Sounds such as explosions and gunfire have long been part of therapy programs for post-traumatic stress disorder. But smells have rarely been included even though they can elicit flashbacks and anxiety in service personnel long after they leave the battlefield.

That could change depending on the results of a $3.5 million study led by University of Central Florida Professor Deborah Beidel and funded by the U.S. Army Medical Research and Materiel Command’s Military Operational Medicine Research Program. Individual behavioral treatment, using virtual reality to enhance the experience, will be used along with small group therapy sessions to help participants diagnosed with PTSD eliminate their fear, manage their depression and anger and reconnect with family and friends.

About 150 military personnel who have fought in Afghanistan or Iraq and have post-traumatic stress disorder will participate. Seventy-five participants will receive treatment at the University of Central Florida. The other seventy-five participants will be recruited from the Charleston, S.C., area and will be treated at the Medical University of South Carolina.

Veterans of any military branch, as well as National Guard and Reserve members, who have served in Iraq or Afghanistan are eligible. For more information on UCF’s portion of the study, go to https://sciences.ucf.edu/psychology/group/anxiety-disorders-clinic-faculty-and-staff/ or call 407-823-1668.

Servicemen and women returning from Iraq or Afghanistan often say smells that remind them of war or the countries where they fought can trigger memories or flashbacks of combat trauma – just as the sound of fireworks produced the same symptoms in Vietnam War veterans, said Beidel, a clinical psychologist who will lead the research in Orlando.

Over five weeks, the individual behavior therapy sessions using virtual reality will gradually expose participants to the sights, sounds and smells of trauma that they experienced in Afghanistan and Iraq. Those smells will include garbage, which is often found where they patrol.

“We hope a more complete treatment will help veterans readjust to their lives in the United States and connect better with their family and friends,” said Beidel, who has several family members who have served in the military. “People who go to war sacrifice so much for all of us. This is a small way that I can give back to the warriors who defend our country.”

The second component of the study will involve 12 weeks of therapy in small groups. For some soldiers, the small-group sessions will be modeled after the typical PTSD therapy sessions offered by the Department of Veterans Affairs. During those sessions, participants discuss their experiences and learn how their peers are dealing with the same issues.

The new study will compare that approach with a comprehensive therapy program that will focus on three issues that returning soldiers often face: how to cope with depression, how to deal with anger and how to reconnect with family, friends and co-workers.

Beidel has extensive experience working with virtual reality and helping veterans. Her research program to treat combat-related PTSD in servicemen and women began in the mid-1990s when she was at the Medical University of South Carolina. More recently, while at the Penn State College of Medicine, she treated Vietnam War veterans suffering from PTSD.

In addition to Beidel, the research team includes Professor Christopher Frueh of the University of Hawaii at Hilo and Professor Thomas Uhde, chair of the Medical University of South Carolina’s Department of Psychiatry & Behavioral Sciences. Several graduate students at the three institutions also will assist with the study.