The efficacy of virtual reality exposure therapy for PTSD symptoms: A systematic review and meta-analysis

Background: Virtual reality exposure therapy (VRET) for PTSD is an emerging treatment of remarkable promise, but its efficacy and safety are still unclear. Our aim was to investigate the efficacy of VRET for individuals with PTSD, and to identify the potential moderating variables associated with interventions. Methods: Literature search was conducted via PubMed, Embase, Web of Science, Cochrane Library, Psyclnfo, Science Direct, and EBSCO. We identified 18 studies on PTSD including 13 randomized controlled trials (RCTs; 654 participants) and 5 single-group trials (60 participants). Results: The main effects analysis showed a moderate effect size (g = 0.327, 95% CI: 0.105-0.550, p< 0.01) for VRET compared to control conditions on PTSD symptoms. Subgroup analysis revealed that the effects of VRET were larger when compared to inactive groups (g = 0.567) than active control groups (g = 0.017). This finding was in agreement with depressive symptoms. A dose-response relationship existed with more VRET sessions showing larger effects. There was a long-range effect of VRET on PTSD symptoms indicating a sustained decrease in PTSD symptoms at 3-month follow-up (g = 0.697) and 6-month follow-up (g = 0.848). The single-group trials analysis revealed that the VRET intervention had a significant effect on PTSD. Limitations: Many of the combat-related PTSD subjects resulted in uncertainty regarding meta-analytical estimates and subsequent conclusions. Conclusions: These findings demonstrated that VRET could produce significant PTSD symptoms reduction and supported its application in treating PTSD.