Abstract
Virtual reality is used in psychotherapeutic applications, but also as a training tool to practice stress management techniques and, hopefully, in the long term reduce the likelihood of developing posttraumatic stress disorder. This chapter begins with an overview of posttraumatic stress disorder and virtual reality technologies used in clinical research. The core of the chapter is dedicated to review studies using virtual reality to learn and practice stress coping skills or preparing military personnel to deal with stressful situations. Our analyses revealed that virtual reality is a promising training tool but more studies are clearly needed. Issues such as realism and the sense of presence are discussed and their role appears more complicated than initially thought.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision. APA, Washington (2000)
Hoge, C.W., Castro, C.A., Messer, S.C., McGurk, D., Cotting, D.I., Koffman, R.L.: Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care. New Eng. J. of Med. 351, 13–22 (2004)
Milliken, C.S., Auchterlonie, J.L., Hoge, C.W.: Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War. JAMA 298, 2141–2148 (2007)
Mental Health Advisory Team (MHAT) V.: Operation Iraqi Freedom 06-08: Iraq / Operation Enduring Freedom 8: Afghanistan. Department of Defense, the United States of America (2008)
Hotopf, M., Hull, L., Fear, N.T., Browne, T., Horn, O., Iversen, A., et al.: The Health of UK Military Personnel Who Deployed to the 2003 Iraq War: A Cohert Study. Lancet. 367, 1731–1741 (2006)
Sareen, J., Cox, B.J., Afifi, T.O., Stein, M.B., Belik, S.-L., Meadows, G., et al.: Combat and Peacekeeping Operations in Relation to Prevalence of Mental Disorders and Perceived Need for Mental Health Care. Arch. Gen Psych. 64, 843–852 (2007)
Sareen, J., Belik, S.-L., Afifi, T.O., Asmundson, G.J.G., Cox, B.J., Stein, M.B.: Canadian Military Personnel’s Population Attributable Fractions of Mental Disorders and Mental Health Service Use Associated with Combat and Peacekeeping Operations. American J. Public Health 98, 2191–2198 (2008)
Bartone, P.T., Adler, A.B., Vaitkus, M.A.: Dimension of Psychological Stress in Peacekeeping Operations. Military Medecine 163, 587–593 (1998)
Callers, J., Foy, D.W., Donahue, C.P., Goldfarb, J.: Post-Traumatic Stress Disorder in Vietnam Combat Veterans: Effects of Traumatic Violence Exposure and Military Adjustment. J. Trauma. Stress 1, 181–192 (1998)
Flack Jr., W.F., Litz, B.T., Keane, T.M.: Cognitive-Behavioral Treatment of War-Zone-Related Posttraumatic Stress Disorder - A Flexible, Hierarchical Approach. In: Follette, V.M., Ruzek, J.I., Abues, F.R. (eds.) Behavioral Therapies for Trauma, pp. 77–99. The Guilford Press, New York (1998)
Karnow, S.: Vietnam: A History. Viking Press, New York (1983)
Britt, T.W.: The Psychology of Serving in Peace and Combat. Praeger Security Intl. (2006)
Thompson, M.M., McCreary, D.R.: Enhancing Mental Readiness in Military Personel. Military Life. In: Britt, T.W. (ed.) The Psychology of Serving in Peace and Combat. Praeger Security Intl., pp. 54–79 (2006a)
U.S. Marine Corps: Combat Stress. Marine Corps Reference Publication 6-11C (NTTP 1-15M). Dept of the Navy, Washington DC (2000)
Adler, A.B., Bliese, P.D., Hoge, C.W., McGurk, D., Castro, C.A.: Early Interventions during Reintegration with Soldiers Returning from Iraq: Randomization by Platoon. Cited in the MHAT-C report, 55 (2008) (in preparation)
Routhier, C.: Programme d’Entraînement à la Résilience Militaire (PERM). Unpublished document : SQFT (2007)
Warner, C.H., Appenzeller, G.N., Barry, M.J., Morton, A., Grieger, T.: The Evolving Role of the Division Psychiatrist. Military Med. 172, 918–924 (2007)
Warner, C.H., Breibach, J.E., Appenzeller, G.N., Yates, V., Grieger, T., Webster, W.G.: Division Mental Health in the New Brigade Combat Team Structure; Part I Predeployment and Deployment. Military Med. 172, 907–911 (2007a)
