Today: Dec 27, 2024
RU / EN
Last update: Dec 27, 2024
Use of Virtual Reality Techniques to Rehabilitate Military Veterans with Post-Traumatic Stress Disorder (Review)

Use of Virtual Reality Techniques to Rehabilitate Military Veterans with Post-Traumatic Stress Disorder (Review)

Volovik M.G., Belova A.N., Kuznetsov A.N., Polevaia A.V., Vorobyova O.V., Khalak M.E.
Key words: post-traumatic stress disorder; PTSD; military veterans; virtual reality; VR; virtual reality exposure therapy; VRET.
2023, volume 15, issue 1, page 74.

Full text

html pdf
1856
1319

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder developing after a traumatic event like participation in combat activities. Objective diagnosis of combat PTSD and effective rehabilitation of war veterans is a current multifaceted problem with particularly high social costs. This review aims to evaluate the potential of virtual reality technique used as exposure therapy tool (VRET) to rehabilitate combat veterans and service members with PTSD.

The review was written following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The final analysis includes 75 articles published in 2017–2022.

VRET therapeutic effect mechanisms were examined along with protocols and scenarios of VRET combined with other interventions influencing PTSD treatment like pharmacotherapy, motion-assisted multi-modular memory desensitization and reconsolidation (3MDR), transcranial magnetic stimulation. The necessity is substantiated of psychophysiological measurements for objectification of PTSD clinical criteria and its dynamics during treatment. It was shown that inclusion of VRET to the package of PTSD rehabilitation interventions positively affects the results due to the enhanced effect of presence and greater experience personalization. Thus, VRET may be an effective, controlled, and cost-effective alternative for PTSD treatment in combatants, including those not responding to conventional therapy.

