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CONFRONTING SOLDIER'S NIGHTMARES -- "PTSD is really a fear

of memories. But a memory is not harmful. What we do is show

soldiers that their memory isn't the same thing as the fearful event."

DR. MELISSA NORBERG, foreground, and Christina Gilliam, rear, are among the researchers at Hartford Hospital's Anxiety Disorder Center who are studying ways a virtual reality machine might be able to help soldiers returning from war who suffer from post-traumatic stress disorder. (photo: SHANA SURECK)

For more about PTSD including the latest on virtual reality therapy, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=ptsd&op=and

Story here... http://www.courant.com/news/custom/to
pnews/hc-warsimulate1203.artdec03,0,1096033.story

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A Plan To Attack Post-Traumatic Stress Disorder

Confronting Soldiers' Nightmares

Virtual Reality Program Could Help Veterans Cope

By WILLIAM HATHAWAY
Courant Staff Writer

The soldier is driving down an arrow-straight road through the desert landscape of rural Iraq. He feels a distant concussion as smoke rises from a Humvee ahead.

The mosquito-like whiz of small arms fire pierces the air. Insurgents are visible on a bridge ahead.

Next comes the hard-edged rat-tat-tat of a .50-caliber machine gun firing from the turret and the tinkle of ejected shell casings falling on the vehicle floor.

The soldier turns to the right and sees a comrade badly wounded.

In an effort to help those damaged by the stress of combat, researchers at Hartford Hospital's Institute of Living are using a virtual reality machine to simulate the sights and sounds of Iraq. Wearing goggles and headphones linked to the machine, mentally scarred veterans can experience the war again, complete with baked desert air and the acrid smell of diesel fuel.

Researchers hope the digital experience — minus blood and death — can help vets recover from post-traumatic stress disorder, a condition marked by nightmares and debilitating fears, irritable outbursts and diminished interest in the pleasurable activities of life.

"PTSD is really a fear of memories," said Melissa Norberg, a post-doctoral fellow at the Anxiety Disorders Center at the IOL. "But a memory is not harmful. What we do is show soldiers that their memory isn't the same thing as the fearful event."

The IOL has begun to enlist veterans with PTSD to see whether a $20,000 virtual reality program run in a darkened room at the Institute of Living in Hartford will help them erase the lingering pain of a traumatic experience. Virtual reality programs have been used to treat a variety of conditions, such as social anxiety, obsessive compulsive disorder, the the fear of flying and other phobias.

Exposure therapy, such as the Iraq program, is used as a supplement to cognitive behavioral therapy, one of the only counseling techniques shown to help PTSD. In cognitive behavioral therapy, counselors talk to patients about the basis of their fears.

In the virtual reality program, they get to relive them. The idea is to gradually expose individuals to the very things they fear, but within a safe environment. By repeatedly experiencing the thing they most fear without the consequences they dread, patients tend to escape a prison of dread.

"The idea is to desensitize them to their fears," said David Tolin, director of the Anxiety Disorders Center.

The IOL and Emory University, where the technology was developed, are both conducting trials to assess the efficacy of the virtual reality software. The need for help in treating veterans is acute, Norberg said. A 2004 study showed that 12.6 percent of veterans assigned to combat duties in Iraq have PTSD. Hartford Hospital is funding the study.

Such therapy might be valuable for a subset of PTSD patients, said Dr. Robert Rosenheck, director of the Veterans Administration's Northeast Program Evaluation Center based in West Haven and a professor of psychiatry at Yale. But some who have mild cases and others with underlying mental health problems or addictions may not be good candidates.

"Treatments really need to be individualized," Rosenheck said. "It makes intuitive sense that [exposure therapy] would work, but we really don't know."

Tolin is optimistic about the potential of the virtual reality therapy, in conjunction with cognitive behavioral therapy.

Cognitive behavioral therapy, he said, holds out the only hope of a lasting reduction of symptoms in PTSD, Tolin said. Antidepressants also work — but only as long as they're taken. As soon as the drug is withdrawn, symptoms return, Tolin said.

"A returning veteran from Iraq might be 22, which means you have to account for the cost of Zoloft and doctors' fees for 60 years," Tolin said.

Tolin and Norberg, however, also hope that the sophistication of their virtual reality machine might attract veterans who are loathe to seek treatments.

Past experience has shown that veterans who most need treatment are the least likely to seek help, they said.

Contact William Hathaway at hathaway@courant.com.

-------------------------

Larry Scott  --

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