Piloting Virtual Reality Environments to Treat PTSD in Healthcare Workers and Patients Consequent to the COVID-19 Pandemic

Piloting Virtual Reality Environments to Treat PTSD in Healthcare Workers and Patients Consequent to the COVID-19 Pandemic

Piloting Virtual Reality Environments to Treat PTSD in Healthcare Workers and Patients Consequent to the COVID-19 Pandemic

Healthcare workers and COVID-19 patients may experience psychological distress consequent to the pandemic, and are at particularly elevated risk for experiencing posttraumatic stress disorder (PTSD), based on evidence from previous infectious disease outbreaks. The best-validated treatment for PTSD is exposure therapy. Exposure therapy help patients suffering from PTSD to revisit and overcome their traumatic experiences. Including virtual reality in exposure therapy has a long history in treating PTSD; and has been used to treat military veterans and first-responders following 9/11. The investigators are developing and testing a virtual reality platform to be used in treating healthcare workers and COVID-19 patients who develop PTSD resulting from their experiences in the COVID-19 pandemic. Participants will complete ten ninety minute sessions, twice a week for five weeks aimed at mitigating their symptoms of PTSD. The pilot study will aim to demonstrate the feasibility and the tolerability of the virtual reality intervention in these populations.

Change in Clinician-Administered PTSD Scale for DSM-5 (CAPS-V) Score. Total Scores range from 0-80. Higher scores indicate greater symptom severity.

Feasibility assessment will include recruitment defined as number of individuals interested in the intervention.

Feasibility assessment will include enrollment defined as number of participants signing the informed consent form.

Feasibility assessment will include retention defined as the number of participants completing the full intervention.

Scored between 0-21: Cut offs: 0-4 = None 5-9 = Mild anxiety 10-14 = Moderate anxiety 15-21 = Severe anxiety Higher scores indicate greater symptom severity.

24 item self-report measure. 19 questions are evaluated. Each item in the scale is rated between 0 (no distress) and 3 (serious distress). The total PSQI score ranges from 0-21. Sleep quality of the patients with a total score of 5 and below is considered "good". A score of greater than 5 refers to poor sleep quality.

The well-validated PCL-5 will assess self-reported PTSD symptom severity. Scores range from 0-80. Higher scores indicate greater symptom severity.

The scale is comprised of 140 items total. The measure is comprised of 14 different scales and respondents indicate on a 5-point scale the frequency of a stress-related event.

11 item self-report measure that measures moral injury. Statements related to distress or feelings of betrayal related to potentially morally injurious events are rated on a 6 point scale ranging from 1 (strongly agree) to 6 (strongly disagree). Score range is 11-66, with higher scores reflecting greater moral injury.

10 point visual analog scale to rate the extent to which work/school, social life and home life or family responsibilities are impaired by his or her symptoms. The 3 items can be summed into a single dimensional measure of global functional impairment that ranges from 0 (unimpaired) to 30 (highly impaired).

Subjects rate their own social functioning over times on a 5-point scale on items covering work for pay, housework, extended family, parenting, marital status, social activity and leisure, family unit and student status (sub-scales). Mean values of all the sub-scales are used, with a range from 0-5. Higher score = worse outcome.

21 item self-report measure measuring moral distress (the emotional state that arises from a situation when an individual feels that the ethically correct action to take is different from what he/she is tasked with doing). Score range is 0-336. Higher scores indicate greater moral distress.

The assessment yields an overall score and profile in 16 areas of life; health, self-esteem, goals and values, money, work, play, learning, creativity, helping, love, friends, children, relatives, home, neighbourhood, and community. Higher scores indicate higher level of quality of life.

Inclusion Criteria: A COVID-19 patient or any healthcare worker providing medical care or support for COVID-19 patients English-speaking Age ≥18 Medically stable Diagnosed with PTSD Ability to provide informed consent and function at an intellectual level sufficient to allow accurate completion of all assessment instruments Stable on psychotropic medication for the prior 60 days Exclusion Criteria: Current significant unstable medical illness such that the participant could not attend sessions regularly or complete assessments Patients who in the investigator's judgment pose a current homicidal, suicidal or other risk Lifetime or Current diagnosis of schizophrenia or other psychotic disorder Participation in a clinical trial or concurrent evidence-based treatment for psychiatric conditions or PTSD during the previous 3 months History of motion sickness or seizures