Selection of key stressors to develop virtual environments for practicing stress management skills with military personnel prior to deployment.

Virtual environments (VEs) are presently being used to treat military personnel suffering from posttraumatic stress disorder (PTSD). In an attempt to reduce the risk of PTSD, VEs may also be useful for stress management training (SMT) to practice skills under stress, but such use necessitates the development of relevant stress-inducing scenarios and storyboards. This article describes the procedures followed to select which VEs could be built for the Canadian Forces. A review and analysis of the available literature and of data collected postdeployment from 1,319 respondents on the frequency of stressors and their association with psychological injuries were pulled together to propose eight potential virtual stressors that can be used to practice SMT: seeing dead bodies or uncovering human remains; knowing someone being seriously injured or killed; receiving artillery fire; being unable to help ill or wounded civilians because of the rules of engagement; seeing destroyed homes and villages; clearing and searching homes, caves, or bunkers; receiving small-arms fire; and participating in demining operations. Information reported in this article could also be useful to document traumatic stressors experienced in theater of operations and their potential impact on psychological injuries.