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  The Nation's #1 Independent Veterans Web Site Click here to make VA Watchdog dot Org your homepage VA NEWS FLASH from Larry Scott at VA Watchdog dot Org -- 06-23-2008 |
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The Nation's #1 Independent Veterans Web Site Click here to make VA Watchdog dot Org your homepage VA NEWS FLASH from Larry Scott at VA Watchdog dot Org -- 06-23-2008 |
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which soldiers see, hear and smell the rigors of combat may help ease war-induced stress.
For more about "Virtual Iraq," use the VA
Watchdog search engine...click here... Story here...
http://www.baltimoresun.com/ Story below:
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Facing demons in 'Virtual Iraq'A 3-D simulator in which
soldiers see, hear and smell the rigors of combat may help ease
war-induced stress
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A study in the New England Journal of Medicine
found that between a quarter and a third of all veterans from these
conflicts will suffer from the disorder and other mental health problems.
Last month, the Rand Corp. estimated that up to 300,000 soldiers will
experience post-war mental health problems.
Virtual Iraq immerses patients in the harsh world that produced their
symptoms.
After putting on virtual-reality goggles and earphones, patients are
transported to two scenarios: a Humvee convoy through the desert or a foot
patrol through a desolate city.
They use a video game handset to control their movements, and by turning
their heads they can change what they see within that environment.
The therapist, who controls all variables in the environment except the
patient's movement, slowly ratchets up the stress level by adding sirens,
sniper fire and explosions.
This digital world is not only full of threats and stressors - roadside
bombs, insurgents firing grenades, a bleeding U.S. soldier slumped in the
Humvee's passenger seat - but also the mundane details that evoke everyday
life for a soldier in Iraq.
Patients hear the sound of a Muslim prayer call and see Iraqi women
walking to market in traditional clothes.
The setup also engages other senses. Under the patient's chair are
powerful bass speakers embedded in a platform; when a bomb explodes
onscreen, the concussion is palpable. Next to the computer console is a
toaster-size odor machine; by inserting pellets, Roy can create a variety
of aromas, including sweat, burning trash and Middle Eastern spices. He
suspects that the scents and noise might be the most effective elements in
evoking Iraq. The brain areas that process odor and sound are closely
networked with the regions that play a key role in fear and memory - two
key components of post-traumatic stress.
The originator of Virtual Iraq is Albert "Skip" Rizzo, a psychologist and
researcher at the University of Southern California. He got interested in
the approach 15 years ago, while trying to rehabilitate people who had
suffered traumatic brain injuries. One day he was surprised to see a
patient completely engrossed in a handheld computer game. Generally, brain
injury patients have trouble concentrating on a task for any stretch of
time.
Rizzo realized that virtual treatments could increase patients' interest
and improve their performance. He was so taken with this idea that he left
his job as a clinical psychologist to become a low-level researcher at USC;
his salary dropped from more than $80,000 to $30,000. He began working
with computer coders, developing virtual software for therapy, and within
a few years had created a number of applications, including one for stroke
patients and another for children with attention deficit disorder.
In 2003 Rizzo, by now a USC professor, realized that the Iraq war would
likely last for years and probably produce large numbers of post-traumatic
stress disorder patients. He began work on Virtual Iraq, and linked up
with other researchers, such as Roy, who shared his vision.
As concern over soldiers' mental health has grown, virtual therapy has
gotten more attention. The Department of Defense is spending about $5
million to fund research at six sites around the country, including Walter
Reed and the Weill Cornell Medical College in New York.
The most persuasive study so far involved a group of 14 New Yorkers
suffering from PTSD after the Sept. 11 World Trade Center attacks. The
subjects, most of whom had tried other treatments without success,
improved significantly after virtual therapy.
Roy is conducting the first controlled study, comparing 15 patients who
get virtual therapy with another 15 who receive more traditional
psychotherapy. Previous research has examined virtual therapy without
comparing it directly to other approaches.
Rizzo, Roy and other researchers regularly incorporate ideas from soldiers
to make the experience more realistic. Programmers at USC will add the
potential for friendly fire and a version that resembles Afghanistan, with
more mountains. At the suggestion of patients, the researchers also added
a weapon, a training model that has no trigger but is the same weight and
size as an M-16 or M-4.
"They like to have a gun in their hand," says Roy. "It makes it more
realistic." Many soldiers hold the gun and crouch while on virtual patrol.
There's no digital firing: Roy says that would undercut the goal of
teaching patients to reduce stress.
Rizzo and others say the digital approach can help the many patients who
have trouble accessing the frightening memories that lie at the core of
the illness. The most commonly used treatment, known as exposure therapy,
asks patients to remember events that trigger panic and stress. Over
several sessions, patients go through this process repeatedly, slowly
draining the thoughts of their haunting power.
Many people with post-traumatic stress disorder have trouble facing their
terrifying memories. A significant percentage - Roy estimates as many as
half of all patients - either refuse to enter into traditional therapy or
don't finish it.
It is this group that will most benefit from virtual therapy, proponents
say. Once immersed in the digital Iraq, patients can more easily recall
painful emotions and events. They must still endure the difficult process
of imagining and talking about what happened to them, Roy says, but they
have help with the crucial first steps.
"Seeing it [on the computer] is definitely not enough," says Roy. "We want
them to use it as a stimulus to describe experiences and feelings."
Some researchers are skeptical that the new method improves on traditional
therapy.
"We don't have empirical evidence that virtual treatment is needed. And
it's quite expensive," says University of Pennsylvania psychologist Edna
Foa, an expert on exposure therapy. "I want to see what motivates this,
other than a fascination with gadgets."
Foa, who works with PTSD patients - including soldiers - in both the U.S.
and Israel, says the images in virtual therapy may be too generic to
effectively elicit patients' own memories.
Rizzo says the entire virtual set-up - computers, software and other
equipment - costs about $7,000. He argues that each one would pay for
itself if it helps even a handful of patients. He and others also say the
program provides ample realism.
The military doesn't allow mental health patients to talk with the news
media. But others who have seen combat say Virtual Iraq elicits powerful
emotional responses.
Navy psychologist Scott L. Johnston spent nine months in Iraq in 2006 and
2007, helping soldiers overwhelmed by acute stress. Because treatment
works best when it given soon after combat, Johnston spent most of his
tour embedded with Marine infantry units in Ramadi and Fallujah. When he
returned to Naval Medical Center in San Diego, he picked up his virtual
therapy research.
When he put on the virtual reality goggles, he found that the environment
triggered a visceral sense of being in combat.
"It brought me back to what I'd experienced," he says. Although Johnston
didn't develop full-blown post-traumatic stress disorder, he did
experience some symptoms after returning to the U.S.: He was hyper-aware
while driving, easily frustrated, and had trouble focusing. He says the
problems have since dissipated.
Johnston now has two virtual therapy studies under way, with 30 subjects.
He says early results show that in 80 percent of patients, symptoms
decreased significantly; in more than half, the problem disappeared
altogether.
Johnston says that from what he has seen, Virtual Iraq produces a response
from any soldier who has seen action in Iraq, whether or not he has PTSD.
"If they've been in combat, they get very serious while they're playing,"
he says. "It seems to be provoking memories."
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