Warner, C.H., Breibach, J.E., Appenzeller, G.N., Yates, V., Grieger, T., Webster, W.G.: Division Mental Health in the New Brigade Combat Team Structure; Part II Redeployment and Postdeployment. Military Med. 172, 912–917 (2007b)
Routhier, C.: Military Resilience Training Program: Executive Report. Presented at the MH & OSI JSB Harmonization of MH Education Initiative (Feburary 2009)
Armfield, F.: Preventing Posttraumatic Stress Disorders Resulting from Military Operations. Military Med. 159, 739–746 (1994)
Pratt, D.R., Zyda, M., Kelleher, K.: Virtual Reality: In the Mind of the Beholder. Computer 28, 17–19 (1995)
North, M.M., North, S.M., Coble, J.R.: Virtual Reality Therapy. An Innovative Paradigm. IPI Press, Colorado Springs (1996)
Stanney, K.M.: Handbook of Virtual Environments. Design, Implementation, and Applications. Lawrence Erlbaum Associates, Mahwah (2002)
Côté, S., Bouchard, S.: Virtual Reality Exposure for Phobias: A critical review. J. Cyber Therapy and Rehab. 1, 75–91 (2008)
Robillard, G., Bouchard, S., Fournier, T., Renaud, P.: Anxiety and Presence during VR Immersion: A Comparative Study of the Reactions of Phobic and Non-Phobic Participants in Therapeutic Virtual Environments Derived from Computer Games. Cyber Psych. and Behav. 6, 467–476 (2003)
Renaud, P., Bouchard, S., Proulx, R.: Behavioral Dynamics in the Presence of a Virtual Spider. IEEE Transactions on Information Technology in Biomedecine 6, 235–243 (2002)
Moore, K., Wiederhold, B.K., Wiederhold, M.D., Riva, G.: Panic and Agoraphobia in a Virtual World. Cyberpsych. and Behav. 5, 197–202 (2002)
Meehan, M.: Physiological Reaction as an Objective Measure of Presence in Virtual Environments. Ph.D. Dissertation. Chapel Hill, U.S.A (2001)
Zimmons, S.: Anxiety and Image Characteristics in Virtual Environments. The Virtual-Pit Experiment. Dissertation. Preliminary Results. Chapel Hill, USA (2004)
James, L.K., Lin, C.-Y., Steed, A., Swapp, D., Slater, M.: Social Anxiety in Virtual Environments: Results of a Pilot Study. Cyberpsych. and Behav. 6, 237–243 (2003)
Slater, M., Pertaub, D.-P., Barker, C., Clark, D.: An Experimental Study on Fear of Public Speaking in a Virtual Environment. In: IWVR 2004, Lausanne, Switzerland (2004)
Pertaub, D.-P., Slater, M., Barker, C.: An Experiment on Public Speaking Anxiety in Response to Three Different Types of Virtual Audience. Presence: Teleoperators and Virtual Environments 11, 68–78 (2002)
Wiederhold, B.K., Wiederhold, M.: Lessons Learned from 600 Virtual Reality Sessions. Cyberpsych. and Behav. 3, 393–400 (2000)
Jang, D.P., Kim, I.Y., Nam, S.W., Wiederhold, B.K., Wiederhold, M.D., Kim, S.I.: Analysis of Physiological Response to Two Virtual Environments: Driving and Flying Simulation. Cyberpsych. and Behav. 5, 11–18 (2002)
Richard, D.S., Lauterbach, D.: Handbook of Exposure. Academic Press, New York (2007)
Wiederhold, B.K., Bouchard, S.: Comprehensive Handbook of Virtual Reality and Anxiety Disorders. Kluewer, Toronto (in preparation, 2011)
Rothbaum, B.O., Hodges, L.F., Ready, D., Graap, K., Alarcon, R.D.: Virtual Reality Exposure Therapy for Vietnam Veterans with Posttraumatic Stress Disorder. Journal of Clinical Psychiatry 62, 617–622 (2001)
Wood, D.P., Murphy, J.A., Center, K., Russ, C., McLay, R.N., Reeves, D., et al.: Combat Related Post Traumatic Stress Disorder: A Multiple Case Report Using Virtual Reality Graded Exposure Therapy with Physiological Monitoring. Studies in Health Technology and informatics 132, 556–561 (2008)
Reger, G.M., Gahm, G.A.: Virtual Reality Exposure Therapy for Active Duty Soldiers. J. Clin. Psych.: In session 64, 940–946 (2008)
Rizzo, A.A., Graap, K., Mclay, R.N., Perlman, K., Rothbaum, B.O., Reger, G., et al.: Virtual Iraq: Initial Case Reports from a VR Exposure Therapy Application for Combat-Related Post Traumatic Stress Disorder. In: Paper presented at the 2007 Virtual Rehabilitation Conference, Venice, Italy (2007)