  1. Beberashvili Z., Javakhishvili J., Tabaghua S. Nature of trauma and pathways to healing authors. Tbilisi: The Georgian Center for Psychosocial and Medical Rehabilitation of Torture Victims (GCRT); 2021; 204 p.
  2. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Arlington, VA: American Psychiatric Publishing; 2013, https://doi.org/10.1176/appi.books.9780890425596.
  3. Wood D.P., Roy M.J., Wiederhold B.K., Wiederhold M.D. Combat-related post-traumatic stress disorder: a case report of virtual reality graded exposure therapy with physiological monitoring in a U.S. navy officer and a U.S. army officer. Cureus 2021; 13(11): e19604, https://doi.org/10.7759/cureus.19604.
  4. Pajak A. Special needs of and promising solutions for incarcerated veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. J Correct Health Care 2020; 26(3): 227–239, https://doi.org/10.1177/1078345820938032.
  5. Kothgassner O.D., Goreis A., Kafka J.X., Van Eickels R.L., Plener P.L., Felnhofer A. Virtual reality exposure therapy for posttraumatic stress disorder (PTSD): a meta-analysis. Eur J Psychotraumatol 2019; 10(1): 1654782, https://doi.org/10.1080/20008198.2019.1654782.
  6. Gramlich M.A., Smolenski D.J., Norr A.M., Rothbaum B.O., Rizzo A.A., Andrasik F., Fantelli E., Reger G.M. Psychophysiology during exposure to trauma memories: Comparative effects of virtual reality and imaginal exposure for posttraumatic stress disorder. Depress Anxiety 2021; 38(6): 626–638, https://doi.org/10.1002/da.23141.
  7. Bukhtiyarov I.V., Glukhov D.V. Posttraumatic stress disorder formation in military officers in combat circumstances. Meditsina truda i promyshlennaya ekologiya 2018; 2: 10–14, https://doi.org/10.31089/1026-9428-2018-2-10-14.
  8. Kharlamenkova N.E. Psychology of post-traumatic stress: results and prospects for future researches. Psihologiceskij zurnal 2017; 38(1): 16–30.
  9. Pineles S.L., Orr S.P. The psychophysiology of PTSD. In: Post-traumatic stress disorder. Nemeroff C.B., Marmar C. (editors). Oxford University Press; 2018, https://doi.org/10.1093/med/9780190259440.003.0022.
  10. Ge F., Yuan M., Li Y., Zhang W. Posttraumatic stress disorder and alterations in resting heart rate variability: a systematic review and meta-analysis. Psychiatry Investig 2020; 17(1): 9–20, https://doi.org/10.30773/pi.2019.0112.
  11. Katz A.C., Norr A.M., Buck B., Fantelli E., Edwards-Stewart A., Koenen-Woods P., Zetocha K., Smolenski D.J., Holloway K., Rothbaum B.O., Difede J., Rizzo A., Skopp N., Mishkind M., Gahm G., Reger G.M., Andrasik F. Changes in physiological reactivity in response to the trauma memory during prolonged exposure and virtual reality exposure therapy for posttraumatic stress disorder. Psychol Trauma 2020; 12(7): 756–764, https://doi.org/10.1037/tra0000567.
  12. Nijdam M.J., Vermetten E. Moving forward in treatment of posttraumatic stress disorder: innovations to exposure-based therapy. Eur J Psychotraumatol 2018; 9(1): 1458568, https://doi.org/10.1080/20008198.2018.1458568.
  13. Zelenina N.V., Nazarov S.S., Marchenko A.A., Rantseva S.A., Vypritskiy P.A., Yusupov V.V. Method for psychophysiological diagnosis of individual signs of chronic post-traumatic stress disorder in military combatants. Patent RU 2692454 C1. 2019.
  14. Shamrey V.K., Marchenko A.A., Lobachev A.V., Tarumov D.A. Modern methods of mental disorders objectification in military service. Social’naa i kliniceskaa psihiatria 2021; 31(2): 51–57.
  15. Bedwell J.S., Bohil C.J., Neider M.B., Gramlich M.A., Neer S.M., OʼDonnell J.P., Beidel D.C. Neurophysiological response to olfactory stimuli in combat veterans with posttraumatic stress disorder. J Nerv Ment Dis 2018; 206(6): 423–428, https://doi.org/10.1097/nmd.0000000000000818.
  16. Ben-Zion Z., Fine N.B., Keynan N.J., Admon R., Halpern P., Liberzon I., Hendler T., Shalev A.Y. Neurobehavioral moderators of post-traumatic stress disorder (PTSD) trajectories: study protocol of a prospective MRI study of recent trauma survivors. Eur J Psychotraumatol 2019; 10(1): 1683941, https://doi.org/10.1080/20008198.2019.1683941.
