First responders at the Federal, State and local level are those on the front lines of providing support to their communities during an emergency or a disaster. Their work domains are emergency public security, firefighting, law enforcement, emergency response, and emergency medical care. Due to the inherent characteristics of the jobs they perform, they are constantly exposed to very stressful, demanding and dangerous work environments. Such an exposure often leads to mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). More than 80 percent of first responders experience traumatic events on their job duty. Various efforts to treat about trauma have been made to address the first responders' mental health. However, existing interventions are not directly targeted at the causes of mental health problems, which is the memory of the adverse events. The objective the proposed research is to investigate the effect of immersive virtual reality (VR) experience on the memory of an adverse event (e.g., fire).

Background: First responders, such as firefighters, experience significant mental health issues due to the high-stress nature of their work. Existing mental health interventions, such as meditation and debriefing, despite their benefits, do not target cognitive processing of traumatic events such as memory and emotion.

Objective: This work aims to examine effects of semantically irrelevant virtual reality (VR) content to intervene in the retrieval of an adverse event memory and its associated emotions. Cognitive models of posttraumatic stress disorder posit that exposure to stimuli that are similar to a previous trauma acts as a trigger for retrieval of the associated memory and bodily reaction (eg, elevated heart rate). This work uses semantically irrelevant VR as an intervention to interrupt the retrieval of the traumatic memory by placing a participant in a VR environment that has a distant semantic connection to the trauma.

Methods: A total of 107 participants recruited from a large public university in Texas was randomly assigned to 1 of 3 groups: control (n=33), comparison (n=37), and intervention (n=37). In stage 1, participants in all groups watched a short video of an actual severe house fire to create a traumatic event memory. In stage 2, the control group stayed seated without doing anything, the comparison group read a paragraph about the Egyptian Ocean as semantically irrelevant follow-up information, and the intervention group watched a 360° VR video of the Egyptian Ocean that features opposite attributes to the fire (eg, blue water vs red fire, cool water vs hot fire). The Positive and Negative Affect Schedule, which has 10 items for positive emotions (eg, attentive and excited) and 10 items for negative emotions (eg, scared and distressed), was administered after each of the two stages. In stage 3, the memory accuracy of the house fire video was assessed using a forced recognition test of 15 pairs of a true image and a fake image generated by artificial intelligence software.

Inclusion Criteria:

• aged at least 18 years
• currently enrolled at the university

Exclusion Criteria:

• under 18 years
• not currently enrolled at the university

Participants were masked about the group they were assigned to.