement was assessed one week and 3 months after the conclusion of treatment using the clinician-administered PTSD scale (CAPS). A small crossover component was included. Results demonstrated that PTSD symptoms improved with both treatments, but there were no statistically significant differences between groups. Dropout rates were higher in VRET. Of those who received VRET, 13/42 (31%) showed >30% improvement on the CAPS, versus 16/43 (37%) who received CET. Three months after treatment, >30% improvement was seen in 10/33 (30%) of VRET participants and 12/33 (36%) in CET. Participants who crossed over (n = 11) showed no statistically significant improvements in a second round of treatment, regardless of condition. This study supported the utility of exposure therapy for PTSD, but did not support additional benefit by the inclusion of virtual reality.
authors.affiliation: 1 San Diego County Mental Health , San Diego, California.
authors.forename: Robert N
authors.initials: RN
authors.lastname: McLay
authors.affiliation: 2 Naval Medical Center San Diego, Directorate for Mental Health, San Diego, California.
authors.forename: Alicia
authors.initials: A
authors.lastname: Baird
authors.affiliation: 3 Naval Center for Combat and Operational Stress Control , San Diego, California.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Webb-Murphy
authors.affiliation: 2 Naval Medical Center San Diego, Directorate for Mental Health, San Diego, California.
authors.forename: William
authors.initials: W
authors.lastname: Deal
authors.affiliation: 2 Naval Medical Center San Diego, Directorate for Mental Health, San Diego, California.
authors.forename: Lily
authors.initials: L
authors.lastname: Tran
authors.affiliation: 2 Naval Medical Center San Diego, Directorate for Mental Health, San Diego, California.
authors.forename: Heather
authors.initials: H
authors.lastname: Anson
authors.affiliation: 2 Naval Medical Center San Diego, Directorate for Mental Health, San Diego, California.
authors.forename: Warren
authors.initials: W
authors.lastname: Klam
authors.affiliation: 3 Naval Center for Combat and Operational Stress Control , San Diego, California.
authors.forename: Scott
authors.initials: S
authors.lastname: Johnston
mesh_terms: D000328:Adult; D003130:Combat Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D016037:Single-Blind Method; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*; D063367:Virtual Reality Exposure Therapy / Q000379:methods*
keywords: active duty; exposure therapy; military; posttraumatic stress disorder; randomized trial; veterans