Efficacy and acceptability of virtual reality imagery rescripting for ptsd due to childhood sexual abuse: a multiple baseline study

This study piloted the efficacy and acceptability of Virtual Reality Imagery Rescripting (VR-ImRs) compared to conventional Imagery Rescripting (ImRs) for PTSD due to childhood sexual abuse (CSA). Eight adult patients with clinician-rated PTSD due to CSA as their primary diagnosis participated, of whom six completed the full treatment. A non-concurrent multiple baseline design with cross-over elements was used, with randomly assigned baseline lengths and treatment conditions. After baseline and a 5session 'education and exploration' phase, six sessions of either ImRs or VRImRs were given, followed by another six sessions of the opposite treatment condition and a 5-week follow-up without treatment. The primary outcome was PTSD symptoms (PCL-5), and secondary outcomes were negative and positive emotions (added PCL-5 items), anxiety and depressive symptoms (HADS) and trauma-related cognitions (PTCI). Data were analyzed with mixed regression. Results showed a significant linear reduction of trauma symptoms and negative emotions only during ImRs. No significant treatment effects on positive emotion, anxiety and depressive symptoms were found for both treatment conditions. Both treatment conditions showed significant positive effects on trauma-related cognitions. This study does not support the efficacy of VR-ImRs in reducing PTSD symptoms. Possibly VR-ImRs keeps people from reprocessing their memories, making it less effective.