Detecting Subclinical Social Anxiety Using Physiological Data From a Wrist-Worn Wearable: Small-Scale Feasibility Study

Background: Subclinical (ie, threshold) social anxiety can greatly affect young people's lives, but existing solutions appear inadequate considering its rising prevalence. Wearable sensors may provide a novel way to detect social anxiety and result in new opportunities for monitoring and treatment, which would be greatly beneficial for persons with social anxiety, society, and health care services. Nevertheless, indicators such as skin temperature measured by wrist-worn sensors have not been used in prior work on physiological social anxiety detection.

Objective: This study aimed to investigate whether subclinical social anxiety in young adults can be detected using physiological data obtained from wearable sensors, including heart rate, skin temperature, and electrodermal activity (EDA).

Methods: Young adults (N=12) with self-reported subclinical social anxiety (measured using the widely used self-reported version of the Liebowitz Social Anxiety Scale) participated in an impromptu speech task. Physiological data were collected using an E4 Empatica wearable device. Using the preprocessed data and following a supervised machine learning approach, various classification algorithms such as Support Vector Machine, Decision Tree, Random Forest, and K-Nearest Neighbours (KNN) were used to develop models for 3 different contexts. Models were trained to differentiate (1) between baseline and socially anxious states, (2) among baseline, anticipation anxiety, and reactive anxiety states, and (3) social anxiety among individuals with social anxiety of differing severity. The predictive capability of the singular modalities was also explored in each of the 3 supervised learning experiments. The generalizability of the developed models was evaluated using 10-fold cross-validation as a performance index.

Results: With modalities combined, the developed models yielded accuracies between 97.54% and 99.48% when differentiating between baseline and socially anxious states. Models trained to differentiate among baseline, anticipation anxiety, and reactive anxiety states yielded accuracies between 95.18% and 98.10%. Furthermore, the models developed to differentiate between social anxiety experienced by individuals with anxiety of differing severity scores successfully classified with accuracies between 98.86% and 99.52%. Surprisingly, EDA was identified as the most effective singular modality when differentiating between baseline and social anxiety states, whereas ST was the most effective modality when differentiating anxiety among individuals with social anxiety of differing severity.

Conclusions: The results indicate that it is possible to accurately detect social anxiety as well as distinguish between levels of severity in young adults by leveraging physiological data collected from wearable sensors.