虚拟现实暴露疗法治疗创伤后应激障碍的Meta分析
Meta Analysis of Virtual Reality Exposure Therapy in the Treatment of Post-Traumatic Stress Disorder
摘要: 目的：采用Meta分析方法评价虚拟现实暴露疗法在创伤后应激障碍治疗中的意义。方法：计算机检索Pubmed、Embase、Cochrane Library、BIOSIS Previews上关于虚拟现实暴露疗法治疗创伤后应激障碍的随机对照试验。利用RevMan5.3统计软件进行资料提取和数据分析。结果：共纳入6篇文献7项随机对照研究涉及创伤后应激障碍患者372例，比较了对照组和虚拟现实暴露组的临床用PTSD量表得分、贝克抑郁量表得分以及随访数据，较全面地分析了虚拟现实暴露疗法在创伤后应激障碍治疗中的意义。结论：虚拟现实暴露疗法对创伤后应激障碍治疗有明显的疗效，但是与传统积极心理疗法相比，在减轻患者典型症状上，它并没有明显优势。但是，在减轻患者抑郁症状以及对患者远期疗效上，它明显优于其他心理疗法。虚拟现实暴露疗法在创伤后应激障碍的治疗中有重要的意义。
Abstract: Objective: To evaluate the significance of virtual reality exposure therapy in the treatment of post-traumatic stress disorder (PTSD) by Meta-analysis. Methods: Randomized controlled trials of virtual reality exposure therapy for post-traumatic stress disorder were retrieved on Pubmed, Embase, Cochrane Library and BIOSIS Previews. RevMan 5.3 statistical software was used for data extraction and data analysis. Results: A total of 372 patients with PTSD in 7 randomized controlled studies involving 6 literatures were included. The clinical PTSD score, Beck Depression Scale score and follow-up data were compared between the control group and the virtual reality exposure group. The significance of virtual reality exposure therapy in the treatment of PTSD was analyzed comprehensively. Conclusion: Virtual reality exposure therapy is effective in the treatment of post-traumatic stress disorder, but it has no obvious advantage in alleviating typical symptoms of patients compared with traditional positive psychotherapies. However, it is significantly superior to other psychotherapies in alleviating depressive symptoms and in its long-term efficacy. Virtual reality exposure therapy plays an important role in the treatment of post-traumatic stress disorder.
文章引用：赵后雨, 屠志浩, 瞿靖芮, 沈兴华 (2019). 虚拟现实暴露疗法治疗创伤后应激障碍的Meta分析. 心理学进展, 9(7), 1268-1276. https://doi.org/10.12677/AP.2019.97156

参考文献

[1] 王广新, 李立(2012). 焦虑障碍的虚拟现实暴露疗法研究述评. 心理科学进展, 20(8), 1277-1286.
[2] 王铭, 江光荣(2016). 创伤后应激障碍的双重表征理论及其检验. 心理科学进展, 24(5), 753-764.
[3] Bisson, J. I., Cosgrove, S., Lewis, C., & Robert, N. P. (2015). Post-Traumatic Stress Disorder. BMJ, 351, h6161.[CrossRef] [PubMed]
[4] Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A Multidimensional Meta-Analysis of Psychotherapy for Ptsd. American Journal of Psychiatry, 162, 214-227.[CrossRef] [PubMed]
[5] Botella, C., Serrano, B., & Rosa, M. B. (2015). 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. Neuropsychiatric Disease & Treatment, 11, 2533-2545.[CrossRef] 
[6] Cahill, S. P., Foa, E. B., & Taylor, S. (2004). Advances in the Treatment of Posttraumatic Stress Disorder: Cognitive-Behavioral Perspectives (pp. 267-313). New York: Springer.
[7] Creamer, M., O’Donnell, C. L., Bryant, M. R., Shalev, A., & Schnyder, U. (2003). Posttraumatic Disorders Following Injury: An Empirical and Methodological Review. Clinical Psychology Review, 23, 587-603.[CrossRef] 
[8] Guideline Development Panel for the Treatment of PTSD in Adults (2017). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults (pp. ES-2). Washington DC: American Psychological Association.
[9] Hamm, A. O., & Weike, A. I. (2005). The Neuropsychology of Fear Learning and Fear Regulation. International Journal of Psychophysiology, 57, 5-14.[CrossRef] [PubMed]
[10] Institute of Medicine (2007). Treatment of PTSD: An Assessment of the Evidence. Washington DC.
