Exploring Treatments for Post-Traumatic Stress Disorder With Veterans Returning to Higher Education: A 21st-Century Approach

• In Event: Peaceable Action: Shaping and Strengthening 21st-Century Resilience Pedagogy

Abstract

Objective:
Military personnel reported having enlisted in the Armed Forces as a means of earning educational benefits upon completion of their service. Many of these same men and women are diagnosed with post-traumatic stress disorder (PTSD). Over the last two decades, PTSD diagnoses have increased (Hodges et al., 2001; Rizzo et al., 2010; Shad et al, 2011). Despite the condition’s prevalence, little has been done to gauge the long-term effectiveness of programs to promote post-service higher education. This paper calls for an increase in longitudinal, outcome-based studies of veterans returning to higher education. The promise of recent innovations in video game technology (e.g., virtual reality exposure therapy [VRET] and corresponding physiological assessment measures) as a viable approach to improving psychosocial rehabilitation are discussed. Studies cautioning that elderly war veterans may be reluctant to embrace these new technology-based treatments we considered (Gamito et al., 2010).

Modes of Inquiry:
Rothbaum, Rizzo, and Difede (2010) define PTSD as “a chronic condition…of persons who experience life-threatening traumatic events.” According to the DSM-V (American Psychiatric Association, 2013), PTSD is “characterized by re-experiencing, avoidance, and hyperarousal symptoms (Rothbaum et al., 2010). A range of treatment options for PTSD exist, including psychological interventions (e.g., social and family based treatments, behavioral treatments, imagery-based treatments, therapies focused on distress tolerance, power therapies, technological-based treatments), pharmacologic treatments, and forms of exposure therapy (ET). (Cukor, Spitalnick, Difede, Rizzo, & Rothbaum, 2009). Virtual reality exposure therapy (VRET) is a recent innovation that provides technologically-supported treatment. Such environments can be used as supplements to established empirically-validated treatments (Cukor et al., 2009; McLay et al., 2010).

Data Sources:
Authors conducted a literature review of treatment programs for PTSD with an eye towards identifying programs that demonstrated resiliency. PTSD treatment programs were categorized in the following manner: 1) summative evaluation, 2) self-report, 3) narrative, and 4) outcome variables.

Findings:
Findings suggest a dearth of research focused on the long-term effectiveness of exposure therapy with active duty military personnel (Reger et al, 2011). The vast majority of PTSD studies rely on self-report measures, and studies are limited by small sample sizes, (Andreano et al., 2009; Rizzo, 2010) lack of randomization (McLay et al., 2010), and single cross-sectional assessment of nonrepresentative samples. Reach supports the use of VRET as a viable treatment, because VRET’s biggest affordance is allowing for total immersion in a way traditional therapies cannot. Yet, our review concluded there is still an over-reliance on self-report, narratives, and short-term solutions rather than strengthen research on PTSD in ways VRET can (e.g., allowing for new kinds of data collection, enhancing existing measures, changing the target variables to something more meaningful).

Scholarly Significance:
Pfefferbaum & North (2008) believe that as the field of VRET matures, “greater attention to the sophistication of research methods and design will increase our understanding.” This paper helps peace education understand how emerging technology, such as VRET, will influence public scholarship.

Authors

• Jennifer Elaine Killham, University of Cincinnati

• Stephen Thomas Slota, University of Connecticut Health Center