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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EPost-traumatic stress disorder (PTSD) first gained public awareness after the Vietnam War, as large numbers of returning veterans presented with depression and problems with substance abuse, which occur frequently with PTSD, and either a lack of or inappropriate emotional responses. As the Iraq War grinds into its fifth year, it\u0027s not surprising that PTSD has regained the headlines.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eanxiety disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EPost-traumatic stress disorder (PTSD) first gained public awareness after the Vietnam War, as large numbers of returning veterans presented with depression and problems with substance abuse, which occur frequently with PTSD, and either a lack of or inappropriate emotional responses. As the Iraq War grinds into its fifth year, it\u0027s not surprising that PTSD has regained the headlines. Bringing a high-tech solution to this latest battlefield is Barbara Olasov Rothbaum, PhD, ABPP, Emory School of Medicine, Atlanta, GA.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EDr. Rothbaum first gained an understanding of the onset of PTSD. Plotting the course of PTSD after trauma exposure, Dr. Rothbaum assessed female rape victims on a weekly basis for a total of 12 weeks following their assault. Results showed that in the first week, 94% met symptomatic criteria for PTSD. \u201cThis indicates that this is the normal response to trauma,\u201d said Dr. Rothbaum. \u201cWhat we wanted to figure out is when a normal response to trauma ends and when a pathopsychological response that requires diagnosis and treatment begins.\u201d While all subjects showed improvement after 4 weeks, a subset of patients stalled in their recovery. \u201cWe now see PTSD as a disorder of extinction. So, what you want to do is extinction training through exposure therapy\u2014therapeutic exposure.\u201d\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003ETherapeutic exposure can be imaginary, wherein the patient recalls the trauma in the present tense, or in vivo, where the site of the trauma is actually revisited; thanks to advances in technology, the trauma also can be virtually recreated. This technique, called virtual reality (VR), reasonably creates all the sensory inputs of sight, sound, vibration, and even smell of an actual traumatic setting. First used to treat Vietnam veterans, VR applications have expanded to include treatment for social disorders, fear of heights, and fear related to the events of 9\/11.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EVR is currently used in conjunction with relaxation techniques, education, and cognitive therapy, but Dr. Rothbaum is investigating the use of pharmacotherapy to enhance the efficacy of VR therapy. The investigative drug is D-cycloserine (DCS), an older antibiotic that has been shown to be a potential cognitive enhancer, facilitating extinction of the fear response in animal studies. Dr. Rothbaum first used DCS to help patients who had a fear of heights [\u003Cem\u003EArch Gen Psychiatry\u003C\/em\u003E 2004] and was eager to try it with veterans who were returning from Iraq.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EHer current study randomizes PTSD patients to one of 3 treatments, alprazolam, placebo, or 50 mg DCS, given 30 minutes prior to VR trauma exposure. \u201cAnimal data indicate that it\u0027s best to have the drug on board during the consolidation as well as during the exposure.\u201d Though results on the first 27 patients are still blinded, all patients seem to be responding well to therapy with VR.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003E\u201cBut you have to ask yourself, \u2018What is the treatment ideal?\u201d Dr. Rothbaum asks. \u201cWell, that would be to prevent PTSD before it starts.\u201d To that end, she has proposed a study of emergency room trauma patients to be treated immediately for PTSD or observed for 12 weeks. The working hypothesis is that early disruption may change how the traumatic memory is consolidated. \u201cIt\u0027s like getting right back on the bike after you\u0027ve fallen off.\u201d\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EFor more information on virtual reality therapy, please visit \u003Ca href=\u0022http:\/\/www.virtuallybetter.com\u0022\u003Ewww.virtuallybetter.com\u003C\/a\u003E.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2008 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/8\/3\/27.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzme61\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}