Virtual Reality Goes to War: A Brief Review of the Future of Military Behavioral Healthcare
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Numerous reports indicate that the incidence of posttraumatic stress disorder (PTSD) in returning OEF/OIF military personnel is creating a significant healthcare challenge. These findings have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD. Virtual Reality delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. This article details how virtual reality applications are being designed and implemented across various points in the military deployment cycle to prevent, identify and treat combat-related PTSD in OIF/OEF Service Members and Veterans. The summarized projects in these areas have been developed at the University of Southern California Institute for Creative Technologies, a U.S. Army University Affiliated Research Center, and this paper will detail efforts to use virtual reality to deliver exposure therapy, assess PTSD and cognitive function and provide stress resilience training prior to deployment.
KeywordsVirtual reality Exposure therapy PTSD Behavior therapy Veterans, service members Military Invisible wounds of war Stress resilience
The projects described here have been sponsored by the Office of Naval Research, TATRC, MRMC, DCoE, and U.S. Army Research, Development, and Engineering Command (RDECOM). Statements and opinions expressed do not necessarily reflect the position or the policy of the United States Government, and no official endorsement should be inferred.
- ASVAB. (2010, December 14, 2010). History of military testing. Retrieved from http://officialasvab.com/history_coun.htm.
- Bilmes, L. (January 20, 2007). Soldiers returning from Iraq and Afghanistan: The long-term costs of providing veterans medical care and disability benefits. Faculty Research Working Paper Series. John F. Kennedy School of Government, Harvard University. Retrieved from http://ksgnotes1.harvard.edu/Research/wpaper.nsf/rwp/RWP07-001.
- Blake, D. D., Weathers, F., Nagy, L. M., Kaloupek, D., Klauminizer, G., Charney, D., et al. (1990). A clinician rating scale for assessing current and lifetime PTSD: The CAPS-1. Behavior Therapist, 13, 187–188.Google Scholar
- Comprehensive Soldier Fitness Program. (December 1, 2010). Main page. Retrieved from http://www.army.mil/csf/index.html.
- Cornum, R. (July 10, 2010). Comprehensive soldier fitness. Retrieved from http://www.army.mil/csf/resources.html.
- Department of Defense. (December 4, 2010a). Retrieved from http://www.defense.gov/news/.
- Department of Defense. (December 4, 2010b). Retrieved from http://www.defenselink.mil/news/casualty.pdf.
- Fischer, H. (December 4, 2010). United States military casualty statistics: Operation new dawn, operation Iraqi freedom, and operation enduring freedom. Congressional Research Service 7-5700:RS22452. Retrieved from http://opencrs.com/document/RS22452/.
- Hovar, C. (December 10, 2010). The military operational medicine research program for the US Army. Retrieved from http://www.donhcs.com/hsr/21_march/doc/presentations/Carl%20Hover%20MRMC%20MOMRP%208%20slides.pdf.
- Institute of Medicine Committee on Treatment of Posttraumatic Stress Disorder. (2007). Treatment of posttraumatic stress disorder: An assessment of the evidence. ISBN: 0-309-10925-6. Accessed on Aug 24, 2007, from http://www.nap.edu/catalog/11955.html.
- Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression and diagnostic severity measure. Psychiatric Annals, 32, 509–521.Google Scholar
- Merians, A. S., Fluet, G. G., Qiu, Q., Saleh, S., Lafond, I., & Adamovich, S. V. (2010). Integrated arm and hand training using adaptive robotics and virtual reality simulations. In Proceedings of the 2010 International Conference on Disability, Virtual Reality and Associated Technology (pp. 213–222) Maia, Portugal.Google Scholar
- ONR. (December 14, 2010). The Office of Naval Research human performance training and education thrust. Retrieved from http://www.onr.navy.mil/Science-Technology/Departments/Code-30/All-Programs/Human-Performance-Training.aspx.
