Annu Int Conf IEEE Eng Med Biol Soc. 2022 Jul;2022:2976-2982. doi: 10.1109/EMBC48229.2022.9871899.
In modern psychotherapy, digital health technology offers advanced and personalized therapy options, increasing availability as well as ecological validity. These aspects have proven to be highly relevant for children and adolescents with obsessive-compulsive disorder (OCD). Exposure and Response Prevention therapy, which is the state-of-the-art treatment for OCD, builds on the reconstruction of everyday life exposure to anxious situations. However, while compulsive behavior pre-dominantly occurs in home environments, exposure situations during therapy are limited to clinical settings. Telemedical treatment allows to shift from this limited exposure reconstruction to exposure situations in real life. In the SSTeP KiZ study (smart sensor technology in telepsychotherapy for children and adolescents with OCD), we combine video therapy with wearable sensors delivering physiological and behavioral measures to objectively determine the stress level of patients. The setup allows to gain information from exposure to stress in a realistic environment both during and outside of therapy sessions. In a first pilot study, we explored the sensitivity of individual sensor modalities to different levels of stress and anxiety. For this, we captured the obsessive-compulsive behavior of five adolescents with an ECG chest belt, inertial sensors capturing hand movements, and an eye tracker. Despite their prototypical nature, our results deliver strong evidence that the examined sensor modalities yield biomarkers allowing for personalized detection and quantification of stress and anxiety. This opens up future possibilities to evaluate the severity of individual compulsive behavior based on multi-variate state classification in real-life situations. Clinical Relevance- Our results demonstrate the potential for efficient personalized psychotherapy by monitoring physiological and behavioral changes with multiple sensor modalities in ecologically valid real-life scenarios.
在现代心理治疗中，数字健康技术提供了先进和个性化的治疗选择，增加了可用性和生态有效性。这些方面已被证明对患有强迫症 (OCD) 的儿童和青少年具有高度相关性。暴露和反应预防疗法是 OCD 的最新治疗方法，基于对日常生活中焦虑情境的暴露重建。然而，虽然强迫行为主要发生在家庭环境中，但治疗中的暴露情境仅限于临床环境。远程医疗治疗允许从这种有限的暴露重建转变为现实生活中的暴露情境。在 SSTeP KiZ 研究（儿童和青少年强迫症的远程心理治疗中的智能传感器技术）中，我们将视频治疗与可穿戴传感器相结合，提供生理和行为测量，以客观地确定患者的压力水平。该设置允许在治疗期间和治疗之外从现实环境中的暴露中获取信息，以了解压力。在一项初步试点研究中，我们探索了个体传感器模式对不同程度的压力和焦虑的敏感性。为此，我们使用心电图胸带、捕捉手部运动的惯性传感器和眼动追踪器来捕捉五个青少年的强迫行为。尽管它们具有原型性质，但我们的结果提供了强有力的证据，证明所检查的传感器模式产生了生物标志物，可用于个性化检测和量化压力和焦虑。这为基于现实生活情境中的多变量状态分类评估个体强迫行为的严重程度开辟了未来的可能性。临床相关性-我们的结果表明，通过在生态有效现实生活场景中使用多种传感器模式监测生理和行为变化，可实现高效的个性化心理治疗。
