With so many armed conflicts occurring around the world, both official and off the record, the number of people scarred by war is increasing exponentially. According to the US Department of Veterans’ Affairs, there were an estimated 1,711,000 war veterans from World War II alive in 2013, 2,275,000 from the Korean War, 7,391,000 from the Vietnam War, and 2,244,583 from the Desert Shield/Desert Storm operations. This gives a total of over 13,600,000 war veterans in the US in 2013. While not every person who has served in a war has had a traumatic experience, and not every traumatic experience leaves long-lasting scars, many of those veterans will leave the service with the awful condition known as Post Traumatic Stress Disorder (PTSD).
What is PTSD? Sometimes, after a dangerous event or series of events, the brain undergoes physical changes that result in symptoms like mood changes, depression, anxiety, flashbacks, and insomnia. Symptoms fall into four categories. Re-experiencing symptoms include nightmares, flashbacks, and omnipresent frightening thoughts. Avoidance symptoms cause a person to stay away from things that might induce memories of the trauma, such as loud noises or crowded spaces. Hyperarousal symptoms include feelings of being constantly on edge, easily startled, tension and anxiety, and insomnia. The last category is negative outlook symptoms, which cause a person to feel hopeless or depressed, and may include feelings of guilt and blame. While PTSD is underreported and underdiagnosed, an estimated 31% of Vietnam veterans have symptoms that warrant a PTSD diagnosis. PTSD can be debilitating and tricky to treat.
Even though efforts have been made to treat these patients, very few will actually receive the support and treatment needed to recover, and even those who begin treatment have a high rate of discontinuing it. The current treatment methods consist mostly of cognitive behavioral therapy and medications, but more than 50% will still retain their PTSD symptoms even after treatment. According to the Wounded Warriors Home organization, more than 540,000 veterans have PTSD. Because of this, the Universities of Florida, Hawaii, and Kansas’ Departments of Psychology have developed a study to evaluate the efficacy of trauma management therapy (TMT). It is a three week intensive outpatient therapy, and it includes a virtual and augmented reality-based exposure therapy component.
112 veterans and active duty personnel participated in the study, assessment for objective measuring of the impact of the study included measures of PTSD (such as the Mississippi scale), sleep, depression, anger, guilt, and social isolation; those assessments were administered at post-treatment, 3-month, and 6-month follow-up. This apparently successful method allowed that 65.9% of the patients no longer reached diagnostic criteria for PTSD another benefit of the treatment (probably because of the outpatient model) is that the majority of the patients reached a 6-month adherence to treatment, which delivers a satisfactory promise.
Of course, more studies need to be done to determine a gold standard for PTSD treatment–the one we have isn’t working well. It’s a complicated disorder and every trauma and every patient is very different, but we think that AR and VR could be a key component of success in rehabilitating patients with this disorder. We’re concerned about applicability for more severe cases, among other issues, but we would love to see AR and VR be explored further in the treatment of PTSD.