  17. Hundt N.E., Ecker A.H., Thompson K., Helm A., Smith T.L., Stanley M.A., Cully J.A. “It didn’t fit for me:” a qualitative examination of dropout from prolonged exposure and cognitive processing therapy in veterans. Psychol Serv 2020; 17(4): 414–421, https://doi.org/10.1037/ser0000316.
  18. Freedman S. Virtual reality treatment for combat related PTSD: is Virtual Azza more effective than traditional exposure treatment? ICH GCP; 2019. URL: https://ichgcp.net/clinical-trials-registry/NCT03000478.
  19. Demkin A.D., Ivanov V.V., Kruglov V.I. New rehabilitation methods in the tratment of military personnel sterss disoreders in foreign armed forces. Izvestia Rossijskoj voenno-medicinskoj akademii 2019; 38(3): 125–131.
  20. Chaabane S., Etienne A.M., Schyns M., Wagener A. The impact of virtual reality exposure on stress level and sense of competence in ambulance workers. J Trauma Stress 2022; 35(1): 120–127, https://doi.org/10.1002/jts.22690.
  21. Jones C., Smith-MacDonald L., Van Veelen N., VanderLaan A., Kaneva Z., Dunleavy R.S., Hamilton T., Vermetten E., Bremault-Phillips S. Therapist and operator experiences utilizing multi-modal motion-assisted memory desensitization and reconsolidation (3MDR) for treatment of combat related posttraumatic stress disorder amongst military and veteran populations. Eur J Psychotraumatol 2022; 13(1): 2062996, https://doi.org/10.1080/20008198.2022.2062996.
  22. International Society for Traumatic Stress Studies (ISTSS). ISTSS prevention and treatment guidelines. 2018. URL: https://www.istss.org/treating-trauma/ new-istss-prevention-and-treatment-guidelines.aspx.
  23. Effective treatments for PTSD. Practice guidelines from the International Society for Traumatic Stress Studies (ISTSS). Third edition. Forbes D., Bisson J.I., Monson C.M., Berliner L. (editors). Guilford Publications; 2020; 558 p.
  24. Rizzo A., Roy M.J., Hartholt A., Costanzo M., Highland K.B., Jovanovic T., Norrholm S.D., Reist C., Rothbaum B., Difede J.A. Virtual reality applications for the assessment and treatment of PTSD. In: Handbook of military psychology. Bowles S.V., Bartone P.T. (editors). Springer; 2017; p. 453–471, https://doi.org/10.1007/978-3-319-66192-6_27.
  25. Keshner E.A., Weiss P.T., Geifman D., Raban D. Tracking the evolution of virtual reality applications to rehabilitation as a field of study. J Neuroeng Rehabil 2019; 16(1): 76, https://doi.org/10.1186/s12984-019-0552-6.
  26. Hutton B., Salanti G., Caldwell D.M., Chaimani A., Schmid C.H., Cameron C., Ioannidis J.P., Straus S., Thorlund K., Jansen J.P., Mulrow C., Catalá-López F., Gøtzsche P.C., Dickersin K., Boutron I., Altman D.G., Moher D. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 2015; 162(11): 777–784, https://doi.org/10.7326/m14-2385.
  27. Massetti T., da Silva, T.D., Crocetta T.B., Guarnieri R., de Freitas B.L., Bianchi Lopes P., Watson S., Tonks J., de Mello Monteiro C.B. The clinical utility of virtual reality in neurorehabilitation: a systematic review. J Cent Nerv Syst Dis 2018; 10: 1179573518813541, https://doi.org/10.1177/1179573518813541.
  28. van’t Wout-Frank M., Shea M.T., Larson V.C., Greenberg B.D., Philip N.S. Combined transcranial direct current stimulation with virtual reality exposure for posttraumatic stress disorder: feasibility and pilot results. Brain Stimul 2019; 12(1): 41–43, https://doi.org/10.1016/j.brs.2018.09.011.
  29. Liu Z., Ren L., Xiao C., Zhang K., Demian P. Virtual reality aided therapy towards Health 4.0: a two-decade bibliometric analysis. Int J Environ Res Public Health 2022; 19(3): 1525, https://doi.org/10.3390/ijerph19031525.
  30. Maples-Keller J.L., Yasinski C., Manjin N., Rothbaum B.O. Virtual reality-enhanced extinction of phobias and post-traumatic stress. Neurotherapeutics 2017; 14(3): 554–563, https://doi.org/10.1007/s13311-017-0534-y.
  31. Landowska A., Roberts D., Eachus P., Barrett A. Within- and between-session prefrontal cortex response to virtual reality exposure therapy for acrophobia. Front Hum Neurosci 2018; 12: 362, https://doi.org/10.3389/fnhum.2018.00362.
