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Skin Conductance Reactivity to Standardized Virtual Reality Combat Scenes in Veterans with PTSD

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Abstract

Interest in virtual reality (VR) as a clinical tool to augment posttraumatic stress (PTSD) treatment has grown substantially in recent years due to advances in VR technology. Moreover, its potential assisted use in the PTSD diagnostic process has been recognized. In this study we examined physiological responding, skin conductance, to a standardized presentation of non-personalized combat-related VR events (e.g. encountering enemy fire; explosions) as compared to non-combat classroom VR events in 19 Veterans with and 24 Veterans without combat-related PTSD who had been deployed to Iraq and Afghanistan. Veterans watched a total of 12 VR scenarios—six combat-related and six non-combat-related—with each scenario gradually increasing in emotional intensity by adding more VR events in addition to repeating prior VR events. Results show that Veterans with PTSD displayed larger skin conductance reactivity across VR combat events, but not for non-combat VR events, as compared to combat Veterans without PTSD. Nevertheless, Veterans with and without PTSD showed a similar reduction of emotional arousal to repeated presentation of the same VR combat events. Within the PTSD sample, the elevated level of VR combat-related arousal correlated marginally with severity of hyperarousal symptoms. This study confirms that the use of a non-personalized and standardized VR presentation successfully distinguishes Veterans with PTSD from those without on a measure of psychophysiological arousal to combat-related VR stimuli. The assessment of physiological reactivity during the repeated presentation of standardized, trauma-related VR events highlights its use for PTSD assessment as well as treatment.

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Acknowledgements

Funding for this study was provided by the Department of Defense and monitored by the U.S. Army Medical Research and Materiel Command, Award Number W81XWH-07-1-0689. This material is the result of work supported with resources and the use of facilities at the Providence VA Medical Center, Providence RI and supported in part by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Rehabilitation Research and Development Service through the Center of Excellence for Neurorestoration and Neurotechnology. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

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  1. Christopher M. Spofford and Mascha van ’t Wout have contributed equally to the study.

Authors and Affiliations

  1. Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI, 02908, USA

    Mascha van ’t Wout, Christopher M. Spofford, William S. Unger, Elizabeth B. Sevin & M. Tracie Shea

  2. Department of Psychiatry and Human Behavior, Alpert Brown Medical School, Brown University, Providence, RI, USA

    Mascha van ’t Wout & M. Tracie Shea

Authors
  1. Mascha van ’t Wout
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  2. Christopher M. Spofford
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  3. William S. Unger
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  4. Elizabeth B. Sevin
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  5. M. Tracie Shea
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Correspondence to Mascha van ’t Wout.

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van ’t Wout, M., Spofford, C.M., Unger, W.S. et al. Skin Conductance Reactivity to Standardized Virtual Reality Combat Scenes in Veterans with PTSD. Appl Psychophysiol Biofeedback 42, 209–221 (2017). https://doi.org/10.1007/s10484-017-9366-0

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