The National Center for PTSD estimates that between 11 percent and 20 percent of veterans who served in Iraq and Afghanistan have PTSD. Among Vietnam War veterans, they estimate that 30 percent have had PTSD in their lifetime.
When veterans return from deployment, they are required to complete a Post-Deployment Health Assessment, or PDHA, which contains 25 questions, including a checklist of symptoms. Veterans must self-disclose their symptoms to the document, and the information goes on their record.
Lucas said veterans and service members filling out the survey might feel pressure not to disclose all of their symptoms. The checklist is impersonal and, because the information from the PDHA is recorded, it might affect future deployment opportunities for still-serving members and job opportunities for veterans. "The culture of the military is to say, 'No, I'm fine,'" Lucas said.
Ellie offers anonymity to patients — the interview is not recorded. Instead, she reads expressions by tracking 66 points on a patient's face, and she also registers speech patterns. Analyzing this data in real time, she responds to patients with active affirmations, like nodding or even saying "mhmm" when patients appear to need it.
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The new study, published in Frontiers, shows that by building rapport with patients and keeping the interview anonymous, Ellie outperformed the PDHA in getting veterans to disclose symptoms. Ellie even topped an anonymous PDHA to show that a conversation, even with a virtual therapist, is effective in assessing PTSD.
"It's a humanlike interaction," Lucas said. "It makes people feel more comfortable sharing personal things, like symptoms of PTSD."
In the future, Lucas hopes that Ellie will be able to report the likelihood of a veteran having PTSD immediately following the interview. That will allow the veterans to make a more informed decision about seeking treatment through therapy.