  32. Verger A., Rousseau P.F., Malbos E., Chawki M.B., Nicolas F., Lançon C., Khalfa S., Guedj E. Involvement of the cerebellum in EMDR efficiency: a metabolic connectivity PET study in PTSD. Eur J Psychotraumatol 2020; 11(1): 1767986, https://doi.org/10.1080/20008198.2020.1767986.
  33. Rousseau P.F., Malbos E., Verger A., Nicolas F., Lançon C., Khalfa S., Guedj E. Increase of precuneus metabolism correlates with reduction of PTSD symptoms after EMDR therapy in military veterans: an 18F-FDG PET study during virtual reality exposure to war. Eur J Nucl Med Mol Imaging 2019; 46(9): 1817–1821, https://doi.org/10.1007/s00259-019-04360-1.
  34. Baek J., Lee S., Cho T., Kim S.W., Kim M., Yoon Y., Kim K.K., Byun J., Kim S.J., Jeong J., Shin H.S. Neural circuits underlying a psychotherapeutic regimen for fear disorders. Nature 2019; 566(7744): 339–343, https://doi.org/10.1038/s41586-019-0931-y.
  35. van Gelderen M.J., Nijdam M.J., de Vries F., Meijer O.C., Vermetten E. Exposure-related cortisol predicts outcome of psychotherapy in veterans with treatment-resistant posttraumatic stress disorder. J Psychiatr Res 2020; 130: 387–393, https://doi.org/10.1016/j.jpsychires.2020.08.011.
  36. van Gelderen M.J., Nijdam M.J., Dubbink G.E., Sleijpen M., Vermetten E. Perceived treatment processes and effects of interactive motion-assisted exposure therapy for veterans with treatment-resistant posttraumatic stress disorder: a mixed methods study. Eur J Psychotraumatol 2020; 11(1): 1829400, https://doi.org/10.1080/20008198.2020.1829400.
  37. Knaust T., Felnhofer A., Kothgassner O.D., Höllmer H., Gorzka R.J., Schulz H. Virtual trauma interventions for the treatment of post-traumatic stress disorders: a scoping review. Front Psychol 2020; 11: 562506, https://doi.org/10.3389/fpsyg.2020.562506.
  38. Jones C., Miguel Cruz A., Smith-MacDonald L., Brown M.R.G., Vermetten E., Brémault-Phillips S. Technology acceptance and usability of a virtual reality intervention for military members and veterans with posttraumatic stress disorder: mixed methods Unified Theory of Acceptance and Use of Technology study. JMIR Form Res 2022; 6(4): e33681, https://doi.org/10.2196/33681.
  39. Rauch S.A.M., Koola C., Post L., Yasinski C., Norrholm S.D., Black K., Rothbaum B.O. In session extinction and outcome in virtual reality exposure therapy for PTSD. Behav Res Ther 2018; 109: 1–9, https://doi.org/10.1016/j.brat.2018.07.003.
  40. van’t Wout-Frank M., Philip N.S. Simultaneous application of transcranial direct current stimulation during virtual reality exposure. J Vis Exp 2021; 167: 10.3791/61795, https://doi.org/10.3791/61795.
  41. Georgieva I., Georgiev G.V. Reconstructing personal stories in virtual reality as a mechanism to recover the self. Int J Environ Res Public Health 2019; 17(1): 26, https://doi.org/10.3390/ijerph17010026.
  42. Vianez A., Marques A., Simões de Almeida R. Virtual reality exposure therapy for armed forces veterans with post-traumatic stress disorder: a systematic review and focus group. Int J Environ Res Public Health 2022; 19(1): 464, https://doi.org/10.3390/ijerph19010464.
  43. Pyne J.M., Constans J.I., Nanney J.T., Wiederhold M.D., Gibson D.P., Kimbrell T., Kramer T.L., Pitcock J.A., Han X., Williams D.K., Chartrand D., Gevirtz R.N., Spira J., Wiederhold B.K., McCraty R., McCune T.R. Heart rate variability and cognitive bias feedback interventions to prevent post-deployment PTSD: results from a randomized controlled trial. Mil Med 2019; 184(1–2): e124–e132, https://doi.org/10.1093/milmed/usy171.
  44. Bourla A., Mouchabac S., El Hage W., Ferreri F. e-PTSD: an overview on how new technologies can improve prediction and assessment of posttraumatic stress disorder (PTSD). Eur J Psychotraumatol 2018; 9(Suppl 1): 1424448, https://doi.org/10.1080/20008198.2018.1424448.
  45. Difede J., Rothbaum B.O., Rizzo A.A., Wyka K., Spielman L., Jovanovic T., Reist C., Roy M.J., Norrholm S.D., Glatt C., Lee F. Enhanced exposure therapy for combat-related Posttraumatic Stress Disorder (PTSD): study protocol for a randomized controlled trial. Contemp Clin Trials 2019; 87: 105857, https://doi.org/10.1016/j.cct.2019.105857.
