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Contribution Details

Type Journal Article
Scope Discipline-based scholarship
Title Real-time assessment of stress and stress response using digital phenotyping: a study protocol
Organization Unit
  • Stephan T Egger
  • Marius Knorr
  • Julio Bobes
  • Abraham Bernstein
  • Erich Seifritz
  • Stefan Vetter
Item Subtype Original Work
Refereed Yes
Status Published in final form
  • English
Journal Title Frontiers in Digital Health
Publisher Frontiers Research Foundation
Geographical Reach international
ISSN 2673-253X
Volume 2
Page Range 18
Date 2020
Abstract Text Background: Stress is a complex phenomenon that may have a negative influence on health and well-being; consequently, it plays a pivotal role in mental health. Although the incidence of mental disorders has been continuously rising, development of prevention and treatment methods has been rather slow. Through the ubiquitous presence of smartphones and wearable devices, people can monitor stress parameters in everyday life. However, the reliability and validity of such monitoring are still unsatisfactory.Methods: The aim of this trial is to find a relationship between psychological stress and saliva cortisol levels on the one hand and physiological parameters measured by smartphones in combination with a commercially available wearable device on the other. Participants include cohorts of individuals with and without a psychiatric disorder. The study is conducted in two settings: one naturalistic and one a controlled laboratory environment, combining ecological momentary assessment (EMA) and digital phenotyping (DP). EMA is used for the assessment of challenging and stressful situations coincidentally happening during a whole observation week. DP is used during a controlled stress situation with the Trier Social Stress Test (TSST) as a standardized psychobiological paradigm. Initially, participants undergo a complete psychological screening and profiling using a standardized psychometric test battery. EMA uses a smartphone application, and the participants keep a diary about their daily routine, activities, well-being, sleep, and difficult and stressful situations they may encounter. DP is conducted through wearable devices able to continuously monitor physiological parameters (i.e., heart rate, heart rate variability, skin conductivity, temperature, movement and acceleration). Additionally, saliva cortisol samples are repeatedly taken. The TSST is conducted with continuous measurement of the same parameters measured during the EMA.Discussion: We aim to identify valid and reliable digital biomarkers for stress and stress reactions. Furthermore, we expect to find a way of early detection of psychological stress in order to evolve new opportunities for interventions reducing stress. That may allow us to find new ways of treating and preventing mental disorders.Trial Registration: The competing ethics committee of the Canton of Zurich, Switzerland, approved the study protocol V05.1 May 28, 2019 BASEC: 2019-00814; the trial was registered at <ext-link ext-link-type=""uri"" xlink:href="""" xmlns:xlink=""""></ext-link> NCT04100213 on September 19, 2019.
Free access at DOI
Official URL
Digital Object Identifier 10.3389/fdgth.2020.544418
PubMed ID 34713030
Other Identification Number merlin-id:19912
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