Showing papers by "Albert Rizzo published in 2015"

Virtual Reality Exposure for PTSD Due to Military Combat and Terrorist Attacks

Abstract: Humans exposed to war and terrorist attacks are at risk for the development of posttraumatic stress disorder (PTSD). Numerous reports indicate that the incidence of PTSD in both returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) military personnel and survivors of the 9/11 World Trade Center (WTC) attacks is significant. These situations have served to motivate research on how to better develop and disseminate evidence-based treatments for PTSD and other related psychosocial conditions. Virtual reality (VR) delivered exposure therapy for PTSD is currently being used to treat combat and terrorist attack related PTSD with initial reports of positive outcomes. This paper presents an overview and rationale for the use of VR exposure therapy with anxiety disorders and PTSD and describes the status of two systems (Virtual Iraq/Afghanistan and Virtual World Trade Center) developed for this purpose.

SimSensei demonstration: a perceptive virtual human interviewer for healthcare applications

Abstract: We present the SimSensei system, a fully automatic virtual agent that conducts interviews to assess indicators of psychological distress We emphasize on the perception part of the system, a multimodal framework which captures and analyzes user state for both behavioral understanding and interactional purposes

A demonstration of the perception system in SimSensei, a virtual human application for healthcare interviews

Abstract: We present the SimSensei system, a fully automatic virtual agent that conducts interviews to assess indicators of psychological distress. With this demo, we focus our attention on the perception part of the system, a multimodal framework which captures and analyzes user state behavior for both behavioral understanding and interactional purposes. We will demonstrate real-time user state sensing as a part of the SimSensei architecture and discuss how this technology enabled automatic analysis of behaviors related to psychological distress.

Catecholamine responses to virtual combat: implications for post-traumatic stress and dimensions of functioning

Abstract: Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even in those without a clinical diagnosis. The variability in outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend to have elevated basal catecholamine levels, though less is known regarding catecholamine responses to trauma-related stimuli. We assessed whether catecholamine responses to a virtual combat environment impact the relationship between PTSD symptom clusters and elements of functioning. Eighty-seven clinically healthy SMs, within 2 months after deployment to Iraq or Afghanistan, completed self-report measures, viewed virtual-reality (VR) combat sequences, and had sequential blood draws. Norepinephrine responses to VR combat exposure moderated the relationship between avoidance symptoms and scales of functioning including physical functioning, physical-role functioning, and vitality. Among those with high levels of avoidance, norepinephrine change was inversely associated with functional status, whereas a positive correlation was observed for those with low levels of avoidance. Our findings represent a novel use of a virtual environment to display combat-related stimuli to returning SMs to elucidate mind-body connections inherent in their responses. The insight gained improves our understanding of post-deployment symptoms and quality of life in SMs and may facilitate enhancements in treatment. Further research is needed to validate these findings in other populations and to define the implications for treatment effectiveness.

Initial Development and Dissemination of Virtual Reality Exposure Therapy for Combat-Related PTSD

Abstract: Military personnel are at risk for the development of posttraumatic stress disorder. Although effective treatments are available, the need for improved treatment efficacy and less stigmatizing approaches to treatment have resulted in the evolution of virtual reality exposure therapy. This chapter reviews the development and dissemination efforts of a virtual reality system supporting exposure therapy for deployment-related posttraumatic stress disorder. Specifically, the chapter will review the work done to incorporate the feedback of military personnel into the early development of a Virtual Iraq/Afghanistan system and also reviews efforts to disseminate this treatment to military and Veteran behavioral health researchers and providers.

Update and Expansion of the Virtual Iraq/Afghanistan PTSD Exposure Therapy System

Abstract: The stressful experiences that have been characteristic of the combat environments in Iraq and Afghanistan have produced significant numbers of returning service members at risk for developing posttraumatic stress disorder (PTSD) and other psychosocial/behavioral health conditions. A growing literature has now evolved that suggests that Virtual Reality Exposure Therapy (VRET) may be a useful approach for addressing this healthcare challenge. This chapter describes the newly updated Virtual Iraq/Afghanistan system for the delivery of VRET for PTSD in United States Service Members and Veterans. In addition to the complete rebuilding of this VRET system using the latest version of the Unity Game Engine, the system’s content and functionality is now being expanded to support the specific VRET needs of combat medics/corpsmen and persons who have experienced military sexual trauma (MST). The system has also been reconfigured for use as a tool for the delivery of psychological resilience and coping skill training prior to a military deployment. This chapter extends upon information presented by Garcia-Palacios et al. in Chap. 14 on the history and rationale for VRET use with PTSD and on the Reger et al. in Chap. 15 on the early development and dissemination of the initial version of the Virtual Iraq/Afghanistan system, also in this volume. The chapter also presents the context and rationale for the updated system and a general overview of the progress on the new projects that aim to expand the relevant and customizable options for conducting VRET with a wider range of trauma experiences and as a tool for use to prevent the incidence of combat-related PTSD via pre-deployment psychological resilience/coping training.