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Part of the book series: Studies in Computational Intelligence ((SCI,volume 337))

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.

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References

  1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision. APA, Washington (2000)

    Google Scholar 

  2. 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)

    Article  Google Scholar 

  3. 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)

    Article  Google Scholar 

  4. 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)

    Google Scholar 

  5. 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)

    Article  Google Scholar 

  6. 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)

    Article  Google Scholar 

  7. 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)

    Article  Google Scholar 

  8. Bartone, P.T., Adler, A.B., Vaitkus, M.A.: Dimension of Psychological Stress in Peacekeeping Operations. Military Medecine 163, 587–593 (1998)

    Google Scholar 

  9. 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)

    Article  Google Scholar 

  10. 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)

    Google Scholar 

  11. Karnow, S.: Vietnam: A History. Viking Press, New York (1983)

    Google Scholar 

  12. Britt, T.W.: The Psychology of Serving in Peace and Combat. Praeger Security Intl. (2006)

    Google Scholar 

  13. 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)

    Google Scholar 

  14. U.S. Marine Corps: Combat Stress. Marine Corps Reference Publication 6-11C (NTTP 1-15M). Dept of the Navy, Washington DC (2000)

    Google Scholar 

  15. 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)

    Google Scholar 

  16. Routhier, C.: Programme d’Entraînement à la Résilience Militaire (PERM). Unpublished document : SQFT (2007)

    Google Scholar 

  17. 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)

    Google Scholar 

  18. 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)

    Google Scholar 

  19. 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)

    Google Scholar 

  20. Routhier, C.: Military Resilience Training Program: Executive Report. Presented at the MH & OSI JSB Harmonization of MH Education Initiative (Feburary 2009)

    Google Scholar 

  21. Armfield, F.: Preventing Posttraumatic Stress Disorders Resulting from Military Operations. Military Med. 159, 739–746 (1994)

    Google Scholar 

  22. Pratt, D.R., Zyda, M., Kelleher, K.: Virtual Reality: In the Mind of the Beholder. Computer 28, 17–19 (1995)

    Google Scholar 

  23. North, M.M., North, S.M., Coble, J.R.: Virtual Reality Therapy. An Innovative Paradigm. IPI Press, Colorado Springs (1996)

    Google Scholar 

  24. Stanney, K.M.: Handbook of Virtual Environments. Design, Implementation, and Applications. Lawrence Erlbaum Associates, Mahwah (2002)

    Google Scholar 

  25. Côté, S., Bouchard, S.: Virtual Reality Exposure for Phobias: A critical review. J. Cyber Therapy and Rehab. 1, 75–91 (2008)

    Google Scholar 

  26. 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)

    Article  Google Scholar 

  27. 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)

    Article  Google Scholar 

  28. Moore, K., Wiederhold, B.K., Wiederhold, M.D., Riva, G.: Panic and Agoraphobia in a Virtual World. Cyberpsych. and Behav. 5, 197–202 (2002)

    Article  Google Scholar 

  29. Meehan, M.: Physiological Reaction as an Objective Measure of Presence in Virtual Environments. Ph.D. Dissertation. Chapel Hill, U.S.A (2001)

    Google Scholar 

  30. Zimmons, S.: Anxiety and Image Characteristics in Virtual Environments. The Virtual-Pit Experiment. Dissertation. Preliminary Results. Chapel Hill, USA (2004)

    Google Scholar 

  31. 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)

    Article  Google Scholar 

  32. 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)

    Google Scholar 

  33. 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)

    Article  Google Scholar 

  34. Wiederhold, B.K., Wiederhold, M.: Lessons Learned from 600 Virtual Reality Sessions. Cyberpsych. and Behav. 3, 393–400 (2000)

    Article  Google Scholar 

  35. 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)

    Article  Google Scholar 

  36. Richard, D.S., Lauterbach, D.: Handbook of Exposure. Academic Press, New York (2007)

    Google Scholar 

  37. Wiederhold, B.K., Bouchard, S.: Comprehensive Handbook of Virtual Reality and Anxiety Disorders. Kluewer, Toronto (in preparation, 2011)

    Google Scholar 

  38. 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)

    Article  Google Scholar 

  39. 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)

    Google Scholar 

  40. Reger, G.M., Gahm, G.A.: Virtual Reality Exposure Therapy for Active Duty Soldiers. J. Clin. Psych.: In session 64, 940–946 (2008)

    Google Scholar 

  41. 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)

    Google Scholar 

  42. 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)

    Google Scholar 

  43. Wiederhold, B.K., Wiederhold, M.: Virtual Reality for Posttraumatic Stress Disorder and Stress Inoculation Training. J. CyberTherapy and Rehab. 1, 23–35 (2008)

    Google Scholar 

  44. 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)

    Google Scholar 

  45. 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)

    Google Scholar 

  46. 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)

    Google Scholar 

  47. 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)

    Google Scholar 

  48. Wiederhold, M.D., Wiederhold, B.K.: Training Combat Medics using VR. Cyberpsych. and Behav. 7, 319 (2004)

    Google Scholar 

  49. 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)

    Google Scholar 

  50. 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)

    Google Scholar 

  51. 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)

    Google Scholar 

  52. 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)

    Article  Google Scholar 

  53. 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)

    Google Scholar 

  54. 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)

    Google Scholar 

  55. 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)

    Google Scholar 

  56. Wiederhold, B.K., Wiederhold, M.D.: Virtual reality therapy for anxiety disorders. APA, Washington (2005)

    Book  Google Scholar 

  57. 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)

  58. Slater, M., Usoh, M.: Representations Systems, Perceptual Position, and Presence in Virtual Environments. Presence: Teleoperators and Virtual environments 2, 221–233 (1993)

    Google Scholar 

  59. Youngblut, C.: What a Decade of Experiments Reveals about Factors that Influence the Sense of Presence. Institute for Defense Analyses, Virginia (2006)

    Google Scholar 

  60. Youngblut, C.: What a Decade of Experiments Reveals about Factors that Influence the Sense of Presence: Latest Findings. Institute for Defense Analyses, Virginia (2007)

    Google Scholar 

  61. 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)

    Google Scholar 

  62. 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)

    Article  Google Scholar 

  63. 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)

    Article  Google Scholar 

  64. 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)

    Google Scholar 

  65. 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)

    Article  Google Scholar 

  66. 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)

    Google Scholar 

  67. 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)

    Google Scholar 

  68. 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)

    Google Scholar 

  69. 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

    Google Scholar 

  70. 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)

    Google Scholar 

  71. 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)

    Google Scholar 

  72. Holden, M.K.: Virtual Environments for Motor Rehabilitation: Review. Cyberpsychology and Behavior 8, 187–211 (2005)

    Article  Google Scholar 

  73. 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)

    Google Scholar 

  74. 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)

    Google Scholar 

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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

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