Virtual Reality May Help Troubled Vets

Simulations being tested as treatment for post-traumatic stress disorder

SUNDAY, April 24, 2005 (HealthDay News) -- Elated with their success in treating phobias with virtual reality simulations, psychologists and software designers are hoping the technology will soon help traumatized veterans.

Their goal is to treat patients with post-traumatic stress disorder (PTSD) by exposing them to video game-like scenarios of warfare. The therapy, now in testing, could revolutionize how the military handles those who develop the disorder in places such as Iraq and Afghanistan.

"This time around, we won't wait 20 years after the fact to treat these veterans. Instead, we'll address it now," said computer scientist Jarrell Pair, of the University of Southern California's Institute for Creative Technology. "Our hope is we won't repeat the past, that we can give soldiers the help they need to have a normal life."

In conjunction with the military, Pair and a colleague are working to convert virtual warfare scenarios developed for a video game -- X Box's Full Spectrum Warrior -- into a program designed for returning vets. A test version is in place at Camp Pendleton, a Marine base near San Diego, and the San Diego Naval Hospital.

Inspired by "Virtual Vietnam," a software program for PTSD patients developed in 1997, the new program immerses veterans in an Iraq-like virtual environment filled with the expected (soldiers, explosions, tanks) and added touches to promote realism (sandstorms, mosques, Muslim calls to prayer).

Why virtual reality? Psychologists often treat phobias by slowly exposing patients to the thing they're afraid of -- airplanes or spiders, for example. But "exposure therapy" isn't always easy to accomplish, and it can be expensive to, say, borrow a jetliner.

In recent years, psychologists have turned to virtual reality, creating computerized simulations of the world that let people become exposed to their fears in the safe environment of a medical office.

At several centers across the United States, patients can put on virtual reality headsets and "walk" through three-dimensional simulations of airports and airplane cabins, or tall buildings. People who are afraid of public speaking can even stand at a real podium and give speeches before an imaginary audience.

In many cases, therapists ramp up the intensity of the simulations as patients become more comfortable, eventually allowing them to "fly" on an airplane or take an elevator to the top of a tall building. Therapists also monitor vital signs to see which triggers set off patients.

The Virtual Reality Medical Center in San Diego, which is helping the military develop PTSD treatment software, claims that it helps 92 percent of phobia patients reach the goals they've set for themselves, which range from the elimination of a phobia to better control of it.

Researchers say there's no reason why the approach won't work in PTSD patients, too, even though their fears may be more complex. "The only other alternative would be to bring these people back to Iraq and try to expose them to the stimuli that created the problem," Pair said. "Here you can control everything that happens in that simulated world."

Through the therapy, psychologists gain an understanding of which events -- such as specific sounds -- set off flashbacks. "When you identify them, you can have the patient recognize that those are cues or stressors," explained Dr. Mark Wiederhold, president of the Virtual Reality Medical Center. The next step is to help veterans learn to overcome their fears by realizing the triggers won't hurt them.

The psychologists won't get there, of course, if the patients don't find the simulations convincing enough to remind them of their experiences. Eyes and ears contribute to the sense of reality, but other senses play a role. Even the addition of a $5 fan to blow a 'desert wind' in the faces of soldiers during a simulation can add to realism, Wiederhold said.

"As important as vision and sound are, other modalities like vibration, wind, heat and smells can increase presence and immersion," he said.

For now, simulations for PTSD patients remain in the testing phase. But researchers hope they'll one day be available to all returning members of the military.

More information

Learn more about virtual reality from the online encyclopedia wikipedia.

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