Effects of Virtual Reality-Based Graded Exposure Therapy on PTSD Symptoms: A Systematic Review and Meta-Analysis

Previous studies reported that virtual reality (VR)-based exposure therapy (VRET) was a clinically beneficial intervention for specific phobias. However, among VRET, VR-based graded exposure therapy (VR-GET) is little known about its efficacy on posttraumatic stress disorder (PTSD) symptoms. Therefore, this meta-analysis investigated the effects of VR-GET for PTSD symptoms. A literature search yielded seven randomized controlled trials. The differences between conditions regarding the primary outcome of PTSD symptoms in the effect size of the individual study were calculated using Hedges' g. The findings showed VR-GET showed a significantly larger effect size for PTSD symptoms (g = 1.100, p = 0.001), compared to controls. However, no significant difference between conventional VRET and controls was found for PTSD symptoms (g = -0.279, p = 0.970). These findings indicated the superiority of VR-GET for PTSD symptoms compared to controls, supporting the importance of immersive PTSD treatments. Nevertheless, the results need to be interpreted with caution due to the substantial number of military service personnel studies. Future trials, considering individually tailored scenarios in virtual environments to cover a wider range of trauma types, are required to investigate its evidence on treating PTSD.