- Ortony, A., Clore, G. L., & Collins, A. (1988). The cognitive structure of emotions. Cambridge: Cambridge University Press.Google Scholar
- Parsons, T. D., Cosand, L., Courtney, C., Iyer, A., & Rizzo, A. A. (2009). Neurocognitive workload assessment using the virtual reality cognitive performance assessment test. Lecture Notes in Artificial Intelligence, 5639, 243–252.Google Scholar
- Parsons, T. D., & Courtney, C. (2010). Neurocognitive and psychophysiological interfaces for adaptive virtual environments. In C. T. Röcker & M. Ziefle (Eds.), Human centered design of e-health technologies. Hershey: IGI Global.Google Scholar
- Parsons, T. D., Courtney, C., Cosand, L., Iyer, A., Rizzo, A. A., & Oie, K. (2009). Assessment of psychophysiological differences of west point cadets and civilian controls immersed within a virtual environment. Lecture Notes in Artificial Intelligence, 5638, 514–523.Google Scholar
- Parsons, T. D., Pair, J., Brennan, J., Silva, T., & Rizzo, A. A. (2008). Sex differences in spatial cognition within a virtual environment: Virtual reality cognitive performance assessment test (VRCPAT). Journal of the International Neuropsychological Society, 14, 2.Google Scholar
- Parsons, T. D., & Rizzo, A. A. (2008c). Neuropsychological assessment of attentional processing using virtual reality. Annual Review of CyberTherapy and Telemedicine, 6, 23–28.Google Scholar
- Reger, G. M., Gahm, G. A., Rizzo, A. A., Swanson, R. A., & Duma, S. (2009). Soldier evaluation of the virtual reality Iraq. Telemedicine and e-Health Journal, 15, 100–103.Google Scholar
- Reger, G. M., Parsons, T. D., Gahm, G. A., & Rizzo, A. A. (2010). Virtual reality assessment of cognitive functions: A promising tool to improve ecological validity. Brain Injury, 7, 24–26.Google Scholar
- Rizzo, A. (2010). Virtual Iraq/Afghanistan and how it is helping some troops and vets with PTSD. Veterans Today. http://www.veteranstoday.com/2010/07/29/virtual-iraqafghanistan-and-how-it-is-helping-some-troops-and-vets-with-ptsd/.
- Rizzo, A., Lange, B., Buckwalter, J. G., Forbell, E., Kim, J., Williams, J., et al. (2010). SimCoach: An intelligent virtual human system for providing healthcare information and support. In Proceedings of the 2010 International Conference on Disability, Virtual Reality and Associated Technology (pp. 213–222).Google Scholar
- Rizzo, A. A., Parsons, T., Buckwalter, J. G., & Kenny, P. (2011). The birth of intelligent virtual patients in clinical training. American Behavioral Scientist.Google Scholar
- Rizzo, A. A., Reger, G., Gahm G., Difede, J., & Rothbaum, B. O. (2009). Virtual reality exposure therapy for combat related PTSD. In P. Shiromani, T. Keane, & J. LeDoux (Eds.), Post-traumatic stress disorder: Basic science and clinical practice (pp. 375–399). New York: Humana Press.Google Scholar
- Rothbaum, B. O., Meadows, E. A., Resick, P., & Foy, D. W. (2000). Cognitive-behavioral therapy. In E. B. Foa, M. Keane, & M. J. Friedman (Eds.), Effective treatments for PTSD (pp. 60–83). New York: Guilford.Google Scholar
- Schneider, S. M., Kisby, C. K. & Flint, E. P. (December 10, 2010). Effect of virtual reality on time perception in patients receiving chemotherapy. Supportive Care in Cancer, Retrieved from http://www.springerlink.com/content/?k=(au%3a(Susan+Schneider)+OR+ed%3a(Susan+Schneider))+pub%3a(Supportive+Cancer+Care).
- Seal, K. H., Bertenthal, D., Nuber, C. R., Sen, S., & Marmar, C. (2007). Bringing the war back home: Mental health disorders among 103, 788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities. Archives of Internal Medicine, 167, 476–482.PubMedCrossRefGoogle Scholar
- Singer, B., & Ryff, C. D. (2001). Understanding aging via person-centered methods and the integration of numbers and narratives. In R. H. Binstock & L. K. George (Eds.), Handbook of aging, the social sciences (5th ed.). San Diego: Academic Press.Google Scholar
- Stanton, D., Foreman, N., & Wilson, P. (1998). Uses of virtual reality in clinical training: Developing the spatial skills of children with mobility impairments. In G. Riva, B. Wiederhold, & E. Molinari (Eds.), Virtual reality in clinical psychology and neuroscience (pp. 219–232). Amsterdam: IOS Press.Google Scholar
- Tanielian, T., Jaycox, L. H., Schell, T. L., Marshall, G. N., Burnam, M. A., Eibner, C., et al. (2008). Invisible wounds of war: Summary and recommendations for addressing psychological and cognitive iInjuries. Rand Report. Retrieved from http://veterans.rand.org/.
- U.S. Army Training and Doctrine Command. (December 2, 2010). The U.S army study of the human dimension in the future 2015–2024 (Pam 525-3-7-01). Retrieved from www.tradoc.army.mil/tpubs/pams/p525-66.pdf.
- Wu, D., Courtney, C., Lance, B., Narayanan, S. S., Dawson, M., Oie, K., et al. (2010). Optimal arousal identification and classification for affective computing: Virtual Reality Stroop Task. IEEE Transactions on Affective Computing, 99, 1–10.Google Scholar
- Zimand, E., Anderson, P., Gershon, G., Graap, K., Hodges, L., & Rothbaum, B. (2003). Virtual reality therapy: Innovative treatment for anxiety disorders. Primary Psychiatry, 9, 51–54.Google Scholar