Експозиційна VR-терапія з елементами керованої релаксації для подолання ПТСР у військовослужбовців

The paper theoretically substantiates the use of exposure-based virtual reality therapy with elements of guided relaxation in psychological support for military personnel with post-traumatic stress disorder. It elucidates the psychophysiological mechanisms of PTSD associated with cognitive-emotional disintegration, chronic stress hyperactivation, impaired regulation of fear responses, and the pathological consolidation of traumatic memories. The potential of VR therapy as a tool for controlled, gradual, and safe immersion in combat-related traumatic stimuli is characterized. Particular attention is paid to the role of desensitization, cognitive reappraisal, sensory and cognitive memory reconsolidation, and the formation of new associations of safety with past traumatic experiences. Contemporary VR-based approaches used in the treatment of combat-related PTSD are summarized, including Virtual Iraq/Afghanistan, Bravemind, VR Exposure for Veterans, 3MDR, and combined protocols integrating VR exposure with biofeedback, relaxation techniques, and neuromodulation methods. The significance of real-time physiological monitoring, individualized calibration of traumatic triggers, and adaptive regulation of stimulus intensity is emphasized as a way to prevent retraumatization and support therapeutic tolerance. A structured model of exposure-based VR therapy with guided relaxation for military personnel with PTSD is proposed. It includes the stages of screening and safety assessment, psychoeducation and therapeutic contracting, trigger calibration, preparatory guided relaxation, construction and dosing of the VR scene, microcycle-based exposure, biofeedback-guided adaptation, cognitive reconstruction, final stabilization, between-session tasks, progress criteria, and hybrid safety protocols. The prospects for developing Ukrainian VR-based rehabilitation programs with flexible sensory load, artificial intelligence-supported personalization, and integration of cognitive-behavioral, body-oriented, and neurophysiological approaches are outlined.