On-line anxiety level detection from biosignals: Machine learning based on a randomized controlled trial with spider-fearful individuals

We present performance results concerning the validation for anxiety level detection based on trained mathematical models using supervised machine learning techniques. The model training is based on biosignals acquired in a randomized controlled trial. Wearable sensors were used to collect electrocardiogram, electrodermal activity, and respiration from spider-fearful individuals. We designed and applied ten approaches for data labeling considering individual biosignals as well as subjective ratings. Performance results revealed a selection of trained models adapted for two-level (low and high) and three-level (low, medium and high) classification of anxiety using a minimal set of six features. We obtained a remarkable accuracy of 89.8% for the two-level classification and of 74.4% for the three-level classification using a short time window length of ten seconds when applying the approach that uses subjective ratings for data labeling. Bagged Trees proved to be the most suitable classifier type among the classification models studied. The trained models will have a practical impact on the feasibility study of an augmented reality exposure therapy based on a therapeutic game for the treatment of arachnophobia.

[1]  Radford M. Neal Pattern Recognition and Machine Learning , 2007, Technometrics.

[2]  Arie Ben-David,et al.  Comparison of classification accuracy using Cohen's Weighted Kappa , 2008, Expert Syst. Appl..

[3]  Lily Tran,et al.  A Randomized, Head-to-Head Study of Virtual Reality Exposure Therapy for Posttraumatic Stress Disorder , 2017, Cyberpsychology Behav. Soc. Netw..

[4]  Dan,et al.  [ACM Press the 15th International Academic MindTrek Conference - Tampere, Finland (2011.09.28-2011.09.30)] Proceedings of the 15th International Academic MindTrek Conference on Envisioning Future Media Environments - MindTrek \'11 - From game design elements to gamefulness , 2011 .

[5]  Mohamed Hammad,et al.  Detection of abnormal heart conditions based on characteristics of ECG signals , 2018, Measurement.

[6]  Lars-Göran Öst,et al.  One-session treatment for specific phobias. , 1989, Behaviour research and therapy.

[7]  Willis J. Tompkins,et al.  A Real-Time QRS Detection Algorithm , 1985, IEEE Transactions on Biomedical Engineering.

[8]  Lanlan Chen,et al.  Detecting driving stress in physiological signals based on multimodal feature analysis and kernel classifiers , 2017, Expert Syst. Appl..

[9]  P. Grossman Respiration, stress, and cardiovascular function. , 1983, Psychophysiology.

[10]  F. J. McGuigan,et al.  Cognitive psychophysiology : principles of covert behavior , 1980 .

[11]  P. Cuijpers,et al.  The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: A meta-analysis , 2018, Scientific Reports.

[12]  P. Emmelkamp Technological Innovations in Clinical Assessment and Psychotherapy , 2005, Psychotherapy and Psychosomatics.

[13]  JoAnn Difede,et al.  Virtual reality exposure therapy for combat‐related posttraumatic stress disorder , 2010, Annals of the New York Academy of Sciences.

[14]  L. Ost,et al.  One-session treatment for specific phobias. , 1989, Behaviour research and therapy.

[15]  Mohamed Hammad,et al.  A novel two-dimensional ECG feature extraction and classification algorithm based on convolution neural network for human authentication , 2019, Future Gener. Comput. Syst..

[16]  Adel Said Elmaghraby,et al.  Intelligent serious games system for children with learning disabilities , 2012, 2012 17th International Conference on Computer Games (CGAMES).

[17]  R. Tibshirani,et al.  Improvements on Cross-Validation: The 632+ Bootstrap Method , 1997 .

[18]  Jasper A. J. Smits,et al.  DISORDERS : A META-ANALYSIS OF RANDOMIZED PLACEBO-CONTROLLED TRIALS , 2008 .

[19]  Daniel McDuff,et al.  Remote measurement of cognitive stress via heart rate variability , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[20]  Daniel O. David,et al.  Virtual reality exposure therapy in flight anxiety: A quantitative meta-analysis , 2017, Comput. Hum. Behav..

[21]  Yun Liu,et al.  Psychological stress level detection based on electrodermal activity , 2018, Behavioural Brain Research.

