Faculty of Technology, Bielefeld University, Bielefeld, Germany.
Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.
J Med Internet Res. 2022 Jul 15;24(7):e32280. doi: 10.2196/32280.
Valuable insights into the pathophysiology and consequences of acute psychosocial stress have been gained using standardized stress induction experiments. However, most protocols are limited to laboratory settings, are labor-intensive, and cannot be scaled to larger cohorts or transferred to daily life scenarios.
We aimed to provide a scalable digital tool that enables the standardized induction and recording of acute stress responses in outside-the-laboratory settings without any experimenter contact.
On the basis of well-described stress protocols, we developed the Digital Stress Test (DST) and evaluated its feasibility and stress induction potential in a large web-based study. A total of 284 participants completed either the DST (n=103; 52/103, 50.5% women; mean age 31.34, SD 9.48 years) or an adapted control version (n=181; 96/181, 53% women; mean age 31.51, SD 11.18 years) with their smartphones via a web application. We compared their affective responses using the international Positive and Negative Affect Schedule Short Form before and after stress induction. In addition, we assessed the participants' stress-related feelings indicated in visual analogue scales before, during, and after the procedure, and further analyzed the implemented stress-inducing elements. Finally, we compared the DST participants' stress reactivity with the results obtained in a classic stress test paradigm using data previously collected in 4 independent Trier Social Stress Test studies including 122 participants overall.
Participants in the DST manifested significantly higher perceived stress indexes than the Control-DST participants at all measurements after the baseline (P<.001). Furthermore, the effect size of the increase in DST participants' negative affect (d=0.427) lay within the range of effect sizes for the increase in negative affect in the previously conducted Trier Social Stress Test experiments (0.281-1.015).
We present evidence that a digital stress paradigm administered by smartphone can be used for standardized stress induction and multimodal data collection on a large scale. Further development of the DST prototype and a subsequent validation study including physiological markers are outlined.
通过标准化的应激诱导实验，我们对急性心理社会应激的病理生理学和后果有了宝贵的认识。然而，大多数方案仅限于实验室环境，劳动强度大，无法扩展到更大的队列或转移到日常生活场景。
我们旨在提供一种可扩展的数字工具，使在实验室环境之外标准化诱导和记录急性应激反应成为可能，而无需任何实验者接触。
基于描述良好的应激方案，我们开发了数字应激测试（DST），并在一项大型基于网络的研究中评估了其可行性和应激诱导潜力。共有 284 名参与者通过网络应用程序使用智能手机完成了 DST（n=103；52/103，50.5%女性；平均年龄 31.34，SD 9.48 岁）或改编后的对照版本（n=181；96/181，53%女性；平均年龄 31.51，SD 11.18 岁）。我们比较了他们在应激诱导前后使用国际正性和负性情绪量表短表的情感反应。此外，我们评估了参与者在程序前、中、后表示的与应激相关的感觉，并进一步分析了实施的应激诱导因素。最后，我们比较了 DST 参与者的应激反应与先前在 4 项独立的特里尔社会应激测试研究中收集的 122 名参与者的经典应激测试范式结果。
在基线后所有测量中，DST 组参与者的感知应激指标明显高于对照-DST 组参与者（P<.001）。此外，DST 组参与者负性情绪增加的效应量（d=0.427）处于先前进行的特里尔社会应激测试实验中负性情绪增加的效应量范围内（0.281-1.015）。
我们提供了证据，证明通过智能手机管理的数字应激范式可用于在大规模上进行标准化应激诱导和多模态数据收集。概述了 DST 原型的进一步开发和包括生理标记物的后续验证研究。
