An Initial Validation of the Virtual Reality Stroop Task (VRST) in a Sample of OEF/OIF Veterans

Currently, neuropsychologists rely on assessment instruments rooted in century old theory and technology to make evaluations of military personnel’s readiness to return-to-duty or return to their community. The present study sought to explore an alternative by evaluating the validity of a neuropsychological assessment presented within a virtual reality platform. The integration of a neuropsychological assessment into a cognitively and emotionally demanding virtual environment – reminiscent of a combat experience in Iraq – offers a more ecologically valid manner in which to evaluate the cognitive skills required in theater. U.S. military veterans’ (N = 50) performance on the Virtual Reality Stroop Task (VRST) was compared with performance on a paper-and-pencil, a computer adapted version of the Stroop task, and the subtests included in the Automated Neuropsychological Assessment Metrics-4 (ANAM4) TBI-MIL test battery. Results supported the validity of the VRST, indicating it demonstrates the typical Stroop effect pattern. The emotional salience of the VRST resulted in slowed reaction time compared to the ANAM Stroop. Further, the complex interference condition of the VRST offers opportunities for evaluation of exogenous and endogenous attentional processing. In the evaluation of threat, participants were noted to perform more accurately and more quickly in low threat versus high threat zones. Ancillary inquiries found no clinically meaningful findings regarding the role of deployment or post-concussive symptoms, and mixed findings regarding the effect of posttraumatic stress symptoms on neuropsychological performance among the three tested modalities.