Neurotechnology and Operational Medicine - Neurotechnology in National Security and Defense - page 72

behavior is determined by the current situation assessment, which maps onto the
process termed interoception in the neurotechnology approach (Figure 6.1b).
Inappropriate help-seeking manifests as the worried well phenomenon; it is an
interoceptive hypervigilance-driven form of panic that creates bottlenecks in
resource delivery by demanding assessment and treatment. Conversely, others may
delay reporting symptoms, with negative implications for outcomes. Literature from
both public health and social science domains provides ample evidence for predict-
able effects of factors such as personality, age, ethnicity, race, career role, socioeco-
nomic status, and gender on the perception of illness and the likelihood of reporting
potential illness to a response facility (Ayalon and Young 2005; Barratt 2005; Engel
et al. 2002; Feldman et al. 1999; Ferguson et al. 2004; Kolk et al. 2002; Lefler and
Bondy 2004; Marshall et al. 1994). Specifically, the behavior of individual agents can
reflect distinct clusters of “Big 5” personality characteristics that impact the thresh-
old for emergence of help-seeking behaviors (Feldman et al. 1999; Ferguson et al.
2004; Kolk et al. 2002; Marshall et al. 1994), the style of self-presentation (Barratt
2005), and the likelihood of seeking help from different resources (e.g., self-help
topics, religious institutions [Ayalon and Young 2005], internet resources, nurse prac-
titioner hotlines, pharmacist, clinical facilities, or emergency responders). A hybrid
simulation, neurotechnology approach is thus envisioned as a common platform for
generating predictions from a formalization of the relationship between individual
situation assessments and mass civilian and military responses to perceived threats
and significant events (Aguirre 2005; Mawson 2005; Perry and Lindell 2003; Stokes and
Banderet 1997).
The ability to predict help-seeking behavior in context can be an asset of
particularly high value for responses to pandemics, bioterrorism, biological war-
fare, unsuspected chemical toxin exposure, or unsuspected radiological exposure.
These scenarios are examples of latent events, which are detected only as the victims
develop symptoms and conclude that they need to seek help. A special case is an
“announced attack” scenario, where information about an impending or developing
attack is released by terrorists to elicit panic responses in the public. The detec-
tion phase, defined as the period encompassing release (or infection), appearance of
symptoms, illness, and first deaths, is a period when public responses to perceived
symptoms and the societal milieu (including information, misinformation and disin-
formation) can have a profound impact on both (1) the ability to detect a significant
latent event and (2) the resulting demands for response assets. When they are neither
understood nor predictable, these individual variations become a significant compo-
nent of noise (or “fog of war”) that can impede the process of detection and the initia-
tion of an effective response. However, a situation assessment simulation approach
can be used to help identify sentinel populations (or features of multiple populations)
to improve the speed and accuracy of detection of a latent event.
Decision support for diagnosis and treatment. The neurotechnology-based
approach is designed to provide a mechanistically based, integrated overview of
the progression of neurological and psychological signs of symptoms from the per-
spectives of both the patient's self-report and the clinical objective and subjective
observations by medical and paramedical staff. This statement is hardly surprising
because the approach is generalized from research directed at elucidating scientific