Trauma management therapy with virtual-reality augmented exposure therapy for combat-related PTSD: A randomized controlled trial
Abstract
Virtual reality exposure therapy (VRET) realistically incorporates traumatic cues into exposure therapy and holds promise in the treatment of combat-related posttraumatic stress disorder (PTSD). In a randomized controlled trial of 92 Iraq and Afghanistan veterans and active duty military personnel with combat-related PTSD, we compared the efficacy of Trauma Management Therapy (TMT; VRET plus a group treatment for anger, depression, and social isolation) to VRET plus a psychoeducation control condition. Efficacy was evaluated at mid- and post-treatment, and at 3- and 6-month follow-up. Consistent with our hypothesis, VRET resulted in significant decreases on the Clinician Administered PTSD Scale and the PTSD Checklist-Military version for both groups. Also consistent with our hypothesis, significant decreases in social isolation occurred only for those participants who received the TMT group component. There were significant decreases for depression and anger for both groups, although these occurred after VRET and before group treatment. All treatment gains were maintained six-months later. Although not part of the original hypotheses, sleep was not improved by either intervention and remained problematic. The results support the use of VRET as an efficacious treatment for combat-related PTSD, but suggest that VRET alone does not result in optimal treatment outcomes across domains associated with PTSD.
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Beidel et al. (2019) showed significant reduction in PTSD symptoms.
“Significant reduction in PTSD symptoms”
From Virtual reality and psychedelics for the treatment of psychiatric disease: A systematic literature review (2020) · cites this paper as Beidel et al. (2019)
In Beidel et al. (2019), 42-50% of each group had significant changes maintaining benefits for as long as six months.
“with 42-to 50% of each group with significant changes maintaining the benefits for as long as six months”
From Virtual reality and psychedelics for the treatment of psychiatric disease: A systematic literature review (2020) · cites this paper as Beidel et al. (2019)
In Beidel et al. (2019), the treatment was long and extensive, with many components (29 sessions total including VRET) that may mask the effectivity of VRET.
“the treatment was long and extensive, with many components (Sessions of group treatment and psychoeducation, 29 in total, counting VRET) that may mask the effectivity of VRET.”
From Virtual reality and psychedelics for the treatment of psychiatric disease: A systematic literature review (2020) · cites this paper as Beidel et al. (2019)
Beidel et al. (2019) did not compare the intensive exposure method used to a different exposure model.
“One important limitation of this study is that it did not compare the intensive exposure method used to a different exposure model”
From Virtual reality and psychedelics for the treatment of psychiatric disease: A systematic literature review (2020) · cites this paper as Beidel et al. (2019)
VRET is effective as an intervention for combat-related PTSD.
“demonstrating the effectivity of VRET as an intervention for combatrelated PTSD.”
From Virtual reality and psychedelics for the treatment of psychiatric disease: A systematic literature review (2020) · cites this paper as Beidel et al. (2019)
In veterans with combat-related PTSD, VRET produced a statistically significant improvement of symptoms, decreasing CAPS by an average of 41.7 points.
“The results demonstrated a statistically significant improvement of symptoms, decreasing by an average of 41.7 points the CAPS”
From Virtual reality and psychedelics for the treatment of psychiatric disease: A systematic literature review (2020) · cites this paper as Beidel et al. (2019)
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“To our knowledge there are only six prospective RCTs that utilized exposure therapy (without VR) to treat US service members with combat-related PTSD (Monson et al., 2006; Morland et al., 2014; Rauch et al., 2015; Resick et al., 2015; Yehuda et al., 2014; Yuen et al., 2015).”
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“Post traumatic stress disorder The randomized controlled trial made by Beidel et al. (2019) examined the utility of VRET for the treatment of combat related PTSD and examined how the group treatment of trauma management therapy specifically enhances treatment outcome for depression, anger, and…”
Background
- Authors
- Beidel, D. C., Frueh, B. C., Neer, S. M., Bowers, C. A., Trachik, B., Uhde, T. W., & Grubaugh, A.
- Affiliations
- University of Hawaii at Hilo (US)
- University of Central Florida (US)
- Medical University of South Carolina (US)
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 61
- Pages
- 64-74
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W2748207128
- Cited by
- 195
- References
- 7
- Citations by year
- 2026: 12 · 2025: 25 · 2024: 25 · 2023: 21 · 2022: 16 · 2021: 24 · 2020: 41 · 2019: 20 · 2018: 8 · 2017: 3
- FWCI
- 24.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Army Medical Research & Materiel Command-Military Operational Medicine Research Program (W81XWH-11-2-0038)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- virtual reality exposure therapy, combat-related posttraumatic stress disorder, group therapy, anger, depression, social isolation, military veterans, Iraq and Afghanistan veterans, active duty military personnel, psychoeducation, sleep disorders, maintenance therapy
- MeSH terms
- Adult, Anger, Depression, Female, Humans, Male, Military Personnel, Psychotherapy, Sleep, Stress Disorders, Post-Traumatic, Veterans, Treatment Outcome, Virtual Reality Exposure Therapy
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