Comparing Virtual Reality Exposure Therapy to Prolonged Exposure in the Treatment of Soldiers with PTSD

Prolonged exposure (PE) is one of the most researched psychotherapies for PTSD. Virtual reality exposure (VRE) has demonstrated growing support as an innovative method for activating the trauma memory during exposure. However, there is limited research on the effectiveness of either treatment with active duty military personnel and there are no head-to-head clinical trials. Soldiers with PTSD from deployments to Iraq or Afghanistan (N = 162) were randomized to 10 sessions of either PE or VRE or were assigned to a minimal attention wait list. All assessments were conducted by a psychologist blind to treatment group. External, independent treatment fidelity reviews were conducted for both treatments. Service members were assessed before randomization, after 5 sessions, at posttreatment, and 3-and 6-months posttreatment. PTSD was assessed with the Clinician Administered PTSD Scale (CAPS). Data were analyzed at the end of the performance period for this study but prior to the end of the period of performance for another grant/recruitment site. Results indicated significant improvement in symptoms for PE and VRE relative to the waitlist control. Contrary to expectations, PE demonstrated greater PTSD symptom reduction relative to VRE, which was statistically significant at the 12-week follow-up assessment. These findings extend previous findings on the efficacy of exposure therapy to an active duty military population and highlight important areas for future research of VRE. The original document contains color images.