Rizzo, A., Parsons, T., Pair, J., McLay, R., Johnston, S., Perlman, K., et al.: Clinical Results from the Virtual Iraq Exposure Therapy Application for PTSD. In: Proceedings of the Army Science Conference, Orlando, FL (November 2008)
Wiederhold, B.K., Wiederhold, M.: Virtual Reality for Posttraumatic Stress Disorder and Stress Inoculation Training. J. CyberTherapy and Rehab. 1, 23–35 (2008)
Gamito, P., Oliveira, J., Morais, D., Saraiva, T., Rosa, P., Leal, A., et al.: War PTSD: A VR Pre-Trial Case Study. In: Widederhold, B.K., Bouchard, S., Riva, G. (eds.) Annual Review of CyberTherapy and Telemedicine, vol. 5, pp. 191–198. Interactive Media Institute, San Diego (2007)
Rizzo, A.A., Difede, J., Rothbaum, B.O., Johnston, S., McLay, R.N., Reger, G., et al.: VR PTSD Exposure Therapy Results with Active Duty OIF/OEF combatants. Studies in Health Technology and Informatics, vol. 142, pp. 277–282 (2009)
Wiederhold, M.D.: Psychological Monitoring during Simulation Training and Testing (Final Report). Issued by U.S. Army Aviation and Missile Command Under contract no. DAA01-03-C-R301 (2005)
Tarnanas, I., Manos, G.: Using Virtual Reality to Teach Special Populations how to Cope in Crisis: The Case of a Virtual Earthquake. Studies in Health Technology and Informatics 81, 495–550 (2001)
Wiederhold, M.D., Wiederhold, B.K.: Training Combat Medics using VR. Cyberpsych. and Behav. 7, 319 (2004)
Stetz, M.C., Long, C.P., Wiederhold, B.K., Turner, D.D.: Combat Scenarios and Relaxations Training to Harden Medics Against Stress. J. Cyber Therapy and Rehab. 1, 239–246 (2008)
Stetz, M.C., Wildzunas, R.M., Wiederhold, B.K., Stetz, T.A., Hunt, M.P.: The usefulness of virtual reality stress inoculation training for military medical females: A pilot study. In: Widederhold, B.K., Bouchard, S., Riva, G. (eds.) Annual Review of Cyber Therapy and Telemedicine, vol. 4, pp. 51–58. Interactive Media Institute, San Diego (2006)
Stetz, M.C., Thomas, M.L., Russo, M.B., Stetz, T.A., Wildzunas, R.M., McDonald, J.J., et al.: Stress, Mental Health, and Cognition: A Brief Review of Relationships and Countermeasures. Aviation Space and Environmental Medecine 78, B252–B260 (2007)
Killgore, W.D.S., Stetz, M.C., Castro, C.A., Hoge, C.W.: The Effects of Prior Combat Experience on the Expression of Somatic and Affective Symptoms in Deploying Soldiers. J. Psychosomatic Res. 60, 379–385 (2006)
Stetz, M.C., Bouchard, S., Wiederhold, B., Folen, R.: The Receptiveness of Stress Management Techniques by Military Personnel. Poster presented at the annual Cyber Therapy Conference, Verbania (Italy) (June 2009)
Stetz, M.C., Strunk, K.K., Reeves, D.L.: The Effectiveness of Immersive Assisted Relaxation Training for Forwards Surgical Teams. Internal Research Report. Contract no. W911NF-07-D-0001 (2009)
Sadowski, W., Stanney, K.: Presence in Virtual Environments. In: Stanney, K.M. (ed.) Handbook of Virtual Environments: Design, Implementation, and Applications, pp. 791–806. Lawrence Elbaum Associates, Mahwah (2002)
Wiederhold, B.K., Wiederhold, M.D.: Virtual reality therapy for anxiety disorders. APA, Washington (2005)
Lombard, M., Ditton, T.: At the Heart of it All: The Concept of Presence. J. Computer-Mediated Comm. 13 (1997), http://jcmc.indiana.edu/vol3/issue2/lombard.html (retrieved November, 2009)
Slater, M., Usoh, M.: Representations Systems, Perceptual Position, and Presence in Virtual Environments. Presence: Teleoperators and Virtual environments 2, 221–233 (1993)
Youngblut, C.: What a Decade of Experiments Reveals about Factors that Influence the Sense of Presence. Institute for Defense Analyses, Virginia (2006)
Youngblut, C.: What a Decade of Experiments Reveals about Factors that Influence the Sense of Presence: Latest Findings. Institute for Defense Analyses, Virginia (2007)