  46. Maples-Keller J.L., Jovanovic T., Dunlop B.W., Rauch S., Yasinski C., Michopoulos V., Coghlan C., Norrholm S., Rizzo A.S., Ressler K., Rothbaum B.O. When translational neuroscience fails in the clinic: dexamethasone prior to virtual reality exposure therapy increases drop-out rates. J Anxiety Disord 2019; 61: 89–97, https://doi.org/10.1016/j.janxdis.2018.10.006.
  47. Herz R.S. Olfactory virtual reality: a new frontier in the treatment and prevention of posttraumatic stress disorder. Brain Sci 2021; 11(8): 1070, https://doi.org/10.3390/brainsci11081070.
  48. van Gelderen M.J., Nijdam M.J., Vermetten E. An innovative framework for delivering psychotherapy to patients with treatment-resistant posttraumatic stress disorder: rationale for interactive motion-assisted therapy. Front Psychiatry 2018; 9: 176, https://doi.org/10.3389/fpsyt.2018.00176.
  49. Bisson J.I., van Deursen R., Hannigan B., Kitchiner N., Barawi K., Jones K., Pickles T., Skipper J., Young C., Abbott L.R., van Gelderen M., Nijdam M.J., Vermetten E. Randomized controlled trial of multi-modular motion-assisted memory desensitization and reconsolidation (3MDR) for male military veterans with treatment-resistant post-traumatic stress disorder. Acta Psychiatr Scand 2020: 142(2): 141–151, https://doi.org/10.1111/acps.13200.
  50. Tang E., Jones C., Smith-MacDonald L., Brown M.R.G., Vermetten E.H.G.J.M., Brémault-Phillips S. Decreased emotional dysregulation following multi-modal motion-assisted memory desensitization and reconsolidation therapy (3MDR): identifying possible driving factors in remediation of treatment-resistant PTSD. Int J Environ Res Public Health 2021; 18(22): 12243, https://doi.org/10.3390/ijerph182212243.
  51. van Gelderen M.J., Nijdam M.J., Haagen J.F.G., Vermetten E. Interactive motion-assisted exposure therapy for veterans with treatment-resistant posttraumatic stress disorder: a randomized controlled trial. Psychother Psychosom 2020; 89(4): 215–227, https://doi.org/10.1159/000505977.
  52. van Deursen R., Jones K., Kitchiner N., Hannigan B., Barawi K., Bisson J.I. The psychophysiological response during post-traumatic stress disorder treatment with modular motion-assisted memory desensitisation and reconsolidation (3MDR). Eur J Psychotraumatol 2021; 12(1): 1929027, https://doi.org/10.1080/20008198.2021.1929027.
  53. Fowler C.A., Ballistrea L.M., Mazzone K.E., Martin A.M., Kaplan H., Kip K.E., Murphy J.L., Winkler S.L. A virtual reality intervention for fear of movement for Veterans with chronic pain: protocol for a feasibility study. Pilot Feasibility Stud 2019; 5: 146, https://doi.org/10.1186/s40814-019-0501-y.
  54. Maples-Keller J.L., Rauch S.A.M., Jovanovic T., Yasinski C.W., Goodnight J.M., Sherrill A., Black K., Michopoulos V., Dunlop B.W., Rothbaum B.O., Norrholm S.D. Changes in trauma-potentiated startle, skin conductance, and heart rate within prolonged exposure therapy for PTSD in high and low treatment responders. J Anxiety Disord 2019; 68: 102147, https://doi.org/10.1016/j.janxdis.2019.102147.
  55. van’t Wout M., Spofford C.M., Unger W.S., Sevin E.B., Shea M.T. Skin conductance reactivity to standardized virtual reality combat scenes in veterans with PTSD. Appl Psychophysiol Biofeedback 2017; 42(3): 209–221, https://doi.org/10.1007/s10484-017-9366-0.
  56. Park J., Marvar P.J., Liao P., Kankam M.L., Norrholm S.D., Downey R.M., McCullough S.A., Le N.A., Rothbaum B.O. Baroreflex dysfunction and augmented sympathetic nerve responses during mental stress in veterans with post-traumatic stress disorder. J Physiol 2017; 595(14): 4893–4908, https://doi.org/10.1113/jp274269.
  57. Park M.J., Kim D.J., Lee U., Na E.J., Jeon H.J. A literature overview of virtual reality (VR) in treatment of psychiatric disorders: recent advances and limitations. Front Psychiatry 2019; 10: 505, https://doi.org/10.3389/fpsyt.2019.00505.
