Innovations
The Ministry of Justice and Security, together with the police, is very involved in innovations in the approach to PTSD. For example, on Wednesday 30 September 2020, a digital expert session was held with researchers from TNO, during which Minister of JenV Ferd Grapperhaus was informed about the developments in this approach.
The police have been working for many years on effective treatment of occupational diseases such as PTSD. Tineke van der Gulik is a joint acting police psychologist. ‘Police employees experience violent incidents, often on a daily basis. That is why the police has made a professionalization in recent years in the field of prevention, support and care around PTSD ‘, says Van der Gulik.
Virtual reality
She lists a number of recent developments: ‘The national roll-out of good information about PTSD, but also Fitpol, an app with information about keeping fit and a digital psychological self-test. We are also investigating how something like virtual reality can contribute to the health of our police employees, ‘says Van der Gulik.
High relapse rate
The police certainly do not want to stand still in the field of prevention, support and care. That is why contact was also sought with the TNO researchers. Marieke Soeter is one of them: ‘Traditionally, the treatment of PTSD has focused on’ talking and taking pills’. Ultimately, however, up to 60 percent of patients will relapse with this treatment. They are faced with partial or complete recurrence of complaints. That’s because the fear memory is not erased by the drugs or the conversations. They only suppress the old fear memory, so that the chance that it can arise remains. ‘
Memory Reconsolidation
Insights from neuroscience and animal research have shown that fear memory is not permanent: ‘Together with Prof. Merel Kindt (UvA), we have now also demonstrated this in humans. Retrieving old memories makes the memory unstable and prone to change. By reconsolidating that memory you can remove existing fear memory. ‘
It turns out to be a promising treatment. ‘With a series of fundamental experiments we have been able to demonstrate that you erase the emotional component, but leave the actual memory intact. In other words, the memory remains, but the patient no longer feels fear. It is a fast and very effective treatment, because 80 percent of the treated patients appear to be rid of their anxiety within one session. We are currently investigating the method in veterans suffering from war-related PTSD and healthcare workers traumatized in the corona pandemic. I think this treatment could also be of interest to the police. ‘
Virtual partners and incorporation
Another interesting development is artificial intelligence (AI) to strengthen patient resilience. This can be done, for example, on the basis of experiences in healthcare. Mark Neerincx leads the research at TNO: ‘We can learn a lot from the way in which diabetes patients deal with stress and how they learn’ healthy thought patterns’ using smart tools. In our research we look for symbiosis between humans and AI. I am enthusiastic about the possibilities of using social robots as a physical and virtual assistant for patients and doctors. They can help with both training and treatment. Incorporation is also possible, or learning healthy thoughts. This is done through training or treatment sessions in virtual reality, where we use a simulated inner voice.
Responsible artificial intelligence
Neerincx’s examples sound abstract. ‘I compare symbiosis with an evolutionary process’, the researcher explains. Both humans and AI benefit from it: they learn to interact and become smarter and more resilient together. This requires strict preconditions: the technology must be fair and responsible, transparent and explainable. We are looking for responsible Artificial Intelligence. The first results are very promising. It is precisely in the development and implementation of responsible AI that the ministry’s support is desperately needed. ‘
Acting police psychologist Tineke van der Gulik is pleased with the innovative developments in the field of PTSD: ‘We want to continue to develop. Our goal is to keep all police officers as healthy as possible in the performance of their high-risk profession. ‘ A better understanding of the individual needs of patients is important in this, she says. Soeter and Neerincx confirm this: ‘With more data-driven methods we are developing more knowledge about PTSD and we can ensure better prevention and earlier detection.’
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