Terapia de Exposição com Realidade Virtual para Transtorno de Estresse Pós-Traumático para bancários: um estudo de caso com o banco virtual

Abstract

Este é um artigo de acesso aberto, licenciado por Creative Commons Atribuição 4.0 Internacional (CC BY 4.0), sendo permitidas reprodução, adaptação e distribuição desde que o autor e a fonte originais sejam creditados.Abstract. Exposure Therapy (ET) is an established treatment for Posttraumatic Stress Disorder (PTSD), in which patients gradually confront trauma memories through mental imagery. Virtual Reality Exposure (VRE) is an alternative for those who have difficulties in recreating such memories. Most studies develop VRE scenarios of war or accidents; however, traumatic events in Brazil are mainly of urban violence. Objective: To evaluate the quality of the Virtual Bank scenario through a pilot case study of a banker with PTSD through a cognitive behavioral therapy protocol. Method: A 39-year-old bank employee diagnosed with PTSD through the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) took part on a Cognitive Behavioral Therapy (CBT) protocol including VRE. Patient's symptoms were assessed through Beck's anxiety and depression inventories, the Screen for Posttraumatic Stress Symptoms and Posttraumatic Cognitions Inventory. The therapy protocol was comprised of 16 sessions divided into three blocks: (i) psychoeducation; (ii) exposure and (iii) cognitive restructuring and relapse prevention. Reassessments were conducted at the end of each block. The sense of presence in the Virtual Bank was assessed through the Presence Questionnaire (PQ). Results: The patient presented at least 60% of reduction on all instruments and no longer met criteria for PTSD at posttreatment. The greatest reduction on PTSD symptoms scores occurred after the VRE block (-44.8%). The mean score of the PQ was 5.24. Conclusion: CBT protocol with VRE was effective in reducing all measures in this case study. Quality evaluation of the Virtual Bank was positive. Results are promising and similar to those of other innovative case studies using VRE for PTSD.Keywords: Posttraumatic Stress Disorder, Cognitive Behavioral Therapy, Virtual Reality, Trauma, Exposure Therapy.Resumo. A Terapia de Exposição é um tratamento padrão-ouro para o Transtorno de Estresse Pós-Traumático (TEPT), na qual os pacientes confrontam gradualmente as memórias traumáticas por meio de imagens mentais. A Terapia de Exposição por Realidade Virtual é uma alternativa para aqueles que têm dificuldades na formação das imagens mentais. Embora a

Vantagens e Desvantagens da Terapia de Exposição Virtual para o Transtorno de Estresse Pós-Traumático.

“…Todos os estudos de caso e série de casos sem uso de grupo-controle apresentaram diminuição da sintomatologia pós-traumática após o tratamento de acordo com a Clinician-Administered PTSD Scale (CAPS) 10 . Em um estudo de caso recentemente publicado 11 , foi observado uma redução de 66.2% da sintomatologia pós-traumática segundo a Screen for Posttraumatic Stress Symptoms (SPTSS) 12,13 .…”