  58. Jones C., Smith-MacDonald L., Miguel-Cruz A., Pike A., van Gelderen M., Lentz L., Shiu M.Y., Tang E., Sawalha J., Greenshaw A., Rhind S.G., Fang X., Norbash A., Jetly R., Vermetten E., Brémault-Phillips S. Virtual reality-based treatment for military members and veterans with combat-related posttraumatic stress disorder: protocol for a multimodular motion-assisted memory desensitization and reconsolidation randomized controlled trial. JMIR Res Protoc 2020; 9(10): e20620, https://doi.org/10.2196/20620.
  59. Bourassa K.J., Stevens E.S., Katz A.C., Rothbaum B.O., Reger G.M., Norr A.M. The impact of exposure therapy on resting heart rate and heart rate reactivity among active-duty soldiers with posttraumatic stress disorder. Psychosom Med 2020; 82(1): 108–114, https://doi.org/10.1097/psy.0000000000000758.
  60. Rothbaum B.O., Hodges L.F., Ready D., Graap K., Alarcon R.D. Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder. J Clin Psychiatry 2001; 62(8): 617–622, https://doi.org/10.4088/jcp.v62n0808.
  61. Eshuis L.V., van Gelderen M.J., van Zuiden M., Nijdam M.J., Vermetten E., Olff M., Bakker A. Efficacy of immersive PTSD treatments: a systematic review of virtual and augmented reality exposure therapy and a meta-analysis of virtual reality exposure therapy. J Psychiatr Res 2021; 143: 516–527, https://doi.org/10.1016/j.jpsychires.2020.11.030.
  62. McLay R.N., Baird A., Webb-Murphy J., Deal W., Tran L., Anson H., Klam W., Johnston S. A randomized, head-to-head study of virtual reality exposure therapy for posttraumatic stress disorder. Cyberpsychol Behav Soc Netw 2017; 20(4): 218–224, https://doi.org/10.1089/cyber.2016.0554.
  63. Meyerbröker K., Morina N. The use of virtual reality in assessment and treatment of anxiety and related disorders. Clin Psychol Psychother 2021; 28(3): 466–476, https://doi.org/10.1002/cpp.2623.
  64. Beidel D.C., Frueh B.C., Neer S.M., Lejuez C.W. The efficacy of trauma management therapy: a controlled pilot investigation of a three-week intensive outpatient program for combat-related PTSD. J Anxiety Disord 2017; 50: 23–32, https://doi.org/10.1016/j.janxdis.2017.05.001.
  65. Beidel D.C., Frueh B.C., Neer S.M., Bowers C.A., Trachik B., Uhde T.W., Grubaugh A. Trauma management therapy with virtual-reality augmented exposure therapy for combat-related PTSD: a randomized controlled trial. J Anxiety Disord 2019; 61: 64–74, https://doi.org/10.1016/j.janxdis.2017.08.005.
  66. Bourassa K.J., Smolenski D.J., Edwards-Stewart A., Campbell S.B., Reger G.M., Norr A.M. The impact of prolonged exposure therapy on social support and PTSD symptoms. J Affect Disord 2020; 260: 410–417, https://doi.org/10.1016/j.jad.2019.09.036.
  67. Deng W., Hu D., Xu S., Liu X., Zhao J., Chen Q., Liu J., Zhang Z., Jiang W., Ma L., Hong X., Cheng S., Liu B., Li X. The efficacy of virtual reality exposure therapy for PTSD symptoms: a systematic review and meta-analysis. J Affect Disord 2019; 257: 698–709, https://doi.org/10.1016/j.jad.2019.07.086.
  68. Maples-Keller J.L., Price M., Rauch S., Gerardi M., Rothbaum B.O. Investigating relationships between PTSD symptom clusters within virtual reality exposure therapy for OEF/OIF veterans. Behav Ther 2017; 48(2): 147–155, https://doi.org/10.1016/j.beth.2016.02.011.
  69. Jones C., Miguel-Cruz A., Smith-MacDonald L., Cruikshank E., Baghoori D., Kaur Chohan A., Laidlaw A., White A., Cao B., Agyapong V., Burback L., Winkler O., Sevigny P.R., Dennett L., Ferguson-Pell M., Greenshaw A., Brémault-Phillips S. Virtual trauma-focused therapy for military members, veterans, and public safety personnel with posttraumatic stress injury: systematic scoping review. JMIR Mhealth Uhealth 2020; 8(9): e22079, https://doi.org/10.2196/22079.
  70. Fowler C.A., Ballistrea L.M., Mazzone K.E., Martin A.M., Kaplan H., Kip K.E., Ralston K., Murphy J.L., Winkler S.L. Virtual reality as a therapy adjunct for fear of movement in veterans with chronic pain: single-arm feasibility study. JMIR Form Res 2019; 3(4): e11266, https://doi.org/10.2196/11266.
  71. Holder N., Holliday R., Wiblin J., Surís A. Patterns and temporal precedence of symptom change during cognitive processing therapy for military sexual trauma-related posttraumatic stress disorder. Behav Cogn Psychother 2019; 47(5): 541–547, https://doi.org/10.1017/s1352465819000183.
