People with post-traumatic stress disorder (PTSD) may feel triggered by certain sights, smells and sounds of everyday life because these may take them back to the traumatic memories they are trying to forget or avoid. Prolonged exposure therapy is a common treatment for PTSD patients. This therapy teaches PTSD patients to become adapted to trauma-related memories, feelings and situations, and helps them learn that these cues are not dangerous and do not need to be avoided, according to the American Psychological Association (APA). Now, researchers from Medical University of South Carolina (MUSC) have developed a wristwatch device that can enhance therapy for PTSD patients by helping them adapt to stressful and trauma-related memories. 

The study describing the findings was recently published in the Journal of Psychiatric Research.

How PTSD affects people

PTSD is a mental health condition in which a particular sound, a certain shop, or a kind of smell can bring back traumatic memories that can increase the heart rate and muscle tension, leading to anxiety and depression. Even if the situation which triggers these memories in a PTSD patient does not pose any real danger, the person might feel the urge to avoid those situations so that they do not feel sad or stressed.

According to the US National Institutes of Health (NIH), PTSD can happen to anyone at any age, and can be treated through medications as well as therapy. 

How the new device works

The new device, called Bio Ware, is designed to enhance the effects of prolonged exposure therapy, and can record the patient’s heart rate, breathing and emotional distress. This is because as part of the Bio Ware system, the patient is made to wear a watch-sized tool around their wrist, attach a discreet button-shaped camera to their clothing, and wear a Bluetooth headphone in their ear, all of which allow their therapists to be virtually with the patients’ in their experience or situation that causes them stress, the study said. Since the therapists can see the patient’s heart rate and breathing, they can guide the person through the experience, optimising the in vivo exposure therapy. 

The researchers collaborated with medical device company Zeriscope to test the wristwatch. They tested the device on service members at the Ralph H. Johnson VA Medical Center, which serves veterans along the South Carolina and Georgia Coast. According to the US Department of Veteran Affairs, between 11 and 30 per cent of veterans experience symptoms of PTSD.

What is in vivo exposure therapy for PTSD patients?

In vivo exposure therapy for PTSD patients involves putting them in safe but triggering and uncomfortable situations outside of their therapy sessions, as a form of homework, in order to make them adapt to those situations. For instance, if a patient has a fear of a crowded grocery store, their therapist will make them visit the store at a busy time to know their reaction.

In vivo exposure therapy has proven successful and helpful to patients when done properly. However, Sudie Back, principal investigator for the study, believes that there is room for error in in vivo exposure therapy because it relies too much on the patient and their interpretation of their own disorders. According to a statement released by MUSC, she said she finds it exciting that the new Bio Ware device, when used alongside evidence-based, exposure treatment methods for PTSD, offers significantly better results for the patients. The researchers noticed significant decreases in both PTSD and depression symptoms with their patients who used the Bio Ware device, the study said. 

New device allows therapists to be virtually with the PTSD patient during exposure therapy

Back believes this is the first time researchers have been able to virtually be with patients during their in vivo exposures and have instant access to their physiological data in the moment to really help them get the most out of these exercises and reduce PTSD symptoms. 

According to Bill Harley, the co-founder and CEO of Zeriscope, the use of the Bio Ware device to enhance PTSD therapy is similar to using a personal trainer, while simple in vivo exposures are like working out on one’s own. He said communicating with patients while simultaneously seeing their biophysics is “incredibly helpful”, and Bio Ware enriches the healing that happens in the in vivo exposures. 

The new device sees how situations affect the patient’s autonomic nervous system

According to Robert Adams, the president and co-founder of Zeriscope, the “special sauce” created with Bio Ware lies in the autonomic nervous system, the statement said. Similar watches were developed in the past, but they only collected pulse information. The Bio Ware device goes a lot deeper by directly questioning the autonomic nervous system, which controls physiological reactions such as heart rate, breathing and blood pressure. 

The same technology is used in lie detector tests. With the Bio Ware device, physicians can determine the galvanic (relating to electric currents generated through chemical action) skin response, change the triggering experience of the PTSD patient accordingly, and observe how the actions that they ask the patient to perform affect the autonomic nervous system.

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