Virtual reality exposure-based therapy for the treatment of post-traumatic stress disorder: a review of its efficacy, the adequacy of the treatment protocol, and its acceptability.
Virtual reality exposure-based therapy for the treatment of post-traumatic stress disorder: a review of its efficacy, the adequacy of the treatment protocol, and its acceptability.
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DOI：
10.2147/ndt.s89542
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发表时间：
2015
影响因子：
3.2
通讯作者：
Garcia-Palacios A
中科院分区：
文献类型：
--
作者：
Botella C;Serrano B;Baños RM;Garcia-Palacios A
创伤后应激障碍(PTSD)的基本特征是在暴露于一个或多个创伤事件后出现特征性症状。根据循证干预指南和经验证据，PTSD最广泛研究和验证的治疗方法之一是长期暴露于创伤事件；然而，暴露疗法可能存在一些局限性。虚拟现实(VR)可以帮助改善长时间的暴露，因为它创造了虚拟的、安全的和可控的情景，可以增强情感参与和接受。除了对VR暴露疗法(VR-EBT)治疗创伤后应激障碍(PTSD)的有效性进行综述外，本研究的目的是通过以下两方面对VR-EBT的使用进行分析：第一，评估使用VR-EBT治疗创伤后应激障碍的心理治疗方案的充分性；第二，分析VR-EBT的可接受性。我们使用之前两次审查中使用的描述符和数据库执行了副本搜索，并更新到2015年4月。接下来，我们对VR-EBT方案的有效性、充分性和可接受性进行了评估。结果表明，VR-EBT治疗创伤后应激障碍是有效的。与充分性相关的研究结果表明，并不是所有使用VR-EBT的研究都报告遵循了循证干预治疗创伤后应激障碍的临床指南。关于可接受性，很少有研究对这一主题进行评估。然而，这些发现是非常有希望的，患者报告了对VR在创伤后应激障碍治疗中的高接受性和满意度。审查中发现的主要弱点集中在需要更多的对照研究，需要使用VR-EBT来标准化治疗方案，以及需要包括可接受性和相关变量的评估。最后，本文展望了VR-EBT在创伤后应激障碍治疗中的应用方向和前景。
The essential feature of post-traumatic stress disorder (PTSD) is the development of characteristic symptoms following exposure to one or more traumatic events. According to evidence-based intervention guidelines and empirical evidence, one of the most extensively researched and validated treatments for PTSD is prolonged exposure to traumatic events; however, exposure therapy can present some limitations. Virtual reality (VR) can help to improve prolonged exposure because it creates fictitious, safe, and controllable situations that can enhance emotional engagement and acceptance. In addition to carrying out a review to evaluate the efficacy of VR exposure-based therapy (VR-EBT) for the treatment of PTSD, the aim of this study was to contribute to analyzing the use of VR-EBT by: first, evaluating the adequacy of psychological treatment protocols that use VR-EBT to treat PTSD; and second, analyzing the acceptability of VR-EBT. We performed a replica search with descriptors and databases used in two previous reviews and updated to April 2015. Next, we carried out an evaluation of the efficacy, adequacy, and acceptability of VR-EBT protocols. Results showed that VR-EBT was effective in the treatment of PTSD. The findings related to adequacy showed that not all studies using VR-EBT reported having followed the clinical guidelines for evidence-based interventions in the treatment of PTSD. Regarding acceptability, few studies evaluated this subject. However, the findings are very promising, and patients reported high acceptability and satisfaction with the inclusion of VR in the treatment of PTSD. The main weaknesses identified in this review focus on the need for more controlled studies, the need to standardize treatment protocols using VR-EBT, and the need to include assessments of acceptability and related variables. Finally, this paper highlights some directions and future perspectives for using VR-EBT in PTSD treatment.