  72. Norr A.M., Bourassa K.J., Stevens E.S., Hawrilenko M.J., Michael S.T., Reger G.M. Relationship between change in in-vivo exposure distress and PTSD symptoms during exposure therapy for active duty soldiers. J Psychiatr Res 2019; 116: 133–137, https://doi.org/10.1016/j.jpsychires.2019.06.013.
  73. Loucks L., Yasinski C., Norrholm S.D., Maples-Keller J., Post L., Zwiebach L., Fiorillo D., Goodlin M., Jovanovic T., Rizzo A.A., Rothbaum B.O. You can do that?!: feasibility of virtual reality exposure therapy in the treatment of PTSD due to military sexual trauma. J Anxiety Disord 2019; 61: 55–63, https://doi.org/10.1016/j.janxdis.2018.06.004.
  74. Norr A.M., Smolenski D.J., Katz A.C., Rizzo A.A., Rothbaum B.O., Difede J., Koenen-Woods P., Reger M.A., Reger G.M. Virtual reality exposure versus prolonged exposure for PTSD: which treatment for whom? Depress Anxiety 2018; 35(6): 523–529, https://doi.org/10.1002/da.22751.
  75. Norr A.M., Smolenski D.J., Reger G.M. Effects of prolonged exposure and virtual reality exposure on suicidal ideation in active duty soldiers: an examination of potential mechanisms. J Psychiatr Res 2018; 103: 69–74, https://doi.org/10.1016/j.jpsychires.2018.05.009.
  76. Reger G.M., Smolenski D., Edwards-Stewart A., Skopp N.A., Rizzo A.S., Norr A. Does virtual reality increase simulator sickness during exposure therapy for post-traumatic stress disorder? Telemed J E Health 2019; 25(9): 859–861, https://doi.org/10.1089/tmj.2018.0175.
  77. Reger G.M., Bourassa K., Norr A.M., Buck B. The impact of exposure therapy on stigma and mental health treatment attitudes among active duty U.S. soldiers with combat related PTSD. J Psychiatr Res 2020; 126: 98–104, https://doi.org/10.1016/j.jpsychires.2020.05.005.
  78. Reger G.M., Smolenski D., Norr A., Katz A., Buck B., Rothbaum B.O. Does virtual reality increase emotional engagement during exposure for PTSD? Subjective distress during prolonged and virtual reality exposure therapy. J Anxiety Disord 2019; 61: 75–81, https://doi.org/10.1016/j.janxdis.2018.06.001.
  79. Shulman G.P., Buck B.E., Gahm G.A., Reger G.M., Norr A.M. Effectiveness of the intent to complete and intent to attend intervention to predict and prevent posttraumatic stress disorder treatment drop out among soldiers. J Trauma Stress 2019; 32(5): 784–790, https://doi.org/10.1002/jts.22427.
  80. Stevens E.S., Bourassa K.J., Norr A.M., Reger G.M. Posttraumatic stress disorder symptom cluster structure in prolonged exposure therapy and virtual reality exposure. J Trauma Stress 2021; 34(2): 287–297, https://doi.org/10.1002/jts.22602.
  81. Jerdans S.W., Grindle M., van Woerden H.C., Boulos M.N.K. Head-mounted virtual reality and mental health: critical review of current research. JMIR Serious Games 2018; 6(3): e14, https://doi.org/10.2196/games.9226.
  82. Trahan M.H., Morley R.H., Nason E.E., Rodrigues N., Huerta L., Metsis V. Virtual reality exposure simulation for student veteran social anxiety and PTSD: a case study. Clin Soc Work J 2021; 49(2): 220–230, https://doi.org/10.1007/s10615-020-00784-7.
  83. Rizzo A.S., Shilling R. Clinical virtual reality tools to advance the prevention, assessment, and treatment of PTSD. Eur J Psychotraumatol 2018; 8(sup5): 1414560, https://doi.org/10.1080/20008198.2017.1414560.
  84. Carl E., Stein A.T., Levihn-Coon A., Pogue J.R., Rothbaum B., Emmelkamp P., Asmundson G.J.G., Carlbring P., Powers M.B. Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. J Anxiety Disord 2019; 61: 27–36, https://doi.org/10.1016/j.janxdis.2018.08.003.
Volovik M.G., Belova A.N., Kuznetsov A.N., Polevaia A.V., Vorobyova O.V., Khalak M.E. Use of Virtual Reality Techniques to Rehabilitate Military Veterans with Post-Traumatic Stress Disorder (Review). Sovremennye tehnologii v medicine 2023; 15(1): 74, https://doi.org/10.17691/stm2023.15.1.08


Journal in Databases

pubmed_logo.jpg

web_of_science.jpg

scopus.jpg

crossref.jpg

ebsco.jpg

embase.jpg

ulrich.jpg

cyberleninka.jpg

e-library.jpg

lan.jpg

ajd.jpg

SCImago Journal & Country Rank