Individualized Treatment for PTSD Using Virtual Iraq Technology
Michael Roy, MD, Col. (Ret.) talks about the efficacy of using Virtual Iraq for treating PTSD, an experiential technology with sights, sounds, and smells that can be highly individualized for the person's experience.
[Dr. Michael Roy] While there are many advances that we would like to be able to make, and I think could be beneficial, maybe one that I'd single out in particular would be the ability to individualize the treatment to tailor it to that specific individual. And we're trying to do that, whether that's using genetics. Maybe physiologic responses. Maybe there are differences we can identify in the brain through different types of brain scans to suggest who is likely to respond better to one form of treatment or another. When virtual reality first started being used to treat PTSD back in the late 1990s, it was really a one-size-fits-all. It was sights and sounds. It was treating Vietnam vets. And they all kind of saw the same sequence. Even the World Trade Center— PTSD studies treating World Trade Center survivors— initially they all kind of saw the same thing. They saw the footage from outside the towers, the plane hitting, and all of that. Even if they had been inside the towers, that gradually evolves so that they had an inside sequence. But the Virtual Iraq environment that we use allows really complete individualization. So you can start off in a Humvee. You can be the passenger. You can be in the gunner's turret. You can be the driver. You can start off on foot—by yourself, with a buddy, with a whole patrol. So you can, as the therapist, control all these elements. We can change the weather—bring up a sandstorm or a rainstorm. Change the time of day. It can be dawn with the sun coming up or a sunset or in the middle of the day, cloudy, bright sunshine, the night vision goggles—that green effect they provide at night. So all of these things can be tailored to that individual patient which I think is really powerful. And something that did not exist even ten years ago; even less than that. So if we keep working in that direction, trying to find what's going to be able to reach out and touch that individual. Using smartphones and other technology to be able to reach out to make it a part of their daily lives, rather than just that one hour a week—or whatever— when they maybe come in to see their therapist. It gets them more engaged, more doing things on their own. And that's really pretty revolutionary. Going from, "Here take this pill," where you're very passive to being actively engaged, an active participant in the treatment, which is arranged around your individual needs—your individual experience. That's really tremendous application of technology. That's why I'm so optimistic that it will work; that it will be able to do better than prior therapies. But we still need to do that research to prove that's the case. But I do think there's tremendous reason for optimism.
Posted on BrainLine May 28, 2013.
Michael Roy, MD, Col. (Ret.) is professor of Medicine and director of the Division of Military Internal Medicine at Uniformed Services University and director of Recruitment for USU's Center for Neuroscience and Regenerative Medicine.
Produced by Victoria Tilney McDonough, Justin Rhodes, and Erica Queen, BrainLine.