Anxiety-provoking activities, such as public speaking, can trigger heightened anxiety responses in individuals with anxiety disorders. Recent research suggests that physiological signals, including electrocardiogram (ECG) and electrodermal activity (EDA), collected via wearable devices, can be used to detect anxiety in such contexts through machine learning models. However, the generalizability of these anxiety prediction models across different activities and diverse populations remains underexplored-an essential step for assessing model bias and fostering user trust in broader applications. To address this gap, we conducted a study with 111 participants who engaged in three anxiety-provoking activities. Utilizing both our collected dataset and two well-known publicly available datasets, we evaluated the generalizability of anxiety detection models within participants (for both same-activity and cross-activity scenarios) and across participants (within-activity and cross-activity). In total, we trained and tested more than 3348 anxiety detection models (using six classifiers, 31 feature sets, and 18 train-test configurations). Our results indicate that three key metrics-AUROC, recall for anxious states, and recall for non-anxious states-were slightly above the baseline score of 0.5. The best AUROC scores ranged from 0.62 to 0.73, with recall for the anxious class spanning 35.19% to 74.3%. Interestingly, model performance (as measured by AUROC) remained relatively stable across different activities and participant groups, though recall for the anxious class did exhibit some variation.
This study addresses the critical issue of reliability for AI-assisted medical diagnosis. We focus on the selection prediction approach that allows the diagnosis system to abstain from providing the decision if it is not confident in the diagnosis. Such selective prediction (or abstention) approaches are usually based on the modeling predictive uncertainty of machine learning models involved. This study explores uncertainty quantification in machine learning models for medical text analysis, addressing diverse tasks across multiple datasets. We focus on binary mortality prediction from textual data in MIMIC-III, multi-label medical code prediction using ICD-10 codes from MIMIC-IV, and multi-class classification with a private outpatient visits dataset. Additionally, we analyze mental health datasets targeting depression and anxiety detection, utilizing various text-based sources, such as essays, social media posts, and clinical descriptions. In addition to comparing uncertainty methods, we introduce HUQ-2, a new state-of-the-art method for enhancing reliability in selective prediction tasks. Our results provide a detailed comparison of uncertainty quantification methods. They demonstrate the effectiveness of HUQ-2 in capturing and evaluating uncertainty, paving the way for more reliable and interpretable applications in medical text analysis.
Social Anxiety Disorder (SAD) significantly impacts individuals' daily lives and relationships. The conventional methods for SAD detection involve physical consultations and self-reported questionnaires, but they have limitations such as time consumption and bias. This paper introduces video analysis as a promising method for early SAD detection. Specifically, we present a new approach for detecting SAD in individuals from various bodily features extracted from the video data. We conducted a study to collect video data of 92 participants performing impromptu speech in a controlled environment. Using the video data, we studied the behavioral change in participants' head, body, eye gaze, and action units. By applying a range of machine learning and deep learning algorithms, we achieved an accuracy rate of up to 74\% in classifying participants as SAD or non-SAD. Video-based SAD detection offers a non-intrusive and scalable approach that can be deployed in real-time, potentially enhancing early detection and intervention capabilities.
Introduction: Healthcare AI models often inherit biases from their training data. While efforts have primarily targeted bias in structured data, mental health heavily depends on unstructured data. This study aims to detect and mitigate linguistic differences related to non-biological differences in the training data of AI models designed to assist in pediatric mental health screening. Our objectives are: (1) to assess the presence of bias by evaluating outcome parity across sex subgroups, (2) to identify bias sources through textual distribution analysis, and (3) to develop a de-biasing method for mental health text data. Methods: We examined classification parity across demographic groups and assessed how gendered language influences model predictions. A data-centric de-biasing method was applied, focusing on neutralizing biased terms while retaining salient clinical information. This methodology was tested on a model for automatic anxiety detection in pediatric patients. Results: Our findings revealed a systematic under-diagnosis of female adolescent patients, with a 4% lower accuracy and a 9% higher False Negative Rate (FNR) compared to male patients, likely due to disparities in information density and linguistic differences in patient notes. Notes for male patients were on average 500 words longer, and linguistic similarity metrics indicated distinct word distributions between genders. Implementing our de-biasing approach reduced diagnostic bias by up to 27%, demonstrating its effectiveness in enhancing equity across demographic groups. Discussion: We developed a data-centric de-biasing framework to address gender-based content disparities within clinical text. By neutralizing biased language and enhancing focus on clinically essential information, our approach demonstrates an effective strategy for mitigating bias in AI healthcare models trained on text.
