Interreality for the management and training of psychological stress: study protocol for a randomized controlled trial

Background. Psychological stress occurs when an individual perceives that environmental demands tax or exceed his or her adaptive capacity. Its association with severe health and emotional diseases, points out the necessity to find new efficient strategies to treat it. Moreover, psychological stress is a very personal problem and requires training focused on the specific needs of individuals. To overcome the above limitations, the INTERSTRESS project suggests the adoption of a new paradigm for e-health - Interreality - that integrates contextualized assessment and treatment within a hybrid environment, bridging the physical and the virtual worlds. According to this premise, the aim of this study is to investigate the advantages of using advanced technologies, in combination with cognitive behavioral therapy (CBT), based on a protocol for reducing psychological stress. Methods/Design. The study is designed as a randomized controlled trial. It includes three groups of approximately 50 subjects each who suffer from psychological stress: (1) the experimental group, (2) the control group, (3) the waiting list group. Participants included in the experimental group will receive a treatment based on cognitive behavioral techniques combined with virtual reality, biofeedback and mobile phone, while the control group will receive traditional stress management CBT-based training, without the use of new technologies. The wait-list group will be reassessed and compared with the two other groups five weeks after the initial evaluation. After the reassessment, the wait-list patients will randomly receive one of the two other treatments. Psychometric and physiological outcomes will serve as quantitative dependent variables, while subjective reports of participants will be used as the qualitative dependent variable. Discussion. What we would like to show with the present trial is that bridging virtual experiences, used to learn coping skills and emotional regulation, with real experiences using advanced technologies (virtual reality, advanced sensors and smartphones) is a feasible way to address actual limitations of existing protocols for psychological stress

Psychophysiological Impacts Associated with Social Media Use

Social media has become increasingly relevant to everyday life since its inception, with new social media applications being created regularly. There has been some research regarding social media use and mental health; with studies finding both negative and positive mental health effects possible. TikTok, one of the newest and fastest growing social media applications has not been studied thoroughly to investigate potential mental health effects. The psychophysiological impacts of social media use have not been explored at all. An initial survey was done to investigate personality and mental health effects of social media use as well as if the reasonings behind social media use played a role in potential mental health effects. The survey data demonstrated that there were significant relationships between personality (specifically neuroticism and extraversion) and several socializing and social media variables; indicating that levels of those personality traits may be crucial to how one socializes and utilizes social media. The survey also found that mental health (via the DASS-21) had significant relationships with several socializing and social media related variables. One important variable found appeared to be using social media to escape their current reality. The pilot laboratory study is the first of its kind; investigating both mental health implications and physiological changes, via heart rate, of TikTok use. Although there have only been four participants thus far, data from the pilot laboratory study indicate that TikTok use may be associated to some changes to heart rate, but changes were unable to be tested using statistical analysis due to the small sample size. Together, the survey and pilot laboratory study show that this is a viable avenue for research and should continue to be investigated with a larger sample size. The information provided in both chapters of this document displays the potential for significant effects to stem from social media use and how those effects may change based on individual differences in personality traits and mental health. Overall, the information in this document could be used as a guide for future research endeavors within this topic of study and help fill the gap in the research regarding psychophysiology and social media

Variability in phase and amplitude of diurnal rhythms is related to variation of mood in bipolar and borderline personality disorder

Abstract Variable mood is an important feature of psychiatric disorders. However, its measurement and relationship to objective measureas of physiology and behaviour have rarely been studied. Smart-phones facilitate continuous personalized prospective monitoring of subjective experience and behavioural and physiological signals can be measured through wearable devices. Such passive data streams allow novel estimates of diurnal variability. Phase and amplitude of diurnal rhythms were quantified using new techniques that fitted sinusoids to heart rate (HR) and acceleration signals. We investigated mood and diurnal variation for four days in 20 outpatients with bipolar disorder (BD), 14 with borderline personality disorder (BPD) and 20 healthy controls (HC) using a smart-phone app, portable electrocardiogram (ECG), and actigraphy. Variability in negative affect, positive affect, and irritability was elevated in patient groups compared with HC. The study demonstrated convincing associations between variability in subjective mood and objective variability in diurnal physiology. For BPD there was a pattern of positive correlations between mood variability and variation in activity, sleep and HR. The findings suggest BPD is linked more than currently believed with a disorder of diurnal rhythm; in both BPD and BD reducing the variability of sleep phase may be a way to reduce variability of subjective mood