Heldal, I., Schroeder, R., Steed, A., Axelsson, A.-S., Spante, M., Widerström, J.: Immersiveness and Symmetry in Copresent Scenarios. In: Proceedings of IEEE Virtual Reality 2005, Bonn, Germany, pp. 171–178 (March 2005)
Krijn, M., Emmelkamp, P.M.G., Biemond, R., de Wilde de Ligny, C., Schuemie, M.J., van der Mast, C.A.P.G.: Treatment of Acrophobia in Virtual Reality: the Role of Immersion and Presence. Behaviour Research and Therapy 42, 229–239 (2004)
Schroeder, R., Steed, A., Axelsson, A.-S., Heldal, I., Abelin, A., Wideström, J., et al.: Collaborating in Networked Immersive Spaces: As Good as Being Together? Comp. & Graph. 25, 781–788 (2001)
Herbelin, B., Riquier, F., Vexo, F., Thalmann, D.: Virtual Reality in Cognitive Behavioral Therapy: a Preliminary Study on Social Anxiety Disorder. In: 8th International Conference on Virtual Systems and Multimedia, VSMM 2002 (2002)
Bouchard, S., St-Jacques, J., Robillard, G., Renaud, P.: Anxiety Increases the Sense of Presence in Virtual Reality. Presence: Teleoperators and Virtual Environments 4, 376–391 (2008)
Michaud, M., Bouchard, S., Dumoulin, S., Zhong, X.-W.: Manipulating Presence and its Impact on Anxiety. In: Paper presented at the Cybertherapy Conference 2004, San Diego (January 2004)
Burkhardt, J.-M., Lourdeaux, D., d’Huart, D.M.: La Conception des Environnements Virtuels pour l’Apprentissage. In: Fuchs, P., Moreau, G. (eds.) Le Traité de la Réalité Virtuelle, 2nd edn. Création des Environnements Virtuels et Application École des Mines de Paris, vol. II, pp. 207–296. Les Presses, Paris (2003)
Moshell, J.M., Hughes, C.E.: Virtual Environments as a Tool for Academic Learning. In: Stanney, K.M. (ed.) Handbook of Virtual Environments. Design, Implementation, and Applications, pp. 893–910. Lawrence Erlbaum Associates, Mahwah (2002)
Cobb, S., Neale, H., Crosier, J., Wilson, J.R.: Development and Evaluation of Virtual Environments for Education. In: Stanney, K.M. (ed.) Handbook of Virtual Environments. Design, Implementation, and Applications, pp. 911–936. Lawrence Erlbaum Associates, Mahwah
Youngblut, C., Huie, O.: The Relationship Between Presence and Performance in Virtual Environments: Results of a VERTS Study. In: Proceedings of the IEEE Virtual Reality (2003)
Bouchard, S., Côté, S., Richard, D.S.: Virtual Reality Applications of Exposure. In: Richard, D.S., Lauterbach, D. (eds.) Handbook of exposure, ch. 16, pp. 347–388. Academic Press, New York (2006)
Holden, M.K.: Virtual Environments for Motor Rehabilitation: Review. Cyberpsychology and Behavior 8, 187–211 (2005)
Stetz, M.C., Long, C.P., Schober, W.V., Cardillo, C.G., Wildzunas, R.M.: Stress Assessment and Management While Medics Take Care of the VR Wounded. In: Widederhold, B.K., Bouchard, S., Riva, G. (eds.) Annual Review of Cyber Therapy and Telemedicine, vol. 5, pp. 165–172. Interactive Media Institute, San Diego (2007)
Thompson, M.M., McCreary, D.R.: Enhancing mental readiness in military personnel. In: Human dimensions in military operations – military leaders’ strategies for addressing stress and psychological support Meeting Proceedings RTO-MP-HFM-134, Paper 4, pp. 4-1–4-12. RTO, Neuilly-sur-Seine (2006b)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Bouchard, S., Guitard, T., Bernier, F., Robillard, G. (2011). Virtual Reality and the Training of Military Personnel to Cope with Acute Stressors. In: Brahnam, S., Jain, L.C. (eds) Advanced Computational Intelligence Paradigms in Healthcare 6. Virtual Reality in Psychotherapy, Rehabilitation, and Assessment. Studies in Computational Intelligence, vol 337. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-17824-5_6
Download citation
DOI: https://doi.org/10.1007/978-3-642-17824-5_6
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-17823-8
Online ISBN: 978-3-642-17824-5
eBook Packages: EngineeringEngineering (R0)