[22]  P. Pauli,et al.  Effect of combined multiple contexts and multiple stimuli exposure in spider phobia: A randomized clinical trial in virtual reality. , 2015, Behaviour research and therapy.

[23]  Bunmi O. Olatunji,et al.  The Cruelest Cure? Ethical Issues in the Implementation of Exposure-Based Treatments , 2009 .

[24]  B. Rothbaum,et al.  A controlled study of virtual reality exposure therapy for the fear of flying. , 2000, Journal of consulting and clinical psychology.

[25]  Mark B. Powers,et al.  Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. , 2019, Journal of anxiety disorders.

[26]  D. Lykken,et al.  Correcting psychophysiological measures for individual differences in range. , 1966, Psychological bulletin.

[27]  R. Kessler,et al.  The cross-national epidemiology of specific phobia in the World Mental Health Surveys , 2017, Psychological Medicine.

[28]  Manolis Tsiknakis,et al.  Review on Psychological Stress Detection Using Biosignals , 2019, IEEE Transactions on Affective Computing.

[29]  Jacob Cohen A Coefficient of Agreement for Nominal Scales , 1960 .

[30]  Jennifer G. Dy,et al.  Emotion Fingerprints or Emotion Populations? A Meta-Analytic Investigation of Autonomic Features of Emotion Categories , 2018, Psychological bulletin.

[31]  A. Przeworski,et al.  A review of technology-assisted self-help and minimal contact therapies for anxiety and depression: is human contact necessary for therapeutic efficacy? , 2011, Clinical psychology review.

[32]  Isabelle Bichindaritz,et al.  Machine learning for stress detection from ECG signals in automobile drivers , 2015, 2015 IEEE International Conference on Big Data (Big Data).

[33]  Jennifer Healey,et al.  Toward Machine Emotional Intelligence: Analysis of Affective Physiological State , 2001, IEEE Trans. Pattern Anal. Mach. Intell..

[34]  Wenjiang J. Fu,et al.  Estimating misclassification error with small samples via bootstrap cross-validation , 2005, Bioinform..

[35]  Richard Gevirtz,et al.  The Promise of Heart Rate Variability Biofeedback: Evidence-Based Applications , 2013 .

[36]  Mobyen Uddin Ahmed,et al.  Supervised Machine Learning Algorithms to Diagnose Stress for Vehicle Drivers Based on Physiological Sensor Signals , 2015, pHealth.

[37]  Leo Breiman,et al.  Random Forests , 2001, Machine Learning.

[38]  Lennart E. Nacke,et al.  From game design elements to gamefulness: defining "gamification" , 2011, MindTrek.

[39]  T. Michael,et al.  Effects of heart rate variability biofeedback during exposure to fear-provoking stimuli within spider-fearful individuals: study protocol for a randomized controlled trial , 2018, Trials.

[40]  Ricardo Gutierrez-Osuna,et al.  Estimating mental stress using a wearable cardio-respiratory sensor , 2010, 2010 IEEE Sensors.

[41]  Ludmila I. Kuncheva,et al.  Technological Advancements in Affective Gaming: A Historical Survey , 2014 .

[42]  Abdelhak Moussaoui,et al.  Short-Term Anxiety Recognition Induced by Virtual Reality Exposure for Phobic People , 2013, 2013 IEEE International Conference on Systems, Man, and Cybernetics.

[43]  Lexie Tabachnick Biofeedback and Anxiety Disorders: A Critical Review of EMG, EEG, and HRV Feedback , 2015 .

[44]  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 .

[45]  Chris Yakopcic,et al.  A State-of-the-Art Survey on Deep Learning Theory and Architectures , 2019, Electronics.

[46]  P. Emmelkamp,et al.  Can virtual reality exposure therapy gains be generalized to real-life? A meta-analysis of studies applying behavioral assessments. , 2015, Behaviour research and therapy.

[47]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[48]  Jennifer Healey,et al.  Detecting stress during real-world driving tasks using physiological sensors , 2005, IEEE Transactions on Intelligent Transportation Systems.

[49]  Mark B. Powers,et al.  Psychological approaches in the treatment of specific phobias: a meta-analysis. , 2008, Clinical psychology review.

[50]  Isabel L. Kampmann,et al.  Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial. , 2016, Behaviour research and therapy.