Mental distress like depression and anxiety contribute to the largest proportion of the global burden of diseases. Automated diagnosis systems of such disorders, empowered by recent innovations in Artificial Intelligence, can pave the way to reduce the sufferings of the affected individuals. Development of such systems requires information-rich and balanced corpora. In this work, we introduce a novel mental distress analysis audio dataset DEPAC, labeled based on established thresholds on depression and anxiety standard screening tools. This large dataset comprises multiple speech tasks per individual, as well as relevant demographic information. Alongside, we present a feature set consisting of hand-curated acoustic and linguistic features, which were found effective in identifying signs of mental illnesses in human speech. Finally, we justify the quality and effectiveness of our proposed audio corpus and feature set in predicting depression severity by comparing the performance of baseline machine learning models built on this dataset with baseline models trained on other well-known depression corpora.
Wearable health devices are ushering in a new age of continuous and noninvasive remote monitoring. One application of this technology is in anxiety detection. Many advancements in anxiety detection have happened in controlled lab settings, but noise prevents these advancements from generalizing to real-world conditions. We seek to progress the field by studying how noise impacts model performance and developing models that are robust to noisy, real-world conditions and, hence, attuned to the commotion of everyday life. In this study we look to investigate why and how previous methods have failed. Using the wearable stress and affect detection (WESAD) dataset, we compare the effect of various intensities of noise on machine learning models classifying levels of physiological arousal in the three-class classification problem: baseline vs. stress vs. amusement. Before introducing noise, our baseline model performance reaches 98.7%, compared to Schmidt 2018's 80.3%. We discuss potential sources of this discrepancy in results through a careful evaluation of feature extraction and model architecture choices. Finally, after the introduction of noise, we provide a thorough analysis of the effect of noise on each model architecture.
Individuals high in social anxiety symptoms often exhibit elevated state anxiety in social situations. Research has shown it is possible to detect state anxiety by leveraging digital biomarkers and machine learning techniques. However, most existing work trains models on an entire group of participants, failing to capture individual differences in their psychological and behavioral responses to social contexts. To address this concern, in Study 1, we collected linguistic data from N=35 high socially anxious participants in a variety of social contexts, finding that digital linguistic biomarkers significantly differ between evaluative vs. non-evaluative social contexts and between individuals having different trait psychological symptoms, suggesting the likely importance of personalized approaches to detect state anxiety. In Study 2, we used the same data and results from Study 1 to model a multilayer personalized machine learning pipeline to detect state anxiety that considers contextual and individual differences. This personalized model outperformed the baseline F1-score by 28.0%. Results suggest that state anxiety can be more accurately detected with personalized machine learning approaches, and that linguistic biomarkers hold promise for identifying periods of state anxiety in an unobtrusive way.
Traditional screening practices for anxiety and depression pose an impediment to monitoring and treating these conditions effectively. However, recent advances in NLP and speech modelling allow textual, acoustic, and hand-crafted language-based features to jointly form the basis of future mental health screening and condition detection. Speech is a rich and readily available source of insight into an individual's cognitive state and by leveraging different aspects of speech, we can develop new digital biomarkers for depression and anxiety. To this end, we propose a multi-modal system for the screening of depression and anxiety from self-administered speech tasks. The proposed model integrates deep-learned features from audio and text, as well as hand-crafted features that are informed by clinically-validated domain knowledge. We find that augmenting hand-crafted features with deep-learned features improves our overall classification F1 score comparing to a baseline of hand-crafted features alone from 0.58 to 0.63 for depression and from 0.54 to 0.57 for anxiety. The findings of our work suggest that speech-based biomarkers for depression and anxiety hold significant promise in the future of digital health.