THE ROLE OF DIAPHRAGMATIC BREATHING IN SELF-REGULATION SKILLS TRAINING

A central component of many psychological interventions is breathing training. Breathing training protocols based on a mindfulness or a cognitive behavioral therapy (CBT) have demonstrated value in the management of psychological and medical ailments. Yet, despite the wealth of literature examining each approach, little direct comparison exists. An additional concern is the proliferation of smart phone health (mHealth) applications (apps) providing breathing training with little empirical evidence to support their clinical use. A possible explanation for the interest in breathing and mHealth apps is the growing body of literature indicating breathing training provides wide ranging health benefits through improved stasis of the autonomic nervous system (ANS). As ANS dysregulation underlies many chronic health conditions such as persistent temporomandibular disorders (TMDs), there is a need for empirical research to identify the most effective modality of breathing training and validate the clinical efficacy of breathing based mHealth apps. Study One compared the effectiveness of a mindfulness breathing meditation (MB) and a CBT based protocol teaching diaphragmatic breathing (DB) to improve biomarkers of ANS stasis. An attention control approach based on the Nolen-Hoeksema task (C) was included as a comparison group. Ninety participants were randomly assigned to either the MB, DB, or C condition. Within each condition, 30 participants were provided skills training with practice time and completed a behavioral self-regulation task. Participants in the DB condition approach had significantly lower breathing rates than those in the MB and C conditions (p \u3c .001). DB condition participants experienced improvements on high-frequency heart rate variability (p \u3c .05) and the standard deviation in NN intervals (p \u3c .001), which served as indicators for ANS stasis. No differences were found between conditions on the behavioral self-regulation task (p’s \u3e .05). Given these results, the DB training protocol was converted into a mHealth app to facilitate a clinical trial with patients suffering persistent TMDs. Study Two examined the additive benefits of including the mHealth app with standard dental care (SDC+) versus standard dental care alone (SDC). Nineteen patients seeking care for persistent TMDs were recruited. All participants were asked to track daily ratings of pain (VAS), relaxation (RR), and complete weekly assessments on several comorbid psycho-social factors. Within the SDC+ condition participants were asked to track the proximate effects of each breathing practice on VAS and RR ratings. Given a high drop-out rate (nine participants) and low overall sample size (N = 10), results are exploratory at best. Within the SDC+ condition, results indicated reliable improvements in average VAS and RR ratings from before and after SDC+ participants used the mHealth app (p’s \u3c .05). Within a one session training paradigm, results supported the use of a DB based intervention above the use of a MB or C intervention. Future research should consider the effects of having multiple training sessions. Study Two results were complicated by a limited sample size and failed to provide a clear picture of whether the conjunctive treatment in the SDC+ condition provided additional symptom relief above traditional dental care alone. Although exploratory results indicated the mHealth app provided temporary improvements in pain and feelings of relaxation, a well powered trial is needed to clarify whether the finding represents an enduring treatment effect

