Effects of Virtual Reality-Based Graded Exposure Therapy on PTSD Symptoms: A Systematic Review and Meta-Analysis

Abstract

Previous studies reported that virtual reality (VR)-based exposure therapy (VRET) was a clinically beneficial intervention for specific phobias. However, among VRET, VR-based graded exposure therapy (VR-GET) is little known about its efficacy on posttraumatic stress disorder (PTSD) symptoms. Therefore, this meta-analysis investigated the effects of VR-GET for PTSD symptoms. A literature search yielded seven randomized controlled trials. The differences between conditions regarding the primary outcome of PTSD symptoms in the effect size of the individual study were calculated using Hedges’ g. The findings showed VR-GET showed a significantly larger effect size for PTSD symptoms (g = 1.100, p = 0.001), compared to controls. However, no significant difference between conventional VRET and controls was found for PTSD symptoms (g = −0.279, p = 0.970). These findings indicated the superiority of VR-GET for PTSD symptoms compared to controls, supporting the importance of immersive PTSD treatments. Nevertheless, the results need to be interpreted with caution due to the substantial number of military service personnel studies. Future trials, considering individually tailored scenarios in virtual environments to cover a wider range of trauma types, are required to investigate its evidence on treating PTSD.

Virtual realities, real recoveries: exploring the efficacy of 3MDR therapy for treatment-resistant PTSD

“…Recent meta-analyses and systematic literature reviews suggest that VRET exhibits comparable efficacy to traditional imaginal exposure therapies for PTSD treatment ( Deng et al, 2019 ; Kothgassner et al, 2019 ; Heo and Park, 2022 ). However, there is no evidence to suggest that VRET outperforms other exposure methods.…”

“…Therefore, whether VRET is a better alternative becomes a matter of cost-effectiveness. Nonetheless, VRET can be considered a viable option for those who struggle with envisioning traumas ( Heo and Park, 2022 ). Customizing software for each client is a time-consuming and potentially cost-ineffective process.…”

Using functional near-infrared spectroscopy to study effects of virtual reality intervention for adolescents with depression in a clinical setting in China: study protocol for a prospective, randomised, controlled trial

“…VR can be used in treatments that concentrate on pain management and relaxation 15 16. VR-based exposure therapy has also been shown as helpful for patients with psychiatric problems such as anxiety, phobias and post-traumatic stress disorder 17–19. In addition, according to recent systematic reviews, VR has the potential to improve depression in adults and older individuals20 21; one study found VR may enhance the clinical efficacy of behavioural activation for depression in adults 22.…”

Effects of virtual reality-based cue exposure therapy on craving and physiological responses in alcohol-dependent patients-a randomised controlled trial

“…Virtual reality (VR) is a practical technology that combines virtualisation and reality to create a digital environment that is similar to the real environment [ 23 ]. Over the past 20 years, VR has been widely used in the study of a variety of mental disorders, such as anxiety disorders [ 24 ] (especially phobias) [ 25 , 26 ], post-traumatic stress disorder [ 27 , 28 ], substance use disorders [ 29 , 30 ], gambling disorders [ 31 , 32 ], eating disorders [ 33 , 34 ], and autism spectrum disorders [ 35 , 36 ]. Virtual reality-based cue exposure therapy (VR-CET) has significant advantages, as VR can not only create more realistic life scene through multiple sensory inputs such as vision, auditory, smell, or touch, but also provide multiple cues for exposure simultaneously, increasing the the realism and immersion of exposure.…”