Prediction of Psychological Flexibility with multi-scale Heart Rate Variability and Breathing Features in an “in-the-wild” Setting

Psychological flexibility (PF) has recently emerged as an important determinant in pain related outcomes. It is related to pain adaptation, social functioning and emotional well-being. A recent study indicates PF being a significant predictor of heart rate variability (HRV) and mediating relationship between HRV and pain interference. In recent years, HRV has been studied using non-linear dynamics approaches which better quantify the fractal behavior of the inter-beat interval time series. In this study, we propose the use of multi-scale HRV features for predicting PF. The new features are tested on a dataset collected from 200 hospital workers (nurses and staff) during their normal work shifts. We show that fusion of breathing signal features further improves the performance showing the complementarity of two feature sets. We achieve an overall improvement of 4.54% F1-score over benchmark HRV features. These results indicate the importance of non-linear features for PF measurement. An accurate measurement of PF can help in developing pain and distress intervention methods by unobtrusive measurement of physiological signals using wearable sensors in real life conditions.

[1]  Gaël Varoquaux,et al.  Scikit-learn: Machine Learning in Python , 2011, J. Mach. Learn. Res..

[2]  Devy Widjaja,et al.  Inhalation/Exhalation Ratio Modulates the Effect of Slow Breathing on Heart Rate Variability and Relaxation , 2014, Applied Psychophysiology and Biofeedback.

[3]  M. Craske,et al.  Mechanisms of mindfulness: emotion regulation following a focused breathing induction. , 2006, Behaviour research and therapy.

[4]  Andrew T. Gloster,et al.  Psychological flexibility as a malleable public health target: Evidence from a representative sample , 2017 .

[5]  Loch Forsyth,et al.  The Effects of Acceptance of Thoughts, Mindful Awareness of Breathing, and Spontaneous Coping on an Experimentally Induced Pain Task , 2014 .

[6]  Jacques Olivier Fortrat,et al.  Respiratory influences on non-linear dynamics of heart rate variability in humans , 1997, Biological Cybernetics.

[7]  S. Morley,et al.  The psychological flexibility model: a basis for integration and progress in psychological approaches to chronic pain management. , 2014, The journal of pain : official journal of the American Pain Society.

[8]  Harald Baumeister,et al.  A guided and unguided internet- and mobile-based intervention for chronic pain: health economic evaluation alongside a randomised controlled trial , 2019, BMJ Open.

[9]  Matthias Weippert,et al.  Sample Entropy and Traditional Measures of Heart Rate Dynamics Reveal Different Modes of Cardiovascular Control During Low Intensity Exercise , 2014, Entropy.

[10]  T. Kashdan,et al.  Psychological flexibility as a fundamental aspect of health. , 2010, Clinical psychology review.

[11]  R. Ley,et al.  The Modification of Breathing Behavior , 1999, Behavior modification.

[12]  L. McCracken,et al.  Comparing the role of psychological flexibility and traditional pain management coping strategies in chronic pain treatment outcomes. , 2010, Behaviour research and therapy.

[13]  Andrew S.C. Rice,et al.  Pain and the global burden of disease , 2016, Pain.

[14]  Mirja A. Peltola Role of Editing of R–R Intervals in the Analysis of Heart Rate Variability , 2011, Front. Physio..

[15]  James L. Abelson,et al.  Respiratory variability and sighing: A psychophysiological reset model , 2013, Biological Psychology.

[16]  Nilly Mor,et al.  Self-focused attention and negative affect: a meta-analysis. , 2002, Psychological bulletin.

[17]  Luciano Bernardi,et al.  Modulatory effects of respiration , 2001, Autonomic Neuroscience.

[18]  Brigitte Widemann,et al.  The Relationship Between Heart Rate Variability, Psychological Flexibility, and Pain in Neurofibromatosis Type 1 , 2018, Pain practice : the official journal of World Institute of Pain.

[19]  Jeffrey M. Hausdorff,et al.  Fractal dynamics in physiology: Alterations with disease and aging , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[20]  H. Trompetter,et al.  Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review , 2016, Cognitive behaviour therapy.

[21]  W. Roth,et al.  Characteristics of sighing in panic disorder , 2001, Biological Psychiatry.

[22]  J. Gross,et al.  Respiratory sinus arrhythmia, emotion, and emotion regulation during social interaction. , 2006, Psychophysiology.

[23]  Harald Baumeister,et al.  Psychological flexibility mediates the effect of an online-based acceptance and commitment therapy for chronic pain: an investigation of change processes , 2017, Pain.

[24]  Ambuj Tewari,et al.  Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support , 2017, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[25]  Pierre Geurts,et al.  Extremely randomized trees , 2006, Machine Learning.

[26]  H. Stanley,et al.  Magnitude and sign correlations in heartbeat fluctuations. , 2000, Physical review letters.

[27]  I. Homma,et al.  Breathing rhythms and emotions , 2008, Experimental physiology.

[28]  G. J. Asmundson,et al.  Do patients with chronic pain selectively attend to pain-related information?: preliminary evidence for the mediating role of fear , 1997, PAIN.

[29]  Pere Caminal,et al.  Refined Multiscale Entropy: Application to 24-h Holter Recordings of Heart Period Variability in Healthy and Aortic Stenosis Subjects , 2009, IEEE Transactions on Biomedical Engineering.

[30]  Geert Crombez,et al.  Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability , 1999, Pain.

[31]  Yuan Bo Peng,et al.  The biopsychosocial approach to chronic pain: scientific advances and future directions. , 2007, Psychological bulletin.

[32]  J. Hirsch,et al.  Respiratory sinus arrhythmia in humans: how breathing pattern modulates heart rate. , 1981, The American journal of physiology.

[33]  Inbal Nahum-Shani,et al.  Building health behavior models to guide the development of just-in-time adaptive interventions: A pragmatic framework. , 2015, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[34]  Jun Wang,et al.  Multiscale permutation entropy analysis of electrocardiogram , 2017 .

[35]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[36]  S. Cerutti,et al.  Advances in heart rate variability signal analysis: joint position statement by the e-Cardiology ESC Working Group and the European Heart Rhythm Association co-endorsed by the Asia Pacific Heart Rhythm Society. , 2015, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.