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Lessons learned from V.R.E.t. with 200 accident victims: a review of 50 consecutive cases

Lessons learned from V.R.E.t. with 200 accident victims: a review of 50 consecutive cases. David Walshe Cork, Ireland. Literature review of accident victims. Diagnosis at 1 year post accident (Mayou R 2001) Accident Phobia 17% P.T.S.D. 17%

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Lessons learned from V.R.E.t. with 200 accident victims: a review of 50 consecutive cases

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  1. Lessons learned from V.R.E.t. with 200 accident victims:a review of 50 consecutive cases David Walshe Cork, Ireland

  2. Literature review of accident victims Diagnosis at 1 year post accident (Mayou R 2001) Accident Phobia 17% P.T.S.D. 17% G.A.D. 18%

  3. Early VRET research • Combination VR software +video games effective Walshe et al (2003)

  4. Tweaking the system ‘tweaking the system Increasing immersion rate from 50% to 92% Walshe et al (2005) • taping sessions useful Walshe et al(2006)

  5. Video games ok

  6. V.R.E.T. with 50 accident phobics • Sex: M 14, F 36 • Age: 25-77 yrs Mean = 44 yrs • VR range 4-25 Mean = 7 sessions • Drop outs = 16 • More than 1 dx = 30 (60%) • Litigants= 34/50 (68%)

  7. Review of 42 patients: efficacy

  8. Lessons learned:Accident phobia ‘tip of the iceberg’ 60% >1 diagnosis (P.T.S.D., anxiety disorder, depression, panic disorder,)

  9. consider appropriate options • Pharmacotherapy • taped imaginal exposure • E.M.D.R.

  10. Lessons learned:Understanding failures • Drop-outs • Anxiety factors V.R.E.T. can be counter- productive • Compensation factors (68% litigants)

  11. Lessons learnedtreatment expectations • Expect success from VRET 70% ‘non phobic’ if complete treatment • but warn of possibility of residual anxiety

  12. the gold standard? ‘Exposure in vivo’or V.R.E.T. Driving exposure

  13. The way forward? • link with driving instructor ? + • virtual car? - • better software for VR/games + • ‘px’. video games-

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