IoT DEVELOPMENT FOR HEALTHY INDEPENDENT LIVING

The rise of internet connected devices has enabled the home with a vast amount of enhancements to make life more convenient. These internet connected devices can be used to form a community of devices known as the internet of things (IoT). There is great value in IoT devices to promote healthy independent living for older adults. Fall-related injuries has been one of the leading causes of death in older adults. For example, every year more than a third of people over 65 in the U.S. experience a fall, of which up to 30 percent result in moderate to severe injury. Therefore, this thesis proposes an IoT-based fall detection system for smart home environments that not only to send out alerts, but also launches interaction models, such as voice assistance and camera monitoring. Such connectivity could allow older adults to interact with the system without concern of a learning curve. The proposed IoT-based fall detection system will enable family and caregivers to be immediately notified of the event and remotely monitor the individual. Integrated within a smart home environment, the proposed IoT-based fall detection system can improve the quality of life among older adults. Along with the physical concerns of health, psychological stress is also a great concern among older adults. Stress has been linked to emotional and physical conditions such as depression, anxiety, heart attacks, stroke, etc. Increased susceptibility to stress may accelerate cognitive decline resulting in conversion of cognitively normal older adults to MCI (Mild Cognitive Impairment), and MCI to dementia. Thus, if stress can be measured, there can be countermeasures put in place to reduce stress and its negative effects on the psychological and physical health of older adults. This thesis presents a framework that can be used to collect and pre-process physiological data for the purpose of validating galvanic skin response (GSR), heart rate (HR), and emotional valence (EV) measurements against the cortisol and self-reporting benchmarks for stress detection. The results of this framework can be used for feature extraction to feed into a regression model for validating each combination of physiological measurement. Also, the potential of this framework to automate stress protocols like the Trier Social Stress Test (TSST) could pave the way for an IoT-based platform for automated stress detection and management

The Mechanisms of Interpersonal Privacy in Social Networking Websites: A Study of Subconscious Processes, Social Network Analysis, and Fear of Social Exclusion

With increasing usage of Social networking sites like Facebook there is a need to study privacy. Previous research has placed more emphasis on outcome-oriented contexts, such as e-commerce sites. In process-oriented contexts, like Facebook, privacy has become a source of conflict for users. The majority of architectural privacy (e.g. privacy policies, website mechanisms) enables the relationship between a user and business, focusing on the institutional privacy concern and trust; however, architectural privacy mechanisms that enables relationships between and among users is lacking. This leaves users the responsibility to manage privacy for their interpersonal relationships. This research focuses on the following question: How does privacy influence the sharing of personal information in interpersonal relationships on Social networking sites? The management of the sharing of personal information is explained using the Need to Belong theory, psychological contract, and approach-avoidance motivation theory. Individuals\u27 desire to interact Socially and engage in relationships where respect for personal information is implied leads to overcoming concerns over privacy. Three essays address the question of interest. Essay 1 explains that this drive is motivated by a fear of Social exclusion from Social transactions and interpersonal relationships and does not rely on the institutional relationship between a user and the Social media website. Essay 2 uses a Social network analysis lens to describe how the multiplexity of relationships and Social influences (both of the network and the self) influence Social interaction and the sharing of personal information. Essay 3 focuses on explaining how individuals\u27 disposition toward subconscious processes of approach or avoidance motivation influence decisions to share and not share personal information. The implication of these studies is that privacy in a process-oriented context--like Facebook--involves different attitudes and beliefs centered on interpersonal relationships rather than institutional ones

The OCARIoT Data Acquisition App

We introduce the OCARIoT Data Acquisition App, a mHealth open source solution that synchronizes and manages data in Health IoT pilots. It was developed during the H2020 project entitled OCARIoT (Smart childhood Obesity CARing solution using IoT potential) and is innovative in the sense that it allows efficient IoT data collection, integration of different commercial devices, improves the user's privacy, data's security and the management of data controllers respecting legal and ethics policies. The application acts as a token manager for accessing external services. Besides the main features of the application, we report the integration of Fitbit services, and the deployment in four Health IoT pilots in Brazil, Greece and Spain. A survey was conducted with users in these three pilots and collected information about their user experience. The results presented excellent feedbacks from the users, with initial needs of synchronizing different children's accounts and privacy, which justified the development of the tool. Finally, we got feedback of improvements in ethics, technological and reuse in Health IoT pilots.The research has been performed under the OCARIoT project, funded from the European Union`s HORIZON 2020 Programme (2014-2020), ID 777082, and from the Brazilian Ministry of Science, Technology and Innovation through Rede Nacional de Ensino e Pesquisa (RNP), ID 003008. We are also thankful to developers who also contributed to the realization of the OCARIoT Data Acquisition App, namely: Jefferson Medeiros, Lucas Rocha, Aislan Monteiro, Alex Figueiredo, Thomas Fisher and Kostas Soutos