Comparing Virtual Reality Exposure Therapy to Prolonged Exposure

NCT ID: NCT01459705

Last Updated: 2015-12-14

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

162 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-10-31

Study Completion Date

2014-05-31

Brief Summary

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This study is evaluating the efficacy of virtual reality exposure therapy (VRET) by comparing it to prolonged exposure therapy (PE) and a waitlist(WL) group for the treatment of post traumatic stress disorder (PTSD) in active duty (AD) Soldiers with combat-related trauma. The investigators will test the general hypothesis that 10 sessions of VRET or PE will successfully treat PTSD, therapeutically affect levels of physiological arousal, and significantly reduce perceptions of stigma toward seeking behavioral health services.

Detailed Description

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The rationale for this study is based on growing evidence demonstrating that VRET is an efficacious treatment for PTSD and holds the potential to improve access to care for Soldiers who would otherwise avoid treatment. Although PE is considered one of the most effective cognitive-behavioral therapies (CBT) for treatments for PTSD, there are reasons why it may not be the most viable option for many Soldiers. First, prolonged exposure requires a level of emotional engagement during exposure to the trauma that many patients are unable to obtain. Second, stigma and concerns about how Soldiers will be perceived by peers and leadership has a dramatic impact on whether a Soldier will seek care. VRET may address these concerns and may also improve treatment outcomes and access to care by augmenting the patient's re-living of the trauma with a sensory-rich environment and moderating stigma perceptions by offering non-traditional treatment that is a preferable option for many Soldiers who are reluctant to seek out traditional talk therapies. Despite its promise as a viable treatment option, few studies have examined VRET for combat-related PTSD and there are no published studies that have compared VRET to PE in the treatment of combat-related PTSD. Positive results may provide new treatment options for all Soldiers, but should prove to be an especially attractive option for Soldiers who either do not respond to, or are reluctant to engage in other established therapies such as PE.

Conditions

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Stress Disorders Post-Traumatic Stress Disorder

Keywords

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Combat Disorders Exposure Therapy Army Personnel

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Prolonged Exposure Therapy (PE)

The PE protocol is based on manualized procedures, which are derived from the theory that effective treatment for PTSD requires that the underlying pathological fear structure be activated and paired with new information that is incompatible with the fear structure. PE involves imaginal exposure and in vivo exposure as the two primary strategies to elicit repeated confrontation of feared but objectively safe thoughts, feelings, situations and events.

Group Type ACTIVE_COMPARATOR

Prolonged Exposure Therapy (PE)

Intervention Type BEHAVIORAL

Prolonged exposure therapy will consist of 10 treatment sessions lasting 90 - 120 minutes each, with additional between-session homework assignments.

Virtual Reality Exposure Therapy (VRET)

The VRET protocol follows the same procedures as the PE protocol with the primary exception being that all instances of imaginal exposure will be augmented by immersion into Virtual Iraq environments, thus creating a situation known as immersive exposure.

Group Type EXPERIMENTAL

Virtual Reality Exposure Therapy (VRET)

Intervention Type BEHAVIORAL

Virtual Reality Exposure Therapy will consist of 10 treatment sessions lasting 90 -120 minutes with additional between-session homework assignments.

Waitlist

The waitlist (WL) participants will be asked to refrain from psychotherapy during the 5 weeks of study participation.

Group Type PLACEBO_COMPARATOR

Waitlist

Intervention Type BEHAVIORAL

This group will refrain from psychotherapy until after the completion of the 5 weeks of study participation

Interventions

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Prolonged Exposure Therapy (PE)

Prolonged exposure therapy will consist of 10 treatment sessions lasting 90 - 120 minutes each, with additional between-session homework assignments.

Intervention Type BEHAVIORAL

Virtual Reality Exposure Therapy (VRET)

Virtual Reality Exposure Therapy will consist of 10 treatment sessions lasting 90 -120 minutes with additional between-session homework assignments.

Intervention Type BEHAVIORAL

Waitlist

This group will refrain from psychotherapy until after the completion of the 5 weeks of study participation

Intervention Type BEHAVIORAL

Other Intervention Names

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PE VRE VRET WL Waitlist Control Group

Eligibility Criteria

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Inclusion Criteria

* PTSD diagnosis as assessed by CAPS
* history of deployment in support of Operation Iraqi Freedom/ Operation Enduring Freedom(OIF/OEF)
* non sexually based deployment related trauma
* three or more months since index trauma
* stable on psychotropic medication for 30 days

Exclusion Criteria

* index trauma in the last three months
* history of schizophrenia, other psychotic or bipolar disorder
* history of organic brain disorder
* suicidal risk or intent or self-mutilating behavior requiring hospitalization in the last 6 months
* ongoing threatening situation
* current drug or alcohol dependence
* history of seizures
* prior history of PE for PTSD
* other current psychotherapy
* physical condition that interferes with proper use of Virtual Reality head mounted display
* history of loss of consciousness since entering active duty service greater than 15 minutes history of schizophrenia, other psychotic or bipolar disorder
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Geneva Foundation

OTHER

Sponsor Role collaborator

National Center for Telehealth and Technology

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gregory A Gahm, PhD

Role: PRINCIPAL_INVESTIGATOR

DCoE- National Center for Telehealth and Technology

Greg Reger, PhD

Role: PRINCIPAL_INVESTIGATOR

DCoE - National Center for Telehealth and Technology

Locations

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Womack Clinical Psychology Service

Fort Bragg, North Carolina, United States

Site Status

Countries

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United States

References

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Other Identifiers

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W81XWH-11-2-0007

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

112226

Identifier Type: -

Identifier Source: org_study_id