Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2020 Experiences of PTSD Sufferers Who Participate in Internet-Based Virtual World Activities in Desktop Virtual Reality Environments Colleen Margaret Crary Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Psychology Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Social and Behavioral Sciences This is to certify that the doctoral dissertation by Colleen M. Crary has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Edoardo Naggiar, Committee Chairperson, Psychology Faculty Dr. Hedy Dexter, Committee Member, Psychology Faculty Dr. Bonnie Nastasi, University Reviewer, Psychology Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2020 Abstract Experiences of PTSD Sufferers Who Participate in Internet-Based Virtual World Activities in Desktop Virtual Reality Environments by Colleen M. Crary BA, San Diego State University, 1994 MA, The Chicago School of Professional Psychology, 2010 Dissertation Submitted in Fulfillment of the Requirements for the Degree of Doctor of Philosophy Psychology Research Walden University August 2020 Abstract Treatments for posttraumatic stress have remained largely static for 3 decades, resulting in low recovery rates, high degrees of retrogression, and noncompliance by patients, calling for new approaches for posttraumatic stress disorder (PTSD) treatment. This qualitative phenomenological study explored the lived experiences of people with PTSD who participate in Desktop Virtual Reality Environments (DVREs). The research questions asked about the lived experiences of adults with PTSD who use the DVRE, and what they perceive as changes in their narratives about PTSD through their use of the DVRE. Twenty-three participants responded to a 10-item, open-ended questionnaire. Findings show that although each participant had their own individual approach, their reported experiences shared commonalities in efforts to establish control over external stressors, create new interpersonal boundaries, explore the self apart from previous self- definitions, connect with others in healthier roles, acquire new skills that gave them newfound confidence, and build resilience to reduce regression when confronted with triggering life events. Implications for positive social change include improved therapeutic outcomes that may curtail the negative personal, interpersonal, and social outcomes prevalent in PTSD, such as antisocial behaviors, substance abuse, and suicidality. Experiences of PTSD Sufferers Who Participate in Internet-Based Virtual World Activities in Desktop Virtual Reality Environments by Colleen M. Crary BA, San Diego State University, 1994 MA, The Chicago School of Professional Psychology, 2010 Dissertation Submitted in Fulfillment of the Requirements for the Degree of Doctor of Philosophy Psychology Research Walden University August 2020 Table of Contents List of Tables ..................................................................................................................... vi List of Figures ................................................................................................................... vii Chapter 1: Introduction to the Study ....................................................................................1 Introduction ....................................................................................................................1 Background ....................................................................................................................6 The Statement of the Problem........................................................................................8 Purpose of the Study ......................................................................................................9 Research Questions ........................................................................................................9 Research Question 1 ............................................................................................... 9 Research Question 2 ............................................................................................... 9 Conceptual Framework ..................................................................................................9 Nature of the Study ......................................................................................................12 Definitions....................................................................................................................13 Assumptions .......................................................................................................... 15 Scope and Delimitations ....................................................................................... 15 Limitations ...................................................................................................................16 Significance of the Study .............................................................................................18 Implications for Social Change ............................................................................. 18 Summary ......................................................................................................................19 Chapter 2: Literature Review .............................................................................................21 i Introduction ..................................................................................................................21 Problem and Purpose ............................................................................................ 21 Relevance of the Problem ..................................................................................... 22 Preview ........................................................................................................................23 Search Strategy ............................................................................................................23 Conceptual Framework ................................................................................................24 The Pioneers of PTSD Diagnoses and Research .................................................. 24 Literature Review Related to Key Concepts ................................................................26 Posttraumatic Stress Disorder Defined ................................................................. 26 Types of PTSD .............................................................................................................27 Complex PTSD ..................................................................................................... 28 Who Acquires PTSD? ........................................................................................... 29 The Moral and Spiritual Injury of PTSD .............................................................. 29 The Social and Relational Ripple Effect of PTSD................................................ 30 PTSD and Suicidality ............................................................................................ 31 Physiological Consequences of PTSD .........................................................................32 Substance Abuse and Addiction ........................................................................... 32 PTSD Brain Physics and the HPA Axis ............................................................... 33 PTSD Therapies Lag Technologically Behind Neuroscience .............................. 35 Virtual Reality: Immersive Technology for PTSD Care ...................................... 36 PTSD and the Self ................................................................................................. 38 The Avatar and the Self ........................................................................................ 38 ii The VRE as a Stable, Safe Place .......................................................................... 40 The Need for Research on DVREs as Venues for Therapeutic Applications....... 41 Summary ......................................................................................................................43 Chapter 3: Research Method ........................................................................................46 Phenomenological Inquiry ...........................................................................................46 Types and Sources of Data ................................................................................... 47 Establishing Validity ....................................................................................................47 Reflexivity............................................................................................................. 47 Analytical Strategies ............................................................................................. 50 Data Collection and Analysis................................................................................ 52 Ethical