This paper explores a novel method for anxiety detection in older adults using simple wristband sensors such as Electrodermal Activity (EDA) and Photoplethysmogram (PPG) and a context-based feature. The proposed method for anxiety detection combines features from a single physiological signal with an experimental context-based feature to improve the performance of the anxiety detection model. The experimental data for this work is obtained from a year-long experiment on 41 healthy older adults (26 females and 15 males) in the age range 60-80 with mean age 73.36+-5.25 during a Trier Social Stress Test (TSST) protocol. The anxiety level ground truth was obtained from State-Trait Anxiety Inventory (STAI), which is regarded as the gold standard to measure perceived anxiety. EDA and Blood Volume Pulse (BVP) signals were recorded using a wrist-worn EDA and PPG sensor respectively. 47 features were computed from EDA and BVP signal, out of which a final set of 24 significantly correlated features were selected for analysis. The phases of the experimental study are encoded as unique integers to generate the context feature vector. A combination of features from a single sensor with the context feature vector is used for training a machine learning model to distinguish between anxious and not-anxious states. Results and analysis showed that the EDA and BVP machine learning models that combined the context feature along with the physiological features achieved 3.37% and 6.41% higher accuracy respectively than the models that used only physiological features. Further, end-to-end processing of EDA and BVP signals was simulated for real-time anxiety level detection. This work demonstrates the practicality of the proposed anxiety detection method in facilitating long-term monitoring of anxiety in older adults using low-cost consumer devices.
Depression and anxiety are psychiatric disorders that are observed in many areas of everyday life. For example, these disorders manifest themselves somewhat frequently in texts written by nondiagnosed users in social media. However, detecting users with these conditions is not a straightforward task as they may not explicitly talk about their mental state, and if they do, contextual cues such as immediacy must be taken into account. When available, linguistic flags pointing to probable anxiety or depression could be used by medical experts to write better guidelines and treatments. In this paper, we develop a dataset designed to foster research in depression and anxiety detection in Twitter, framing the detection task as a binary tweet classification problem. We then apply state-of-the-art classification models to this dataset, providing a competitive set of baselines alongside qualitative error analysis. Our results show that language models perform reasonably well, and better than more traditional baselines. Nonetheless, there is clear room for improvement, particularly with unbalanced training sets and in cases where seemingly obvious linguistic cues (keywords) are used counter-intuitively.
Psychological distress is a significant and growing issue in society. Automatic detection, assessment, and analysis of such distress is an active area of research. Compared to modalities such as face, head, and vocal, research investigating the use of the body modality for these tasks is relatively sparse. This is, in part, due to the limited available datasets and difficulty in automatically extracting useful body features. Recent advances in pose estimation and deep learning have enabled new approaches to this modality and domain. To enable this research, we have collected and analyzed a new dataset containing full body videos for short interviews and self-reported distress labels. We propose a novel method to automatically detect self-adaptors and fidgeting, a subset of self-adaptors that has been shown to be correlated with psychological distress. We perform analysis on statistical body gestures and fidgeting features to explore how distress levels affect participants' behaviors. We then propose a multi-modal approach that combines different feature representations using Multi-modal Deep Denoising Auto-Encoders and Improved Fisher Vector Encoding. We demonstrate that our proposed model, combining audio-visual features with automatically detected fidgeting behavioral cues, can successfully predict distress levels in a dataset labeled with self-reported anxiety and depression levels.
Anxiety affects human capabilities and behavior as much as it affects productivity and quality of life. It can be considered as the main cause of depression and suicide. Anxious states are easily detectable by humans due to their acquired cognition, humans interpret the interlocutor's tone of speech, gesture, facial expressions and recognize their mental state. There is a need for non-invasive reliable techniques that performs the complex task of anxiety detection. In this paper, we present DASPS database containing recorded Electroencephalogram (EEG) signals of 23 participants during anxiety elicitation by means of face-to-face psychological stimuli. EEG signals were captured with Emotiv Epoc headset as it's a wireless wearable low-cost equipment. In our study, we investigate the impact of different parameters, notably: trial duration, feature type, feature combination and anxiety levels number. Our findings showed that anxiety is well elicited in 1 second. For instance, stacked sparse autoencoder with different type of features achieves 83.50% and 74.60% for 2 and 4 anxiety levels detection, respectively. The presented results prove the benefits of the use of a low-cost EEG headset instead of medical non-wireless devices and create a starting point for new researches in the field of anxiety detection.