[11] Koenen, K. C., Ratanatharathorn, A., Ng, L., Mclaughlin, K. A., Bromet, E. J., Stein, D. J., & Kessler, R. C. (2017). Posttraumatic Stress Disorder in the World Mental Health Surveys. Psychological Medicine, 47, 1-15.[CrossRef] 
[12] Lee, C. W., & Cuijpers, P. (2013). A Meta-Analysis of the Contribution of Eye Movements in Processing Emotional Memories. Journal of Behavior Therapy and Experimental Psychiatry, 44, 231-239.[CrossRef] [PubMed]
[13] *Mclay, R. N., Wood, D. P., Webbmurphy, J. A., Spira, J. L., Wiederhold, M. D., Pyne, J. M., & Wiederhold, B. K. (2011). A Randomized, Controlled Trial of Virtual Reality-Graded Exposure Therapy for Post-Traumatic Stress Disorder in Active Duty Service Members with Combat-Related Post-Traumatic Stress Disorder. Cyberpsychology Behavior & Social Networking, 14, 223.[CrossRef] [PubMed]
[14] *Mclay, R. N., Baird, A., Webb-Murphy, J., Deal, W., Tran, L., Anson, H., & Johnston, S. (2017). A Randomized, Head-to-Head Study of Virtual Reality Exposure Therapy for Posttraumatic Stress Disorder. Cyberpsychology, Behavior, and Social Networking, 20, 218-224.[CrossRef] [PubMed]
[15] Negu, A., Matu, S. A., Sava, F. A., & David, D. (2016). Virtual Reality Measures in Neuropsychological Assessment: A Meta-Analytic Review. The Clinical Neuropsychologist, 30, 1-20.[CrossRef] [PubMed]
[16] Norr, A. M., Smolenski, D. J., & Reger, G. M. (2018). Effects of Prolonged Exposure and Virtual Reality Exposure on Suicidal Ideation in Active Duty Soldiers: An Examination of Potential Mechanisms. Journal of Psychiatric Research, 103, 69-74.[CrossRef] [PubMed]
[17] North, M. M., North, S. M., & Coble, J. R. (1996). Effectiveness of Virtual Environment Desensitization in the Treatment of Agoraphobia. Presence: Teleoperators and Virtual Environments, 5, 127-132.[CrossRef] 
[18] Panagioti, M., Gooding, P. A., Triantafyllou, K., & Tarrier, N. (2015). Suicidality and Posttraumatic Stress Disorder (PTSD) in Adolescents: A Systematic Review and Meta-Analysis. Social Psychiatry and Psychiatric Epidemiology, 50, 525-537.[CrossRef] [PubMed]
[19] Raquel, G., Lúcia, P. A., Freire, C. E. S., Ivan, F., Paula, V., & Mel, S. (2012). Efficacy of Virtual Reality Exposure Therapy in the Treatment of PTSD: A Systematic Review. PLoS ONE, 7, e48469.[CrossRef] [PubMed]
[20] *Ready, D. J., Gerardi, R. J., Backscheider, A. G., Mascaro, N., & Rothbaum, B. O. (2010). Comparing Virtual Reality Exposure Therapy to Present-Centered Therapy with 11 U.S. Vietnam Veterans with PTSD. Cyberpsychology, Behavior, and Social Networking, 13, 49-54.[CrossRef] [PubMed]
[21] *Reger, G. M., Koenen-Woods, P., Zetocha, K., Smolenski, D. J., Holloway, K. M., Rothbaum, B. O., Gahm, G. A. et al. (2016). Randomized Controlled Trial of Prolonged Exposure Using Imaginal Exposure vs. Virtual Reality Exposure in Active Duty Soldiers with Deployment-Related Posttraumatic Stress Disorder (PTSD). Journal of Consulting and Clinical Psychology, 84, 946-959.[CrossRef] [PubMed]
[22] Sherman, J. J. (1998). Effects of Psychotherapeutic Treatments for PTSD: A Meta-Analysis of Controlled Clinical Trials. Journal of Traumatic Stress, 11, 413-435.[CrossRef] 
[23] Steenkamp, M. M., & Litz, B. T. (2013). Psychotherapy for Military-Related Posttraumatic Stress Disorder: Review of the Evidence. Clinical Psychology Review, 33, 45-53.[CrossRef] [PubMed]
[24] Watkins, L., Sprang, K., & Rathbaum, B. (2018). Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions. Frontiers in Behavioral Neuroscience, 12, 258.[CrossRef] [PubMed]