Abbott Deah, Shirali Yasmin, Haws J Kyle, Lack Caleb W
Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States.
World J Psychiatry. 2017 Sep 22;7(3):133-147. doi: 10.5498/wjp.v7.i3.133.
It is difficult to accurately assess and differentially diagnose the anxiety disorders. The current system of assessment relies heavily on the subjective measures of client self-report, clinical observation, and clinical judgment. Fortunately, recent technological advances may enable practitioners to utilize objective, biobehavioral measures of assessment in a clinical setting. The current body of literature on two of these biobehavioral tools (eye-tracking and electrocardiogram devices) is promising, but more validation and standardization research is needed to maximize the utility of these devices. Eye-tracking devices are uniquely capable of providing data that can be used to differentially diagnose anxiety disorders from both other commonly comorbid and misdiagnosed disorders. Both eye-tracking and electrocardiogram devices are able to provide change-sensitive assessment information. This objective, real-time feedback can assist clinicians and researchers in assessing treatment efficacy and symptom fluctuation. Recently developed wearable and highly portable electrocardiogram devices, like the wearable fitness and behavior tracking devices used by many consumers, may be particularly suited for providing this feedback to clinicians. Utilizing these biobehavioral devices would supply an objective, dimensional component to the current categorical diagnostic assessment system. We posit that if adequate funding and attention are directed at this area of research, it could revolutionize diagnostic and on-going assessment practices and, in doing so, bring the field of diagnosis out of the 20th century.
准确评估和鉴别诊断焦虑症并非易事。当前的评估体系严重依赖于来访者自我报告、临床观察和临床判断等主观测量方法。幸运的是,最近的技术进步或许能让从业者在临床环境中使用客观的生物行为测量方法进行评估。目前关于其中两种生物行为工具(眼动追踪和心电图设备)的文献很有前景,但还需要更多的验证和标准化研究,以最大限度地发挥这些设备的效用。眼动追踪设备具有独特的能力,能够提供可用于将焦虑症与其他常见的共病及误诊疾病进行鉴别诊断的数据。眼动追踪和心电图设备都能够提供对变化敏感的评估信息。这种客观的实时反馈可以帮助临床医生和研究人员评估治疗效果和症状波动情况。最近开发的可穿戴且高度便携的心电图设备,就像许多消费者使用的可穿戴健康和行为追踪设备一样,可能特别适合为临床医生提供这种反馈。利用这些生物行为设备将为当前的分类诊断评估系统提供一个客观的维度组成部分。我们认为,如果在这一研究领域投入足够的资金并给予关注,它可能会彻底改变诊断和持续评估的实践,并借此将诊断领域带入21世纪。