The Acceptability and Efficacy of Wearable Devices in Digital Mental Health
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(Thesis)
Date
2022
Authors
Hunkin, Hugh
Editors
Advisors
Zajac, Ian
King, Daniel
King, Daniel
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Thesis
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Abstract
Rapid advancements in technology through the early twenty-first century have led to
the emergence of a new paradigm in mental health, in which digital platforms could become a
fundamental part of mental healthcare delivery. Wearable devices, which are computational
devices worn on the body, might form an important element of these new approaches by
capturing and interpreting physiological data associated with psychological states. This
thesis presents a series of studies investigating the range of wearable devices for the treatment
of mental health problems, the perceived acceptability of these devices, and the evidence for
one specific device modality, aided meditation.
In Study 1, a literature review was conducted to identify wearable devices that could
be used in the treatment of anxiety-related symptoms, determine what supporting evidence
existed for each device modality, and explore potential clinical implications of using those
devices. The review identified early-stage evidence for the use of heart rate variability
biofeedback devices, but limited research on other modalities, indicating a need for further
high-quality research.
Study 2 surveyed a community sample of 427 adults to investigate perceived
acceptability of wearable devices for treating mental health problems. Interest in using
wearable devices as adjuncts to conventional therapy was strong, with acceptability closely
linked to perceived device effectiveness (β = 0.28-0.30). Wearable devices also appeared to
have greater acceptability in the presence of negative attitudes toward conventional therapies,
suggesting they might help reduce barriers to treatment.
Studies 3 and 4 focused on evaluating one particular device: the Muse
electroencephalogram (EEG) meditation headband. In these studies, 68 adult participants used the device during a series of lab-based meditation tasks, with a subset (n = 29) also
completing 14 days of home practice. Study 3 investigated the potential of the headband
measures to assess state mindfulness, a process variable linked to psychological benefits
resulting from meditation practice. The primary headband measure showed sensitivity to
both within-participants (d = 0.56) and between-participants (r = -0.50) differences on a task
measure of state mindfulness. Aggregate measures over 14 days’ practice explained around
30% of variance in self-reported trait mindfulness and related constructs. EEG biomarkers
thus appear to have potential as a novel objective method of mindfulness measurement.
Study 4 used a crossover trial design (auditory feedback of the primary headband
measure vs no feedback) to examine the effect of receiving feedback. The feedback
condition resulted in a higher level of state mindfulness (RR = 1.15), a lower level of the
primary headband measure (d = -0.22), and differences in subjective experience of
meditation. These results suggest that with appropriate guidance, feedback may be an
effective adjunct to meditation.
Together, these studies support the notion that wearable devices could be effective
and engaging adjunctive digital mental health interventions. The results support the use of
synchronous feedback of practice quality data to enhance the therapeutic benefits of
meditation practice, and were consistent with the mechanisms through which neurofeedback
is theorised to function. Continuing engagement with wearable devices by both researchers
and clinicians is recommended.
School/Discipline
School of Psychology
Dissertation Note
Thesis (Combined PhD & MPsych (Clin)) -- University of Adelaide, School of Psychology, 2022
Provenance
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